Dorothea Orem's Self-Care Theory In Nursing

Dorothea Orem was born July 15, 1914 in Maryland. Orem was a decorated nurse. She was awarded her nursing diploma from Providence Hospital in Washington, D.C. In 1939 she graduated with her Bachelor of Science in Nursing Education from Catholic University of America and in 1945 excelled again when she earned her Master of Science in Nursing. During her career she

For centuries the development of nursing knowledge has been influenced by numerous theorists and their respective theories. These theories have influenced, and continue to influence, nursing education, practice and research. (Johnson & Webber, 2005)

I chose to do a concept analysis on ‘Self-Care.’ The nursing theory that uses this concept is Orem’s theory of nursing. This theory is a grand theory and consists of three minor interrelated theories; self-care,

Nursing theories have been a fundamental tool used to explain, guide and improve the practice of nursing. Theorists have contributed enormously to the growth of nursing as a profession. The four grand theorists I chose are Virginia Henderson, Peplau, Myra Levine and Jean Watson. These theorists have contributed tremendously in the field of nursing through their theories, and research. One thing the theorists have in common is that they are patient centered. They are all concerned on ways we can improve our responsibility to the patients, their families and the environment. They have different ideas but they are all aiming towards achieving the same goal, which is patient satisfaction and safety. Their differences are in their areas of

According to Petiprin (2015), Dorothea Orem’s theory is used to encourage a person to become more independent. Petiprin (2015) further states that it is true of rehabilitation settings, (Such as,)for example HealthSouth Sunrise Rehabilitation Hospital in which patients are transitioning out of being cared for by physicians and nurses and to exclusive self-care at home. According to George (2011), Dorothea Orem has developed three connecting theories: the theory of self-care, the theory of self-care deficit and the theory of the nurse system. George defines the term metaparadigm as the core content of a discipline (2011). George further states that the metaparadigm of the discipline of nursing comprises of four major concepts: person, health, environment and nursing (2011). At HealthSouth Sunrise Rehabilitation Hospital, the mission of our operations is the delivery of quality healthcare in the most appropriate, safe, patient-centered environment (HealthSouth, 2015). The purpose of this paper is to discuss Dorothea Orem theory, metaparadigm and how it relates to nursing practice at HealthSouth Sunrise Rehabilitation Hospital.

The nursing process does not merely treat the patient as a physical body, but rather treats the patient holistically. The central philosophy of Dorothea Orem's self-care deficit nursing theory "is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they're able" (Dorothea Orem, 2012, Nursing Theory). However, although self-care may be the core of Orem's theory, the decision to engage in self-care must be facilitated by the patient's social and physical environment, of which the family can play a critical role in shaping.

The profession of nursing requires a capacity and joy for caring and healing others both mentally and physically. Nurses spend their careers caring for patients and their families often in the worst and most frightening periods of their lives. Nursing responsibilities can be lengthy, stressful and physically and emotionally demanding. The demands of the nursing profession coupled with the nursing shortage and longer work hours put even more stress on nurses. Despite these extreme demands, many nurses do not fully appreciate the importance self-care. Yet without proper care for themselves, nurses are not able to provide the best care for their patients.

A nursing theory that has influenced my professional nursing practice is Jean Watson’s Theory of Human Caring. In this theory she addresses how nurses care for their patients. Caring is the essence of the nursing profession and is a relationship formed between the nurse and the patient. In Watson’s theory she believed that caring could assist the patient to gain control in their own health care, become educated, and in the end find health. Watson focused on the patient’s mind, body, and soul and this is the aspect of her theory that I try to use in my professional practice. As a new nurse straight out of nursing school I focused more on protocols and procedures to make sure I was doing everything right. My patients had good outcomes but I was amazed when I started thinking about the patient as a whole and not just thinking about the illness they had and how to treat it. Many times just treating the patient’s

Nursing was, for my sixteen year old self, taking care of the sick. Little did I know the complexities of that definition. Still, taking care of the sick was interesting enough to make nursing my major. I started practicing nursing years ago. However, I still struggle defining and explaining my profession to others. I usually start by differentiating nursing from medicine. Nurses see patients as humans rather than a disease that needs treatment (Zaccagnini & White, 2014, p. 15). However, as I advance my career, I must actively incorporate nursing theory into my practice. Nursing theory gives a foundation to understand patients and their health problems better. The use of nursing theory provides a framework to evaluate nurses’ interventions on a higher standard (Zaccagnini & White, 2014). Kenney described five steps to follow once the decision to include nursing theory has being made. This paper will explore the process of applying the Kenney’s five steps into my practice.

Kristen M. Swanson’s Caring Theory is the solution in bridging the gap between nursing practice and theory. It offers an explanation of the links between patient well-being and the caring process (Tonges & Ray, 2011). Swanson explained that nurses should be able to demonstrate that they care about their patients, and that caring about their wellbeing is as important as their patients’ current medical problem (Tonges & Ray, 2011).

The two theories that have helped to form my personal perspective on nursing are Erickson; and Rogers. Helen Erickson’s model is based on caring for an individual patient based on their own unique needs and perspective (Nursing Theories and Models, 2017). Erickson’s model took concepts from several other theorists such as Maslow, Padget, Seyle, and Lazarus and combined them to create a nursing model that takes care of each individual patient based on their needs ( Reed, 2017). This theory helps me to be more cognizant of the individual needs of my patient, not all patients regardless of disease process are the same. Each patient may have different underlying factors or circumstances that affect their health and current situation. Rogers’ theory is broader, viewing nursing as both an art and science, promoting health and wellbeing to patients regardless of where they are (Nursing Theories and Models, 2017). The science of nursing involves the knowledge and research of nursing, and the art is applying that science for the betterment of the patient. This theory views an individual as part

In a nutshell, Orem uses her Self-Care Theory to view health as a state composed of developed mental and bodily functioning and human structures. This is because it includes psychological, social, physical, and interpersonal aspects (Caruso, Cisar & Pipe, 2008). Basically, major assumptions of Orem's self-care theory include the fact that people should be responsible and self-reliant in relation to their own care and that of others, especially family members. Orem argued that

Orem efforts on achieving her objective towards the quality of nursing to improve recovery process in hospitals. The framework integrates ideas in a way to generate a diverse approach of examining a given phenomenon (Orem, 1991). It is relatively simple; however, it allows the generalizability in a broad diversity of patient’s conditions. The theory can be used by nursing professionals to direct and enhance practice in compliance with other authenticated concepts, regulations, and values (Orem, 1991). The theory is relevant to current POI since it provides theoretical concepts that will help nurses to relate psychiatric population to psychotropic medication to metabolic syndrome, and to health care access. Furthermore, Orem's theory concentrates on three associated components namely theory of self-care deficit, the theory of self-care, and theory of nursing process (Orem, 1991). These three elements relate to current POI since the first part relates to the disparity of health care, the second part to patient self-care, and lastly, the third part to the medication and recovery

Orem’s SCDNT is a general theory. It started out as three theories. The theory of nursing systems, the theory of self-care deficits, and the theory of self-care were the first three theories. The theory of dependent care was added later and goes a long with the theory of self-care. Part foundation of the SCDNT was believed to be the moderate realism position, even though she never specifically mentioned it. A lot of the things that would talk about, or take a stance on, reflected this position. “According to the moderate realism position, there is a world that exists independent of the thoughts of the knower. Although the nature of the world is not determined by the thoughts of the knower, it is possible to obtain knowledge about the world.” (Berbiglia & Banfield, 2014) This means that humans make their own decisions and their actions are deliberate.

Nursing is a unique profession which is built upon theories that guide everyday nursing practice. According to Taylor, Lillis, & Lynn (2015), “Nursing theory differentiates nursing from other disciplines and activities in that it serves the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices” (p. 27). Many nurses may unknowingly apply a theory or a combination thereof, along with critical thinking to get the best outcome for a patient. Theories are used in practice today because they have been supported by research and help the profession uphold its boundaries. Most nursing theories consist of four concepts which are the patient, the environment, health, and nursing. Each patient is at the center of focus and they have the right to determine what care will be given to them using informed