My Client Is Margie M, A 69 Year Old Widower With Chronic Venous Stasis Ulcers

The theory focuses on the ability of a person to meet his or her own needs. Developed in the year 1970, Orem’s theory focused on the three various concepts, namely self-care, self-care deficit, and the nursing system. Self-care is a group of activities or processes that a person performs to maintain health, life, and wellbeing (Orem, 2001). For instance, self-care is being demonstrated when a chronic heart failure patient checks his or her weight daily, takes prescribes medications, and avoids salty foods. Self-care deficit happens when an individual is not able to provide effective self-care (Orem, 2011). Nurses are able to assist patients in this state by educating them with their disease condition and treatment compliance. A nursing

Three connecting theories developed by Dorothea Orem are the theory of self- care, the theory of self-care deficit and the theory of the nurse system (George, 2011). Self-care theory is offering an

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.

Dorothea Orem is known as one of the foremost nursing theorists. She is credited with the development of a nursing grand theory, the self-care deficit nursing theory (SCDNT). The beginning of her career can be traced back to Washington, D.C. in the mid 1930’s. Though she was a Baltimore, Maryland native, Orem pursued her nursing education at Catholic University of America (CUA) in Washington, D.C., graduating with baccalaureate and Master’s degrees in 1939 and 1945 respectively. Following her education, Orem held many job positions across multiple nursing disciplines, including working as a private nurse, nurse educator, administrator, director, and private contractor (McEwen & Wills, 2011).

The model is concerned with the provision and management of self-care. A requirement for nursing exists when a person is unable to maintain for him/herself self-care action which is therapeutic in sustaining life and health, recovering from disease and injury or coping with their effects. Meet own needs through nutrition, fitness, hygiene, rest and relaxation, interpersonal relationships, meaningful work, spiritual practices, prevention and health promotion practices

Self-care in nursing is a very important aspect when it comes to being a successful RN. In order to perform well at your job and in order to take care of your patients, you must take care of yourself. Many people have different forms of self-care whether that be going to church, getting exercise, spending time with your, or even taking a vacation. Whatever self-care means to you; it is a major part of nursing in order to take care of your patients. This is so important because it has a domino effect on all parties involved; if you don’t take care of yourself how can you care for a sick, ill patient. One of the major nursing theorist that strongly advocated for self-care was Dorthea Orem (Black, 2014). For Dorthea self-care and personal health were hand in hand with one another (Black, 2014).

Dorothea Orem's Self-Care Theory. (2011, October 14). Retrieved November 6, 2011, from Nursing Theories Web site: http://currentnursing.com/nursing_theory/self_care_deficit_theory.html

Orem focuses on nursing as a deliberate human action and notes that all individuals can benefit from nursing when they have health-derived or health-related limitations for engaging in self-care or the care of dependent others (Gunther, 2016). The nurse chooses deliberate actions from nursing systems to bring about desirable conditions in persons. The goal of nursing is to move a patient toward responsible self care or to meet existing healthcare needs of those who have health care deficits (Gunther, 2016). Orem expects people to be responsible for themselves and to seek help when they cannot maintain therapeutic self-care or dependent-care (Fawcett, 2003).

Dorothea Orem's self-care deficit theory was born while Dorothea Orem (1917-2007) was working in the Department of Health Education and Welfare (HEW) as a curriculum consultant. At this time in the history of the profession, nursing was just emerging as a unique academic discipline. Orem's theory was designed to answer the fundamental question: What is nursing? Orem defined nursing as a way of realizing every patient's desire to engage in self-care in a manner to "sustain life and health, recover from disease or injury and cope" with the consequences of major health events and daily life (El-Kader n.d.). Major assumptions of the theory include that "people should be self-reliant and responsible for their own care and others in their family needing care" (Dorothea Orem's self-care deficit theory, 2012, Current Nursing). Fundamentally, nursing and the nursing process is designed to enhance self-care and to address deficits in self-care.

Dorothea Orem created the self-care theory in 1959 and continued to build upon her theory until 2001. The purpose of Orem’s theory was to define nursing, discuss the relationship among the nurse and the patient, and to promote a clear understanding of the scope of nursing (Taylor, Self-Care Deficit Theory of Nursing, 2006). Today, Orem’s theory is widely known and is utilized in nursing curriculum, as well as continuing education topics for healthcare providers.

Dorothea E. Orem devoted her life to defining nursing and the nurse’s role in improving the patient’s overall health, which she coined the Self-Care Deficit Theory. Orem’s theory is quite a complex one, which can be simplified by identifying that it is three theories in one: self-care theory, self-care deficit theory and nursing systems theory. In 1959, as Orem first began the evolution of the Self-Care Deficit Theory, she defined the nurse’s role as another self. This nursing theory is the foundation for nursing as it actually defines the art of nursing, the actions that drive the nurse and the nurse’s provision of care through the nursing systems theory. To place in simplistic terms, Orem assumes that all humans desire to care for self. In the self-care theory, she states that individuals are meant to care for themselves and their basic needs by promoting life, health, development and well-being (Banfield, 2011). When something happens that does not allow the human to care for self, a deficit occurs. This deficit drives the need for specialized nursing care to restore the human’s health so they can resume self-care.

Numerous nursing hypotheses have been developed in the course of the most recent century with an end goal to guide practice, training and research for nursing students, RNs, and other health care professionals. In spite of the differing qualities of these theories and models, four ideal models or metaparadigm concepts have come to light that are presently widely acknowledged as key to the discipline of nursing, i.e., person, health, environment, and nursing (Hanucharunkul, 1989). One of the theories which truly emerges and has the qualities of a competent nursing theory is Dorthea Orem’s Self-Care Theory. The self-care theory depicts self-care and care of dependents as a learned behavior which serves the purpose of regulating the ability to function, develop, and maintain human anatomical strength, by being responsible for self (Orem, 1985). It also explains why and how nursing care should be used to supplement rather than supplant a person’s self-care ability (Denyes, Orem, & Bekel, 2001). An analysis of Orem’s self-care model, since its origin till the present time, reveals that the model’s key concepts are compatible with the four metaparadigm concepts of nursing, and if adapted appropriately, this model can be rewarding when applied to clinical practice, in client care, and also for nursing students and practicing nurses.

The foundation for the nursing profession that provides principles to generate knowledge defines nursing theory. Successful nurses must be rooted in theory and understand the philosophy that drives their actions. Dorothea Orem is a nurse with a vision that studied human behavior, with the core concept of self-care in the patient/nurse relationship. This paper seeks to explain Dorothea Orem’s Theory including the contribution of her research as it relates to nursing development and paradigms of nursing.

Failure for a person to be able to maintain their self-care requisites through the power of their self-care agency results in a person’s self-care deficit (Masters, 2012). The self-care deficit theory explains how individuals can be assisted through nursing. The five nursing methods utilized to meet the self-care needs are: acting for or doing for another, guiding and directing, providing physical or psychological support, providing and maintaining an environment that supports personal development, and teaching (Masters, 2012).