Essay about Orem

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,

When people think about nurses, many ideas come to mind. They think of the hideous old starched, white uniforms, a doctor’s handmaiden, the sexy or naughty nurse, or a torturer. The media and society have manipulated the identity and role of nurses. None of these ideas truly portray nurses and what they do. Nurses are with the patients more than the doctors. People do not realize how little they will encounter the doctor in the hospital until they are actually in the hospital. People quickly realize how important nurses are. Because nurses interact with their patients constantly, nurses are the ones who know the patients best.

Orem and Roy have the different attitude toward the concept of nursing. Orem sees nursing as an intervention to meet the daily needs for self-care and medical-care patients need ("Dorothea Orem 's Self," 2011.)

Across the United States, hospitals are experiencing a nursing shortage. Yet, according to the American Association of Colleges of Nursing, 63,857 students graduated from nursing school in 2015 alone and enrollment is increasing. It seems like a lot of new nurses to fill those vacancies, does it not? Studies show, however, that within a year, about thirty percent of those new graduates have voluntarily left their job (Hillman). Further studies have attributed the high turnover rate to new nurses’ lack of competency to handle conflict, make critical decisions, and function autonomously (Bratt). Many of the new graduates are disappointed with the hospital’s orientation, or lack thereof. Lack of knowledgeable preceptors and lack of nursing staffing in general has led to new nurses being thrown into autonomous function more quickly. Without proper training, these nurses must make sound clinical judgements and provide competent care to patients, which anyone can imagine is stressful. Today, Nurse Residency Programs (NRPs) are being instituted in numerous hospitals as a way to improve new graduate nursing skill, but research shows many other benefits to these programs. NRPs also reduce hospital spending costs, increase patient safety, and most importantly increase new nurse retention rates.

In 1947, shortly after graduating with her Master’s in nursing, Dorothea Orem accepted a position with the Indiana State Board of Health, where she first thought of her theory of nursing. She left that position to work at the U.S. Department of Health, Education, and Welfare (HEW), the predecessor for the U.S. Department of Health and Human Services, from 1957-1959. While at HEW, she took on the role of curriculum consultant and was tasked with the improvement of nurse training through curriculum development (Johnson & Webber, 2010). It was Orem’s role in this project that provided the impetus for her nursing theories as she began to explore the connections between nursing, education, and self-care. Taylor (2011) notes that Orem’s first published article,

Research in the professional practice of nursing was built upon a wide variety of theories that were presented by many well-known nursing theorists. Nursing theories that may be recognized today include Florence Nightingale’s Environmental Theory, Dorothea Orem’s Self-Care Deficit Theory, Madeleine Leininger’s Cultural Care Theory, and Hildegard Peplau’s Interpersonal Process Theory. These individuals and their respective theories

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

The credibility of a profession is based upon its ability to create and apply theory. Nursing as a whole has not been at the forefront of theoretical research being much more practical or hands-on in nature. Unless nurses increase the value placed on research and the body of knowledge that establishes the legitimacy of their practice then nursing will remain in a subordinate position in the medical environment. Theorists anticipated that by conceptualizing models of nursing, practitioners would be able to become more autonomous in their clinical settings while increasing the visibility and authority of nursing as a discipline. It

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).

The profession of nursing has matured from the time of Florence Nightingale. Nursing has gone from just treating dying soldiers on the battlefield to helping guide people through their entire lives from birth to death. The maturation of nursing has led to changes in nursing philosophy and allowed for practitioners of Nursing to meld these philosophies together to form their own philosophy. In this paper I will explain my philosophy of nursing and compare it to Virginia Henderson 's definition of nursing along with discussing some of the changes to Nurse philosophy I will also discuss some of the difficulties to being a patient advocate.

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.

Theory is a cluster of concept or ideas that propose a view concerning a phenomenon to guide nursing practice (Chitty, 2005). The four concepts basic to nursing that are incorporated in this paper are nursing, person, health, and environment (Cherry & Jacob, 2005). The goal of this paper is to describe the core concept of nursing shared amongst Dorothea Orem and Virginia Henderson’s theories. The comparison and analysis of concept definitions between these two theories will also examined. Finally Henderson’s theory of concept statement, metaparadigm and her philosophy will be explored.

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.

When I first began the program I believed that the role of the registered nurse was to care for the patient’s grievances, which was limited to the physical aspect of patient care. I thought that nurses would simply be following orders based on the doctor’s orders. I quickly learned throughout the semester this was a great misrepresentation of the roles of the registered nurse. Throughout this semester, I learned that registered nurses work based off of their own assessment and diagnosis, and they work to improve all aspects of patient care. I learned that the registered nurse was not limited to one role, and that the registered nurse would be working to improve herself in all aspects of practice.

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.