Relevant Grand Nursing Theory

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

Theory development stems from personal experiences, intuition, and knowledge of the theorist (Burns et al., 2013). When a scholar develops a theory, it has to be tested through research. The findings of the study are then presented to experts in the area of academics and the field of practice (Burns et al., 2013). The presentation of the findings allows experts to provide constructive criticism, highlight the pros and cons of the theory, and acknowledge whether or not the theory can be accepted as a guide to practice. This theory evaluation paper will give the reader a theory description, theory analysis, and an assessment of Dorothea Orem’s self-care deficit theory of nursing (Alligood et al., 2010).

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

In the article written by Ford, (2009), the doctorate of nursing practice (DNP) has an important role to play in the current health care system which is constantly changing. As healthcare around the world is transforming, the Institute of Medicine (IOM) 2011 report mentioned that in the United States, Advanced practice nurses play a vital role in the rapid complex changes based on the full extent of their education and training. This article describes some of the positive role of the advance practice Nurse as a facilitator in the regulatory and policy developments. The Advance practice nurse participates and provide cost-effective care models that will improve the access and quality of care of the population. Another positive area for the APN in this current healthcare system is health promotion, health maintenance, and prevention. In this evolving health care system, it gives the Advance practice nurse the opportunity to set up acute and primary care settings that will positively impact health care delivery as they meet the needs of an expanding, aging, and chronically ill population. All over the world, the NP’s role has developed and is beneficial to health care systems and health care consumers. As Advance practice nurses we must use this great opportunity to advance our role and work with others to improve and transform health care globally. DNP graduate 's role is include leadership, research, practice, education, and

As popular as the ADN is today, there is a huge momentum to encourage nurses to receive their BSN instead of an ADN. Nurses that are already entering the workforce at the BSN level are not only more skilled at following and understanding evidenced based practice, but they are also more prepared to go on to school to complete their masters or doctorate degrees. In the changing face of healthcare, more nurses with advanced degrees will be needed to provide primary care as in the role of nurse practitioners. APRNs are going to be in higher demand in community care, public health nursing, evidence based practice, research, and leadership. Shortages of nurses in these positions create a “barrier to advancing the profession and improving the delivery of care to patients” (IOM, 2010, p. 170). Shortages of APRNs and the increasing need for nurse practitioners to provide primary care is why the IOM is recommending to increase the amount of BSN educated nurses entering the workforce to 80% and to double the number of doctorate nurses by 2020 (IOM, 2010, p. 173) The goal to increase the nursing workforce to 80% BSN educated nurses and double the amount of nurses with doctorate degrees is a formidable goal, but increasingly necessary. Patients are becoming more complex inside and outside of the hospital setting with chronic multiple comorbidities. BSN educated nurses are not only better prepared to care for these

Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories. The grand nursing theories are a

The Self-Care Deficit Theory of Nursing impacts modern health as well as nursing more so than expected during its creation and evolution. The Institute of Medicine (IOM, 2001) demanded the need for health care to shift from acute care setting to management of disease. Consequently, today’s health care is in the midst of a paradigm shift, as it redirects its attention towards patient centered care, disease prevention and wellness promotion. The Affordable Care Act implemented regulations, enforced by financial reimbursement to ensure that hospitals have shorter lengths of stay, lower readmission rates and strategies to enhance health promotion, disease prevention and improved quality of life (Taylor, 2012). The government has placed incredible demands on the health care system as baby boomers are aging and chronic diseases are becoming more complex requiring increased use of technology and nursing support. In order to meet the legislative requirements, administrators and educators must transition to the structure and concepts provided by the Self-Care Deficit Nursing Theory, for it is in this theory, nurses are empowered to better care for the patients as they present with complex self-care needs requiring specialized assistance from highly advanced, educated nurses who prepare these patients to return home better equipped for self-care despite their chronic conditions.

Developing a nursing philosophy is important to a nurse as it serves as a guide and is the foundation for personal nursing practice. Following a personal nursing philosophy can enhance your nursing career, make you a better nurse and improve patient outcomes. However, it is difficult to choose one nursing theorist, as there are viewpoints from several theorists that align with my personal theories. Choosing one theory is not only difficult, it is possible to change a theory during your nursing career or draw from various theories while working with patients and their families depending on the situation. Consequently, nurses are taught the foundation of multiple theorist and there does not seem to be one correct model. It is a matter of finding one that fits your

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).

Core concepts are the basis for a theory or model; concepts help in the development of theories. Theorists have developed different models or theories but have common core concepts. This paper will identify the core concept of ‘the role of nursing,’ which two theorists, Dorothea Orem and Virginia Henderson both utilized. We will compare and analyze the concept definitions among both theorists, and discuss the practical use of Orem’s self care theory.

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.

The purpose of this paper is to provide an introduction, purpose, and rational for selecting a nursing theory. I will describe the theory by identifying the purpose, concepts/definitions, relationships/structure, and assumptions. I will use the Chinn & Kramer evaluation criteria to critique this chosen theory. Finally I will describe a plan for implementing the theory into my practice setting, identifying any barriers and challenges.

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.

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.