Traditionally, Nursing Has Not Been Accorded The Professional

Middle range theories “lie between the grand nursing models and more circumscribed, concrete ideas” (McEwen & Wills, 2014, p. 37). There are numerous middle range theories specifically created for the nursing profession. These theories serve to guide nurses in their nursing duties, offering insight into an abundance of topics ranging from objective, fact-based data to the more subjective, personalized material. Each middle range theory can be further grouped into four subgroups; descriptive, explanatory, predictive, and prescriptive. Descriptive theories describe and examine major ideas. The purpose of a descriptive theory is not to link one concept to another, but rather to simply study the perceivable philosophy. In comparison, explanatory

And all of them continue to develop with wide-ranging nursing research. We will continue our analysis using professional nursing practice in New Zealand. In modern days all nurses have to obtain the bachelor of nursing degree to become a registered nurse. So universities and polytechnics are the main providers of nursing degree. They are closely supervised by the Nursing Council of New Zealand (NCNZ) to ensure the compliance with the requirements of competencies for registered nurses. In New Zealand before you can practice you have to obtain the registration from NCNZ through passing the states final and being fit to practice. Fit to practice means you have to be of a good character, speak good English, and have to acquire the necessary knowledge (NCNZ, n.d.). Also nurses have to provide selfless service and think about the nursing profession when they represent themselves in the society. As any other profession nursing has to abide to the code of ethics. It consists of set of values which applies to nurse- client relationship, nurse-colleague, nurse-organization and nurse-society relationships. They all include autonomy, beneficence, non-maleficence, justice, confidentiality, veracity, fidelity, guardianship of the environment and its resources, being professional in the context with the above relationships (New Zealand Nurses Organization, 2010). So as we found out nursing has got all necessary features of the profession. Professional nursing practice has got four

Dorothea Orem is a notable figure in the nursing community, receiving several Honorary Doctorate degrees (McEwen & Wills, 2014). Orem was a member of the Board of Health in Indiana from 1949 until 1957 (McEwen & Wills, 2014). She received her first form of nursing education at the Providence Hospital School of Nursing in Washington, DC. She continued to educate her self by attaining her master’s degree in nursing from Catholic University in 1945. Orem experienced nursing from both practical and educational perspectives,

Dorothea Orem is known as the nursing theorist who developed the Orem’s Self-Care model, which focused on enhancing the individual’s ability for self-care and ability to care for their dependents when they need to. Orem’s personal history and professional experiences created the framework of her theory and its nursing process when nursing care is needed. Orem was born in Baltimore, Maryland in 1914 and had early exposure to nursing through her aunt who was an operating room nurse. Orem earned a nursing diploma in 1934 at Providence Hospital Nursing School in Washington, DC where she practiced in

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.)

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

Nurses develop professional skills through a process called “Professionalization.” Ghadirian uses four factors to describe this; cognitive dimension, attitudinal dimension and psychomotor dimension. They then further describe the cognitive dimension as the “professional knowledge” a nurse must have (2014). Without knowledge of illness or the human body, a nurse can not practice professionally. Ghadirian then suggests that even with extensive professional knowledge, a nurse can not be professional without the ideals and ethics of a nurse, or the ability to provide care (2014). A nurse can not be professional without all the dimensions. A nurse must have the values of a nurse, knowledge of a nurse and the ability to provide care.

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,

To this end, I believe middle-range theories are best suited to advance nursing knowledge and practice in the 21st century. “Middle-range theories are at those levels of conceptualization that could inform nursing practice and research, and thus continue the cycle of advancing foundational knowledge and enhancing quality care”, (Meleis, 2012). Middle-range theories were created to help the nursing profession realize its overall mission and goal, now and in the future; to alleviate pain, suffering and distress, as well as promote health-seeking behaviors which will lead to improved health outcomes and attainable goals. Because middle-range theories lie in the middle of grand theories and situation specific theories, they are directed more toward specific interventions that can be implemented at the ‘bedside’. As such, they are designed to provide frameworks to manage patients’ experiences with symptoms, as well as the ability to understand responses to health and illness phenomenon.

Nurses may play different roles in the field, but their responsibilities are all very similar. Nurses must be confident in everything they do and be patient with people. They should have strong listening

Dorothea Orem was born in1914 in Baltimore, Maryland. She earned her nursing diploma from the Providence Hospital School of Nursing in Washington, D.C., in 1930, before she went on to complete her Bachelor of Science in Nursing and Master of Science in Nursing at Catholic University of America in Washington, D.C., in 1939 and 1945 respectively. Orem occupied numerous high profile nursing positions during her lifetime. She was director of nursing in various institutions and was a member of group of nursing theorists who formulated the framework for North American Nursing Diagnosis Association. She proposed Self-Care Deficit Theory of Nursing, which is made up of

Over the decades, the field of nursing has been facing difficulty with receiving acceptance as a respectable occupation. This is because there were often certain prejudices associated with the profession (which made it hard to attract good candidates). However, in the last several years, nurses have become an integral part of any health care team. To fully understand how this took place requires examining the historical trends. This will be accomplished by focusing on: self-regulatory issues and the way social perceptions impacted career decisions. Once this takes place, is when these elements will show the challenges effecting the development and practices of the discipline. (Kitson, 1996, pp. 1647 1651)

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

Nightingale had the power and was in the right position to establish modern nursing (Stein 1998). Nightingale said, “Let us never consider ourselves as finished nurses…we must be learning all our lives”. In the years of 1860 through 1899 the Unites States laid the groundwork for nursing. Following England’s format, the school of nursing would remain separate from the hospital, so that the educational needs would be kept separate from patient needs. The first doctoral program for nursing was instituted at the university of Pittsburg in 1954 (Stein 1998). In today’s society, the education and learning of nurses consist of programs, offerings, and independent studies in order to broaden a nurse’s ability (Stein 1998). The education required to become a register nurse today is, a Bachelor in science degree along with a nursing degree.

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.