Two Vulnerable Populations and Two Nursing Theories Essay

Nursing should not be looked upon or practiced as a mere physical approach to healing. Nursing should encompass the aspect of restoring each individual patient to his/her maximum physical and emotional state of being. In order to achieve such a goal, a patient must be able to bond with her caregiver on a personal level (Blais & Hayes, 2011). Jean Watson’s caritas factors sets an environment where the patient can obtain optimum health benefits (Blais & Hayes, 2011). The goal of this paper is to state my philosophy of nursing, the important dynamics and values that led me to adopting this philosophy, and the reason why I choose nursing as a profession. I will further explain how Jean Watson’s principles of philosophy is

Dorthea E. Orem’s self-care model emphasizes both a patient 's ability and responsibility to care for themselves. Self-care as defined by Orem as “the practice of activities that individuals initiate and perform on their own behalf to maintain life, health, and well-being” (Catalano, 2015, p. 58). Since individuals function at varying levels, Orem has identified three levels of nursing care: wholly compensated care, partially compensated care, and supportive developmental care. This theories goal is to help each individual reach his or her maximum level of function and to take responsibility for his or her health (Catalano, 2015). Self-reliance is also core value in my own personal life. I believe that a person who is capable of performing any part of their own self-care should be encouraged to do so because it will help them become independent, improve their psychosocial status, and promote self worth at a time when they rely so heavily on other people for their care. Orem’s theory matches my own belief of the importance of independence and self-reliance because the main goal is to help patients become as self-reliant as possible in their healthcare. This theory emphasizes the important role of education in nursing in order to enable them to take control of their own health. Because of health deficits, some individuals may require more assistance from care providers. However, even these patients should be encouraged and allowed to do whatever they are able to do for

Dorothea Orem’s theory accepts and describes the premise of self-directed personal care (Alligood et al., 2010). Orem’s theory also explains and predicts when the nurse will be needed once the illness has challenged an individual's functional capacity. The purpose of the theory is to focus on individual’s being able to care for themselves on their own, identify when nurses are needed to help individuals progress to better health. Besides, self-health care is put in place to acknowledge that nurses can aid individuals to get back to their functional baseline abilities on time. (Alligood et al.,

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.

It is essential that nurses are capable of incorporating theory into their practice. Recognizing fundamental concepts such as vulnerability is a crucial element to providing effective care. Vulnerability is an elusive concept that is described as part of the human condition (Sellman, 2005). The process of vulnerability itself is very individualized and may be presented differently for each person experiencing it (De Santis & Barroso, 2011). Within this paper, I will extensively explore the definition of vulnerability, the defining factors that embody the concept, and how the knowledge of this concept can influence nursing practice.

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).

Many different factors can affect these abilities and must be considered by nurses when providing comprehensive care. She referred to this new thought process as the Self-care Deficit Theory of Nursing, which also is known as the Orem Model of Nursing. Orem published the basis for this theory in her book Nursing: Concepts of Practice in 1971. The Self-care Deficit Theory of Nursing earned Orem much acclaim and respect within the medical world. She became a lead theorist in nursing education and practice for the rest of her career. Her book, Nursing: Concepts of Practice, is still widely read today as it enters into its sixth edition. Wayne,

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

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).

Orem’s theory of self care deficit specifies when nursing is needed. “Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care” (Current Nursing, 2010, para. 16). Orem’s created five methods of helping; which are acting for and doing for others, guiding others, supporting one another, providing an environment that promotes personal development, and teaching one another.

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.

Dorothea Orem’s self-care deficit theory’s nursing goal is to assist individuals to meet all their self-care needs by teaching them with skillful healthy habits (Hood, 2014, p. 137). In order for nurses to provide the support needed by an individual, they must assess all their patients’ self-care requisites. As explained by Moore (2015), “Orem uses the self-care requisites as a basis for assessment [in] the nursing process.” These self-requisites are universal needs that arise due to illness and/or changes in developmental stages (Hood, 2014). Dennis (1997) described in detail Orem’s basic conditioning factors that must be assessed to gather sufficient information about the individual and about their ongoing and emerging self-care requisites. Orem’s basic conditioning factors include: age, gender, developmental state, health state, health care system, sociocultural/spiritual orientation, family systems, patterns of living, environment, and available resources (Dennis, 1997).

Nursing Science continued to transform in the 70’s.Dorothea Orem was one of the most prominent nursing personalities that thrived in improving the standards of nursing through self-care deficit theory in 1971. The main objective of care is the self and thus catering every needs that revolve around it to perform self-care. Orem’s work had become so significant today that her Assessment for Care Evaluation method is the standard for evaluating health conditions.