Orems Theory Of Nursing - Coursework Example

Nursing Theorist Grid Orem’s Theory of Nursing is based on the underpinning principles that nursing may be defined as the provision of self-care that can be therapeutic in sustaining life and health, in recovering from disease or injury, or coping with their effects for any individual. The theory is composed of three general theories. These three related theories are collectively referred to as Orem’s General Theory of Nursing. These are, The Theory of Self-care, The Theory of Self-care Deficit, and The Theory of Nursing Systems. The Theory of Self-care states that self-care is a learned behavior and a deliberate action in response to a need. It centers on the individual and his problem, not around the medical illness that the person is suffering from. Orem identified three categories of self-care requisites, universal self-care requisites, developmental self-care requisites, and health-deviation self-care requisites. The theory of self-care deficits proposes that nursing care is necessary when individuals are affected by any limitations that prevent them to meet their self-care needs. Therefore, self-care deficits, not medical diagnosis, determine the needs for nursing care. According to Orem, the only legitimate need for nursing care is when a self-care deficit exists. Orem’s self-care theory is based on the concepts of self-care, self-care agency, self-care requisites, and therapeutic self-care demand. The theory of self-care deficits describes and explains when people need nursing care. Orem specifies five methods that nurses use top help meet the self-care needs of the patient. These 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. Acting or doing for another may include the three requisites of universal, developmental, and health deviation, and the last four relate only when the client has needs related to health deviation. The third main theory of Orem is known as Theory of Nursing Systems. According to this, the nurse determines and assesses the legitimate need for nursing care depending on the ability of the client to meet self-care needs based on whether or not actually a deficit exists. If a deficit exists, then the nurse plans care that identifies the roles of the nurse, the client, or the family. Collectively, the actions of all these agencies are known as nursing system, and Orem identified three categories of nursing system, wholly compensatory, partly compensatory, and supportive-educative. The nurse would select the system depending on the client’s needs assessment based on his abilities to perform self-care activities. In the wholly compensatory system, the patient is unable to perform any self-care actions and is totally dependent on the nurse to perform them for him. In this, the nurse supports and protects the client, compensated for the client’s inability to care for self, and attempts to provide care for the client. In the partial compensatory system, both the patient and nurse perform self-care actions with the major role shifting from the patient to the nurse with the change of self-care demands. The third nursing system is the supportive-educative system, where the nurse’s role is to promote and support the patient as the self-care agent (Orem, D. E., 2001). Theory’s Historical background: Historically, in attempting to plan a nursing curriculum for licensed practical nurses, Orem was searching for a pragmatic framework to organize nursing knowledge. She focused on the two very vital and basic questions in nursing practice, “what is nursing” and “why do people need nursing care.” While theorizing these two questions, she discovered that nursing is a service to people, not a derivative of medicine, and nursing promotes the goal of self-care. It was very evident that people need nursing care when they are unable to care for themselves. Therefore, self-care and self-care deficits in clients were the prime drivers for her theory, and in 1971, she presented the Self-Care Deficit Theory of Nursing in her book Nursing Concepts of Practice and has continually revised and updated her theory (Fawcett, J., 2000). The theory developed from interest in curricula for diploma and baccalaureate programs and the necessity to differentiate between technical and professional education. Therefore its utility to nursing education is enhanced by theorist’s interests. This theory is widely used as a conceptual framework in associate degree nursing program. Major theory assumptions related to: Define according to theorist: How does this concept relate to nursing practice? How does this concept relate to nursing education? Person According to Orem’s theory a person may be defined as an individual who receives the nursing care, who functions biologically, symbolically, and socially. He is considered to be having the potential for learning and development, has the capacity to self-knowledge, can engage is deliberate actions, interpret experiences, and perform beneficial actions. He is subject to the force of the nature and if educated can learn to meet self-care needs. He has the capacity to reflect upon himself and the environment, symbolize his experience, and use symbolic ideas in thinking, communicating, and guiding efforts that are beneficial to self and others. This concept relates to nursing practice in the order that human functions can be modified, and they can be integrated to include physical, psychological, interpersonal, and social aspects. From the nursing education point of view, a person’s self-care needs are met by learned behavior, and when learning of self-care measures do not happen, others must learn the care and provide it (Fawcett J., 1995) Health Health is defined as a state of physical, mental, and social wellbeing, not merely absence of disease or infirmity. This also speaks about relationship between health and wellbeing from the holistic perspective. In practice, nurses must understand that an individual is an integrated whole that comprises of internal physical, psychological, and social parts with varying degrees of self-care abilities with need for customized action plan. In practice, nurses must understand that an individual is an integrated whole that comprises of internal physical, psychological, and social parts with varying degrees of self-care abilities with need for customized action plan. In practice, the nurses must understand that care must be personalized, and through a sense of personalization, wellbeing is a perception of contentment, happiness, and pleasure. Self-care deficits may result from physical, mental, and social perspectives, and nursing action plan must recognize these aspects of health. In nursing education, this implies that nurses need to learn health promotion and health maintenance. This also signifies that the nurse would promote through education the individual’s responsibility for self care (Foster, P.C., & Bennett, A.M., 2002). It is also important that the nurses be educated to see an individual as an integrated whole composed of internal physical, psychological, and social nature who have varying extents of self-care deficits. Nursing Nursing is defined as a service geared towards self-help and helping others. Nursing is required when self-care demands exceed a patient’s self-care ability or agency. In nursing practice this aspect of the theory promotes the patient as a self-care agent, where the skill of the nurse is the nursing agency. Adults are self-reliant and are expected to be responsible for themselves. Whenever there is a self-care deficit, nursing can apply education, knowledge, skills, or techniques to provide the care or design it. In practice, nurses must analyze their roles from the point that nursing is a human service. It is important for the nurses to plan the services in a different manner from other available services by its focus on persons with inabilities or deficits to maintain the continuous provisions of healthcare. Nursing is necessary when the individual fails to maintain the quality and extent of health-deviation related self-care that, according to Orem’s theory is therapeutic in sustaining life and health (Orem, D. E., 2001). The relation to nursing education is that nursing is defined as a service that incorporates the theoretical basis of nursing science, art, and humanities that is expected to generate nursing prudence that enables the nurse to seek advice in new or difficult situations, to make correct judgments, to decide to act in a particular manner or to act. These will all be derived from a sound nursing education. The nursing education must enable the nurse to learn communicating, coordinating, establishing and maintaining therapeutic relations, and rendering assistance to maintain and promote life processes, growth and development of the client employing psychophysiologic modes of functioning (Orem, D. E., 2001). Environment Environment is defined as the individual’s external physical and psychosocial surroundings. This refers to the person’s relations, family, and significant others and the physical surroundings as well as the setting in which nursing occurs that may range from the person’s home to clinical agencies, to the society as a whole. According to Orem, environment is tridimensional that encompasses physical, socioeconomic, and community features. The physical features relates to maintenance of human structure, functioning, and wellbeing. Socioeconomic features relate to family and its composition by roles and ages, cultural prescriptions for authority, and responsibilities and rights of the family. Community environment comprises of population and its composition by family units, collaborating social units, and government voices. Nursing practice must take care of the environmental conditions while planning an action. Nursing practice must take care of assessment of patient’s and his family’s previous lifestyle roles and responsibilities, acknowledge patient’s frustrations and limitations, reinforce his abilities and progress, and encourage the patient to return to a normal lifestyle that brings him back to his previous healthy environment. Nursing education must be directed to promotion of personal development through motivation to establish appropriate goals and must incorporate techniques to adjust behavior to meet these goals since these can impact a person’s ability to provide self-care (Fawcett, J., 2000) Reference List Fawcett, J. (2000). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. Philadelphia: F.A. Davis Co. Fawcett J. (1995) Analysis and evaluation of conceptual models of nursing 3rd edn. FA DAVIS Company, Philadelphia. Foster, P.C., & Bennett, A.M. (2002). Self-Care Deficit Nursing Theory: Dorothea E. Orem. In J.B. George (5th edition), Nursing theories the base for professional nursing practice (pp.125-149). Upper Saddle River, New Jersey: Prentice Hall. Orem, D. E. (2001). Nursing: Concepts of practice (6th ed.). St. Louis: Mosby. Read More