Orems Nursing Theor - Coursework Example

Orem’s Nursing Theory Name Institution Affiliation Abstract Several people are adept in performing nursing actions, but it takes learning and critical thinking for a person to be a qualified nurse. The roles of a professional nurse involve fulfilling the responsibility to assist individuals in their health and help them maintain well-being. In order to carry out nursing roles and responsibilities, individuals must have an underpinning hypothesis entrenched in their thinking, which obliges their actions. Lack of the driving potency in the practice of nursing may cause the practitioners to have less motivation in their profession. Nurses who are motivated have a clear goal set in their practice, which most often produces a positive patient outcome. This paper will critically analyze Dorothea Orem theory of nursing and its relevance to the nursing practice. Introduction Nursing Theories A theory refers to a collection of correlated ideas that guide a practice. It is a group of rational proposals used as ideologies in explaining a given concept. Nursing theory comprises of a set of ideas, concepts, definitions derived from the nursing models which offers a logical perception of nursing. Nursing theories provide information about the best practices in the nursing profession, goals and functioning of nursing. Care provision in the nursing profession is based upon these different theories. The following are the most prominent theories of nursing and the individuals who developed them. The Need Theory by Virginia Henderson Unitary Human Beings Theory by Martha Rogers. Interpersonal Theory by Hildegard Peplau Transcultural Nursing by Madeleine Leiniger Self-Care Theory by Dorothea Orem As indicate earlier, this paper shall focus on the self-care theory by Dorothea E. Orem Dorothea Orem Dorothea Orem was born and raised in Baltimore, Maryland. She attended her studies in Seton High school where she graduated in 1931. Orem proceeded with her education in Providence Hospital School of Nursing in Washington and attained a diploma. In 1945, she earned a B.S. in Nursing Education from the Catholic University of America. Most of her initial years in nursing practice were at Providence Hospital in Washington and St. John’s Hospital, Lowell, Massachusetts. In her career, she mainly focused on training, exploration, and administration. She had a diverse background in clinical practice. During her post-graduate studies, she came up with the definition of nursing that was adopted globally. It was during her career at as a consultant in the Education Office, Department of Health, Education and Welfare in Washington that she took part in a project aimed at improving practical nursing training. In this program, she was inspired to find situations in which a decree is arrived at that nursing care is needed. In her research, she came up with the concept of a nurse being “another care”. She later converted this idea to “self-care,” which gave birth to Self-Care Deficit Nursing Theory. Self-care requires that when individuals are able, they can care for themselves but in situations where they are unable, nurses step in and offer necessary assistance and help in order to enable them to cope up with their condition. With regards to children, nursing care is obligatory when parents or guardians are not in a position to offer adequate care required. Dorothea Orem worked with several other organs and institutions, for instance, the faculty members from the American Catholic University in the progression of her concept. She received numerous awards, honorary, and doctor of science degrees in her career. She later passed on in June 2007. Orem’s Self-Care Deficit Theory of Nursing (SCDNT) Orem’s theory provides an analysis of human beings application of self-care in order to sustain health standards and seek for nursing care when there are far reaching constraining factors that are beyond personal self-care. The theory places the primary responsibility for healthcare into the hands of patients. Under Orem’s theory, there exists an established relationship between patients and nurses, which is facilitated through education, teaching, and environmental sustainability upheld by the nurse (Masters, 2014). Her main focus was the philosophical thought about nursing, which helps in establishing the meaning of nursing as a science through understanding concepts that relate to care and practice. According to Orem, the nursing theory is aimed at symbolizing the nature of nursing and its application for the benefit of mankind. This theory has gained worldwide recognition (Johnson &Webber, 2010). Several nursing schools and colleges across the globe have adopted SDNT theory in their program of studies (McEwen & Wills, 2007). Orem’s grand theory explicates the correlation involving persons, health, and the environment. She distinguishes four metaparadigm models of nursing discipline, which are the nurse, health, environment and person. Person In the Orem’s theory description, a person is delineated as a character with physical and emotional needs, which are needed for the person’s health. These are the physical, psychological, and environmental facets of and individual. According to SCDNT, the environment refers to the surrounding a human being puts him/herself. This external environment of a person and its components affects the internal environment of the same person directly or indirectly. For a person to function effectively, maintenance of a sound internal environment needs to be adhered to, which comprises the health state of an individual. Health Health is a condition that incorporates a group of people or a person. According to McEwen et al., health is an experience symbolism and an ability to relate to other people (McEwen &Willis, 2007). Wellness is attained when the totality of a person is in congruence, that is, when all the body parts of a person are functioning effectively. Nurse This is a trained person who is equipped with full knowledge and power to assist in handling all the scantiness that hinders self-care. There are several methods, which Orem put forth in nursing that assist patients meet their self-care demands. These include acting for another, directing and leading the way, offering physical assistance, providing an ancillary environment for instruction, and improving healthcare needs. Levels of Orem’s Self-Care Deficit Theory of Nursing Theory of Self- Care The theory of self-care is categorized into three major elements. First, Orem talks about universal health care needs, which are the ultimate elementary facets of healthcare. Valuation of these needs determines an individual’s requirements for achieving the prime state of health. Assessing factors, such as the food taken by a person, air, water, daily activities, sleep and social interactions, aids a nurse in understanding the individual to come up with the best health care plan. According to the universal self-care, each person should have the personal knowledge of self-care. Self-care needs involve all the actions aimed at providing self-care (Johnson &Webber, 2010). For illustration, individuals need to be aware of all the food they eat and how it affects their health. When a person or other human units, such as the family is aware of the universal self-care, the nurse will come in easily in helping to provide self-care needs. The measure comprises involvements and coaching, which help an individual to walk towards the paths of wellness. All these actions are aimed at maintaining optimum health. The next facet of self-care is health deviation self-care prerequisites. In this category, there are deviations from health care, which arise as a result of illness or injury that make it impossible for a person to carry out self-care (Coster & Norman 2009). Under this condition, an individual is forced to make adjustments to fit in the circumstance or concentrate on the actions that they are incapable of accomplishing. Theory of Self-Care Deficit Self-care deficits are conditions or limitations, which bar individuals from maintaining self-care. Under this circumstance, people become incapacitated in maintaining their health; therefore, a nurse or other people come in to intervene either physically or psychologically (Biggs, 2008). The main focus of the nurse is to provide remedies to the limitations in order to help the person develop self-care needs. Some of the methods employed by the nurse include coaching, guiding, and supporting, which depend on the sternness of the individual’s limitation. In the application of SCNDCT to a person, the nurse categorizes an individual as having deficits in self-acre and establishes best solutions in guiding the person back to normalcy. The underlying factor in this theory is that it explains the need and reasons why a person requires nursing care. The nurse goes ahead and makes an assessment of self-care requirements before developing a therapeutic process. The decisions that a nurse undertakes in self-care deficit theory are determined by the nurse’s perception and values that are guided by their observations, intellect, and thinking through critical analysis in their nursing profession (Sitzman & Eichelberger, 2010). This stage identifies the real practice of nursing among practitioners and provides models, which act as guiding principles in the progression and development of nursing (Nursing Theories, 2011). Theory of Nursing Individuals are categorized into three main modalities by the nurse in the process of recovering their self-care abilities. However, this can vary and one can move from one procedure to the other depending on the adoption characteristics. If a person needs full nursing care to attain self-care needs, he/she will need full compensatory support in order to attain self-car goals. This implies that a nurse employs education and other supportive mechanisms to help the individual acquire self-care information. Under the guiding principles of SCDNT, the nurse acts as an instructor and provides an efficient setting for the healing progress. In the self-care deficit theory provided by Orem, much focus is directed towards the valuation and implementation. In the valuation process, the nurse determines the knowledge an individual in self-care and the motivation they have towards achieving the state. Once these abilities have been determined by the nurse, strategic plans are then put in place in order to meet the person’s health deficits demands. During the implementation stage, the nurse needs to focus on the correct nursing system in helping individuals in the self-care deficit conditions. The nurse should demonstrate the significance of self-are to patients and explain to them how they should carry themselves about in their home and other places outside the health facility. The nurse is also obliged to provide the patient with both moral and support and encouragement in the implementation stage. This is crucial in doing away with any doubt among the patients and any overwhelming feeling. Once the patient has recognized the roles he/she has on the healthcare plan, the nurse must be able to evaluate the outcomes of the program and establish if further implementation is required. There are also instances where nurses are required to accommodate some special needs of individual patients, such as personal demonstrations and a very close support contact. Research In 2009, Armer applied Orem’s theory of self-care deficit on post-surgery breast cancer survivors who were at the risk of developing lymphedema. The main aim of the program was to establish a significant supportive nursing education system and avert the impeding problem of lymphedema. Lymphedema is a condition in which lymph conducting system fails to accept back the lymph in the blood stream that causes a stockpile of the lymph the interstitial space (Fu, Axelrod & Haber, 2008).). Cancer patients are prone to this condition as a result of the surgery and radiation treatment (Fu, Axelrod & Haber, 2008). This condition can be chronic and affect patients in their entire lifetime. Self-care can, however, be applied to reduce the severity of the situation. According to the research by Armer et al., an investigation into education and self-care needs was conducted and evaluated the results. Self-care to avert the risk of the condition involved aspects, such as evading weight gain and obesity, striving to ensure that affected spots are free from any infection, and decrease the rates of hand touch to the affected areas. Disease management entailed in the self-care consisted of physical lymph drainage, deep breathing practices, belly massage and ancillary clearance aimed at improving the lymph functioning (Amer et al. 2009). The supportive nursing coordination employed in this research was similar wit Orem’s theory of self-care deficit. Under this research, there are some aspects that were consistent with Orem’s self-care requisites, but some loopholes emerged in the process of self-care. For instance, according to the study, numerous patients were not adhering to the instructions they were taught during nursing intermediation. There was also lack of support for the patients, which made the researchers make some adjustments to their study. The adjustments they made incorporated motivational dialogs and solution engrossed therapy. These acted as aids to Orem’s theory of self-care, especially inspiration and realization in making the process beneficial for patients. According to the research, it was also discovered that many patients are facing four different challenges; Poor attention and exercise with regards to self-care both internally and externally to factors crucial to self-care. Poor reasoning in the context of self-care reference perspective. Lack of motivation Lack of consistency performance in the self-care actions. The research also pointed out different subjects involved in the study with regards to their level of self-care. The most prominent subject is a nurse whose actions are incorporated into the care plan. The process begins with a poor self-care agency where a patient is less motivated and lacks the knowledge to undertake self-care responsibilities. The process is developed by establishing the possibility of contacting Lymphedema. Although the focus is put on reducing the risk of the condition, many patients do not understand the significance of self-care actions. The subjects were then distributed to various agencies in order to have different self-care abilities in their demonstration and preventive interventions in averting the risk of lymphedema. According to the research, SCDNT is a significant theory in the practice of nursing for helping a patient establish a system of sustenance and education. Furthermore, the study analysis is important in exemplifying how incorporation of aspects, such as goal attainment and motivational directions are vital components in the application of SCDNT theory. The research also points out several potential glitches in the Orem’s theory of self-care deficit. This is important in the nursing practice by pointing out at the diverse category of patients’ population that nurse’s encounter. These diverse elements in the patients range from culture, age, and gender. As such, it may be challenging for the nurses to apply the required time in implementing the learning techniques. This, therefore, implies that the Orem’s self-care deficit theory may not be effectively instigated due to the time limiting factor by the nurse. In as much as the theory concentrates on the patients’ self-care, the most underlying factor is the rapport developed between the patient and the nurse, which results in a constructive communication aimed at effecting self-care management. The nurse takes several responsibilities in this process initially from education roles to motivating and supporting where required. Conclusion Nursing is a practice that requires sincerity that is established through a relationship between the nurse and the patient. The main focus of this link is for the sole purpose of nursing and no other medical aspects. There are underlying patterns in nursing, which are experiential, aesthetic, ethical, and personal (Carper, 2006). As seen in the research by Amer, the theory is widely acceptable and applicable across the globe with numerous modifications, which is aimed at encouraging individuals to take a personal responsibility for their wellness, both physically and psychologically. In the normal life situation, there are many eminent unpredictable health conditions. These conditions can cause a shift in the demand of self-care where the incorporation of a nurse may be needed (Johnson & Webber, 2010). The wellbeing and health of individuals, therefore, call for the incorporation of personal initiative, family support and nursing experience in order to achieve a healthy society population. References Armer, J.M., Shook, R.P., Schneider, M.K., Brooks, C.W., Peterson, J., Stewart, B.R. (2009) Enhancing Supportive-Educative Nursing Systems Reduce Risk of Post-Breast Cancer Lymphedema. Self-Care, Dependence-Care & Nursing. 17:10 6-15. Biggs, A. (2008). Orem's self-care deficit nursing theory: Update on the state of the art and science. Nursing Science Quarterly, 21(3), 200-206. Carper, B. (2006). Fundamental patterns of knowing in nursing. In L. C. Andrist, P. K. Nicholas, & K. A. Wolf (Eds.), A history of nursing ideas (pp. 129-137). Sudbury, Canada: Jones and Bartlett Publishers. Coster, S., & Norman, I. (2009). Cochrane reviews of educational and self-management interventions to guide nursing practice: a review. International journal of nursing studies, 46(4), 508-528. Fu MR, Axelrod D, Haber J. Breast-cancer-related lymphedema: Information, symptoms, and risk-reduction behaviors. Journal of Nursing Scholarship. 2008;40:341–348. Johnson, B.M. & Webber, P.B. (2010). An Introduction to Theory and Research in Nursing. Wolters Kluwer health, Lippincott Williams and Wilkins. Philadelphia Masters, K. (2014). Nursing theories: a framework for professional practice. Jones & Bartlett Publishers. McEwen, M., and Wills, E.M. (2007) Theoretical Basis for Nursing. Lippincott Williams & Wilkins. Philadelphia. Nursing Theories. (2011). Dorothea Orem's Self-care Theory. Retrieved from http://currentnursing.com/nursing_theory/self_care_deficit_theory.html Sitzman, K., & Eichelberger, L. W. (2010). Understanding the work of nurse theorists: A creative beginning. Jones & Bartlett Publishers. Read More