Dorothea Orem: Self-Care Deficit Theory of Nursing
Credentials and Background
Dorothea Elizabeth Orem was born in 1914 in Baltimore, Maryland. She graduated Seton High School in Baltimore in 1931and graduated from the Providence Hospital School of Nursing in Washington, D.C in 1934. Orem continued her education at the Catholic University of America to earn her bachelors in Nursing Education in 1939, and a Masters in Nursing Education in 1945 (Medical Archives, 2018).
Orem’s nursing career consisted of a variety of titles, positions, and facilities. She gained experience in various departments such as pediatrics, adult medical-surgical units, emergency departments, operating rooms and private duties. After earning her advanced degrees,
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More specifically, the person is under nursing care with potential certain limitations and a variable degree of self-care. Additionally, Orem and Taylor (2011) mention four concepts directly related to the major concept of person, consisting of self-care agent, self-care agency, self-care limitations, and the self as self-care agent (p. 39). According to Masters (2015), self-care agency is a learned behavior with the goal to control one’s own development and daily activities necessary to meet personal needs. Self-care agency contains three parts. The first fragment includes the “operational capabilities for persons’ deliberate engagement in self care”, the second requires the identification of capabilities a person needs to engage in self care, and the third one includes the understanding of “the foundational capabilities and dispositions needed for the engagement in any and all forms of deliberate action (Orem & Taylor, 2011, p. 39). Additionally, Orem and Taylor (2011) mention basic conditioning factors affecting personal and environmental aspects. According to Orem and Taylor (2011), the factors include demographics like age, gender, developmental and health state, sociocultural orientation, family system factors, patterns of living, environmental factors, and resource availability and adequacy (p. …show more content…
154). Orem’s self-care deficit theory is applicable to nursing today as it encompasses the modern holistic view of patient care (Masters, 2015). An example of modern day nursing practice utilizing Orem’s theory is with renal patients. With an ever-increasing elderly population, renal care is one of the prominent current nursing focused issues (O’Shaughnessy, 2014). O’Shaughnessy, 2014, wrote a continuing nursing education article on the importance of Orem’s theory in relation to elderly patients performing peritoneal dialysis. The examination was of elderly patient’s self-care abilities and the success of nursing staff allowing patients to do as much individual care as possible. “Orem’s theory postulates that people have a natural ability for self-care, and nursing should focus on identifying these deficit areas” (O’Shaughnessy, 2014, p. 496). The argument proposed is that peritoneal dialysis at home allows the elderly patient to maintain life closer to their previous life pre-dialysis. In order for the patients to be successful with their home peritoneal dialysis nurses have to assess the gaps in care that need to be addressed. The gaps in self-care can be corrected through education, demonstration, teach-back, and evaluation of meeting expected outcomes (O’Shaughnessy, 2014). This example
Individualised approach to care planning essay The care planning process is a fundamental part of nursing, Barrett et al (2012) emphasises the importance of the process by recognising it as a clinical skill that needs to be learnt and developed. Care planning enables information to be gathered, taking in to consideration an individual’s biological, psychological, sociocultural, environmental and politico economic status. These factors are incorporated in to the care planning process to enable an individualised care plan that meets the holistic needs of the individual (Doenges and Moorhouse, 2012). The aim of this assignment is to explain and explore an individual approach to care planning and how using a nursing process and nursing model collectively will provide a holistic approach to care.
Theory Evaluation of Orem’s Self-Care Deficit Nursing Theory Self-Care Deficit Nursing Theory, Part III Theory Evaluation Dorothea Orem’s Self-Care Deficit Nursing Theory (SCDNT) has been a part of nursing theory since publication in 1971 (Fawcett & Desanto-Madeya, 2012). During this time, it has been used as a framework for many research projects and nursing school curriculum and as a guide to nursing practice (Fawcett & Desanto-Madeya, 2012). Is the theory congruent with current nursing standards?
The feeling of being able to alleviate the suffering of an acutely ill patient is at once incredibly satisfying and immensely humbling. I am constantly in awe of the fact that by coming to work everyday, I have the privilege of helping others who cannot care for themselves. During my time in my Clinical Care Extender Internship, I developed a special interest in caring for the geriatric population and have had the opportunity of serving as a personal caregiver to an elderly woman with dementia. I do not take the trust and confidence that my patient places in me lightly and work hard to advocate and provide for her safety because she deserves no less. Thus, in the interest of patient advocacy, as a nurse in your facility, I will seek to improve the practices that will keep my patients safe and promote their healing.
Dorothea Orem’s self-care deficit nursing theory is one such nursing theory that has been reworked to take into account the changes in our world, while still maintaining the initial framework (Taylor & Renpenning, 2011). Purpose of Self-Care Deficit Nursing Theory Dorothea Orem (as cited in Taylor & Renpenning, 2011) described her purpose in formalizing the Self-Care Deficit Nursing Theory as a way of defining the structure of nursing and explaining knowledge, rules and roles of nursing. Orem was attempting to answer the question of why, when and how a nurse is needed in the care of a patient (Smith & Parker, 2015). According to Younas (2017), self-care deficit nursing theory is also a practical effort to delineate the patient role along with that of the nurse.
It is underpinned by values of respect for persons, individual right to self-determination, mutual respect and understanding. It is enabled by cultures of empowerment that foster continuous approaches to practice development.’ This type of care approach is focused solely on the person and the concept of personhood (HSE, 2010). It is imperative that the nurse hears the voice of the older person.
The school taught hospital and home care nurses how to teach other nurses. She was aware of the poor reputation of nurses and sought out to change the image of nursing. To improve overall conditions for nurses, she began working relationships with philanthropists, journalists, law makers, and administrators so that patient care would improve and respectable women would be drawn to the profession. Using her strong voice and determination, she fought constantly for healthcare reform for all individuals and sought for an improvement in health standards focusing on cleanliness and
As SCDNT is described as a conceptual model, there are many concepts, however, according to Smith and Parker (2105) there are six main concepts, four being patient related and two nursing related along with a peripheral concept that connects with all the concepts. The first patient related concept of self-care is defined as a purposeful action to maintain life, while the second concept of self-care agent is defined as the person receiving care (McEwen & Wills, 2014). The agent can be further defined as the patient, a family member delivering care or the nurse (Smith & Parker, 2015). Therapeutic self-care demand is outlined as the nurse delivering care due to the patient’s inability to provide their own therapeutic care (McEwen & Wills, 2014).
Caring for The Individual: An Examination of Personal Nursing Philosophy Arianna Mailloux 400164224 NURSING 2AA3 Ashley Collins Harris February 19, 2018 As a novice nurse, developing and understanding of ones’ own personal feelings about nursing is important to help shape your clinical practice. Within this paper I will examine my personal assumptions, beliefs and values of the four nursing paradigms to develop a personal philosophy of nursing. This philosophy will be aligned with a known nursing theory and the comparisons will be discussed. Section I: Personal Philosophy of Nursing Person
Orem’s Self-Care Deficit theory includes 3 constituent theories, namely; the theory of self-care, the self-care deficit theory and theory of nursing systems. The theory states that an individual as an obligation to tend to their own needs. The person has a right and responsibility to engage in continuous self-maintenance, the capability to do so is termed an ‘’agency’’ ( Denyes, Orem and Bekel , 2001). In a nursing environment promoting independence is integral to practice, as with the thinking behind Orem’s theory , ‘’Implementing interventions to maintain a sense of control over their own experience of health maintenance promotes better outcome’s ‘’ (O’Shaughnessy ,2014). In practice ,using the self-care theory , the individual efficiently attends to their own need and also maintains their
Professional practice reflects autonomy when the nurse respects patient’s rights to make decisions about their health care” (Taylor, 1997). At the nursing home, I witnessed many of the nurses discuss with the residents what they wanted to do about certain situations. Autonomy honors the fact that it is the patient and the families right to make certain decisions about health care. Nurses also are constantly making sure that they can provide their patients with the best information to help them make a more successful choice about their health care (Taylor
Person centred care is associated with treating people with respect, acknowledging their rights as human beings and having a trusted and therapeutic relationship between the person and their care provider (McCormack et al, 2011). Guidelines of person centred care give clarity towards how nurses should behave and such knowledge and expertise they should develop. These skills acquired can then be used to enhance person centred care through self and team assessment (McCormack et al, 2008). In this essay, I will critically explore individualised person centred care in association with McCormack’s model. I will identify how this model can improve the experience of care for the older person.
Tom Kitwood (1997) cited in (The Open University, 2017) supports the approach of seeing and treating people as individuals, he calls this ‘person-centred care’. This approach looks at the physical, social and psychological needs of the individual. Person-centred care encourages people to have more involvement in making decisions about their care so they get the support and service they need. There are three main types of long-term care settings such as residential care homes which offer different degrees of personal care, Nursing homes offer care which requires the skills of qualified nursing staff and long-stay hospitals which offer a more specialised medical care. (The Open University, 2017).
The 14 fundamental needs are what guide the nursing process which nursing use to guide their care plan. Virginia Henderson theory separated the nursing care from the medical care because she wanted to focus on the patient as a whole (Blais& Hayes, 2016). The nurse who is caring for a patient with dementia will determine if the patient is capable of doing any of the needs on his or her own, will need the nurse to guide them with these needs or to take full responsibility for the patient to reach all of the 14 fundamental needs. The nurse is coming up with a plan of care for the patient and basing it on what Virginia Henderson believes a nurse’s role for the nurse should be. Which is the nurse will take full responsibility for the patient needs, or offering assistance to the patient while they are no longer able to do independently and working with the patient to promote independence (Ahtisham& Jacoline,
Nurses intervention are there to coordinate the rhythm between human and environment and assisting the patient in the change process and toward a better health. 9. Dorothea Orem- Orem’s theory creates self care, known as the practice of activity, in which the patient performs his personal routine and needs independently to maintain health and lifestyle, according to age, developmental state, experiences in life, and cultural background. Orem identifies 5 requisites as known as; Activity of Daily Living; .The maintenance of sufficient intake of food and water.
Providing care to a patient is a particularly challenging process that requires a great deal of effort from a nurse. A nurse’s ability to give quality care to their patient is an important aspect to a patient’s life both now and in the future. As such, nurses must exhibit specific qualities in their practice in order to maintain the best standard of care for their patients. Given this, I believe that the standards of knowledge, advocacy, and self-awareness are foundational to the nursing practice and to a nurse’s capacity to provide quality patient care. Knowledge