Presented by Arackathazhath, M.X,. George, J,. Siby, T,. Smith, S,. Stephen, M,. And Varghese, R,.
Dorothea Orem One of the America’s foremost nursing theorist. Started in early 1930’s with AD in nursing. Education journey ends up in 1976 with a Honorary Doctorate of Science. In 1976, first publication of her nursing theory. In 2001 last edition of her revised theory was published.
Orem’s Theory of Self CareDeficit. Is the central focus of Orem’s General Theory of Nursing. It specifies when nursing is needed. It describes and explains how people can be helped through nursing. Results when a self care agency (patient) can’t meet his/her self care need or administer self care. One of the most widely used models in nursing today.
Four Metaparadigm Conceptsas per Orem’s Theory. Orem’s self care is defined as the practice of activities by individuals that they personally begin and execute their on behalf in maintaining their life, health and well being. Orems self care model of nursing is implemented within the nursing metaparadigm concepts of person, environment, health and nursing. This theory is a person centered and as a person centered theory it is highly compatible with the practice of nursing.
Four metaparadigm Human Being: An individual beneath the care of a nurse. Health: A state characterized by soundness or wholeness of developed human structures and of bodily and mental functioning.(Orem, 1995,p.101)
Four Metaparadigm concepts Environment: Internal and external condition in which human being lives. Nursing: It helps provides self care needs when patients are unable to do themselves.
Ways to Improve Nursingpractice Based on Orem’sTheory. Nursing Care Plan: Nursing care plan includes assessment, nursing diagnosis, nursing intervention, expected outcomes and evaluation. Self care aspect of Orem’s theory applies to the assessment and evaluation of the nursing process. Orem emphasizes how once own self care is important for maintaining health and well being. For example, maintaining our health through diet, exercises, meditation and annual physical checkup.
Ways to Improve NursingPractice Based on Orem’s SelfCare Deficit Theory. Theory based nursing can improve nursing practice: Delivery of patient care based on theoretical principles can promote successful outcome. The Orem’s theory is compatible with the traditional medical model, has been widely used in practice and education and recently has been the basis of education.(Hood, L.J. 2010). Orem’s nursing theory has been used to guide acute and chronic care nursing departments, for utilization review programs, and in undergraduate and graduate nursing programs.(Hood,L.J.(2010)
Ways to Improve NursingPractice Based on Orem’sTheory. Helping-Trusting, Human care relationship. Orem’s theory can be achieved by acting and doing for others, guiding and supporting, by providing and promoting personnel development in relation to meet the future demands. For instance, nurse provides instructions,guidence and discuss the care plan with the patient and family when they get admitted to the hospital. Nurse’s supportive protective attitude, and effective communication skills aids the patient and the family to trust on him/her.
Case Study. Mr. Wilson, 68 years old male patient, newly admitted to the hospital with the diagnosis of heart failure/pulmonary edema. He is 5 feet 8 inches tall and weighs 162 pounds. Initial assessment/history data reveals that he was unable to meet his self care needs, he was experiencing shortness of breath, so that he cannot do the daily activities. Mr. Wilson has been experiencing fatigue, which leads to the difficulty to maintaining a balance between activity and rest. Mr. Wilsons care plan includes, the self care deficit due to impaired gas exchange, decreased cardiac output, fluid volume excess, fear and fatigue related to disease process . Nursing system measures include oxygen, elevate the head of the bed, bed rest, monitor rate and quality of respirations, monitor ABG/Pulse oximetry, Digoxin to improve cardiac output, lasix and potassium replacement, foley catheterization to monitor intake/output. Morphine for dyspnea and discomfort. Assist with personal activities as tolerated and needed. Provide frequent rest periods between nursing care procedures, quiet and restful environment.
Conclusion Orem’s theory provides a comprehensive base to nursing practice, function, self care needs and nursing system based on research. Orem’s theory’s application can be further extended to the areas of nursing curricula, education, administration and research. Her self care approach is contemporary with the concepts of health promotion and maintenance. A patient progress from an inability situation or limited ability to the goal of self care .
References. Chinn, P. L., & Kramer, M. K. (2004). Integrated knowledge development in nursing(6th ed.). St. Louis: Mosby. Foster, P. C. & Bennett, A. M.(2002). Self care deficit nursing theory. Hood, L. J. (2010). Leddy & Peppers Conceptual Bases of Professional Nursing(7th ed.). Philadelphia: Lippincott Williams & Wilkins. Nursing Theories: the Base for Professional Nursing Practice, Julia, B. G. Orem, D. E. (1980). Nursing: Concepts of Practice(2nd ed.). New York: McGraw-Hill. Orem, D. E.(1985).Nursing: Concepts of Practice(3rd ed.). P 180. New York: McGraw-Hill. Orem, D. E. (1990). A Nursing Practice Theory in Three Parts, nursing theories in practice(pp 47-60). New York: National League for Nursing.