Dorothea Orem was one of America's foremost nursing theorists. She studied nursing in the 1930s and 1940s, earning her BSN and MSN. Orem developed her theory of self-care in the 1960s while working as a director of nursing and for the state health board. Her theory separates nursing into three conceptual theories: self-care, self-care deficit, and nursing system. Orem defined nursing as helping individuals deal with actual or potential self-care deficits. She received many honors for her contributions to the development of nursing theory.

1. Dorothea Orem
• Born in Baltimore, Maryland.
• One of America’s foremost nursing theorist.
• Father was a construction worker.
• Mother was a homemaker.
• Youngest of two daughters.
EDUCATION
• Studied at Providence Hospital school of Nursing in Washington D.C. in 1930’s
• Got her B.S.N.E. in 1939 and her M.SN.E in 1946 both from the Catholic University of America in
1946.
• 1958-1960 upgraded practical nursing training at Department of Health, Education and Welfare.
• Was editor to several texts including Concepts Formalization in Nursing: Process and Production,
revised in 1980, 1985, 1991, 1995, 2001
NURSING EXPERIENCE
• Early nursing experience included operating room nursing, private duty nursing (in home
hospital), pediatric and adult medical and surgical units, evening supervisor in the emergency
room, biological science technician.
• 1940-1949 Orem held directorship of both nursing school and the department of nursing at
Providence Hospital in Detroit.
DEVELOPMENT OF THEORY
• 1949-1957 Orem worked for the Division of Hospital and Institutional Services of the Indiana
State Board of Health. Her goal was to upgrade the quality of nursing in general hospitals
throughout the state. During this time she developed her definition of nursing practice.
• 1958-1960 U.S Department of Health, Education and Welfare where she help publish
“Guidelines for Developing Curricula for the Education of Practical Nurses” in 1959.
• 1959 Orem subsequently served as acting dean of the school of Nursing and as an assistant
professor of nursing education at CUA. She continued to develop her concept of nursing and self
care during this time.

2. • Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980, 1985,
1991, 1995, and 2001.
• Continues to develop her theory after her retirement in 1984.
ACHIEVEMENT
• 1976 and 1980 Honorary degree of Doctor of Science.
• 1980 CUA Alumni Association Award for Nursing Theory.
• 1988 Doctor of Humane Letters from Illimois Wesleyan Universary.
• 1988 Linda Richards Award.
• 1991 National League for Nursing.
• 1992 Honorary Fellow of the American Academy of Nursing.
• 1998 Doctor of Nursing Honoris Causae from the University of Missouri.
IMAGE OF NURSING
• Orem began her theory development in the 1960’s, and her first publication was in 1971. During
that time the mass media played a small role in portraying nursing as a respected profession but
unfortunately played a much larger role in the destruction of that image.
• In the early 1960’s Nurses were depicted as subordinate to Physicians in films and on television.
For example, in TV shows such as Dr. Kildare and Ben Casey, nurses were shown delivering
messages to the doctors, carrying trays and doing minimal skill level tasks. Throughout the
show, the doctors were condescending towards the nurses, and constantly portrayed as
superior.
• In 1962 a revolutionary TV show came about, and for the first time nurses were depicted in a
positive realistic light.
METAPARADIGM CONCEPT
• PERSON: An individual with physical and emotional requirements for development of self and
maintenance of their well-being.
• ENVIRONMENT: Client’s surrounding which may affect their ability to perform their self-care
activities.
• HEALTH: “Structural and functional soundness and wholeness of the individual” (Orem 1991).

3. • NURSING: The acts of a specially trained and able individual to help a person or multiple people
deal with their actual or potential self-care deficits.
Orem’s Theory of Self Care
• Each person has the need for self care in order to maintain optimal health and wellness.
• Each person possesses the ability and responsibility to care for themselves and dependants.
• Theory is separated into three conceptual theories which include: self care, self care deficit and
nursing system.
• Self care is the ability to perform activities and meet personal needs with the goal of
maintaining health and wellness of mind, body and spirit.
• Self care is the a learned behavior influenced by the metaparadigm of person, environment,
health and nursing.
• Three components: universal self care needs, developmental self care needs, and health
deviation.