What did Orem contribute to the nursing world? A novice’s perspective
Introduction
Dorothea E. Orem (1914-2007), a nursing theorist best-known for her influential work on self-care theory, has had a profound, ongoing impact on nursing practice, education and research (Hartweg 1991, p. 36-42; Alligood & Marriner-Tomey 2006, p. 256). Through her work, Orem defines nursing from several aspects, presenting a conceptualized nursing framework. Beyond that, her self-care deficits model is favoured by clinicians, and serves as guidelines for nursing practice as well as for in-depth research (Hinchliff & Schober 1995, p. 184). This paper focuses on discussing Orem’s contributions in the advancement of nursing theory and practice, and identifying some of its limitations in the context of contemporary nursing care.
Define “nursing”
Orem defines “nursing” through structured nursing knowledge. In the 1950s, Orem originated the idea of “self-care” from reflecting of her work experience on searching for the meaning of nursing, and over the next four decades, she continued to develop this ground
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The practical knowledge that nurses employ to help individuals who cannot perform self-care to sustain their daily activities stems from science. Self-care is engaged in results seeking behaviour to regulate human function such as knowing body fluid balance to meet self-care requirement (Denyes 2001). Moreover, Orem (1980, p.14) urges that nurses must keep exercising and growing scientific based knowledge for practice. Orem (1980, p.6) believes that nursing is a human service, an action that is needed to overcome human limitations. The philosophy underlying the nursing actions is humanism. Based on these values, her self-care framework have been established to explore the philosophy of nursing (art), what is nursing, why people need nursing and what goals nursing wants to achieve
This approach is based on four principles which are; to teach patients to assume their responsibility, to be well informed about their prevailing health issues, make them realize that their cooperation and willingness in treatment and prevention plan is in their own benefit and, let them take their own decisions. As narrated by Taylor (2006), Dorothea E. Orem's Self-care deficit theory of nursing emphasize that "People should be self-reliant and responsible for their
She goes beyond the past tendencies of just looking at the differences of nursing theories to ideas that unite them to evoke new creative ideas. She tries to explain how the theoretical framework of caring evolved into philosophical, conceptual and epistemological undertaking and differs from just caring. Concurrently, nursing’s focus on the relationship of caring for health and healing differentiated it from other disciplines. However, I felt, the difference between “just caring” and caring in nursing can explain through exploring the concepts of healing and consciousness. Even though, nurses possess an ethical obligation for caring, the ultimate aim is to restore health through healing. These two concepts were not explicitly defined in the conceptual framework of caring. The other main elements missing in the Metaparadigm of the caring theory are environment and culture that seek to inform and embrace
This paper is a first attempt at forming and articulating my own philosophy of nursing.
... M.A. (2006). Applications of Dorthea Orem's self care deficit nursing theory. In M.E. Parker (Ed.) (2006). Nursing theory and nursing practice (2nd ed., pp. 149-155). Philadelphia: EA. Davis Company.
Thorne, S. (2010). Theoretical Foundation of Nursing Practice. In P.A, Potter, A.G. Perry, J.C, Ross-Kerr, & M.J. Wood (Eds.). Canadian fundamentals of nursing (Revised 4th ed.). (pp.63-73). Toronto, ON: Elsevier.
The nursing theories that are currently in place in the emergency room to promote professional growth and development are vital; however, there are other nursing theories that could be implemented to help improve professional growth and development. A theory that should be implemented to more effectively promote professional growth and development is Orem’s theory of self-care deficit. Orem’s theory is considered a “realistic reflection on nursing practice” (McEwen & Wills, 2014, p. 146). If the nurse is not taking care of him or herself, “stress [can] accumulate [and the] nurse can … become angry, exhausted, depressed, and sleepless” (Ruff & Hoffman, 2016, p. 8). By the nurse having these feelings he or she is not able to take care of him
The ongoing education and training which supports the nursing as a profession must be maintained. The self-concept of nurses is enormously important in maintaining a professional identity.
Throughout this philosophy paper, I have explored what nursing is based on my personal values and beliefs as it relates to the body of work in nursing. I value the importance of holistic nursing and the care of patients being individualized for them and their family. Also, effectively collaborating among health care professionals to ensure quality care for patients. Additionally, the importance of health promotion as one of the main roles of nurses is being a teacher, since promoting health prevents illness and increases the level of health in clients. These principles will serve as a guide for my personal standards of nursing practice.
Nursing is considered one of the most trusted professions in the world. It is an essential part in the caregiving of sick, injured, and even healthy individuals. Developing a philosophy with any profession is the beginning basis of any practice. The nursing philosophy is usually incorporated from the science of nursing. That is because the field of health care is constantly changing, which causes the need of better competence in the health field of providing caring (Flagg, 2015). With nursing it starts by the science behind it. Then along with knowledge and experiences, that is when the nursing philosophy is developed. Researching differences between new ideas and cultural differences can then expand the viewpoint into a bigger picture.
The human becoming theory posits quality of life from each person's own perspective as the goal of nursing practice. It is a human science theory that views individuals as an open, unitary and free-willed beings that co-creates their health and interact with their environments. The human becoming theory views nursing as a basic science with a unique knowledge base. Parse defined unitary as the indivisible, unpredictable and ever-changing part of human that makes choices while living a paradoxical pattern of becoming in mutual process with the universe (Parse, 2004). Health is living one’s own chosen values; it is the quality of life experienced and described by the person and it cannot be given, guarded, manipulated, judged or diagnosed. It is a process of becoming that is unfolding and cannot be prescribed or described by societal norms but by the individual living t...
I chose to do a concept analysis on ‘Self-Care.’ The nursing theory that uses this concept is Orem’s theory of nursing. This theory is a grand theory and consists of three minor interrelated theories; self-care, self-care deficit, and nursing systems. (Parker & Smith 2010). Orem defines self-care as when an individual initiates activities and performs to maintain life, health and well-being on their own and self-care deficit as not meeting adequate self-care requisites which include “limitations for knowing, deciding and producing care to self or dependent. (Parker & Smith, 2010)
There are three primary concepts in the SCDNT. The concepts are self-care, self-care deficit and nursing systems (McEwen & Wills, 2011). In addition, authors McEwen and Willis breaks down Orem’s self-care theory with several requisites. They are universal, developmental, health deviation and therapeutic (McEwen & Wills, 2011). Plus, concepts of deliberated action and product of nursing are defined.
Self awareness in nursing refers to how glowing nurses comprehend themselves, their strengths, weaknesses, attitude and ethics in order to better transact with their patients. Self- awareness includes review of self, together with self confidence. Self -regulation express beyond one`s emotion and being trustworthy. For nurses to be able to empathize with their patients and treat them with compassion, they have to be self aware. When nurses are self aware, they are capable to adapt to, or certainly change their attitudes and deed in order to understand how unusual people take care of them hence improving the nurse- patient relationship. Nurses must reflect carefully on whether they can sustain in dependence in caring for a client and whether the relationship interferes with gathering the client’s needs. It is also essential to be sure that providing care to family and friends does not interfere with the care of other clients or with the dynamics of the health care group. Before making the conclusion, the nurse may possibly wish to discuss the situation with colleagues and the employer.
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).
Nursing entails self- directed and cooperative health care for the society at large in all contexts. It includes the promotion of appropriate practices to enhance health, prevention of diseases,