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Critique of Dorothea Orem's self-care deficit theory
Critique of Dorothea Orem's self-care deficit theory
Evaluation of Dorothea Orem's self-care deficit theory
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Health Issues Paper
Laterra S. Brown
Walden University
Health Issues Paper
In the elderly population, there are several healthcare deficits noted, the issue is when these patients are abandon by nurses due to work environment issues such as staff shortage, assignment acuity disagreements, and etc. As stated, health care deficits most often affect the elderly population, but it can affect anyone that have a debilitating disease or trauma. I have over three years of nursing experience working in a nursing home, so I am very familiar with self- care deficits in the elderly population. When dealing with the elderly population I integrate the Dorothea Orem’s Self –Care Deficit Theory into my practice to address the issue at hand. What is the Dorothea Orem’s Self-Care Deficit Theory? Dorothea Orem’s Self-Care Deficit Theory is a grand
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The Self-Care Deficit Theory answers the question, why people need nursing, which is related to factors dealing with the limitations of the individual that leads to the individual inability to perform self-care properly. According to Parker & Smith (2010), “nursing is legitimate or needed when the individual’s self-care capabilities and care demands are equal to, less than, or more than at a point of time. With an existence of this inequality, a self-care deficit exists and nursing is needed” (p.126). As a Med-Surg nurse, on the daily basis, I am faced with patients that have a variety of limitations. By incorporating the Orem’s Self-Care Deficit Theory into my practice, it guides and enhances my practice through thoroughly assessing the patient’s needs and identifying their
... Through the demonstration of these values on a daily basis, the nurse is able to not only take better care of his or her patients, but is also able to take care of his or herself. Through self-care, the nurse is able to better understand the phenomena of the client, and is able to provide better client-centered care.
During my career as a registered nurse I have had the privilege of caring for my patients at the bedside and meeting their needs holistically. Additionally, the safety of my patients is one of the most important aspects of my current role. The experience of advocating for my patients during my nursing career has taught me to place my patient’s health and wellbeing first. The second most important aspect of nursing that I have learned during my career is how to meet my patient’s needs as a whole, not just physically but also emotionally and psychologically applying the holistic approach to each patient. I believe that the patient’s needs
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
Houde, S., & Melillo, K. (2009). Caring for an aging population. Journal Of Gerontological Nursing, 35(12), 9-13. doi:10.3928/00989134-20091103-04
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
Still, the previous advantages discussed should influence the nurse to improve in identifying patient vulnerability. This is evident by this patient where I utilized my interpersonal skills to communicate to this patient so that he/she is aware that he/she is not alone in this journey. Nurses need to utilize models and theories to guide nursing practice. For instance, McCormack’s framework focuses on patient-centered care which influences nurses to understand the patient as a whole and their values (Abley, 2012, p. 42). Being able to identify values will give nurses and myself a better comprehension about the patients resulting in worthiness and belonging expressed. As a result, informing nurses about patient’s subjective vulnerability because a trust and understanding relationship is established. This is supported in a clinical experience where a patient “felt understood and opened up for further interactions based on trust” through an honest, supportive relationship with a nurse (Gjengedal, 2013, p. 134). Nurses should provide patient-focused provision of service, and assist this patient in overcoming his/her obstacle as a way of encouragement. Furthermore, Sellman (2005) explains how encouragement may compromise human flourish (p. 7), it is dependent on the situation and it cannot be assumed all encouragement will lead to harm. This informs nurses to be aware of the consequences that prevent the
The APRN listens and engages with the patient as care and compassion take place. As the nurse discerns what the patient’s needs are and considers obstacles to achieving optimal care the application of theory is necessary as the process is not always quantifiable. The APRN who does not learn nursing theory may focus primarily on EBP and miss this engagement opportunity with the patient. One may prescribe medication; however, if the patient does not take the medication, then the nurse assumes the patient is noncompliant. The application of Watson’s themes where appropriate helps the APRN discern how to help the patient become compliant. It is necessary to care for the patient outside of the idea of only providing care to understand the obstacle in that patients circumstances and reach improved patient outcomes to any disease
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)
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 purpose of this paper is to review the theory of self-regulation and how it can be applied to practice in health care settings to improve patient outcomes. According to Johnson (1997), more than 25 years of research has influenced the development of the self-regulation theory, which is about coping with healthcare experiences. Health problems have shifted from acute to chronic where it has been identified that personal behaviors are linked to over half of societies chronic health problems (Ryan & Sawin, 2009). As the modern nurse strives to provide specialized care and improve patient outcomes, the utilization of nursing theory continues to gain importance. This theory explains how patients use specific types of information to cope with health care events thus providing a rational for selecting information that can be expected to benefit patients. The concept of self-regulation has been a part of nursing practice in a circumlocutory fashion for years. It has been most commonly referred to as self-management creating considerable ambiguity and overlapping of definitions for that term and self-regulation (SR). For the purpose of this paper these terms will imply that people follow self-set goals introduced by their health care provider.
Self-care has a very different meaning for people. It varies from person to person and can be based on age, gender, religion, occupation, and their type of lifestyle that they live. For myself, my self-care has changed since starting nursing school and I now know have to look at it in terms of nursing. Although my self-care has not changed substantially I now have to realize that being a nurse, I will have more responsibility’s and will be taking care of others and I cannot take care of others until I take care of myself. Self-care is very important for many reasons; in my opinion a healthy person in mind, body and soul is a happy person. You cannot take care of others if you yourself are not healthy and happy.
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).
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.
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.
In the practice of nursing, needs are an everyday phenomenon and are a common theme among many nursing theories accessible today. These nursing theories help implement care planning of the patient needs for the best possible outcome. Some examples of need theories include Virginia Henderson’s Nursing Needs Theory and Abraham Maslow’s Hierarchy of Needs (McEwen & Wills, 2011).