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APPLICATION OF OREM'S Self-Care Deficit Theory IN NURSING PRACTICE
Self care deficit nursing theory
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Recent changes in health care have raised uncertainty in the way care is delivered to patients both directly and in indirect ways. As the rise in health care cost continues to increase, nursing administrators find themselves in the midst of decisions that involve direct care and staffing issues all while having to provide high-quality care to patients (Nurse Journal, 2017). Advanced nursing practice can be further advanced through the use of effective theory formulation. The purpose of this paper is to discuss my selected nursing theory, discuss my goals and objectives for the practicum, and to create a timeline of practicum activities.
Self-Care Deficit Nursing Theory The selected nursing theory is the Roy Adaptation Model Theory (RAM). The RAM was first published in the early 1970's by Sister Callista Roy. The RAM focuses on the patient's bio-psycho-social well-being based on four adaptation concepts which are: physiological needs, self-concept, role function and interdependence (Modesto Junior College, 2012). RAM uses nursing behavioral knowledge to balance the understanding of a patient's physiological well-being in the physical world and thinking and feeling with the human experience in a cosmic world as well (Rogers & Keller, 2009).
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When performing patient contact, I will assess the patient to provide an accurate diagnosis along with differential diagnosis to be able to provide the best possible treatment available while being under the guidance of my clinical preceptor.
2. Education will be a major task and goal during clinical days. Promoting health prevention and health promotion using the RAM for diabetic patients to prevent further risk of complications by the end of the clinical rotation.
3. Be able to show competency with differential diagnosing based upon the disease process and show strong communication skills with my
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)
Jean Watson is a well-respected American nursing theorist who created the Theory on Human Caring. Watson’s concept on caring for a human being is simple, yet has much depth and meaning, and holds strong for nurses to work with compassion, wisdom, love, and caring. The Theory on Human Caring is necessary for every nurse, as it is our job to care for others in a genuine and sensitive way. The theory is extensive; its core foundation is based on nine concepts all interrelated and primarily focused on a nurse giving a patient care with compassion, wisdom, love, and caring (Watson, J., 1999). The nine essential aspects consist of: values, faith-hope, sensitivity, trust, feelings, decision-making, teaching-learning, environment, and human needs. Watson also created the Caritas Process consists of ten different ways of giving care:
A nurse is able to achieve this great balance, with the patient and self, by being conscious of the environment that surrounds them and through self awareness. For example, in the scene of an emergency, first and foremost, a nurse must check the environment before started emergent care. Both the patient and nurse must be safe for treatment to be effective. The environment is what surrounds us; our workplace, home, communities, issues we think about, the people we interact with, and the emotions associated with these interactions. The nurse knows that all of these components play an integral role in maintaining stability in a person’s life and health. The nurse assumes care of not just a disease process but of a human being as a whole; a family, a livelihood, a spirit, a person. A nurse knows that in order for holistic care to be effective, the care taker themselves should be at a point of stability as well. A true nurse knows that in order to excel you must know your limits and understand that while your main goal is to help the patient regain their strength, identity, and independence, that goal does not have to be achieved by compromising your own self, identity, and
My interest in this topic is a result of recent experiences with Diabetes Mellitus, Type 1 (DMI), especially with the following two instances: a young adult patient admitted at the hospital following a DKA episode during one of my nursing rotations and one of my instructors with type 1 diabetes. Also, my father was diagnosed with type 2 diabetes, this has increased my eagerness to study and explore more about the disease.
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
... 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.
To make good nursing decisions, nurses require an internal roadmap with knowledge of nursing theories. Nursing theories, models, and frameworks play a significant role in nursing, and they are created to focus on meeting the client’s needs for nursing care. According to McEwen and Wills (2014), conceptual models and theories could create mechanisms, guide nurses to communicate better, and provide a “systematic means of collecting data to describe, explain, and predict” about nursing and its practice (p. 25). Most of the theories have some common concepts; others may differ from one theory to other. This paper will evaluate two nursing theorists’ main theories include Sister Callista Roy’s
Nursing theories are actions care that a nurse provides to a patient to prevent a sickness, maintain and promote health. Many of the theorists contribute to a frame work or a blueprint of how nurses should provide care to patients. Many these theories are part of nursing care and most of them they go hand in hand. Nursing theory aims to describe, predict and explain the phenomenon of nursing (Chinn and Jacobs1978).Nursing is apprehensive with laws and principles governing the life processes and functioning of sick or well human beings. Nursing theories are beneficial in understanding the knowledge of nursing and its application (Smith and Liehr, 2008).
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.
The best way to look at nursing theories is like the foundational block. Nursing theories are important set the tone of how a nurse will practice. A nurse will use intuition, practice, past expertise and events, and couple with learned theories to work every day in order to give the best patient care. it is all the more important to appreciate what first advanced nursing beyond mechanisms of practice to becoming a knowledge-based force in healthcare: That force is nursing theory and the theoretical thinking and research that generate theory. The complexity and depth of nursing are reflected in its structure of knowledge, which includes discipline-specific components such as philosophies, theories, and research and practice methodologies”( Reed, 2006). Patient care is a wide topic, but a key role in a patient’s care is the patient themselves, an educated patient is vital to their well being and higher level of care.
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).
While completing a master’s degree at the University of California- Los Angeles, Sister Callista Roy theorized that the ultimate goal of nursing was to promote adaptation (Clarke, Barone, Hanna, & Senesac, 2011). Applying scientific knowledge to nursing practice, her framework aimed to improve nursing care by providing a holistic perspective to the adaptive behaviours of individuals and groups. Since publication in 1970, Sister Callista Roy has continued to refine her theory of adaptation, addressing its limitations and expanding upon philosophical insights (Roy, 2009). Today, Roy’s theory is one of the most commonly used frameworks in nursing, guiding research, education, and clinical practice (Shosha & Al kalaldeh, 2012). Hence, the purpose of this essay is to provide an in-depth review of Sister Callista Roy’s adaptation model and discuss its contributions to nursing research and evidence based practice.
Sieloff, C. L., & Raph, S. W. (2011). Nursing theory and management. Journal of Nursing Management, 19(8), 979-980. doi:10.1111/j.1365-2834.2011.01334.x
The grand theory to be analyzed in this paper is Orem’s Self-Care Deficit Nursing Theory (SCDNT). The method used to analyze Dorothea Orem’s theory is Walker and Avant Theory Analysis (WAT). Theory analysis is a process of evaluating a nursing theory. The WAT is comprised of seven steps. The steps are defining the origins, meaning, logic, usefulness, details, structure and testability of the theory (McEwen & Wills, 2011). “Critical reflection of a theory determines how well the theory serves its purpose” (McEwen & Wills, 2011, p.95). Therefore, a critical reflection will be applied to the SCDNT. The purpose of this paper is to analyze and critique the SCDNT using the WAT method of theory analysis.
Nursing theories are significant to the nursing practices since they offer assumptions, hypotheses, and ideas which can be utilized in different situations of patient care. The models provide a wide range of conceptual structures that nurses can base their practices. This paper shall discuss two nursing theories including Betty Neuman Systems’ Model and Roy Adaptation approach about their application on patient care. The theories are described in detail and compared regarding the nursing metaparadigm which comprises of person, environment, health, and nursing (Branch et al. 2016). The models shall also be applied to a clinical scenario which is also illustrated in the paper. Indeed, the nursing theories help in enhancing better