Nursing Theory Presented By Michol Popp Patrick Murphy Janice Schmuckal and Toni Stout In 1914 Dorothea Orem was born in Baltimore Maryland One of Americas foremost nursing theorists ID: 692829
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Dorothea Orem’sSelf Care Deficit
NursingTheoryPresented By:Michol Popp, Patrick Murphy, Janice Schmuckal and Toni StoutSlide2
In 1914, Dorothea Orem was born in Baltimore, Maryland
One of America’s foremost nursing theoristsFather was a construction workerMother was a homemaker
Youngest of two daughtersSlide3
Education
Studied at Providence Hospital School of Nursing in Washington D.C. in early1930’sEarned her B.S.N. in 1939 and her M.S.N. in 1946 both from the Catholic University of AmericaIn 1957 she moved to Washington D.C. to take a position at the Office of Education, U.S. Department of Health, Education, and Welfare as a curriculum consultant1958-1960 she worked on a project to upgrade practical nurse training, as a result, Guides for Developing Curricula for the Education of Practical Nurses
was developedSlide4
Nursing Experience
Early nursing experience included operating room nursing, private duty nursing (in home and hospital), pediatric, medical and surgical units, evening supervisor in the emergency room, and biological science technician1940-1949 Orem held directorship of both the nursing school and the Department of Nursing at Providence Hospital in DetroitSlide5
Development of Theory
1949-1957 After leaving Detroit after 8 years, 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 practiceSlide6
Development of Theory
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 at this timeMembers of the Nursing Models Committee at CUA and the Improvement in Nursing Group, which later became the Nursing Development Conference Group (NDCG), all contributed to the development of the theoryIn 1970 she left CUA and began her own consulting firm, and published her first book, Nursing: Concepts of Practice in 1971
Subsequent editions were published in 1980, 1985, 1991, 1995, and 2001
Orem continued to develop her theory after her retirement in 1984Slide7
Achievements
1976 Georgetown University conferred Orem the honorary degree of Doctor of Science1980 CUA Alumni Association Award for Nursing Theory1988 Doctor of Humane Letters from Illinois Wesleyan University1988 Linda Richards Award1991 National League for Nursing
1992 Honorary Fellow of the American Academy of Nursing
1998 Doctor of Nursing
Honoris Causae
from the University of MissouriSlide8
Nursing’s Metaparadigm
Human Beings Environment Health
NursingSlide9
SCDNT in regards to human beings
One of the foundations of the SCDNT is, “the view of human beings as dynamic, unitary beings who exist in their environments, who are in the process of becoming, and who possess free-will as well as other essential human qualities”
“Five broad views of human beings that are necessary for developing understanding of the conceptual constructs of self-care deficit nursing theory and for understanding the interpersonal and societal aspects of the nursing systems”:
(1) person
(2) agent
(3) user of symbols
(4) organism
(5) objectSlide10
SCDNT in regards to environment
Considerations:What is the patient’s environment like? Do they live at home, assisted living, ECF? Does the patient’s environment support the patients needs: room for walker/wheelchair use, ramps, appropriate assistive devices in the bathroom, etc. Do they have a support system? If needed, who takes care of them if unable to do for themselves?Does their environment prohibit them in performing self-care tasks? Slide11
SCDNT in regards to health
The concept of health in Orem’s Self-care framework refers to all the conditions that are interacting with the patient. The nurse not only treats the disease but takes into consideration the patient as a whole. His or her mental, physical, biological and spiritual needs have to be met.Slide12
SCDNT in regards to nursing
This theory represents Orem’s work regarding the substance of nursing as a field of knowledge and as a field of practiceNursing = Practical Science In practical sciences, knowledge is developed for the sake of the work to be done; in the case of nursing, knowledge is developed for the sake of nursing practice. Slide13
Orem’s Theory of Self Care
The primary source for Orem’s ideas about nursing was her experiences in nursingEach person has a need for self care in order to maintain optimal health and wellnessEach person possesses the ability and responsibility to care for themselves and dependentsTheory is separated into three conceptual theories which include: self care, self care deficit and nursing systemSlide14
Orem’s General Theory of Nursing
Consists of three theories referred to as "Orem's General Theory of Nursing”:Self-Care Theory: describes why and how people care for themselvesSelf-Care Deficit Theory: describes and explains why people can be helped through nursing Nursing System Theory: describes and explains relationships that must be brought about and maintained for nursing to be produced Slide15
Orem states that “if a person’s capabilities are inadequate to meet the therapeutic demand, a self-care deficit exists” Slide16
Orem’s Definition of Nursing
Nursing is the provision of self-care which is therapeutic in sustaining life and health, in recovering from disease or injury, or coping with their effectsNursing promotes the goal of patient self-careNursing is a service to people, not a derivative of medicineSlide17Slide18
Orem’s Nursing ProcessConsists of three steps:
Step 1: Determine why the patient needs careStep 2: Design a nursing system and plan the delivery of careStep 3: Management of nursing systems-planning, initiating, and controlling nursing actionsSlide19Slide20
Self-Care
Self-care is behavior directed by individuals to themselves or their environments to regulate factors that affect their own development and functioning in the interests of life, health, or well-being. Self-care deficit is the relationship of inadequacy between self-care agency and the therapeutic self-care demand.
Self- Care
Agency
A self-care agency is the complex capability of maturing and mature individuals to determine the presence and characteristics of specific requirements for regulating their own functioning and development, make judgments and decisions about what to do, and perform care measures to meet specific self-care requisitesSlide21Slide22
Five Methods of Nursing Help
Acting or doing forGuiding and directing TeachingProviding physical or psychological supportProviding and maintaining an environment that supports personal development Slide23Slide24
Three Nursing Systems
Wholly Compensatory: a patient’s self-care agency is so limited that he/she depends totally on others for well-beingPartly Compensatory: a patient can meet some self-care requisites but needs a nurse to help meet othersSupportive-educative: a patient can meet self-care requisites but needs help in decision making, behavior modification or knowledge acquisitionSlide25Slide26Slide27
While watching the following video, think of self-care nursing diagnoses related to this situation.
http://youtu.be/T8UR7Rm-MUM
Remember to return to the rest of the presentation following the video clip! It may not continue automatically, click each slide to move onto the next… Slide28Slide29
Major assumptions of Orem’s general theory of nursing are as follows:
Human beings require continuous deliberate inputs to themselves and their environments to remain alive and functions in accord with natural human endowments.
(2) Human agency, the power to act deliberately, is exercised in the form of care of self and others in identifying needs for and in making needed inputs.
(3) Mature human beings experience privations in the form of limitations or action in care of self and others involving and making life sustaining and functioning regulating inputs.
(4) Human agency is exercised in discovering, developing, and transmitting to others ways and means to identify needs for and make inputs to self and others.
(5) Groups of human beings with structure relationships cluster tasks and allocate responsibilities for proving care to group members who experience privation for making required deliberation input to self and others.Slide30
Strengths of the SCDNT
A foundation to nursing practiceExplains the need for nursing care Not only addresses the needs for the individual but addresses the needs of the family/support system as well Slide31
Limitations of the SCDNT Unless familiar with the language being used throughout Orem’s SCDNT, it may be difficult to understand
A great deal of work is needed in regard to the structuring of existent knowledge around the practice sciences and the foundational sciences that Orem identifiedSlide32
References:
Kearney-Nunnery, R. (2008). Advancing your career: Concepts of professional nursing (4th ed.). Philadelphia, PA: F. A. Davis Company.
Marriner-Tomey, A., & Alligood, M. R. (2010).
Nursing theorists and their work
(7
th
ed.). St. Louis, MO: Elsevier.
Orem, D. E. (2001).
Nursing: Concepts of Practice
(6
th
ed.). St. Louis: Mosby-Year Book.
All images were retrieved from GoogleSlide33
Orem Discussion
In evaluating your own practice, what ways have you empowered your patient in achieving self-care? Are there times when you or your co-workers enabled a self-care deficit? Explain.After watching the video, describe what nursing system applies to the scenario; Wholly Compensatory, Partly Compensatory, or Supportive-educative? What barriers do you see limiting the patient in reaching the Supportive-educative system?
Have you used Dorothea Orem's Nursing Theory in your nursing career? Give one example of how you may have used the Self Care Deficit Nursing Theory in your practice.