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Orem's Theory

Exploring The Theory of Orem

Melissa Greenidge

on 17 November 2012

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Transcript of Orem's Theory

Dorothea Orem Biographical Timeline.... Dorothea Orem Orem's Theory Wanted to illustrate how
nursing involves being a
system to support
patients in reaching a higher state of
functioning. Wanted to create a concept capturing what nursing is and what nurses do . Wanted to show
nursing and the
aspects involved in 
nursing in a
scientific way. What was she thinking??? 1914 - Born in Baltimore, Maryland
Father was a construction worker,
Mother was a homemaker, and she
Was the younger of two daughters. 1934 Received nursing diploma from Providence Hospital School in Washington, D.C.
Operated based on the tradition of " Daughter of Charity"
Where Orem had two aunts worked 1934-1936 & 1942
Practiced as a nurse at Providence Hospital Early nursing
experience included:

Operating room nursing
Private duty nursing (home and hospital)
Emergency room 1934-1936 1942-Her earliest
years in nursing were spent
in practice at Providence
Hospital,Washington D.C

1936-1937-St. John’s Hospital, Lowell,

1945-1948- After receiving advanced
degrees,Orem focused primarily on
teaching, research, and administration.

Orem served as director of the
Providence Hospital School of Nursing
in Detroit, Michigan.

1945- Catholic University of America,
Earned a MSN in Nursing Education.

(She worked as a staff nurse, private duty
nurse, nurse educator and administrator and nurse consultant). 1964-1970
Associate Professor in the school of nursing of CUA and continue to develop her concept of nursing and self-care. 1965-1966 Dean of the school of nursing of CUA 1968-1971 Development and Publications of Framework & Concepts 1971 Published Nursing:
Concepts of Practice
(outlines theory of self care
deficit) 1970s - 1980s Became a spokes person for nursing and wanted to share what she felt nursing represented in order to understand the nursing role 1980 – Orem received an
award from the CUA Alumni
Association for Nursing Theory
2nd Edition of The Nursing:
Concepts of Practice was
revised and the theory was
being practiced by many
1984- Retired, but worked on
the third edition of Nursing:
Concepts of Practice
1985- Published the 3rd ed. of
Nursing: Concepts of Practice 1991 - Published the 4th ed.
of Nursing: Concepts of
-The continued development
of different editions shows
that Orem recognized the
importance of change to have
a working system or in this
case the working nursing
framework model 2007 Died Orem dedicated 50yrs to the development and enhancement of the self-care deficit nursing theory and left behind the International Orem Society R.I.P Religious Past and Impact on
Model Creation: Through Orem’s Charity work with the Daughter of Charity she cared for those with the inability to care for themselves and it was through this work that she was able to reflect and create her theory. The Mission statement of the Daughters of Charity that Orem belonged to stated that “their ministry touches those in need through education, health care, social and pastoral services”. As climate and conditions of nursing evolved Orem continued to see the pattern of caring for those who needed help, those who could not help themselves physically, mentally, or due to lack of education and therefore as a nurse she felt it was her duty to fix this health care deficit be it by educating the individual or providing total care. She felt as a follower of God and how he wanted his followers to live she was able to fulfill that duty in the nursing role. Through her charity work and religious beliefs she created the theory of Self Care Deficit. The Daughter of Charity Dorothea Orem’s nursing is rooted in a nursing tradition of the Daughters of Charity (DOC) founded by Vincent and Louise. Sisters are called the “Servants of the Sick Poor” (Libster, 2008). The Daughter of Charity cont. Orem attended Providence Hospital School of nursing in Washington, D.C, which was operated by daughter of charity. She had an aunt who worked at providence hospital operation room as a supervisor who is a Daughter of Charity (DOC). She also had another aunt who is also a daughter of charity. Dorothea said (Libster, 2008):

“At old Providence, nurses were in nursing. I was brought up this way, nursing was nursing and medicine was medicine. Physicians and nurses worked together but the nurse was not under the physician in any sense of the word”
It means that” The nursing was viewed as service people, not the servant of medicine.

Therefore her heritage that rooted from cultural and spiritually of the Daughters of Charity influenced the notion of her conceptualization of her nursing theory addressing self-care. The original ideas for the model developed while Orem served as a hospital consultant nurse with the Indiana State Board of Health. Self care limitations of individuals were the object of nursing and nursing was focused on planning nursing care. The idea was that person becomes a patient because of a legitimate inability (limitation) to care for himself or herself when recovering from illness or injury (Renpenning & Taylor, 2003).

Orem’s idea of nursing was further developed when she worked as Curriculum Consultant at the Office of Education, U.S. Department of Health, Education, and Welfare.

As reflecting on her own unique experiences and observations- she found answers to “what condition exists when judgment are made that people need nursing”. The answer was “ the inabilities of people to care for themselves at times when they need assistance because of their state of personal health” (Renpenning & Taylor, 2003) Development of ideas Human beings require continuous, deliberate inputs to themselves and their environments to remain alive and function in accordance with natural human endowment.
Human agency, the power to act deliberately, is exercised in the form of care for self and others in identifying needs and making needed inputs
Mature human beings experience privations in the form of limitations for actions in care for self and others involving and making of life-sustaining and function-regulating inputs.
Human agency is exercised in discovering, developing, and transmitting ways and means to identify needs and make inputs to self and others.
Groups of human beings with structured relationships cluster tasks and allocate responsibilities for providing care to group members who experience privations for making required, deliberate input to self and others. Underlying Assumptions The philosophical foundation of Orem’s Model is moderate realism.

“The tenants of moderate realism are that human beings are powerful agents to act on their own behalf, that there is an objective world outside an individual, that knowing is partial but constantly evolving and that there is a tendency towards determinism and causability” (Meleis, A., 2012 pg. 216). Philosophical Foundation of Orem’s Model An Analysis of Dorothea Orem’s Model of Nursing Care Nursing she learned at the Providence Hospital.
Nursing was considering as a body of knowledge.
Her own knowledge background and philosophy.
Philosophical view or moderate realism
Nurses could not communicated nursing to physician or administrator Influences in developing the Model 1958-1959 Curriculum Consultant at the Office of Education, U.S. Department of Health, Education, and Welfare.
What is nursing?
Under what condition, an individual is in need of nursing?
What is domain and boundary of nursing? Initial start of the Model It is nursing conceptual model and a Grand theory
It is systems theory
Descriptive theory
It is of the Totality Paradigm Describing the model Orem's Self-care Model Model Structure Orem's Metaparadigms of Nursing Nursing: Orem describes the concept of nursing is an art,
service, and process of providing expert support and helping
to individuals who require assistance (Orem, 1995). Nursing Health- Orem describes the concept of health as
a state of being whole in structure and function.
In her detail description she does however break
up the state of “wholeness” in health and being
healthy into parts stating “The physical, psychological,
interpersonal, and social aspects of health are inseparable
in the individual” (Orem, 1995. Pp. 97) Health Environment- Orem describes the concept of
environment as an individual’s surroundings
which involve interactive physical, biological,
social and chemical features, which as humans
we are never separated from (Orem, 1995). Environment PERSON– Orem describes the concept of person
as a patient, the recipient of care, and an individual who
has limitations to result in deficient self care or dependent
care (Orem, 1995). Person Critiquing Orem's Theory Simplicity Generality Critique potential application to practice Importance Accessibility Theory in Practice........ 1939- Catholic University
of America, earned a BSN
in Nursing education.
1939-1941- She taught
biological sciences and
nursing. References
Full transcript