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The Nursing Profession explained through Dorothea Orem’s Se
Transcript of The Nursing Profession explained through Dorothea Orem’s Se
Overview of the Theory
Theory of Self-Care focuses on how people take care of them selves and explaining why they care for themselves the way they do. This theory suggests that nursing the patient is necessary just in case the patient cannot perform self-care activites.
This theory breaks down into 3 categories: Development, Operability, and Adequacy
“…therapeutic self-care demand consists of the summation of care measures necessary to meet all of an individual’s known self-care requisites”(qtd. Orem, 2001, p.491).
Basic Conditioning Factors : factors that affect the efficiency of the method of therapeutic self-care demand or self-care agency of a person.
Orem presents 3 types of self-care requisites: Universal self-care requisites, developmental self-care requisites, and health deviation self-care requisites.
Universal self-care requisite are all vital activities humans need to do as a part of living. Such as having sufficient intake of air,water, food, and removal of waste.
Developmental self-care requisites are marked by different stages in life that are major life events like college, marriage, and retirement.
Health deviation self-care requisites is assessing the deviation of proper human being structure or function.
Contribution to Nursing
Orem's theory of self-care is being used to asses patients with mental disorders such as schizophrenics to help them make better life style decisions.
There are multiple causes of lack of motivation for patients with schizophrenia, whether it is the medication causing the chemical imbalance of dopamine or their lacking ability of "attending to environmental stimuli" researchers want to improve their motivation by developing their self-care agency.
The patient's lack of motivation can affect their functional outcome, and sometimes their social skills are affected so this puts them at risk of not being able to gain social support to contribute to a better functional outcome.
Name of Theory:
Dorothea Orem’s theory is titled the Self-Care Deficit Theory of Nursing. This theory was established in 1971 as apart of her novel, Nursing: Concepts of Practice, which discusses and explains her self-established theory of nursing.
This theory focuses on the concept of nursing based on Orem’s professional outline of the nursing profession by breaking the theory down into three sub-theories.
-The Theory of Self Care
-The Theory of Self-Care Deficit &
-The Theory of Nursing Systems
Education & Career (cont.)
After Orem obtained her advanced nursing degrees she began teaching biological science and nursing courses from 1939-1941 at Providence Hospital School of Nursing in Detroit, Michigan. This was where Orem was promoted to Director of Providence Hospital School of Nursing from 1945-1948.
From 1959-1964, Orem worked as an Assistant Professor and as an Associates Professor from 1964-1970, and from 1965-1966 she was the Dean of Nursing for the short period of time. Orem served all three of these job titles at the Catholic University of America, this is the where Orem has earned both her B.S and M.S degrees in nursing education.
Overview of Theory (cont.)
Theory of Self-Care Deficit is when adults learn how to perform actions that contribute positive improvement to survival, quality of life, and well-being. This sub-theory focuses on providing physical and psychological support for the patients as well as guiding them to become independent and learn how to better take care of themselves.
The Theory of Nursing Systems explains what needs to be maintained in order for the profession of nursing to be preserved. This sub-theory introduces the 3 systems: the wholly compensatory system, the partially compensatory system, and the supportive-educative system.
The Wholly Compensatory System is when the patient is completely dependent on the nurse to perform self-care activities.
The Partially Compensatory system is where both the patient and the nurse collaborate together to perform self-care activities because the patient can still perform some but not all self-care activities.
The supportive-educative system, the patient has the ability to perform self-care activities but still needs guidance from the nurse whether it is advice in decision-making or knowledge.
Education & Career
Dorothea Orem Attended Seton Hall High School which was located in Baltimore, Maryland.
In 1934, Orem obtained her diploma from Providence Hospital School of Nursing located in Washington, D.C and continued her nursing career by pursing a B.S in nursing education at the Catholic University of America in 1939 and by 1945, she has earned her M.S in nursing education.
After Orem received her B.S in nursing education she began her nursing profession working at Providence Hospital in Washington, D.C from 1934-1936 and 1942 and at St. John’s Hospital in Lowell, Massachusetts from 1936-1937.
Once Orem earned her M.S in nursing education she contributed her time in the research, teaching, and administration fields of nursing.
Contribution to Nursing (cont.)
In patients with schizophrenia their EM (external motivation) and their IM (internal motivations) are affected by this mental disorder. The goal is to improve the components, especially the IM because studies have shown that tasks that help improve the IM have lead to increase in perceived competency and their ability to learn a skill.
But the problem with seeing improvement is that there is still no specific cause of decrease in motivation for schizophrenic patients. There are multiple possible causes but the reason for decrease in motivation levels are still vague. This makes finding the solution more difficult because researcher do not know what the cause of the problem is to begin with.
Self-care agency focuses on intention, choice and especially motivation. Researchers used Orem's Self-Care Deficit Theory as a framework for assessing the issues of lack of motivation in schizophrenic patients even though there is still yet to be a solution to be found.
Overview of Theory (cont.)
Orem's self-care theory focuses on assisting patients in gaining their ability to perform self-care activities and having the guidance of nurses.
This theory gives nurses a purpose in the nursing profession other than just the physical aspect of helping a patient. They need to learn why and how a person performs self-care activities to better assess the patient and be their mentor and guide throughout the entire process so they can eventually stand on their own two feet and perform actions that contribute positive improvement in their healthy and physical well-being.
Therapeutic self-care involves the nurses and patients as well as others which affect the self-care capabilities and meeting self-care needs.
By breaking down the patient's basic conditioning factors this can give specific treatment according to their background to better diagnose the problem and the patient.
Masters, K. (2013). Role Development in Professional Nursing Practice,
Pickens, J. (2012). Development of Self-Care Agency through Enhancement
of Motivation in People with Schizophrenia. Self-Care, Dependent-Care & Nursing, 19(1), 47-52.