Application of Orem’s self-care deficit theory to resolve an issue in nursing practice
Application of Orem’s Self-care Deficit Theory
Application of Orem’s Self-care Deficit Theory
The nursing profession is continually growing, and its development is often influenced by various theories and their application in unique scenarios that continue to develop. Such a theory is Dorothea Orem’s self-care deficit theory that was articulated in the 1950s but was published in the 1970s after which it received more recognition and gained widespread acceptance throughout the medical profession. According to the self-care theory, the need for nursing can be systematically determined via assessment of the patient and their needs. The theory argues that patients are capable of self-care and that nursing is needed when the self-care becomes insufficient (Green, 2013).
The need for nursing also arises when the patient’s ability to perform self-care are hindered by either disease or deficiency in the knowledge necessary to perform the self-care. Orem’s self-care deficit is not only applicable to the assessment of whether a patient needs nursing or not, the theory transcends the nursing practice and has influenced nursing education, nursing research, as well as guided the professionalism of nursing practice and provided a blueprint via which the nursing practice can be held accountable or their actions while performing their duties of dissemination of nursing services (Orem & Taylor, 2011). In this paper, Dorothea Orem’s self-care theory will be discussed in relation to the discussing practice. However, the paper will focus on the theory’s application, especially in the nursing education sector. A systematical evaluation of the impact of the theory of the nursing practice, specifically concerning the education sector, will inform this paper and will form the basis for the arguments throughout the paper.
The Orem’s self-deficit has gained worldwide acceptance in the nursing profession since the theory was published in the 1970s. Its effectiveness and clarity in defining the specific issues in the nursing profession are not in question. The theory is often used as a positive reference for nurses in their practice of nursing. The theory defines interactions between patients and nurses and promotes a clear understanding of the basic definition of nursing. The theory defines what nursing entails, what it should entail and what it should not entail. The theory clearly communicates the definition and structure of nursing practices. It further defines the specific outcomes that should be used to measure the effectiveness of the nursing care being received by a patient or being offered to a patient. The theory also demonstrates the role of nurses in ensuring that their nursing practice is effective and acts as a code-book for nurses in determining their accountability with respect to the various situations they may face during their nursing professions (Richard & Shea, 2011). To this end, the theory has widely been used in the education of nurses globally and used by most institutions to inform their nursing education curricula. A number of universities and colleges have developed curricula based on the theories defined by the principle. The University of Missouri is one such institution where the theory has been used to define the curricula and to shape the nursing education program at the institution. The theory is also useful in guiding the administrations of the learning institutions as well as guiding nursing research.
In helping define and structuring of the education curricula, the theory is often broken down into its components to form the various achievable outcomes in the learning process of aspiring nurses. For instance, in most institutions, there are five semesters of nursing education. In restructuring the learning process to echo the principles of the self-care theory, each semester is viewed as a learning stage, and specific outcomes are determined for the semester. For instance, in a single semester of the five-semester program, three aspects of the nursing profession need to be obtained. These three aspects include the ‘agency’ course, the clinical practicum, as well as the ‘systems’ course. These three aspects pretty much define the entire nursing practice. In the agency course, the patient is the main agenda. The patient’s requirements and requisites that determine the level of nursing care they need are taught (Orem & Taylor, 2011). Skills obtained from this learning exercise equip the nurses with the necessary knowledge to do a professional assessment of the patient’s needs and determine the level of self-care the patient is capable of and the level of nursing needed to cater for the self-care deficit in the patient.
The systems course defines the structures and the institutions in which the nursing profession practices. Nurses often work under particular institutions with structures and principles unique to their establishments. The section of the curricula seeks to equip the nurses with the knowledge of the various structures and to help in setting up the environment that can allow the best application of their nursing knowledge (Berbiglia, 2011). The third part of the system, the clinical practicum, deals with the actual treatments that nurses can offer to the patients. None of the three aspects is more important than the other.The three aspects often work together to help define the nursing profession.
The theory provides the guideline and a blueprint for institutions as well as to the students in the nursing profession. Some concepts in the theory are crucial to the best application of the theory in actual practice. For instance, the deficit concept defines the reasons why people may require nursing services.The principles of the deficit concept are crucial in the assessment phase of patients. The therapeutic demand for the nursing services is determined at this stage. Therapeutic demand is a summation of all the measures that are necessary at any given time to meet the demands of self-care of a given person. The theory clarifies that for a human being to achieve self-care their therapeutic demand needs to be low due to their ability to meet most, if not all, of their needs. In the assessment phase, the practitioners assess a person’s personal ability to meet their therapeutic demand. The assessment is crucial as it enableshe nursing practitioners to determine the nature of self-care deficit present in the person and the necessary actions to meet the therapeutic demand of the person. The nursing practitioners are expected to cover the deficit.In this respect, the deficit theory informs the nursing profession in many ways. It helps the nurses to assess people and to determine the level of help and the nature of the help they can offer to the patient. It also provides a checklist of actions that guide the nursing professionals in discharging their duties to the patients under their care. The theory addresses the needs of both the patient and the nurses and defines the relationships between the two (Alligood, 2013).
In the nursing profession, ethical dilemmas are the order of the day. In the daily interactions with their patients, it is usual for the nurses to face ethical challenges. Even though nurses are generally guided by a code of ethical conduct, the application of the ethical principles often varies with different nurses based on their experience, their beliefs, and the institutions’ beliefs. The self-care deficit theory is no exception to the ethical concerns facing the nursing profession. While offering the nursing services, the self-care deficit theory demands that nurses do a comprehensive assessment of the patients in order to make a determination of what they need to offer the patients (Mohammadpour et al., 2015).
More often than not, the patients actual needs are ignored and are only considered depending on the nurses experience and their personal judgment. If a nurse is not experienced in offering a givenservice, they may ignore the patient’s need. At times, the nurse may develop stereotypes against particular patients based on their experiences. The stereotypes often define the relationships between the patient and the nurse. The theory and its application require that nurses act in the most professional manner possible. It assumes that personal prejudices and institutional beliefs and practices may not affect the nursing practice. However, this is not the case. The nursing institutions and the level of nursing professionalism affect the level of care that patients receive. Even though the theory does not have specific legal or ethical considerations against its application, ethical concerns on the part of the nurses will always arise and affect the quality ofcare received by the patients.
Evidently, the self-care theory has influenced the nursing profession globally for several decades. Its application ranges from the nursing practice, nursing education, nursing institution’s administration, as well asresearch in thenursing field. The theory provides a framework on which the nursing profession is founded. This paper has examined the impact and the application of the self-care in nursing education. How the theory has influenced and inspired the educational curricula globally is an important aspect that the paper has touched upon and helps to show the significant impact the theory has had on the nursing practice, education, as well as guiding research into the nursing practice. Clearly, the foundations of most education institution’s curricula are founded on Orem’s self-care theory.Nursing theory is instrumental in the developments in the nursing profession (Banfield, 2011). The nursing practice always has room to improve in terms of application, research and offering of the optimum care to patients.
In conclusion, the self-care deficit theory defines the needs of the patient after an assessment of the patient, and the nurse are able to meet the therapeutic demand of the patient after determining the level of care the patient needs. The theory also defines what nursing entails, what it should entail and the sections of the nursing profession that researchers can find ways to improve upon. It is clear that the theory focuses on the relationships between the nurse and the patient. The theory has obvious weaknesses regarding the relationships between the nurse and the society. The theory does not have a clear definition of the family and the role the family can play in supporting of meeting the therapeutic needs of the patient (Alligood, 2013). The theory’s application in physicalcare has been excellent, but it highlights its weaknesses as far as the patients’ psychological are is concerned.Expanding the theory’s principles to cover the psychological aspects of the patient is the obvious possible area of application that presents opportunities to researchers seeking to continue the development of nursing theory and its application in the nursing profession.
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Mohammadpour, A., RahmatiSharghi, N., Khosravan, S., Alami, A., &Akhond, M. (2015). The effect of a supportive educational intervention developed based on the Orem’s self‐care theory on the self‐care ability of patients with myocardial infarction: a randomized controlled trial. Journal of clinical nursing.Orem, D. E., & Taylor, S. G. (2011). Reflections on Nursing Practice Science The Nature, the Structure, and the Foundation of Nursing Sciences. Nursing science quarterly, 24(1), 35-41.Richard, A. A., & Shea, K. (2011). Delineation of Self‐Care and Associated Concepts. Journal of Nursing Scholarship, 43(3), 255-264.