nursing theorist: dorothea orem self-care deficit theory

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Nursing Theorist: Dorothea Orem Self-Care Deficit Theory. Presented by MSN Students: Cheryl L Holz RN, BSN Anna Marshall RN, BSN. Dorothea Orem 1914- June 22,2007 Born in Baltimore, Maryland Died at home in Skidaway Island. Education: - PowerPoint PPT Presentation

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Nursing Theorist: Dorothea Orem

Nursing Theorist: Dorothea OremSelf-Care Deficit Theory

Presented by MSN Students:Cheryl L Holz RN, BSNAnna Marshall RN, BSN1Dorothea Orem 1914- June 22,2007 Born in Baltimore, MarylandDied at home in Skidaway IslandEducation:

Diploma (early 1930's) Providence Hospital School of Nursing, Washington, DC

BSN Ed. (1939) and MSN Ed. (1945) from the Catholic University of America, Washington, DC.

[Introduce the nursing theorist and pertinent personal information (2)]Father-construction worker who liked fishing.Mother-homemaker who liked reading.Younger of two daughtersDorothea Elizabeth Orem, born in 1914 (Baltimore, MD), died June 22 of 2007. She received a diploma in nursing in the early 1930s and went on the earn BSN (1939), MSN (1945) and honorary doctorates of science (1976, 1980) and Humane Letters (1988). (next slide)2Credentials & BackgroundHonorary Doctorates:

Doctor of Science from Georgetown University (1976) and Incarnate Word College in San Antonio, Texas (1980)

Doctor of Humane Letters from Illinois Wesleyan University, Bloomington, Illinois (1988)

Doctor Honoris Causae, University of Missouri-Columbia (1998).

She received a diploma in nursing in the early 1930s and earned a BSN (1939), MSN (1945, honorary doctorates of science (1976, 1980) and Humane Letters (1988).

3Credentials & BackgroundSpecial Awards:

Catholic University of America Alumni Achievement Award for Nursing Theory (1980)

Linda Richards Award, National League for Nursing (1991)

Honorary Fellow of the American Academy of Nursing (1992).4Early Nursing ExperiencesClinicalORPrivate Duty Nursing (home & hospital)Staff nursing (pediatric & adult medical and surgical units)Evening supervisor-ER

Education:Biological science teacher Assistant Director of School of Nursing

Consulting:Indiana St. Board of Health (1949-1957)Office of Education, US Department of Health, Education, and Welfare (1957-1959)

Her early nursing experiences included clinical roles: practice roles as a staff nurse in medical-surgical and pediatric settings, OR, assistant director of nursing in a general hospital; nursing education as a teacher of biological sciences in a nursing program and as an assistant director of a school of nursing. She served as a nurse consultant with the Indiana State Board of Health from 1949-1957, and later with the Office of Education for the U.S. Department of Health, Education, and Welfare. 5Theoretical Sources & InfluencesEugenia K. Spaulding-great friend & teacher only

Cites no particular nursing leader as a direct influence on her work.

Does cite many other nurses works in terms of their contributions to nursing:Abdullah, Henderson, Johnson, King, Levine, Nightingale, Orlando, Peplau, Riehl, Rogers, Roy, Travelbee, and Weidenbach, et alCites numerous other authors from other disciplines:Chester Barnard, Rene Dubos, Robert Katz, Ernest Nagel, Hans Selye, Ludwig von Bertalanffy, et al

Between 1949 and 1959, she began to develop ideas regarding the uniqueness of nursing in an effort to clarify the subject matter of nursing in general. She questioned the domain and boundaries of nursing as a field of practice and a field of knowledge. Her theory of nursing evolved over the course of four decades as ideas were developed and refined in an attempt to help formalize a framework by which to organize nursing knowledge. The experiences of her personal nursing career, her studies in the areas of formal logic and metaphysics, and her abilities to reflect as well as her collaborations with students, practitioners, researchers, educators, administrators and scholars challenged her and aided in the development of a general theory of nursing.

6Theoretical Sources & Influences-contdHuman organization, action theory

An area of philosophy concerned with theories about the processes causing intentional/willful human bodily movements of more or less complex kind

http://en.wikipedia.org/wiki/Philosophy_of_action, retrieved 10/10/08

7Theoretical Sources & Influences-contdThe works of: AristotleThomas Aquinas Barnard (1962)Kotarbinski (1965)Macmurray (1957)Parson, Bales, and Shils (1953)B.J.F Lonergans Insight(1958) [on reflective thinking], Assays by Wallace (1979, 1983) [for recent clarifications]. Orem, D.E (1987). Orems general theory of nursing. (p.73)

Aristotle & Thomas Aquinas- action theory, others-context of action, deliberate action theory8

Origins

1949-1959Began to develop ideas regarding the uniqueness of nursing

In effort to formalize a framework by which to organize nursing knowledge, she asked the following questions

1949-1959: While Orem was working as a nurse consultant with Indiana State Board of Health (traveling around observing and talking to nurses), she recognized the ability of nurses to do nursing, but inability to talk about nursing. These questions were derived from the need to understand the subject matter of nursing in general9OriginsWhat is nursing?How was it different from other disciplines? How was it similar?What is the domain and what are the boundaries of nursing as a field of practice and a field of knowledge?What condition exists when judgments are made that people need nursing?

(Answer: The inabilities of people to care for themselves at times when they need assistance because of their state of personal health)

10Ideas evolved from:

Unique experiences of her personal nursing career

Observations in practice

Study of formal logic and metaphysics

Use of resources from many fields

Abilities in methods of reflect and questioning

Collaborations with students, practitioners,researchers, educators, administrators and scholars

Metaphysics: 11Formalization1960-1980 through extensive reading and self-reflection

collaborations with students, practitioners, researchers, educators, administrators and scholars

Formalization of ideas occurred during the years, 1960-1980. 12Publications1971-Nursing: Concepts of Practice

Editor for Nursing Development Conference Group (NDCG)-prepared & later revised Concept Formalization in Nursing: Process and Product

1980, 1985, 1991, 1995, and 2001- subsequent editions of Nursing Concepts of Practice

1984: Orem retired

Manyincluding13PracticeFirst documented use:1973-John Hopkins HospitalIn nurse-managed clinics

Various clinical populations & age groupsNeonates to the elderlyHealth promotion practices & care of the sick(The nursing management of pertussis was described from the SCDNT perspective).Beth Israel Medical Center, Newark, New Jersey-first acute care hospital in NE United States-nursing care philosophy based on Orems self-care deficit model.Used in work with adolescent alcohol abusers, employees with RA, women recovering from radical mastectomies, families and children with CF, patients with congestive heart failure, diabetes, and many more.(Marriner & Tomey, 3rd Ed. 1994, pg 187)14Practice-contdEthnically & culturally diverse populationsOrems SCDNT: translated into Italian, French, Spanish, Dutch, and JapaneseCurrently, translations of some or all of her most recent work in Germany, Thailand, and Norway, et al.Used throughout the worldGreat Britain, Taiwan, Thailand, Japan, Korea, Canada, Australia, New Zealand, South Africa, Israel, Germany, Spain, Italy, France, Belgium, the Netherlands, Bolivia, Colombia, Uruguay, and Mexicoemphasis on self-care is not completely congruent with some peoples expectations of nursing practice; (Expectations with regional and cultural groups can vary)15Central PhilosophyThe philosophy of Orems SCDNT is based upon:patients wish to care for themselvesmoderate realism

16Conceptual Theoretical ModelR=relationship;