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Reply post # 1Collapse SubdiscussionAshley Bailey

Ashley BaileyMondayAug 30 at 4:05pm

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After reviewing the many nursing theories outlined in Hood Chapter 6, Dorothea Orem’s self-care deficit theory appealed to me the most. According to Orem’s theory, “the purpose of nursing is to help people meet their self-care needs… with focus on how the person is affected by human or environmental conditions which can negatively affect their overall health and quality of life” (Hood 2018). Orem’s theory is further broken down three ways: self-care, self-care deficit, and nursing systems all integrated (Hood 2018) which is directly relatable to my current nursing role.

I currently work in the home health care setting where our major focus is identifying the needs, or self-care deficit, of the patient during our comprehensive admission assessment. This assessment outlines the patients’ needs, or ability to engage in their care, based on physical and physiological findings that may hinder or support the patient during their health care journey. The patients’ current living arrangement and frequency of caregiver availability are all related to functional ability. Our main goal as home health care nurses is to prevent re-hospitalizations by reducing risks that the patient may endure while on our services. With that, by utilizing my admission nursing assessment I’m able to identify the patient’s ability to participate in their care and identify their needs and limitations.

Orem’s theory outlines the nursing system and further breaks down the role of the nurse into three subcategories: wholly, partially, and supportive. Another example of how my practice relates to this theory is that this initial assessment also helps to identify the role of the nurse and other disciplines during their episode of care and how we as clinicians can get the patient more functionally independent at home. Just as Orem’s theory outlines, my role as the home health care nurse most certainly fluctuates from a major role when care is initiated to then playing a minor role as the patient meets goals and becomes more self-sufficient during the episode of care.

In conclusion the theory of self-care, per Orem, all boils down to the individual being able to maintain their health and the role of the nurse in prioritizing areas of concern utilizing the nursing diagnosis to aid the patient to achieve self-care. My role as the home health nurse is to identify those needs, aid the patient to meet those needs, therefore decreasing the self-care deficit of the patient.

Hood, L. J. (2018). Nursing Models and Theories. Leddy & Pepper’s Professional Nursing (9th ed. pp#145-#146). Wolters Kluwer.

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A-H: Discuss which of the nursing models or theories presented in Hood (2018) Chapter Six appeals to you the most. Provide three examples of how your practice is supported by this theory.

Reply post #2Collapse SubdiscussionCandace Metcalf

Candace MetcalfTuesdayAug 31 at 3:18pm

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There are many different nursing theories that all allow for different types of people to create a care plan that matches their beliefs and strengths while still meeting the needs of the patient. Orem’s Self-Care Deficit theory focuses on meeting the self-care needs of the patient that they cannot meet themselves, focusing on; self-care, self-care deficit, self-care requisites, and agency (Hood, 2018). Another theory is Parse’s Human Becoming Theory, which focuses on the patient as a human being with an emphasis on quality of life improvement through co-constitution, coexistence, and situation freedom (Hood, 2018).

There are disparities between these two philosophies that could create conflict between two nurses practicing them. A nurse using Orem’s theory could feel that the nurse using Parse’s theory could let care needs fall between the gaps. Parse’s theory focuses on presence to create connection, and the nurse focusing on the person as a whole could let self-care gaps lapse if the patient does not specifically ask for them due to assuming that they are done for the patient and focusing more on the connection rather than how care is linked to healing.

On the other hand, the nurse practicing with Parse’s theory rather than Orem’s could feel that their colleague was too focused on the care that needed to be done rather than the person’s quality of life as a whole. Orem’s theory could be seen as focusing too much on “needs” rather than the growth of the person as a whole, which could be seen as a detriment to overall well-being and quality of life rather than just on how to heal from the situation they are currently in.

Finally, the two theories could have conflict over the fact that the nurse prescribing to Orem’s needs could easily underestimate the patient’s ability for self-care if not given the proper assessments and reassessments and end up doing too much for the patient while in care, while the nurse using Parse’s theory could see that they spend more time focusing on the patient’s interactions with the environment so they could see what the patient can actually do on their own before offering to do the care that they cannot do themselves.

Hood, L. J., (2018). Leddy and Pepper’s professional nursing (9th edition). Wolters Kluwer.

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I-R: Imagine you are working with a nurse who uses Dorothea Orem’s Self-Care Deficit Theory to guide her nursing care and decisions. You, however, ascribe to Parse’s Human Becoming Theory as the foundation of your nursing practice. Discuss three problems or disagreements in providing care that may come up due to these differing perspectives.