Every time a nurse cares for and evaluates a patient, in essence, the nurse asks is the individual able to feed him or herself and maintain his or her body abode in a healthful manner? If not, what must he nurse do to enable a state of homeostasis in that individual's environment to take place? But Orem also stresses the nurse, in assessing self-care must regard whether the individual him or herself can identify when that patient's body or abode is under threat -- for instance, can an elderly person take precautions when cooking? Will he or she know when the stove is left on or off? On the most basic of levels, of course, self-care regarding the provision of elimination and excrements and the basic functional tasks of physical maintenance are necessary. But less obviously, in terms of wellness, a nurse must ask, can the individual maintain a balance between activities and rest? Will an unattended child, for instance, tire him or herself out but refuse to go to sleep? Or can an adolescent get him or herself out of bed on time, to be functional for school or will he or she burn the midnight oil, partying into the wee hours of the night, if left alone? (Orem, 1995)
Equally critically, the model poses the query, is there a balance between solitude and social interaction -- does an elderly person who has lost a loved one retreat into solitude, likewise does a young mother have the time for respite, beyond the demands of husband, child, work and home. The model counsels the nursing practitioner thus to monitor emotional as well as physical hazards that must be guarded and attended to facilitate above all the goal of nursing, which is the preservation of human life, human functioning, and human well beings Maintain a state of social, personal, as well as physical normalcy in the promotion of human functioning and human development within social groups is the primary goal of the model. (Orem, 1995) When there is a deficit in the ability of an...
(Hartweg, 1995)
In addressing contemporary nursing concerns and problems, this model's stress upon enabling patients and treating them holistically is particularly valid. By stressing the need for patient empowerment, and the need as well for nurses to facilitate that empowerment in the absence of a patient's ability to perform basic life functions, the model is both proactive yet does not deny the needs of a patient, even when temporarily or permanently disabled, as a socially and physically functional being.
Works Cited
Fawcett, J. (1995) Analysis and Evaluation of Conceptual Models of Nursing. Third edition. Philadelphia: F.A. Davis Company.
Orem, D. (1995) Nursing Concepts of Practice. Fifth edition. St. Louis: Mosby.
Hartweg, D.L. (1995). Dorothea Orem: Self-care deficit theory. In C.M. McQuiston & A.A. Webb, Editor. Foundations of nursing theory: Contributions of 12 key theorists (pp. 139-202). Thousand Oaks, CA: Sage Publications, Inc.
Appendix:
Diagram of Orem Model accessible on World Wide Web at http://members.aol.com/annmrn/nursing_portfolio_I_index.html. Retrieved 5 Feb 2005
As Follows:
Orem's Self-Care Model: A Professional Nursing Practice Model Diagram
Person (client/patient) self-care deficits are the result of environmental situations.
3 systems exist within this professional nursing practice model
Compensatory system-nurse provides total care
Partially compensatory system-nurse & patient share responsibility for care
Educative-development system-client has primary responsibility for personal health, with nurse acting as a consultant
