Orems

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Orems RogersTheories of Nursing

• N260 - Julie Chenoweth, Heather Gulian,
• Nancy Jeffery, Lindsey Martin, Bradley Thompson

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OREMS THEORY

• Dorothea Orem
• (1914-2007)
• Education RN, Ed. MSN multiple honorary
  doctorates
• Best known for Orems Self-Care Model Self-Care
  Theory in the Ambulatory Setting
• Self-Care Deficit Nursing Theory (SCDNT)
• Self-Care Framework
• Self-care model in 1959

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OREMS THEORY

• Model focuses on the patients self-care
  capacities and the process of designing nursing
  actions to meet the patients self-care needs
• Its a framework for caring that emphasizes and
  encourages independence
• Idea that all patients wish to care for
  themselves
• Often used in rehabilitation and primary care
  settings to promote independence

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OREMS THEORY

• Focused on self care requisites and self care
  deficits
• Identified universal self care requisites,
  developmental self care requisites, health
  deviation requisites
• deficit occurs when a person cant meet his/her
  own requisite of care

• Basic Requisites Areas
• Air Activity and rest
• Water Solitude and social interaction
• Food Hazard prevention
• Elimination Promotion of Normality

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OREMS THEORY

• Appropriate care is developed through three
  operations
• 1) Diagnostic determine patients ability to
  provide effective self-care
• 2) Prescriptive planning stage
• 3) Regulatory designs, plans and produces a
  system for care

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OREMS THEORY

• Three types of systems for care
• Wholly compensatory nursing system used when a
  patient cant perform the self-care alone
• Partly compensatory nursing system used when
  patient can perform some areas of self-care but
  cant perform other areas
• Supportive-educative nursing system is used when
  a patient can and should do the self-care alone

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ROGERS THEORY

• Martha Rogers
• (1914 1994)
• 1937 BSN George Peabody College
• 1945 MA in Public Nursing from Columbia
  University
• 1952 MPH Johns Hopkins University
• 1954 Sc.D. Johns Hopkins University
• 1952-1975 Professor and Head of the Division of
  Nursing at NYU

Source American Nurses Association, 2008.
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ROGERS THEORY

• Proponent of rigorous scientific study
• 1961 Educational Revolution in Nursing
• 1964 Reveille in Nursing
• 1970 An Introduction to the Theoretical Basis of
  Nursing

Source Society of Rogerian Scholars, 2008.
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ROGERS THEORY

• The individual (unitary human being)
• Energy field that coexists within the universe
  and continually interacts with the environment
• Continually changing and evolving along life
  process
• More than a sum of its parts

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ROGERS THEORY

• Homeodynamics
• Resonancy
• Helicy
• Integrality

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ROGERS THEORY

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ROGERS THEORY

• Unitary human being is a four dimensional energy
  field identified by pattern and manifesting
  characteristics that are specific to the whole
  and which cannot be predicted from the knowledge
  of parts. (Potter Perry, 50)

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ROGERS THEORY

• Views the goal of nursing to
• Maintain and promote health, prevent illness,
  and care for and rehabilitate ill and disabled
  client through humanistic science of nursing.
  (Potter Perry, 49)
• Assist people in achieving their maximum health
  potential. Maintenance and promotion of health,
  prevention of disease, nursing diagnosis,
  intervention, and rehabilitation encompass the
  scope of nursings goals. (Rogers in Chitty
  Black, 142)

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OREMS ROGERS THEORIES

• Similarities
• Patient centered
• Holistic
• Focus on patient and their environment
• Assist patient to reach maximum health potential
• Emphasis on health promotion and preventative
  health care

• Differences
• Practical versus Theoretical
• Testability of theory
• Simple versus complex theoretical underpinnings.

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RogerianImplications for Practice

• Intent
• Consciousness
• Therapeutic Touch
• Energy Fields
• Environment
• Mental State
• Creativity
• Holism

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Orems TheoryImplications for Practice

• Wholly Compensatory System (nurse compensates for
  patients inability to participate in their
  self-care)
• A bedridden oncology patient arrives via
  ambulance for chemotherapy. Family insists upon
  keeping patient at home however, leaves patient
  alone with nurse in chemo clinic for treatment.
  Patient requires O2 at 2L/min, continuous tube
  feeding at 90cc/hr, Foley catheter, bedpan. Nurse
  in clinic administers chemo premeds and chemo
  changes dressing around G-tube due to leaking
  administers O2 at 2L/min empties Foley at end of
  treatment places patient on bedpan one time.

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Orems TheoryImplications for Practice

• Partly Compensatory System (give and take
  between nurse and patient)
• Preterm labor patient regularly visits clinic for
  BP monitoring, etc. Patient is on bed rest (at
  home), except for weekly visit to clinic. Nurse
  assists patient out of wheelchair into bathroom,
  assists with urine sample collection, and assists
  onto exam table. Nurse administers injection of
  terbutaline and educates patient regarding oral
  terbutaline.

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Orems TheoryImplications for Practice

• Supportive-Educative Role (monitor and regulate
  patients self-care)
• Newly diagnosed diabetic patient received
  diabetic care teaching while in hospital. Now,
  patient visits clinic and reports highly variable
  BS/chemstrip readings. Nurse suspects patient may
  be performing procedure incorrectly. Nurse
  assesses that patient has been cutting some of
  his chemstrips in half to save money. Nurse
  instructs patient that cutting strips exposes
  chemicals and inaccurate readings may result.
  Additionally, nurse assesses that patients wife
  (who does family cooking) did not receive any
  nutritional education while patient was
  hospitalized. Nurse begins nutritional counseling
  and provides wife with referrals to nutritional
  services department.

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REFERENCES

• Rebecca (2006). Drawing challenge. Retrieved
  October 19, 2008 from http//drawing-game.blogspot
  .com/search/label/3020birds20in203020days?upda
  ted-max2006-12-11T233A343A00-053A00max-result
  s20.
• Potter, P., Perry, A. (2009). Fundamentals of
  Nursing (7th ed.). St. Louis Mosby Elsevier.
• Wikipedia (2008). Martha E. Rogers. Retrieved
  October 19, 2008 from http//en.wikipedia.org/wiki
  /Martha_E._Rogers.
• American Nurses Association (2008). Martha
  Elizabether Rogers. Retrieved October 19, 2008,
  from http//images.google.com/imgres?imgurlhttp/
  /www.nursingworld.org/ClientResources/Images/Hall
  2520of2520Fame/ROGERS.JPGimgrefurlhttp//www.nu
  rsingworld.org/FunctionalMenuCategories/AboutANA/W
  hereWeComeFrom_1/HallofFame/19962000Inductees/roge
  me5577.aspxh180w150sz12hlenstart1um1u
  sg__f8tzh3lKSCiCAhrFEvrS-cSwvFEtbnidYu5o9dVwtc
  troMtbnh101tbnw84prev/images3Fq3Dmartha2
  Brogers2Bnursing26um3D126hl3Den26rls3Dcom.m
  icrosoften-us.
• Society of Rogerian Scholars (2008). Martha E.
  Rogers. Retrieved October 19, 2008, from
  http//www.societyofrogerianscholars.org/biography
  _mer.html.
• Chitty, K., Black, B. (2007). Professional
  nursing Concepts challenges (5th ed.). St.
  Loius Saunders Elsevier.

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REFERENCES

• Chitty, K.K. Black, B.P. (2007). Professional
  nursing Concepts challenges (5th ed.).
• St. Louis, MI Saunders, Inc.
• Fawcett, Jacqueline (2002). Dorothea Orem's
  Self-Care Framework. Retrieved October 15, 2008,
  from http//www4.desales.edu/sey0/orem.html.
• Wikipedia (2008). Orem Model of Nursing.
  Retrieved October 15, 2008, from
  http//en.wikipedia.org/wiki/Orem_model of
  nursing.
• Nurses.info (2008). Dorothea E. Orem. Retrieved
  October 15, 2008, from http//www.nurses.info/nurs
  ing_theory_person_orem_dorothea.htm.
• St. Anthony College of Nursing (2008). Dorothea
  Orem. Retrieved October 15, 2008, from
  www.sacn.edu/images/oremsframe.jpg

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REFERENCES

• George, J.B. (1980). Nursing Theories The Base
  for Professional Nursing Practice (2nd Ed.). New
  Jersey Prentice Hall
• Johnson, B.M. Webber, P.B. (2004). An
  Introduction to Theory and Reasoning in Nursing.
  Philadelphia, PA Lippincott, Williams,
  Wilkins.
• Kim, H.S. Kollak, I. (1999). Nursing Theories
  Conceptual and Philosophical Foundations. New
  York, NY Springer Publishing Company
• Sitzman, K. Eichelberger, L.W. (2004).
  Understanding the Work of Nurse Theorists A
  Creative Beginning. Boston, MA Jones Bartlett
  Publishers.