Examining Dorothea Orems Self Care Deficit Theory

Examining Dorothea Orems Self Care Deficit Theory Dorothea Orems theory, self-care deficit, is one of the famous models used in nursing today. In 1914, Dorothea Orem was born in Baltimore, Maryland. First, Orem studied at Providence Hospital school of Nursing in Washington D.C. and received her nursing diploma in 1930s. After that, Orem continued to study, and got her Bachelor of Science in Nursing Education in 1939 and Master of Science in Nursing Education in 1945, both from the Catholic University of America (Hartweg, 1995). She has received her honorary degree of Doctor of Science from Georgetown University in 1976 and 1980. Orem also earned CUA Alumni Association Award for Nursing Theory in 1980. Moreover, in 1988, she received Doctor of Humane Letters from Illinois Wesleyen University, and awarded the Linda Richards Award. In addition, she also received National League for Nursing in 1991 and Honorary Fellow of the American Academy of Nursing in 1992. In 1998, she earned the Doctor of Nursing Honoris Causae from the University of Missouri. In her early experiences, she worked in operating room nursing, private duty nursing, pediatric and adult medical and surgical units, evening supervisor in the emergency room, and biological science technician. Other than that, from 1940 to 1949, Orem has taken the position as director in both nursing school and the department of nursing at Providence Hospital in Detroit. From 1949 to1957, Orem had worked for the Division of Hospital and Institutional Services of the Indiana State Board of Health to upgrade the quality of nursing in general hospitals throughout the state. While working, she had noted that nurses had difficulty articulating needs to hospital administrators in the face of demands made upon them regarding such issues as length of stay, scheduling admissions and discharges, etc. (McLaughlin-Renpenning and Taylor, 2002). Thus, she started to develop her definition of nursing practices. After reflecting upon her own nursing experiences, Orem says an understanding that the reason why individuals could benefit from nursing was the existence ofà ¢Ã¢â€š ¬Ã‚ ¦self care limitations (Orem, 1978, cited in Fawcett, 2005, p.230). Orem then moved to Washington D.C. in 1957 and become a consultant in the Office of Education. She was working to improve the nursing component of a vocational nursing curriculum. After that, she realized that the curriculum couldnt be determined until there was an understanding of the subject matter of nursing in general. In 1959, she took the position as an assistant professor at The Catholic University of America, where she continued to develop her concept of nursing and self-care. Orems ideas were further formalized after she joined the Nursing Development Conference Group (NDCG). This group, who came together in 1968, was committed to the development of structured nursing knowledge and to nursing as a practice discipline (Hartweg, 1995). Orem says her ideas are primarily the result of reflecting upon her experiences and she was not influenced by any one person, but she states that formal logic and metaphysics were among other disciplines that influenced her work. (Hartweg, 1991) In 1970s, she has first published her book, titled Nursing: Concepts of Practice. It was the conceptual frameworks original publication. Orems work characterized as a time for changes within the nursing profession, being a time for planning, researching and expanding nursing roles. (Chinn Kramer, 2004) Orem defined nursing as an act of assisting others in the provision and management of self-care to maintain or improve human functioning at home level of effectiveness. In general, nursing is an act of proving of self-care for person who needed in order to maintain the optimal health and wellness. Everyone possesses the ability and responsibility to care for themselves and dependents. Nursing is a service to people, not a derivative of medicine. Nursing promotes the goal of patient self-care. According to Orems theory, it is divided into three parts, which are theory of self-care, self-care deficit and nursing system. Theory of self care Orems self-care theory is based on the concepts of self-care, self-care agency, self-care requisites and therapeutic self-care demand. Self-care consists of those activities performed individually by a person to promote and maintain personal well-being throughout life. Self care agency is the ability of a person to perform their self-care activities. Self-care agency consists of two agents, self-care agent and dependent care agent. Self-care agent is a person who provides the self-care and dependent care agent is a person other than the individual who provides the care, for example, the patients. Therapeutic self care demand is the totality of self care actions to be performed for some duration in order to meet self care requisites by using valid methods and related sets of operations and actions. Self-care requisites also called as self-care needs. It is an action directed towards provision of self care. There are three categories of self care requisites, which are universal, developmental and health deviation. Universal self-care requisites are defined as the needs that are common to all individuals activities of daily living. Moreover, the universal self-care requisites are identified by eight elements, which are air, water, food, elimination, activity and rest, solitude and social interactions, prevention of harm, and promotion of normality. Developmental self-care requisites are the needs resulting from the interventions and teachings designed to return a person to or sustain a level of optimal health and well being. For example, educate the child on toilet using and eat healthy diet. Health deviation self-care requisites are the needs resulting from illness, injury and disease or its treatment. Theory of Self-Care Deficit Theory of self-care deficit is the self-care needed by a person when their ability has achieved certain limitation. In another meaning is that a person benefits from nursing intervention when a health situation inhibits their ability to perform self-care or creates a situation where their abilities are not sufficient to maintain own health and wellness. The nursing action will be focuses on identification of limitation and implementing appropriate interventions to meet the needs of person. Nursing is required when an adult is incapable in the provision of continuous effective self-care. In addition, there are five methods of helping identified by Orem, which are acting (or doing for another), guiding, supporting (physically or psychologically), teaching and providing an environment to promote the patients ability to meet current or future demands. The nurse can use any of these to help the individual. Theory of Nursing Systems Theory of nursing system is defined as the nursing interventions needed when individual are unable to perform the necessary self-care activities. In other way of meaning, this theory also defined as a series of actions a nurse takes to meet a patients self-care needs. It describes the nursing responsibilities, roles of the nurse and patient, rationales for the nurse-patient relationship, and the types of actions needed to meet the patients demands. Nursing system composed of three systems, which are wholly compensatory, partial compensatory and supportive-educative. Wholly compensatory is a nurse need to provide full self-care for the patient, because the patients self-care agency has exceeded the limitation that he or she must depends on others (nurse) for well-being. For examples, the coma patient paralysed patient or mental retardation patient. Partial compensatory is some self-care requisites that need the assistant from nurse to meet, but some can be done by patient. For example, give assistance in ambulation for the patient who is following on surgery. Supportive-educative is a nurses action of using knowledge, support and encouragement to develop the self-care abilities of patient in terms of decision making or behavior control. For example, advising the teenagers on effects of smoking or taking drugs. The reason why I choose to write Dorothea Orem is because I feel curious to know more about her after Madam Jaya taught us about the nursing theorists. During in that class, I heard that Madam Jaya said she likes Orems theory. So, when I read the theory, I started to feel like to know more about her and how she comes out with such theory. After I did some research on Dorothea Orem, I found that I started to like her theory. Its true that when an individual has exceeded their limitation of abilities, the self-care deficits occur. Thus, provision of self-care is needed to assist the individual to cope up the activities in daily living.

Roles and responsibilities of leaders

Management and leadership go hand in hand for effective running of activities and processes within the organization. As brilliantly put by many authors, success can never be achieved in any organization without the engagement of a good leader who is able to restructure, solve problems and guide other employees within their organizations. Previous it has been strongly suggested that leadership and management approaches within an organization affect the way service provision is delivered and eventually the performance and success within the organization. Excellency in leadership always starts with the leader and the way he treats those under his management, communication is the most crucial and delegation of power to the rest of the members of the organization, responsibilities should be entrusted to the rest of the staff in the organization so that they can always be part of the solution to matters pertaining the organization. (Newstrom, 1997) The term leadership entails the motivation of people or a team in order to achieve certain organizational goals and objectives. One of the main roles for leaders is to influence the people they lead through incentives, promotions, discipline, dynamics and teamwork with the aim of attaining and maintaining a healthy organizational culture.   Leaders have the responsibility of being participative, supportive, directive and more importantly achievement adjusted with a view to defining certain tasks for their followers (Newstrom, 1997). Many organizations require that their leaders design work agenda for their followers and get concerned with their aspirations, feelings, achievements, problems and outside environment in order to centre all interests to the organization. For a perfectly healthy organization, the leader has to be the servant of the workers in the sense that, he always listens to the workers and do as they want the work done because usually they are the people who are at the ground and they tend to understand the organization better than the leader, so its up to the leader to see that he communicates perfectly with his staff in matters pertaining enhancement of the organization.  Ã‚   (Conger and Pearce, 2003) In every organization, leadership is crucial for maintaining a healthy organizational culture within itself. The main role that a leader is entitled to undertake is to plan, control and direct other individuals to perform specific tasks within the organization. Organizational culture usually entail the –lets work together- spirit whereby the organization behaves like a ‘society’ where there   are values, norms and rules which   all individuals adhere to. Since these are people who work together under the guidance of their leaders, certain beliefs are entrenched in their lives which give birth to encouragement and enthusiasm thus a healthy organizational culture. Leaders therefore utilize a healthy organizational culture to balance work life chores in order to achieve the best form the employees. (Conger and Pearce, 2003) The most important and powerful resources within any organization are the leaders. These are the people who are responsible for influencing the way the organizational culture and climate is modeled. They either create good or bad working environments and thus they are able to determine the development agenda for the organization (Newstrom, 1997). Good management culture starts with a good understanding of effective communication i.e. politeness and patience; Previous research has indicated that employees tend to work better when cherished up by leaders who are up to the task. However, due to diversity, lack of training, lack of motivation, diversification among today’s leaders and lack of definite systems to govern leadership today, there has been slow improvement and many organizations have been failed by their leaders. Reference Conger, J.A., and Pearce, C.L. (2003): Shared Leadership: Reframing the Hows and Whys of Leadership. Thousand Oaks, CA: Sage Publications Newstrom, W. (1997): Organizational Behavior; Human Behavior at Work; New York: McGraw-Hill

Living In America During the Mid-to-Late 1800’s Essay

America was not a great place to be in the late 1800’s, especially if you were a Native American, immigrant, or African-American. The Native Americans’ homelands were brutally taken over, and they were forced to live on reservations. The immigrants had to deal with the terrible living conditions in the cities and the persecution against them because of their appearance. The African-Americans, despite being declared all the rights of a citizen, were segregated, and voting in the South was made nearly impossible. During this time, living in America would have been a negative experience. One of the things that made life in America hard for the Native Americans was the Dawes Act of 1887. The Dawes Act stated that the Native Americans would be given 160 acres of land per household, and that they had to farm it. The Act was a failure. The Native American people were not farmers, and couldn’t farm the land well. They also weren’t given the proper farming equipment. They were also not given the proper medical attention, and the teachers provided to them were poorly trained. The Dawes Act was a negative thing in Native American life. Many immigrants expected to find the streets paved with gold in America, but found that city conditions were terrible. Diseases the cholera, malaria, tuberculosis, and typhoid were common. Tenements, which were cheap places to live, were extremely overcrowded and unsanitary. Crime flourished in the cities. The horrible living conditions in the cities made living in America a negative experience for immigrants. Life was especially difficult for Asian immigrants. Americans made fun of the Chinese hair and dress, and gave them the name ‘coolies’. Japanese immigrants were dubbed â€Å"The Yellow Peril†. Because the Chinese were good workers who were willing to work for less, American workers complained and the Chinese Exclusion Act was passed to prevent Chinese immigration. The Alien Land Law was passed to prevent noncitizen Asians from owning land. Between the persecution from the American people and the American government, life in America for Asians was a very negative experience. Despite the rights they had just been given after the Civil War, African-Americans in this time found new unfair laws being passed. The Jim Crow laws required separation of African-Americans in schools, parks, hospitals, public buildings, water fountains, and other places. In the case of Plessy vs. Ferguson, the Supreme Court ruled that separate facilities for whites and African-Americans were allowed, as long as they were equal, but the facilities for African-Americans were always inferior to those of the whites. Being an African-American in America at this time was a negative experience. New laws designed to prevent African-Americans from voting were also passed in the late 1800’s. Despite being given the right to vote, many southern states required that African-Americans must own land and pay a poll tax in order to vote, which was very difficult for African-Americans to achieve during this time. Many southern states also required voters to take a literacy test, but the test given to African-Americans was a lot harder than the one given to whites. Just to make sure that no whites were being prevented from voting by these laws, a law was passed that anyone who could vote before the new laws were passed were exempt from them. These unfair laws ensured that African-Americans didn’t have a voice in government, which made life during this time a negative experience for them. Whether it was living conditions, unfair laws passed by the U.S. government, or racism by other American citizens, life during this time was made very difficult for African-Americans, Native Americans, and immigrants. The African-Americans and Native Americans were abused by the American government, while immigrants were being made fun of and taken advantage of by the American people. Life in this time for these people was a very negative experience.

Critically evaluate and discuss the advantages and...

Microeconomics Coursework Essay Critically evaluate and discuss the advantages and disadvantages of Customer Boycotts. Compare and contrast either Coca Cola or Bacardi with another consumer boycott of your choice and discuss appropriate microeconomic theoretical models. Firstly to understand this question we need to understand what a customer or consumer boycott actually is. Well it is normally called by an organisation or a group of individuals, asking consumers not to buy a specific product, or the products of a specific company, in order to exert commercial pressure. This is usually done to get the company to change behaviour, to cease an activity or to adopt a more ethical practice. For this essay I am going to discuss many†¦show more content†¦(Can Consumer boycotts work, 2002 [online]. Available at: I mentioned briefly earlier something called a primary effect, well this would be where the target organisation changes its practice. Many targets are however reluctant to change as the result of hostile pressure, and even if changes are made they may try to hide the fact that the consumer action had any effect. There is also the fact that most boycotts are small by comparison to the overall sales, so a target can ride out a boycott. Thus the primary effects may be small and many boycotts may be judged not to have succeeded. So this could be seen as a disadvantage. But the secondary effects are an advantage and are the effects that are not connected to the target. They are effects on other organisations that are not in conflict and can therefore change without the public knowing. Secondary effects can be changes to regulations, lasting change in industry practices, allowing substantial growth entrance of ethical players into the market or effects on decisions of similar organisations to the target. (Why Secondary Effects, [online]. Available at: An example of secondary effects is if someone refuses to buy Nescafe (the coffee brand from Nestle) then he may choose to buy a brand from a much smaller company. The positive effect to this smaller company is much larger than the negative effect to Nestle. The new company may find out that many people are switching to it on ethical grounds and position itself