When nursing began in the Florence Nightingale days, nurses learned their nursing practices from theories. There were two theorist names Dorothea Orem and Virginia Henderson that had their own perspective on nursing practices. This paper will discuss compare and analyze the concepts based of each of these ladies theories to show how they are related. These two ladies developed their own ideas on how nursing should be practiced. Henderson
In 1955 Virginia Henderson wrote the 14 components of basic nursing care, this is known as the human need theory. The theory identified areas that the patient may lack in taking care of their selves when sick, and these are the 14 components of basic nursing care. The 14 components are: breathing good, good oral intake/good nutrition, normal functioning of bowel/bladder, sleep/rest, dressing/undressing, keeping normal body temperature, cleanness of patient promote good skin integrity, keep away from injuries/dangers, good communication of fears/emotions, meeting spiritual needs, working, playing/participating in games or recreations, and learning. The development of theory helped nurses know how to assess, plan, implement, and evaluate their patients (George, 2011). Orem
Dorothea Orem wrote a theory called the self-care deficit theory, and this theory consist of three theories the self-care, self-care deficit, and the theory of nursing systems. In this theory she explain how person can take care of their selves, when a person needs help caring for their selves, and last is when person needs medical attention. The first theory is self-care, and this is when a person is able to maintain their well-being and health. This theory can differentiate depending on what stage of life your end such as your age, developmental state, or where you live. Within the self-care theory is three self-care requisites. The requisites are universal self-care requisites, developmental self-care requisites, and health deviation self-care.
Example universal of self-care requisites is common activities of daily living (ADL’s). Example of developmental self-care requisites is adjusting to new job or change with your body. The last example is of health deviation self-care, and this is when person able to take care of medical problem. The second theory is self-care deficit when person self-care demand out weights their self-care abilities, and nursing is needed. Orem list five ways of helping that nurses can use. The five ways are doing for others, guiding, meet their physical/emotional needs, providing supportive environment to assist person development, and teaching another. The last theory is the theory of nursing system. This theory is when the nurse provides care because the patient is unable to care for their self. Orem discusses three different types of nursing systems that will meet patient self-care requisite.
The first system is wholly compensatory nursing system, and this system is when patient depends fully on the nurse to care for them. Example of this system is a patient who had a major stroke. The second system is the partly compensatory nursing system, and this system when patient can take care of some of their needs but still needs nursing care. Example of this system is patient who has pneumonia and can still feed their selves, but depends on nursing to provide IV antibiotic treatment. The last is the supportive-educative nursing system, and this is when patient is capable taking care of doing self-care, but needs support/education on medical conditions. Example of this when home health goes out to teach patient how to do wound care on their wound so they do not have to depend on nursing (“Dorothea Orem’s Self-Care Theory”, 2012).
Comparing the Concepts
These theorist Orem and Henderson have a common concept on how a nurse should practice nursing. Theses theorist have established in their theories the role of nursing. They have differ approaches when it comes to the how nurses should practice their care. Henderson theory identifies 14 component of human needs that patient may not take care of when they are sick. Henderson theory is for nursing to assess the 14 component as a whole, andintervene in the areas needed. In comparison Orem’s theory of self-care deficit identifies when patient lacks self-care abilities to take care of their self then it is responsibility of the nurse to meet the patients self-care demand.
These two theorist differ in the aspect that Henderson focuses more on taking care of the patient in a more acute setting. Orem has more of a focus in her theory of nursing system on educating the patient on their health conditions or self-deficit so they can take care of their self (George, 2011). Orem’s Self-care Theory Implication on Nursing Practice
Orem general theory is “Nursing has its special concern mans need for self-care and the provision and the maintenance of it on continuous basis in order to sustain life and health, recover from disease and injury, and cope with their effects, “(George, 2011). Nurse’s everyday are practicing the self-care theory of Orem in a variety of health care settings. When a nurse gets a new patient the first they do is identify their self-care deficits and self-care abilities. This allows nurses to focus on the patient’s self-care deficit, and start taking care of the patient needs.
When the nurse identifies the self-care deficit then that allows them to start assessing the situation, create care plan for the patient, and start treating/teaching on the self-care deficits. Example is when a new patient is admitted to the hospital the nurse assesses the patient’s problem, starts taking care of the problem, identifies where teaching is needed, and creates care plan so patient will get better (“Dorothea Orem’s Self-Care Theory”, 2012). Metaparadigm
Orem’s metaparadigm consist of four factors: Human being, health, nursing, and environment. The factor is human she describes human as self-care, and self-care is practice of our activities of daily living that promotes life and well-being. The second factor is health, Orem describes health as being whole and sound physical, mentally, and socially for the person well-being. The third factor is nursing, she describes nursing as a needed service to meet the self-care of humans. The last factor is environment, and she describe the environment as anything around the human that can hinder their ability to perform their self-care (” Dorothea Orem’s Views on Nursing Metaparadigm”, n.d.). Philosophy
According to “Dorothea Elizabeth and her philosophy on self-care” (n.d.), “are patients wish to care for themselves.” Basically what Orem is saying if the nurse lets the patient take care of themselves to best of the their ability they will get over their sickness quicker. This relates to nursing today because the more we enable patients to learn and take care their health condition they will function more independently. Example of Orem philosophy in nursing is when patient is home health, and the nurse is simply there to teach them about congestive heart failure, and how to take care the disease we are enabling the patient to take care to themselves. Conceptual Model
Orem’s conceptual model is related to her theory of self-care. The model defines her three theories of self-care, self-care deficit, and theory of nursing system. When the person self-care demand exceed their self-care abilities, then nursing is needed. Nurses can help patients meet their self-care needs by using the conceptual model. The conceptual model identifies how nurses can assist the patient under self-care deficit by using the 5 areas identified earlier in this paper. Under the theory of nursing the nurse should identify the patient learning needs, and address them so the patient is meeting his/her self-care needs in the end, and is healthy (“Orem’S Self-Care Model”, n.d.). Conclusion
Orem and Henderson agenda for their theories is to establish nursing practice guidelines for nurses. They two theorist help define the role of nursing, and the profession. In the nursing world nurses practice these two theories in their everyday practices. Nurses have learned how to identify problems of patient when they arrive, and how to address them so they can get on the road to recovery. Nurses also learned how to identify a self-care deficit in patients so it can be addressed, then the nurse educates patient on self-care deficit where they can care for themselves. These two theories basically sum down to assessing, implementing, care planning, and educating the patients.
Dorthea Elizabeth and her Philosophy on self-care. (n.d.). Retrieved from http://n207grpfsuccessorsoforem.blogspot.com/p/introduction.html Dorothea Orem’s Self-Care Theory. (2012). Retrieved from
http://currentnursing.com/nursing_theory/self_care_deficit_theory.html Dorthea Orem’s Views on Nursing Metaparadigm. (n.d.). Retrieved from http://oremstheory.webs.com/definedconcepts.htm
George, J. B. (2011). Nursing Theories: The Base for Nursing Practice (6th ed.). Retrieved from The University of Phoenix ebook Collection database.
Orem’s Self-Care Model. (n.d.). Retrieved from