Dorthea Orem's Theory Of Self-Care And Patient Independence In Nursing

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Dorthea Orem was born in Maryland in 1914 and in 1939 received a bachelor of science in nursing education (Black, B. et. al., 2011). She later published her theory of self-care that suggests nurses should only do for a person what that person cannot do without assistance (Black, et. al., 2011). This theory gives the patient the ability to express autonomy and allows them more control over his or her care. This theory in itself has many components and interrelated theories that emphasize the importance of self-care and patient independence throughout an individual’s care. With this theory in mind nurses will be able to create positive patient outcomes.
Orem believed that people naturally want to care for themselves and that nurses should encourage
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(2011), maintaining an effective level of care using this theory is developed through three operations. The first operation is diagnostic, where the nurse-patient relationship is established. This is when a baseline of the patient’s ability is assessed and a demand for care is determined. The next operation is prescriptive. At this time, the nurse should review different methods, actions, and priorities within each patient’s needs, in order to formulate a plan of care. The last stage is regulatory when a nurse decides on a level of care. For example, if a patient is fully dependent on the nurse, the nurse will decide on a compensatory level of care where the patient contributes minimally. Others may only need supportive education where the patient has the ability to care for oneself, but may need some level of guidance or education. (Black, et. al, 2011).
For decades, this theory has applied to nursing practice in a number of ways. Self-care encourages nurses to engage each individual in their own care, which allows for a better quality of life and improves patient outcomes (Simmons, 2009). In order to do so, nurses must maintain health care knowledge and skills, as well as motivation to carry out self-care practices, and maintaining a value of health and a belief that patient contribution will reduce the likelihood of illness (Stark,
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As nurses contribute to their patients’ care, it is important to allow them a sense of autonomy. By providing the patient with freedom and a choice in regards to their care, they are more likely to see positive outcomes. Even when a patient is experiencing a self-care deficit, it is important for nurses to develop a plan of care that incorporates the patient’s abilities into their daily routine. When a nurse is successful in encouraging this behavior, often times a patient’s quality of life increases, and a boost in confidence may be observed. By encouraging independence instead of dependency when able, I believe our health care system will go through a positive

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