Models and Theories Focused on Nursing Goals

Wholly Compensatory: The nurse performs all self-care for the patient (e.g., a patient in a coma).

Partially Compensatory: The nurse and patient work together to perform self-care (e.g., a nurse helping a post-operative patient walk for the first time).

Supportive-Educative: The nurse acts as a teacher or a consultant, helping the patient develop the skills they need to perform self-care independently (e.g., a nurse teaching a diabetic patient how to self-administer insulin).

Application in Practice

In my practice as a nurse on a general medical-surgical floor, I apply Orem's theory to every patient.

Assessment: Upon admission, I assess each patient's ability to perform self-care activities like hygiene, mobility, and medication management. I use this assessment to determine if there is a self-care deficit. For example, a patient admitted for a severe infection may be too weak to bathe themselves, indicating a deficit.

Intervention: Based on the assessment, I implement the appropriate nursing system. For a patient who is post-surgery and disoriented, I would use a wholly compensatory system to ensure all their basic needs are met. For a patient recovering from a stroke who can partially feed themselves but needs help, I would use a partially compensatory system.

Patient Education: My ultimate goal is to move every patient toward independence using the supportive-educative system. I teach patients about their medications, wound care, and disease management. For a patient with a new colostomy, I would provide emotional support and guide them step-by-step until they can confidently perform their own ostomy care. This empowers them to manage their health after discharge, which is the core of Orem's theory.

Sample Answer

Orem's Self-Care Deficit Nursing Theory

Orem's Self-Care Deficit Nursing Theory is based on the idea that people are more effective when they are self-reliant and that the purpose of nursing is to help patients achieve a state of optimal self-care. The theory has three interrelated concepts:

Theory of Self-Care: This defines why a person needs to perform self-care actions and what those actions are.

Theory of Self-Care Deficit: This explains why nursing is needed. It states that a nursing need arises when a person is unable to meet their own self-care needs.

Theory of Nursing Systems: This outlines the role of the nurse in meeting the patient's self-care needs. The nurse can provide care through three systems: