Dorothea Elizabeth Orem

PRESENTED BY: MEGAN DAVIS, MEISHEL

FORTINO AND KIM MCPIKE

Self-Care Deficit Nursing Theory (SCDNT)

Focus on patient self-care capacity
Nurses should only do for the patient what they cannot

do for themselves
Three interrelated theories

Self-Care
Self-Care Deficit
Nursing System

Three Operations

Theory of Self-Care
Self-care is the ability to perform activities and meet

personal needs with the goal of maintaining health

and wellness of mind, body and spirit.
Self-Care Requisites

Universal
Developmental
Health Deviation

Theory of Self-Care Deficit

Every developed person has the ability to meet self-

care needs. When a person experiences the inability

to meet their needs due to limitations, a self-care
deficit exists.
Nursing focuses on identifying the deficit and

implementing appropriate interventions to meet the

needs of the patient.

Theory of Nursing System

The ability of the nurse to assist the patient in

meeting current and potential self-care demands.

It specifies how the patients self-care needs will be

met by the nurse, patient or both.

Three Operations
Diagnostic: establish relationships and explore

self-care needs.
Prescriptive: begin planning care based on

mutually identified self-care needs.

Regulatory: nurse designs, plans and produces a

system for care.

Diagnostic
Nurse-patient relationship
Explore self-care needs
Contracts
Influences

Prescriptive
Planning stage
Mutually identified self-care needs
Deficits determined
Nurse reviews various approaches

Regulatory
Systems of care:

Wholly Compensatory
Partial Compensatory
Supportive-educative Compensatory

Compensatory levels can fluctuate

Orems Timeline
Born in 1914
1930s- diploma in nursing
1939- BSN
1945- MSN
1976-1998- honorary nursing and science doctorates
Died in 2007

Orems Motivation and Influence

Nursing experience included:

operating room
private duty
medical surgical units (pediatric and adult)
ER supervisor
biological science technician
Acting Dean
Assistant Professor

Achievements
Worked for the Division of Hospital and

Institutional Services of the Indiana State Board of

Health

Her goal was to upgrade the quality of nursing in general

hospitals throughout the state.
During this time she developed her definition of Nursing
Practice.

Publications

Nursing: Concepts of Practice

Guidelines for Developing Curricula for the Education of
Practical Nurses

Orems Philosophy

Orems theory is based upon the philosophy that all

patients wish to care for themselves. It is believed that
ordinary people in todays society want to be in control
of their lives. They can recover more quickly and
holistically if they are allowed to perform their own
self-care to the best of their ability.

Four Global Concepts

Human Being

Environment

Health

Nursing

Evaluation
Orems SCDNT relevant to the medical field
Global Concepts
Narrow View?
Theory in practice

Conclusion

Orem has provided not only an intellectual and

practical basis for nursing, but also a language for
nursing. Orem, a visionary, deliberatively worked
through, developed, and shared her understanding
of nursing with others. She helped others to move
nursing from a technological basis to a theoretical
one, a science, and she showed the relationship
between the two.

Nursing is perhaps best described as the giving of

direct assistance to a person, as required, because of
the persons specific inabilities in self-care resulting
from a situation of personal health.
-Dorothy Orem, 1959

Case Study
Jimmy Joe is 75 years old. He is POD#2 for a total hip
replacement. He has a history of: CHF, BMI of 35.2
and is HOH. PTA, he lived alone in an apartment with
three stairs to his entryway and required no assistive
devices. He is ambulating to the bathroom with a gait
belt and front-wheeled walker. He requires moderate
assistance getting in and out of bed. He is taking 2
tabs of Norco-5 every 6 hours. He plans to discharge
home tomorrow with home health care.

Case Study Questions

1.

What deficits does this patient have that prevents

him from providing his own self-care?

2. What system of care does Mr. Joe fit into?

A.
B.
C.

Wholly Compensatory
Partially Compensatory
Supportive-educative Compensatory

References