Saturday, July 17, 2010

Rio D. Domalaon

Nursing theories is very essential for us (nurses) in our daily work. It provides us with a sound basis to describe, explain, and predict factors that influence nursing care. In nursing, caring is the core of nursing practice. As a profession, we need to develop theoretical knowledge based on research findings to form the foundation of nursing practice. Therefore, development and validation of nursing theory will help in strengthening nursing practice. It is also a source of professional autonomy and power, and it guides in nursing education, research and practice and differentiates nursing practice from other disciplines.

Nursing theory should, in general, have a significant impact on clinical practice. Patient care situations can usually be viewed within the context of some theoretical framework. Dorothea Orem's general theory of nursing provides one such framework. The theory essentially defines the need for nursing care. This need occurs whenever a person experiences some limitation or deficit which interferes with their ability to maintain self-care. Further, the theory delineates the various interactions which should occur between a nurse and a patient.

Dorothea Orem's general theory of nursing describes nursing as a complex form of deliberate interpersonal action that ultimately provides a helping human health service. She chose the name ‘deficit’ as it describes and explain a relationship between abilities of individual, their children or adults for whom they care. The notion ‘deficit” does not refer to a specific
type of limitation, but to the relationship between the capabilities of the individual and the need for action.

Working outside your home country is a great challenge; you will encounter a diverse culture wherein the acceptance of the plan of care varies to each individual. In my experience, especially here in the gulf region it is very difficult to apply in a clinical setting the theory of Orem because of several factors most likely with their health beliefs, culture, and perception towards their recovery. Like for example, a Middle Eastern patient complaint a minor cut injury on the distal toe but hemodynamically stable, majority of their basic ADL will be dependents to the nurses. Like for instance, he/she will ask to drink water even if it is within his/her reach and he/she is able to manage still they will call the nurse to spoon feed them like a small baby in diapers. In addition to that, even if the nurses will explain the importance of being independent and the theory of Orem will takes place in this case. However, they will not accept what you will tell them, instead you will be bad forever until they discharge. Their mentality is different, if they are sick they are really sick and you have to serve them like majesty.

Marlon Pandeling

Thinking about nursing is as important as doing nursing. The conceptual structure of the discipline of nursing must be known by those nurses who practice nursing and those who teach nursing. Nurses in practice must be able to identify the phenomena that are of concern to them, and must have a framework for reflecting on their practice. It is very important for us nurses to know the different theories in relation to nursing. Such theory is the self-care deficit theory by Dorothea Orem.

The focus of Orem's model of nursing is to enhance the patient's ability for self-care and extend this ability to care for their dependents .A person's self-care deficits is a result of their environment. Three systems exist within the professional nursing model: the compensatory system, in which the nurse provides total care; the partial compensatory system, in which the nurse and the patients share responsibilities for care; and the educative-development system, in which the patient has the primary responsibility for personal health, with the nurse acting as a consultant. The basic premise of Orem's model is that individuals can take responsibility for their health and the health of others, and in a general sense, individuals have the capacity to care for themselves and their dependents.

In application to my present job, the theory of Dorothea Orem is a very useful tool. It serves as a guideline to maintain my composure as a nurse. At present, I am assigned in a medical-surgical ward, a total care is very much more important in rendering nursing care to my patients.

Erlie Bobadilla

I have been in the Nursing Profession for two and half decades now and I can say that I am a living witness that the Theory of Self Care by Dorothea Orem became one of the foundations of Nursing Practice across all settings. Orem’s Theory can be applied to nursing assessment and evaluation of the nursing process where the emphasis is on the importance of how one’s ownself is important for maintaining life,health development and well-being.Nurse can easily make her assessments only where there is direct contact between her, the client, and the client’s family.

We all know that the nurses’ role wherever we are, is to help client sick or well to maintain or achieve level of optimal health and wellness of all our patients.We nurses must act as teacher,support person,friend,creating a conducive and therapeutic environment to all clients.
Nursing is the act of caring,nurturing and healing but as always it goes beyond simply caring for the patient with illnesses and diseases,it’s also caring for the person inorder for him/her achieve the optimal health and wellness both in body and spirit.
Sad to say,at present ,this is not really happening.Nursing now becomes a job not a vocation.Some people took nursing only to go abroad and earn money,to be able to provide their families with the material needs they want,to be able to give comfort to their families if working overseas,if working in the Philippines,their goal is to gain experience so they can work abroad.They are not really there for their patients.Most of them are task- oriented rather than patient-oriented.

Abroad we have all the latest technologies,computerize machines that we can use in rendering  and delivering care to all our patients,we connect them to monitors but we often forget that by simply touching our patients could make them feel well and even better. So I am calling all nurses,we have to act as advocate for our patients and let them feel that we are here for them to support and assist them till they achieve full recovery as guided by D.Orem’s theory. We have to let them know also that machines can help them for the diagnosis of their disease but we have to let them feel that we are always around 24/7 for them.

Catherine Gemora

Being a nurse is no easy feat. One must wake up early in the morning or early in the evening to prepare for work come good or bad weather. Before going to the workplace, the nurse must make sure that her paraphernalias are complete, her uniform well pressed, her hair neat and tidy and most of all, her smile well plastered on her face.  Four years in college is never enough to be prepared for the experiences one earns on nursing practice. I, myself is a living witness on how challenging it really is.

I am a pediatric nurse in one of the government hospitals in my province. Five days a week, I face the gruesome reality that whether I like it or not, I’m going to take care of 15-20 patients in a ward. How could I render quality nursing care to my patients without compromising their health and mine? That is the question I ask myself every time. The reality discouraged me so greatly at first that I kept on doubting if indeed it is my vocation to enter the profession that I have chosen until I met a particular patient. Let’s call her X. X, a preterm baby, was admitted at the neonates ward for acute respiratory distress syndrome. She was intubated, with orogastric tube for feeding and on very close monitoring. Naturally as a healthcare giver, I assisted her on her daily basic needs. I gave her feeding, checked her oxygenation status frequently, aided her during elimination and comforted her significant others. Unconsciously, I was using Orem’s self care deficit theory, particularly that of the wholly compensatory mechanisms. After a month from admission, X’s status improved. She was weaned and was extubated successfully. Gradually she was able to tolerate breastfeeding. Nearly two months in the hospital, X’s condition greatly improved and was discharged. Having witnessed X’s fight to survive made me realize how fullfilling it is to be able to help the sick. Honestly, I have never expected that she will make it through. Because of her, I learned to love my profession. She unknowingly encouraged me to become the kind of nurse that I am now.

Orem’s theory is constantly applied in my nursing practice. Understanding the concepts on the significance of balance between the person’s self-care abilities and his or her universal self care needs helped me serve my clients in the most humane, compassionate and competent way possible.