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.


Ann Glasheen said...

It appears that you have used nursing theory as a means to complain about an entire ethnicity. I have had similar nursing experiences with Middle Eastern clients; however, I find your assessment to be exaggerated and offensive. Cultural differences do not equate to "bad" and do not justify some of your other comments. There are many practices in our culture that seem bizarre or "bad" to others - personally, I find it impossible to provide the best patient care when I participate in that type of judgment.

riodomalaon said...

With your respect Ann Glasheen, it is not exaggerated and offensive. This article signifies the challenges and observation we have encountered in a clinical setting. Indeed it is the reality, that is why we should always consider the individuality of our clients.In addition to that, I am not complaining about the whole ethnicity, what I'm trying to see here is the uniqueness of each individuals according to his beliefs and social orientation which the person has experience in his environment.Yes, you are right that cultural diversity do not equate bad behavior which may sometimes we misinterpreted. The theory of Orem suggested to be flexible in a various types of patients in order to render the best nursing care as well as to satisfy our clients needs.

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