Nursing Leaders Past and Present, Research Paper Example

Pages: 5

Words: 1350

Research Paper

Abstract

Introduction

This work examines the nursing theory of Dorothy Orem, a leader in the nursing field. Orem conceptualized what is known as the self-care deficit theory, which will be reviewed in this work in writing.

Nursing Leadership Defined

The work of O’Brien (2010) states that nursing leadership “is described as referring to the “ability to guide, motivate, and inspire, and to instill vision and purpose.” (p.220) O’Brien states that the provision of leadership requires that one must “be able to influence beliefs, opinions, or behaviors of others and to persuade others to follow your direction.” (2010, p. 220) The roles and competencies of nurse leaders include those identified in the work of Garrison, Morgan, and Johnson (2007) and include the following:

Values clarification;
Lifestyle management;
Goal setting
Nurtures relationships with organizational leadership;
Liaisons with healthcare leaders in the community;
Recognizes the needs of clients;
Maintains evidence-based practice;
Supports ‘interdisciplinary team care;
Represents the organization to the community;
Mentors new nurses; and
Facilitate communication. (O’Brien,2010, p. 227)

Dorothea Orem: A Nursing Leader

Dorothea Orem is a leader in nursing due to her development of the self-care deficit theory, which is a general theory of nursing and one of the models used most widely in nursing today. Orem was born in Baltimore, Maryland and receiving her nursing diploma from Providence Hospital School of Nursing located in Washington, D.C. Orem additionally received three honorary doctorates as well as an Alumni Achievement Award for Nursing Theory in 1980 from Catholic University of America. (Bridge, Cabell, and Herring, nd , paraphrased) The work of Bridge, Cabell and Herring (nd) relate that Orem “…recognized a need to look for the uniqueness of nursing” and specifically sought to answer the question of precisely “What is nursing?, What is the domain and what are the boundaries of nursing as a field of practice and a field of knowledge?, and “What condition exists when judgments are made that people need nursing?” (nd, 2) The work of Andan (2010) states that Orem viewed man “as an integrated whole composed of an internal physical, psychologic, and social nature with varying degrees of self-care ability.” (p.1) The patient was viewed by Orem as “an individual with health related limitations that make him or her incapable of continuous self-care or dependent care.” (Andan, 2010, p.1) The self-care requisites or demands are stated to be beyond the patient’s self care abilities and are due to the patient’s “lack of knowledge, skills, motivation or orientation.” (Andan, 2010, p. 1) Health was defined by Orem as “a state of wholeness or integrity of a human being: a state where one is structurally or functionally whole or sound.” (Andan, 2010, p.1)

Orem’s Self-Care Deficit Theory

Orem went to work in Washington D.C. in 1957 and was employed as a consultant in the Office of Education charged with the task of improving the “…nursing component of a vocational nursing curriculum.” (Bridge, Cabell, and Herring, nd, 2) It was the determination of Orem that until the subject matter of nursing was understood generally that there was no way that the curriculum could be decided. Orem became assistant professor at The Catholic University of America in 1959 and her concept of nursing and self-care underwent further development and experienced formalization following her interaction with the Nursing Development Conference Group (NDCG) a group that is reported to have been “…committed to the development of structured nursing knowledge and to nursing as a practice discipline.” (Bridge, Cabell, and Herring, nd, 6) Orem’s conceptual framework was first published in 1971 in the work entitled “Nursing: Concepts of Practice”. Chinn and Kramer (2004) state that Orem’s work provided a great contribution to the 1970’s as that decade was “a time for changes within the nursing profession, being a time for planning, researching and expanding nursing roles.” (p. 36) Orem’s ideas came at a time when nursing was being acknowledged as a legitimate science. (Chinn and Kramer, 2004, 36) Orem’s theory defines the four concepts that comprise the metaparadigm of nursing: (1) human beings; (2) environment; (3) health; and (4) nursing. Nursing is viewed by Orem as “an art through which the practitioner of nursing gives specialized assistance to persons with disabilities of such a character that greater than ordinary assistance is necessary to meet daily needs for self care and to intelligently participate in the medical care they are receiving from the physician. (Orem, cited in Bridge, Cabell and Herring, nd, 5)

The importance of Dorothea Orem’s conceptual framework is illustrated in the fact that this framework has been “used increasingly as a guide for nursing research.” (Hartweg, 1995, p.39) Hartweg additionally states that recent research has utilized Orem’s framework and specifically that the work of Harper (1984) has tested four hypotheses that were deduced from propositions in Self-care Deficit theory and findings “supported several of Orem’s (1980) propositions including the following: (1) selfcare systems result from use of knowledge and skills to meet requisites; and (2) self-care is learned within the context of social groups through human interaction and communication. (Hartweg, 1995, p.40)

Public Image of Nursing Today and the Effect of Nurse Leaders’ Achievement

The perception held by this writer of the public image of nursing today is one that is positive for the most part and this is because of the inherent participatory nature of nursing in today’s healthcare provision. Whether the nurse practitioner or the clinical nurse, participatory nursing is required in delivery of effective and efficient healthcare for patients in the health care environment of today. Nursing leaders such as Henderson, Orem, and contemporary leader Joanne Disch, and their acknowledgement of the requirement of nursing leadership that values participatory relationships in healthcare delivery greatly support and further the positive public view of nursing in today’s contemporary health care delivery environment.

Conclusion

Having read the information related herein and having considered the information contained in this work in writing, the writer of this work has had the opportunity to reflect upon the real value of the provision of the nurse to the patient and to their family members. The provision of knowledge and information to the patient that enables them to fully participate in their own health care and recovery is a valuable provision and one that ensures that the patient will have the best possible chance to regain their health and to do so while retaining some of their autonomy in the health care service delivery process. The nurse has the unique opportunity to enable their patients to better health status through assisting them in helping themselves.

References

Andan, Adam (2010) Orem’s Nursing Paradigm. Retrieved from: http://upoun207tfn.blogspot.com/

Bridge, J., Cabell, S., and Herring, B. (nd) Dorothea Orem’s Self-Care Deficit Theory. Troy University. Retrieved from: http://prism.troy.edu/~scabell/Orem.pdf

Chinn, P. L., & Kramer, M. K. (2004). Integrated knowledge development in nursing (6th ed.). St. Louis: Mosby.

Hartweg, Donna L. (1995) Dorothea Orem: Self-Care Deficit Theorie. Volume 4 of Notes on Nursing Theories. Sage, 1997. Retrieved from: http://books.google.com/books?id=nyvV6K6LJ9sC&dq=Dorothea+Orem,+nursing+leader&source=gbs_navlinks_s

O’Brien, Mary Elizabeth (2010) Servant Leadership in Nursing: Spirituality and Practice in contemporary Health Care. Jones and Barlett Learning 12010. Retrieved from: http://books.google.com/books?id=vArXRIPzux4C&dq=Dorothea+Orem,+nursing+leader&source=gbs_navlinks_s

Orem, D.E. (1995). Nursing concepts of practice (5th ed.). St. Louis: Mosby-Year Book.