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Dorothea Orem

Born: 1924

Place of Birth: Baltimore, Maryland

Biography

• Dorothea Orem earned her Bachelor of Science in Nursing Education in 1939 and Master of Science in Nursing in 1945
• During her professional career ,she worked as a staff nurse ,private duty nurse ,nurse educator and administrator and nurse consultant
• Received honorary Doctor of Science degree in 1976
• Dorothea Orem as a member of a curriculum subcommittee at Catholic University recognized the need to continue in developing a conceptualization of nursing.
• Published first formal articulation of her ideas in Nursing: Concepts of Practice in 1971, second in 1980, and finally in 1995

Theory

Self-Care Theory

The purpose of Dorothea Orem’s Self Care Model is to allow individuals and their families to maintain control of their healthcare. Self-care is ongoing throughout the continuum of life and is forever evolving.

            Self-care Deficit is the key to Orem’s Self-Care Model because it identifies when and how much a nurse is needed in the care of the patient. Nursing care is needed if there is a problem that prevents a person from reaching their optimal health.

            Orem believes there are three components to the Self-care nursing model, the compensatory system, the partial compensatory system and the educative-developmental system. 

            The Compensatory system is when the nurse provides total care for the patient. This patient cannot do anything for themselves including but not limited to activities of daily living and ambulation. This patient is totally dependent of the nurse for survival, such as an acute Stroke patient.

            The second of Orem’s systems is the Partial Compensatory. The nurse must assist in the care of the patient but the patient and family can assist as well. A pneumonia patient, who is very short of breath, may require the nurse to monitor vital signs, oxygen saturations, assist in ADL’s and ambulation. The patient will be able to resume their own care when they are better but need the assistance and education a nurse can provide at this time.

            The third of Orem’s systems is the Educative-developmental system. The patient has primary control over their health; the nurse assists with education and promoting safe health practices. The patient who has high cholesterol may fit into this category, diet, exercise regimen and medication is important education for this patient. The nurse would teach the patient how to properly maintain good health practices.

            Restoring, promoting and maintaining health are the goals Dorothea Orem’s Self-care Model promotes. The model looks at the patient as a whole and how they interact with their environment. Self-care is an ever changing process throughout the continuum of life and requires constant reassessment.

Contributions

• 1949-1957 Orem 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.
• 1958-1960 US Department of Health, Education and Welfare where she help publish "Guidelines for Developing Curricula for the Education of Practical Nurses" in 1959.
• 1959 Orem subsequently served as acting dean of the school of Nursing and as an assistant professor of nursing education at CUA. She continued to develop her concept of nursing and self care during this time.
• Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980, 1985, 1991, 1995, and 2001.
• Continues to develop her theory after her retirement in 1984

Died: June 22, 2007

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