MARTHA-ROGERS-and-OREM THEORY OF NURSING

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1. MARTHA ROGER’S SCIENCE OF UNITARY HUMAN BEING (SUHB)

2. Who was Martha Rogers and why is she important to the science and art of Nursing? Rogers was a highly educated nurse who earned her doctorate degree from John Hopkins University in 1954. She wrote 200 + articles, 3 books and founded the society of Rogerian scholars 1988. Developed a conceptual model of nursing that focused on the impact on energy fields and patterns in nurse, patient and environmental interactions. Rogers saw human beings as pandimensional (without physical or psychological boundaries) resulting in “Unitary Whole” with sharing and exchanging of energy occurring within one’s environment.

3. WORKS Her publications include: Theoretical Basis of Nursing (1970) Nursing Science and Art: A Prospective (1988) Nursing: Science of Unitary, Irreducible, Human Beings Update ( 1990) Vision of Space Based Nursing (1990).

4. Rogers’ Theory of Unitary Human Beings The belief of the coexistence of the human and the environment has greatly influenced the process of change toward better health.

5. TWO DIMENSIONS OF SUHB Science of nursing - which is the knowledge specific to the field of nursing that comes from scientific research   Art of nursing - which involves using the science of nursing.

6. Rogers’ theory defined Nursing as “ an art and science that is humanistic and humanitarian .

7. Roger’s Metaparadigm PERSON A person is an open system continuous process with the open system that is the environment.

8. HEALTH Passive health – To symbolize wellness and the absence of disease and major illness

9. NURSING It is the study of unitary, irreducible, indivisible human and environmental fields: people and their world . N ursing exists to serve people , and the safe practice of nursing .

10. Nursing is an empirical science it . How it becomes an art? It aims to promote harmony between human field and environment field in a way to optimizes wellbeing to all to promote health and wellbeing persons

11. ENVIRONMENT These energy fields are irreducible, pandimensional sharing of energy and patterns with human through synchronous interactions.

12. Energy Fields

13. Principles of Hemodynamics Hemodynamics the way in which persons life process evolve. Homodynamic should be understood as a dynamic version of homeostasis ( physiological equilibrium) Homeodynamic principles postulate a way of viewing unitary human beings. The three principles of hemodynamics are;  Resonance  Helicy  Integrality

14. Application of Theory

15. Application of Roger’s Theory in Nursing

16. Clinical Practice

17. Brief History – Life B orn in July 15, 1914 in Baltimore, Maryland. Her father was a construction worker and her mother is a homemaker.

18. Brief History – Life She was the youngest among two daughters. Dorothea Orem died on June 22, 2007 in Savannah, Georgia, where she had spent the last 25 years of her life as a consultant and author. She was 92.

19. One of America’s foremost nursing theorists . Dorothea Orem earned her Bachelor of science in nursing education in 1939 and Master of science in nursing in 1945 Received honorary Doctor of Science degree in 1976

20. Works Orem subsequently served as acting dean of the school of Nursing and as an assistant professor of nursing education at CUA 1959. 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

21. Assumptions of the Self-Care Deficit Theory

22. Assumptions of the Self-Care Deficit Theory

23. M ajor Concepts of the Self-Care Theory Nursing – is art, a helping service, and a technology Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective

24. Goal of nursing

25. Goal of nursing

26. Health Health is “being structurally and functionally whole or sound.” H ealth is a state that encompasses both the health of individuals and of groups, and human health is the ability to reflect on one’s self, to symbolize experience, and to communicate with others.

27. Environment The environment has physical, chemical and biological features. It includes the family, culture, and community.

28. Human being H as the capacity to reflect ,symbolize and use symbols. Conceptualized as a total being with universal ,developmental needs and capable of continuous self care A unity that can function biologically, symbolically and socially

29. Basic Conditioning Factors

30. Therapeutic self care demand

31. 3 categories of self care requisites are:--

32. Provision of care associated with elimination process Balance between activity and rest, between solitude and social interaction Prevention of hazards to human life well being and Promotion of human functioning

33. Health deviation self care

34. Health deviation self care

35. Health deviation self care

36. Theory of self care deficit

37. 5 Methods of Helpin g

38. Theory of Nursing Systems Describes how the patient’s self care needs will be met by the nurse , the patient, or both Identifies 3 classifications of nursing system to meet the self care requisites of the patient :- (next)

39. Wholly compensatory system Persons with these limitations are socially dependent on others for their continued existence and well-being .” care of a newborn care of client recovering from surgery in a post-anesthesia care unit

40. Partial Compensatory Nursing System [ Either ] the patient or the nurse may have a major role in the performance of care measures.” Example: Nurse can assist postoperative client to ambulate, Nurse can bring a meal tray for client who can feed himself

41. Supportive-Educative System This is also known as supportive-developmental system, the person “is able to perform or can and should learn to perform required measures of externally or internally oriented therapeutic self-care but cannot do so without assistance.”

42. Orem’s Theory and Nursing Process Orem’s approach to the nursing process presents a - method to determine the self care deficits and then - to define the roles of person or nurse to meet the self - care demands .

43. Nursing Process

44. Orem’s Nursing. Process Diagnosis and prescription ;determine why nursing is needed. analyze and interpret –make judgment regarding care Design of a nursing system and plan for delivery of care Production and management of nursing systems

45. Step 1-collect data in six areas:- The person’s health status The physician’s perspective of the person’s health status The person’s perspective of his or her health The health goals within the context of life history ,life style, and health status The person’s requirements for self care The person’s capacity to perform self care

46. Step 2 Nurse designs a system that is wholly or partly compensatory or supportive-educative. The 2 actions are :- Bringing out a good organization of the components of patients’ therapeutic self care demands Selection of combination of ways of helping that will be effective and efficient in compensating for/ overcoming patient’s self care deficits

47. Step 3 Nurse assists the patient or family in self care matters to achieve identified and described health and health related results ..collecting evidence in evaluating results achieved against results specified in the nursing system design Actions are directed by etiology component of nursing diagnosis E valuation

48. Therapeutic self care demand Adequacy of self care agency Nursing diagnosis Methods of helping Air - Maintain effective respiration Water - No problem Food maintain sufficient intake Inadequate Adequate Inadequate Potential / Risk for impaired respiratory status Potential Fluid imbalance Actual nutritional deficit R/T N ausea Guiding & directing Teaching Providing physical support

49. Application of Orem’s theory to nursing process Personal factors Universal Self-Care Developmental self care Health deviation Medical problem & plan Self care deficits - 8th grade Teenage pregnancy No work - Married Child-2 - Urinary retention Intermittent self catheterization - Pain - No BSE Infrequent physical examination - No HRT - Poor health ability to manage effects - Surgery on reproductive organs Difference between knowledge base & lifestyle

50. Strengths A major strength of Dorothea Orem’s theory is that it is applicable for nursing by the beginning practitioner as well as the advanced clinicians . Orem’s theory provides a comprehensive basis for nursing practice. It has utility for professional nursing in the areas of nursing practice, nursing education and administration.

51. She specifically defines when nursing is needed: Nursing is needed when the individual cannot maintain continuously that amount and quality of self-care necessary to sustain life and health, recover from disease or injury, or cope with their effects . The terms self-care, nursing systems, and self-care deficit are easily understood by the beginning student nurse and can be explored in greater depth as the nurse gains more knowledge and experienc e.