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Clinical Practice Analysis Nursing Models Health And Social Care Essay

Paper Type: Free Essay Subject: Health And Social Care
Wordcount: 2460 words Published: 1st Jan 2015

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Concepts should not be considered as either being permanent or static but should be considered open to new knowledge, perception, experiences and also data (Alligood and Tomey 2006). The nursing models were established to help clinical nurses in developing new roles and partnerships and also create better models of nursing care in order to facilitate a better clinical practice (www.health.nsw.gov.au/nursing/projects/models_of_care.asp). Nursing models are usually referred to as operational models for redesigning the nursing practice that will provide better nursing care for the patient on an organizational setting, primarily hospitals and long term care facilities. The models however can take a different form on the organizational level. They however only mean that that there has been some form of redesigning. This redesigning is usually mainly at the patient care delivery level or the nursing level. The only way to differentiate such models at the level of organization is by attaining those that do not care delivery. These are mainly levels such as innovative pay and also the programs of clinical advancement. Nursing practice models differ from the traditional models in either of the following structural dimensions. It is either through the degree to which the practice by individual nursing is differentiated based on their individual educational level, the degree to which nursing practice is more of self managed rather than managed by traditional supervisors, the degree to which case management is deployed and also the degree by which teams are employed. Teams in this case mean either nursing or multi-displinary. According to Mayer, Madden, and Lawrenz (1990), the models that they evaluated have varying degrees of employing various structural approaches to reorganize the nursing practice. Past studies and also the present studies show reflections on the applicability of the models and also the nursing models. This allows the validation and construction of new action forms in nursing care. It also helps to identify limits and relations between professions and individuals who are in need of care. In order to give a description, explanation, forecasting or even a prescription of nursing care, there is need to have articulated and communicative conceptualizations of reality which can either be invented or discovered.

Case study: HIV/AIDS patients

Among many cases that affect the human nature other than the cancer kind of diseases, Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) has the greatest negative effect on mankind. The case study within the practice which best utilizes the nursing models is on the Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS). This case study best shows how the nursing model by Dorothea Orem can best service the patients and bring a form of relief to the patients. There have been models and theories that have been put in practice or give an explanation of the self-care related phenomena guide solutions that respond to the involved people¿½s needs and interests and equip nurses to help patients take care of themselves, as AIDS is a chronic illness that depends on the patient¿½s personal care to gain a better quality of life and prolong survival. Models including that of Dorothea Orem are used in nursing to ensure that there is adequate care given to those with HIV/AIDS. The use of this model or theory is because those who suffer HIV/AIDS have low immunodeficiency. This has a great effect on the normal functioning of the body. It however rests upon the patients to ensure that they maintain good health. People suffering from HIV/AIDS require constant care and support from the society. They also require not to be looked down upon by those who offer the care delivery to them. It therefore shows that the model of nursing by Orem can easily boost the morale of the patients if they a re given a chance to have the self care by themselves. It however also requires that there be moderate to high levels of participation by the health care deliverers in order to ensure that the patients are well equipped on how to go round the self care.

Nursing models by Orem

Models are considered conceptual reference frameworks, constructed representations on some aspect in the environment, using abstractions as fundamental blocks. The self care model of nursing or better known as the Orem model of nursing was established by Dorothea Orem in 1959. In her theory of administering care the patient is looked upon or is encouraged to be an independent person. This helps in the recovery of the patient as they are directed to use the best ways possible to ensure their well being. Self care is considered as an individual¿½s performance towards a better health, life and also well being through practice of given activities. The recovery and development of health is achieved when a patient apprehends the orientations. This helps to retain the structural integrity and also the human functioning. For those suffering Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS), there are diseases which are related that occur. They may include the acquisition of opportunistic infections as the body has a low immune system, difficulty in taking sufficient food intake, lack or deprived sleep, nausea and/ or altered palate due to collateral medical effects, weight loss, fatigue, an decrease in body mass. Other than the physical changes, the patient may also have an onset of psychological alteration such as low self image and self esteem. There are also changes in lifestyles of the patient due to maybe prejudice, side effects of the medication and even constant and frequent visits to the health centre.

Areas of changes

The self care model by Orem consists of mainly three theories which revolve mainly around the nursing theory, self-care deficit and also the self care theory itself. On the theory of self care there are three levels that are of concern such as universal care, health deviation and also developmental. This means care which aims at maintaining the integrity of human functioning and structure. According to the self care deficit theory, it shows that the patient has to be dependent and in a situation whereby the patient is incapable or has limitations to providing self care. This is what needs to be changed in the Dorothea Orem¿½s model of nursing in order to deliver better care. By doing away with such theories it will prove better and well managed to finally offer better care towards the patients. It therefore becomes relevant to view such a case scenario as a way to improve self care through the use of the Orem nursing model where a patient should be considered as an independent person. There have been researches done that have articulate the use of this model of nursing.

Outcome of the use of the nursing model by Orem

a. The use of the theory by Orem by patients suffering from HIV/AIDS

As such was the case scenario of patients in an educative proposal of how to have eye self exam by those who suffer from Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS). There were several detailed diagnosis that were identified from most of the patients. Based on the profile that was as a result from the analysis of the patients, it proved that patients require help. The demand on self care on universal and developmental level ensures that patients get moderate if not high levels of help. Basing the facts from the deduced results it showed that there was a level of competency in the patients. This shows that the patients can conduct their own eye self exam. The results also justify that for patients suffering HIV/AIDS, it is possible for them to have adequate nursing care. Through the analytical questions that were posed in order to achieve the analysis of the model showed that nursing care systemization for self-care among HIV/AIDS patients, using the nursing process; to the patient¿½s possible accomplishment of the eye self-exam; to the identification of HIV patients¿½ self-care attitudes and deficits through the universal, developmental and health deviation requisites. Besides, the nursing model collaborated as a method to help patients. The resulting results show that the Orem¿½s theory can give guidance. This guidance however serves as a guide to how care delivery is done on those with HIV/AIDS. It also elaborates more on the need to have assessment on the HIV/AIDS patient on self eye exam. The analysis of the study also showed that the nursing model by Dorothea Orem can also be used in the nursing curriculum.

b. The use of Orem¿½s model of nursing involving the HIV/AIDS patients

The analyzed study offered important information to guide nursing research, as it demonstrated that the use of Orem¿½s Theory permitted testing an eye self-exam teaching model in HIV/AIDS patients, which can be included in the nursing curriculum. There were discoveries that were made in the Orem¿½s theory. This included the fact that there was little or small input from the limited number of participants. It therefore proved hard to make a possible. However, there was qualitative results that made it possible to have a view on the competency in HIV/AIDS patient to run an eye self test. The tested propositions were based by the fact that a higher proportion of HIV patients at different stages had irreversible eye alterations due to lack of early diagnosis and treatment. It therefore goes to show that patients require help for universal development and health deviation requisites.

c. Orem model of nursing for the purpose of nursing management

Based on the research done on people with HIV/AIDS, there is a considerable gap that the nurses should bridge. Mainly this gap is mostly in the learning of nursing based on the educative and supportive system of nursing there has been detailed nursing curriculums that help in implementing the Orem¿½s model of nursing. The outstanding results from the use of Orem¿½s model in nursing showed that there could be use of the model in the management of the nursing in care services. This was a measured achievement towards self care for patients suffering from HIV/AIDS. It proved to be a success and therefore can be used in the nursing management. The practice of nursing is becoming more targeted as the self care proved to be an instant success. Mainly after the nursing interventions, the care quality in nursing can be measured to form an assessment.

d. Better instruments for future and further diagnosis of diseases

Based on the findings of how effective the Orem¿½s model of nursing is on Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) it only goes to show that with future studies of other diseases, this Orem¿½s model of nursing can be utilized to the advantage of the patients and also to the advantage of the nursing practice as a whole. In the practice of this Orem¿½s model of nursing, it proves comforting to the patient which should be the general idea behind nursing (Alligood and Tomey 2006). It offers comfort to the patient as they have the knowledge that someone else has faith in them to take good care of themselves. It also boosts their morale in knowing that they are yet capable of taking care of themselves to attain better health

General conclusion

For nurses who undertake the use of Orem¿½s model of nursing they can easily find out gaps or self care deficits which they can try to fill in. The act of learning more in order to fill in the deficit can also help in the diagnosis which might be corresponding. By the use of the Orem¿½s model of nursing, it becomes easy for those in the nursing practice to identify means and ways through which they might better the practice. Basing on facts that the Orem¿½s model of nursing was established in the early 1965, it has been used widely in nursing areas such as on pregnant women, HIV/AIDS patients, adolescents and also hypersensitive patients. There has been progress from theory to practice by the use of the use of the model in nursing by Orem. There is proven and theoretical framework as it has helped nurses to offer support to patients of HIV/AIDS. Besides just intervention for those with HIV/AIDS, the model of nursing by Orem ensures that attitude of the patient and also the self care deficits are clearly identified. It therefore proves that the model in nursing by Orem can is actually a valid instrument. It can therefore be used to bridge the gap between the researchers and also the research subject. As a means of ensuring that those in the nursing practice utilize the Orem¿½s model in nursing, there can be a venture into other areas other than HIV/AIDS to areas such as diabetes. By the use of the Orem¿½s model in nursing it has opened up more opportunities through which support education can offer. There is better service offered since the Orem¿½s model in nursing was established and more research in this area is proving fruitful. This is because of the research done based on people with Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) has been seen as a step closer to ensuring that the patients do not suffer. It also has ensured that there is better treatment both at a physical and psychological level. Though it might prove as a remedy or cure to the disease it has definitely given the patients a better understanding of themselves. It has also created ways in which the patients can be self reliant based on the stages of the Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS).


It therefore goes without saying that the Orem¿½s model in nursing is a true model that should be utilized more for the sake of the patients. It helps in boosting the self esteem of the patient which giving a detailed analysis to those in the profession of nursing. It provides a better view on how strategies should be laid out in order to achieve better health care delivery. Patients no matter the kind of ailment they suffer from but especially those suffering from Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV/AIDS) should be taken as independent patients. They should be taught various ways of self care other than the eye self care. Through such ways it proves profitable for both the patients and also those in the nursing practice. The model in nursing by Orem proves a sufficient way to manage the practice of nursing and on the other hand creates a study for other patients who might benefit from the model.


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