Ensuring a healthy life style is a central focal point for every individual, community and the government. With every individual of the society being healthy, the community as a whole will be healthy. Consequently the government will have to spend less on health sector and will have more chances of diversifying its public sector spending. When we talk about ensuring a healthy life style, self care is the most important element. In fact, self care is the basic pillar on which all other elements stand.
According to Orem, self care comprises of all activities than an individual initiates himself in order to ensure his health and well being (Nursing Theories 2010). These initiatives may include taking care of minor things which individuals normally tend to overlook. This may range from taking physical care by ensuring sufficient intake of food, water and air to taking care of mental health by creating a balance between rest time and activity.
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However, when an individual fails to take care of his well being on his own behalf and needs a medical assistance, it is referred to as self care deficit. It is this self care deficit which paved way for various nursing theories and highlights the importance of the role that nurses play in a society. Orem (Alligood and Tomey 2006, p. 255) states that nursing is a helping service and its goal is to overcome human limitations and to make certain that the patient is provided with assistance to cope up with his illness or injury until he rovers from it. When an individual is unable to cope up with his physical or mental instability, nursing renders him the required assistance and the methods and techniques that nurses use in order to attain their goal is known as nursing system.
Self Care Deficit Nursing Theory:
Summing up the individual concepts of self care, self care deficit and nursing, leads us to the Self Care Deficit Nursing Theory. According to Parker (1993, p. 241), Self Care Deficit Nursing Theory is a nursing theory which aims at providing direction for practice to nurses. Since the primary aim of nurses is to provide assistance to their dependant, they need a direction to help patients meet their self care need. This means nurses need to understand the proper nursing system and apply it in their practice.
About a century back, nursing was considered as a low profile, vocational occupation. However, with the theory based nursing studies and a proper nursing system in place, it has become a more meaningful and professional occupation. Florence Nightingale was the first person to highlight the need of a nursing system. Since then the profession has evolved through various phases. In the contemporary era, Dorothea Orem came up with a comprehensive approach towards how the profession should be practiced so as to achieve the required results. Today, nursing is studied like any other dignified science discipline.
Starting with initial nursing theories, according to Cherry and Jacob (n.d., p. 56) , Nightingale's concept of nursing and care taking was the most comprehensive one of that era. It revolved around elements including ventilation, noise, variety, diet, light, happiness and hygiene. This meant that she recognized and took an initiative to create awareness about the fact that health care has a scope much beyond the conventional definition of health care.
Various nursing theorist came up since Nightingale's era and although the basic idea of all theorists was more or less same, however, with the passage of time nursing theories have taken a more scientific approach. While Nightingale's theory was only based on physiological and psychological human needs, contemporary theorists have added spiritual, moral and social dimensions to it too. For instance, Henderson's nursing theory covers all elements proposed by Nightingale, along with elements like spiritual worship, maintaining body postures and temperatures, freedom of expression, elimination of body waste, avoiding environmental dangers and ability to learn in order to satisfy human curiosity. Having said that, Henderson's theory assumes that the patient would be willing to return to health and nurses are will have to look after him only until he recovers. Another assumption is also made that all nurses will perform their task with unconditional devotion. Both these assumptions are not always true.
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Moving on to the contemporary era, Orem's nursing theory is not only more comprehensive, but also more scientific. According to Orem, Self Care Deficit occurs when the self care agency fails to meet the respective self care demands. This shortfall results in self care deficit and thus indicates that a nursing agency is required. Her theory starts with the preventive element of self care, highlights the role of nurses after self care deficit occurs and extends that role not to just the recovery of the patient, but also to educate the patient about self care. This approach makes Orem's approach more sustainable as it does not restrict itself to health care provision, instead it also focuses on health promotion and maintenance. The biggest limitation of her theory is that it focuses primarily on illness rather than well being as a whole.
There are various other nursing theorists that emerged since then. Each of them added new dimensions to nursing theories including behavioral systems, environmental energies and interpersonal processes. As a consequence the science of nursing has evolved over a period of time, thus providing basis for further research and expanding the scope for development of nursing as an academic discipline.
Application of Nursing Theories:
Nursing theories are beneficial in a way that they define relationships between various elements associated with the field of nursing and health care. These theories further provide a direction for its research and practical application and helps predicting the consequences of that practice and the response of the dependant. The study of nursing theories helps nurses to understand and explain their experiences. Most importantly, it helps them to be able to critically analyze a problem or a situation that they would not be able to do otherwise. As a result their ability to find alternate solutions to their problem enhances. Moreover, it helps them in effective decision making and ensuring the quality of nursing care.
In research and education, the study of nursing theories helps in generation of new ideas and assists in discovering and filling the information gaps in particular areas of study. It further helps in designing the curriculum for the study of nursing as an academic discipline. Many of these nursing theories emphasize the idea of observation and states that any event that is experienced by the dependant, or the nurse, or by both during their interaction should be considered as part of the nursing practice. This concept not only makes way for more communication between a patient and a nurse, but also helps understanding and predicting events that could not have been understood and predicted otherwise. The application of various nursing theories in practice helps the dependant to achieve greater level of satisfaction.
The term community in general means a group of people who have some important aspect of life in common while health care is about ensuring physical, mental and spiritual well being. The amalgamation of both leaves us with the concept of community health which basically refers to meeting the needs of society by identifying the problem and managing interpersonal communication within the community. The spectrum of the role that a nurse plays in a community setting is broader as compared to nursing an individual. A community nursing system not only focuses on care provision, but also encompasses the tasks of managing, leading, promoting, researching and educating the community as a whole. The practice of community health nursing covers residential and occupational settings, schools and ambulatory care. Nursing theorists argue that unlike individual nursing systems, community nursing is a very population oriented one and is practiced in an environmental context.
It is an already established notion that nursing theories provide a base and direction for nursing practice. Self Care Deficit Nursing Theories are primarily focused on the interpersonal relationship and efficient communication between the dependant and the nurse. In this context nursing theories can only be implemented effectively if it is made a part of a standardized practice in the organization and a cohesive commitment from the nursing staff can be ensured. Failure to adhere to the standardized nursing system and relying on a trial and error method may put the patient's life at stake. Furthermore, it may result in the development of trust deficit between patients and the care providers.
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Alligood, M and Tomey, A 2006, Nursing theory: utilization and application, Elsevier, United States of America.
Parker, M 1993, Patterns of nursing theories in practice, National League for Nursing Press, New York.
Cherry, B and Jacob, S 2005, Contemporary nursing: issues, trends and management, Elsevier, United States of America.
Nursing Theories 2010, Dorothea Orem's Nursing Theory, viewed 10 November 2010, <http://currentnursing.com/nursing_theory/self_care_deficit_theory.html>.