Theory of Nursing Systems

Refers to a series of actions a nurse undertakes to aid in meeting a person’s self-care needs.
Describes nursing responsibilities; roles of the nurse & patient
Rationales for the nurse-patient relationship
The essential organizing component of the Self-Care Deficit Theory of Nursing because it establishes
the form of nursing and the relationship between patient and nurse properties.
Focused on person
There are three support modalities identified in theory: wholly compensatory; partly compensatory;
supportive-educative

Three Support Modalities:

The client’s ability for self-care involvement will determine under which support modality they would
be considered
A person may fluctuate between support modalities at any given time

Wholly compensatory system

The patient has no active role in the performance of his care
The nurse acts for the patient
An individual requires total nursing care to fulfill self-care needs
A patient’s self-care agency is so limited that she or he depends on others for well-being
The nurse accomplishes patient’s therapeutic self-care; compensates for patient’s inability to engage
in self-care; supports and protects patients

Partly compensatory system

Both nurse and patient work together to perform activities to achieve desired self-care goals
A patient can do some self-care measures but needs a nurse to assist her to meet others
It has a give and take relationship between the nurse and the patient
The nurse compensates for self-care limitations of patient

Supportive-educative system
Requires uses of resources and educational tools to teach the person & family to perform their own
self-care
Indicates that the patient contributes mostly in his/her self-care and the nurse’s role is merely to
monitor & regulate the patient’s self-care
The patient accomplishes self-care & regulates the exercise & development of self-care agency
The patient is able to perform, or can learn to perform, required measures of therapeutic self-care but
cannot do so without assistance
A patient can meet self-care requisites but needs help in decision-making, behavior control, or
knowledge acquisition

Sources:
Theoretical Foundations of Nursing Module
http://faculty.ucc.edu/nursing-gervase/orem
www.slideshare.net/jben501/dorothea-orem-theory
http://jlerner.wordpress.com/2010/04/20/a-look-at-orem’s-self-care-deficit