NURSING THEORY

Dorothea Elizabeth Orem

Dorothea Orem, one of America’s foremost nursing theorist develop the self-care Deficit
Nursing theory, a caring approach that uses experiential and specialized knowledge (science) to
design and produce nursing care (art). She identified 3 classifications of nursing system to meet
the self-care requisites of the patient:

 Wholly Compensatory System

 Partially Compensatory System
 Supportive Compensatory System

CLASSIFICATION OF NURSING JUSTIFICATION

SYSTEM
Wholly Compensatory Nursing System
Partially Compensatory Nursing System
Supportive - Educative System
This is represented by a situation in which
the individual is unable “to engage in those
self-care actions requiring self-directed and
controlled ambulation and manipulative
movement or the medical prescription to
refrain from such activity. Persons with these
limitations are socially dependent on and
well-being.”
This is represented by a situation in which
the patient can meet some needs. Both the
nurse and the patient engage in meeting self-
care needs.
This is also known as supportive
developmental system; the patient can meet
self-care requisites, but needs assistance with
decision making or knowledge and skills to
learn self-care. The patient has primary
control over their health; the nurse assists
with education and promoting safe health
practices

Orem defined self-care as “the practice of activities that individuals initiate and perform on
their own behalf in maintaining life, health and well-being”. This theory could be a vital and
important in the condition of the client in promoting immediate recovery.

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Florence Nightingale: Environmental Theory

Florence Nigthingale, widely known as the “Lady with the Lamp”, created the
Environmental Theory. According to her nursing, “is an act of utilizing the environment of the
patient to assist him/her in his/her recovery.” (Nightingale 1860-1969). It involves the nurse’s
initiative to configure environmental settings appropriate for the gradual restoration of the
patient’s health and that external factors associated with the patient’s surroundings affect life or
biologic and physiologic processes.

Environmental factors affecting health defined in her environmental theory are the following
factors present in the patient’s environment:

 Ventilation
 Light
 Bed and Bedding
 Cleanliness of Rooms and Walls
 Personal Cleanliness
 Nutritional

The manipulation of these environment factors is essential to the recovery of the patient. It
must also be assured that the significant others are well aware of the tasks that are necessary
to be performed to contribute to the possible return of health of the patient. In the case of
patient A proper ventilation and maintaining room temperatures is essential in order to keep
the air pure and prevent patient from being too warm and cold. Adequate light provides,
“quite real and tangible effects upon the human body.” Keeping the room, walls, beddings
and the patient herself clean can provide patient’s comfort thus contributing to patient’s
recovery. Maintaining good hygiene and daily dressing to the surgical wound is essential to
prevent infection. Ensuring adequate nutrition is essential as well.

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Virginia Henderson: The Nature of Nursing Model

Henderson’s theory states that the unique function of the nurse is to assist the patient,
either sick or well, in the performance or those activities contributing to health or its recovery,
that patient would perform unaided if they had the necessary strength, will or knowledge. This
would help the patient gaining independence as rapidly as possible.

Nurses play an active role. Nurse serves to make patient “complete” or “whole”, or
“independent”. The nurse is expected to carry out physician’s therapeutic plan individualized
care is result of the nurse’s creativity in planning for care. Nurse should have knowledge to
practice individualized and human care and should be a scientific problem solver. Concerned
with taking care of patient’s needs and assisting them with activities of daily living – activities
that the clients would have been capable of doing had they not been sick or incapacitated .
Nurses are also crucial instruments for dying patients to have peaceful death and in consoling
loved ones when the inevitable happens.

In the Nature of Nursing Model, the nurse role is, “to get inside the patient’s skin and
supplement his strength will or knowledge according to his needs.”

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