Term Paper on "Nursing Administration"

Term Paper 12 pages (3931 words) Sources: 1+

[EXCERPT] . . . .

INTEGRATION of PARTICIPATORY DEVELOPMENT and OREM'S SELF-CARE MODEL for ORGANIZATION- and COMMUNITY-WIDE IMPLEMENTATIONS in the AREA SERVED by an OBSTETRICS/GYNECOLOGY CLINIC (a PATIENT-CENTRIC MODEL)

The objective of this work is to examine Orem's Self-Care Model and identify the administrative and issues and problems in this model. This work will design an appropriate nursing management model to include a strategic plan in addressing nursing administrative issues or problems in this model. This strategy will be justified with appropriate concepts, principles and theories of nursing management and the implications of the newly designed model considered.

The work of Donna L. Hartweg entitled: "Dorothea Orem: Self-Care Deficit Theory" states that Orem's self-care model is increasingly used as a framework of practice in specific institutions. This has significant implications for nursing service administration." (1991) Hartweg relates that the application of Orem's self-care model to "nursing service administration" has been reported in studies including that of Allison (1985) who reported the perspective of an administrator on "structuring of the nursing practice based on Orem's theory of nursing. Elements of the nursing system for a patient with a spinal cord injury were developed. Self-care capabilities and limitations, self-care requirements, and related nursing actions were identified for this patient population. Using Orem's concept of nursing agency, Allison further identified how the role and function of the professional, technical, and vocational nurse were defined in relationship to each of these components." (Hartweg, 1991) Orem's theory has been applied in various forms in nursing education with curricular content that differentiates the "role and function of the technical and professional nurse in the program at Thornton Community College in South Holland, Illinois." (Hartweg, 1991; paraphrased) it is reported that Orem's theory of nursing was utilized at Georgetown University in its exposure of baccalaureate nursing students to theory early in the program, which is believed to have broadened their perspective of nursing. (Hartweg, 1991; paraphrased) Orem proposed in 1980 that "self-care systems result from use of knowledge and skills to meet known requisites and that self-care is learned within the context of social groups through human interaction and communication." (Hartweg, 1991)

I. NURSING ADMINISTRATION CONSIDERATIONS in OREM'S THEORY

Orem's Self-Care theory is reported in the work of Peeratiyutawong, Hanucharurnkul, and Panpakdee entitled: "A Self-Management Program for Improving Knowledge, Self-Care Activities, Quality of Life, and Gycosylated HbA1c Among Thai Persons with Type 2 Diabetes Mellitus" which relates a study for testing the effectiveness of a self-management program that had been designed to improve cognitive behaviors, knowledge, diabetes self-care activities, quality of life and HbA1c for patients with type 2 Diabetes Mellitus." (2006) the theoretical framework upon which this study was based was the self-care theory of Orem and cognitive behavior therapy. The self-management group participation was in five sessions: (1) pathology of diabetes mellitus, problem-solving and goal setting skills; (2) dietary control and communication skills; (3) drug self-administration and cognitive restructuring skills; (4) exercise; and (5) foot care and self-monitoring. The methodology used in the five sessions were a supportive educative nursing system comprised of presentation, discussion, and skills training. Noted among the benefits of the self-management program were those of: (1) improved knowledge; (2) improved self -- care activities; and (3) quality of life.

The work of Hanucharurnkul entitled: "Nursing Knowledge Development: An Update" that in the nursing discipline the substance is "nursing knowledge or nursing theory, nursing scholarship, and the essence of nursing." (2006) the development of global or grand theories began in the 1960s and one of these grand theories is that of Orem's self-care deficit nursing theory. These theories are stated by Hanucharurnkul to "provide broad perspectives regarding the nature of outsourcing, the person, and health and the environment. They held to define nursing and nursing research. "

II. EXAMINING the FEASIBILITY of OREM'S MODEL of NURSING

The work of Marianne Goodwin entitled: "Is Feasible for the Nursing Division at St. Vincent's Hospital to Adopt Dorothea Orem's Model of Nursing?" relates that centric to Orem's model is "the individual and his/her need for self-care. The model is concerned with the provision of management of self-care. A requirement for nursing exists when a person is unable to maintain for him/herself self-care action, which is therapeutic in sustaining life and health, recovering from disease and injury or coping with their effects. (Orem, 187 1: 1; as cited in Goodwin, 1990) Orem emphasizes the complimentary nature of the nurse-patient relationship, which is "the essence of Orem's model." (Goodwin, 1990) and means that the actions of the nurse assist the patient in assuming responsibility for their health-related self-care by: (1) making up for existent health-related deficiencies in the patient's capabilities for self-care; and (2) supplying the necessary conditions for the patients to withhold or maintain or increase their capabilities for self-care in order to maintain, protect and promote their functioning as human beings." (Orem, 1980; 11; as cited in Goodwin, 1990)

Orem states that "self-care is a requirement of every person, man, woman, and child. When self-care is not maintained, illness, disease or death will occur." (Orem, 1980: 6; as cited in Goodwin, 1990) Orem describes self-care deficit by stating: "People can benefit from nursing because they are subject to health-related or health-derived limitations that render them incapable of continuous self-care or dependent care, or that result in ineffective care." (Ore, 1980: 27; as cited in Goodwin, 1990) Orem's model is one that "adopts a 'Development World View' from the identifiable stages she describes in self-care agencies throughout life." (Goodwin, 1990) Orem (1980) states that the conceptual framework of nursing systems "...are formed when nurses use their abilities to prescribe, design, and provide nursing for legitimate patients (as individuals or groups) by performing discrete actions and systems of action. These actions or systems regulate the value of or the exercise of, individual capabilities to engage in self-care and meet the self-care requirements of the individual therapeutically." (29; as cited in Goodwin, 1990) Orem's model is described by Fawcett (1984) as being one "derived from inductive reasoning." (Goodwin, 1990)

The structural and functional components of Orem's model are examined in the work of Goodwin who states that Orem made a clear identification of the "four major nursing metaparadigm concepts..." (1990) the first, or the patient is the model's primary focus. Secondly, the environment is identified and Orem notes that requirements of self-care "have their origins in human beings and the environmental factors, elements, conditions..." Third, Orem views health "as an ideal, that is, when living things are structurally and functionally whole (1980, 118; as cited in Goodwin, 1990) the fourth, Nursing Actions are defined by Orem as: (1) a creative effort of one human being to help another (1980: 6); and (2) action performed by nurses for the benefit of others." (1980: 92) Within Orem's theory the nursing process is three specific stages: (1) diagnosis and prescription; (2) designing and planning; and (3) production and management.

III. SYSTEM-WIDE IMPLEMENTATION of OREM'S MODEL IS DIFFICULT

The work of Marilyn E. Parker entitled: "Patterns of Nursing Theories in Practice" states the senior nursing administrator faces the question of whether nursing theory should be adopted within the agency or organization. In the initiative to adopt a model of nursing, the four primary considerations are stated to be: (1) the environment; (2) the financial resource base; (3) the acquisition of knowledge resources; and (4) development of tools for the implementation. (Parker, 1993) System-wide theory implementation is acknowledged in the work of Parker (1993) to be "very difficult." Parker reports that development of the philosophy, assessment tools, standards, orientation manual and appraisal tools were done according to the manner in current literature with all tools being adjusted in an ongoing manner. Parker states that theory provides a frame of reference for nursing practice and provides direction for articulation with other theories and knowledge bases." (Parker, 1993) Parker relates that the view of nursing in an organization guided by the Self-Care Deficit Nursing Theory is demonstrated to go through the integration of theory in the mission/philosophy, the objectives of the nursing department, the orientation program, the staff development programs related to nursing practice, the performance appraisal system, the quality improvement program, and nursing research conducted in the organization."

IV. SELF-CARE SUPPORT REQUIREMENTS of NURSING STAFF

The work entitled: "Supporting Self-Care: The Contribution of Nurses and Physicians" relates: "Nursing work in self-care focuses on identifying and assessing self-care needs and abilities, intervening in ways that meet these needs and evaluating the effectiveness of the interventions with clients. The goal of self-care from a nursing perspective is to improve the client's health status, coping and functional abilities. This is accomplished through the collaboration of clients, their families and support networks with members of the health care team." (Health Care System, Canada, 2007) Additionally stated is: Orem (1991) delineated three possible roles for nurses: (1) to compensate for a person's inability to perform self-care by doing it for her or him; (2) to work together with the patient to meet his or her health care needs; and (3) to support and educate… READ MORE

How to Reference "Nursing Administration" Term Paper in a Bibliography

Related Term Papers:

Nursing Shortage This Work in Writing Research Proposal

Nursing Shortage

This work in writing will take under consideration the fact that there has been a nursing shortage and will attempt to answer the question of whether nursing has… read more

Research Proposal 7 pages (2268 words) Sources: 5 Topic: Nursing / Doctor / Physician

---

Nursing Law Dissertation

Critical Care Nursing

Regarding Legal Liability

the critical care nursing regarding legal liability issues

Definition of key concepts

Introduction to the history of forensic nursing

Interaction with patients with legal… read more

Dissertation 30 pages (9400 words) Sources: 1+ Topic: Nursing / Doctor / Physician

---

Nurse Research Evidence-Based Nursing: Develop Essay

Nurse Research

Evidence-Based Nursing:

Develop a nursing research question.

In what ways can the use of evidence-based practice help to reduce low morale, high turnover and personnel shortages amongst nurses?… read more

Essay 2 pages (600 words) Sources: 2 Style: APA Topic: Nursing / Doctor / Physician

---

Nursing Retention Strategies Term Paper

Nursing Retention

It is true that hospitals suffer from high turnover of nursing staff. However, studies show that does not need to be the case if the organization's management recognizes… read more

Term Paper 6 pages (1811 words) Sources: 4 Style: APA Topic: Nursing / Doctor / Physician

---

Nurse Practitioners' Autonomy the Current Role Term Paper

Nurse Practitioners' Autonomy

The current role of nurse practitioners in the United States will need to be upgraded significantly in the near future for two important reasons. For one, as… read more

Term Paper 6 pages (2015 words) Sources: 6 Topic: Nursing / Doctor / Physician

---

View 100+ more related papers  >>