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Dorothea Orem’s Philosophy of Self-Directed Care Essay


Creating a successful nursing framework that will help tend to the needs of the patients successfully is a challenging task. It is crucial to make sure that the patient should be able to engage in self-directed care so that healthy habits could be developed and that problems could be located at the earliest stages of their development. For these purposes, Dorothea Orem’s nursing philosophy should be viewed as the foundation of the strategy. However, the theory could also benefit from expanding the concepts of communication and quality management. Particularly, the opportunities for a nurse to improve skills and acquire new knowledge should be explored.

Personal Nursing Philosophy

Building a personal nursing philosophy is crucial to the success of the intervention and treatment strategies used to meet the needs of the patient. Therefore, the choice of the ideas that will guide the nurse’s decision in the course of the intervention will determine the success of the therapy. Although the principle of self-care is not new in nursing, I believe that, by assuming the strategy suggested by Dorothea Orem, I will be able to make a difference in the modern nursing environment. Since the approach created by Orem places a very heavy emphasis on the significance of self-care among patients, it will help increase the rates of awareness among the community members; as a result, health rates among the target population are likely to improve significantly as the patients will be able to access the necessary information within a short amount of time and receive the nursing services required to recover fast.

The assumptions of the philosophy created and promoted by Orem are rather simple – the theory is founded on suggesting that the patients should initiate and perform as many health-related rituals and processes as possible, thus, learning more about their body and unique needs. On the one hand, the principles that Orem promoted as the essential ideas on which modern nursing should be based imply that the nurse should shift a significant number of responsibilities to the patient.

For instance, locating the databases for learning about the appropriate guidelines, identifying the symptoms of the developing diseases or disorders, monitoring the key processes to determine the unique properties of one’s organism, etc. are challenging tasks for an average citizen. On the other hand, by encouraging the patients to engage in the process of self-cognition, a nurse is likely to prompt the increase in awareness rates regarding topical nursing issues, as well as determining the characteristics of one’s body and its functioning. The latter details are likely to be very useful in defining the therapy and treatment that the patient will have to receive in case of a health issue. Also, while the idea of gaining awareness independently might be viewed as problematic in the middle of the 20th century when Orem first started developing the model, it has become much more plausible in the era of information technology.

By using social networks and other platforms for information sharing, one is likely to shed a lot of light on the topics that most members of the population used to be unfamiliar with before. Orem’s concept of self-care has truly revolutionized the realm of nursing, offering a plethora of opportunities for a significant improvement in the patients’ recovery rates. As long as one is capable of following the standard rules for keeping in good health and detect the recent issues in a manner as efficient and expeditious as possible, the chances for the nurse to treat the disease or the disorder successfully are inspiringly high (Raille-Algood, 2012).

The theory suggested by Orem can be defined as the analytical one since it encourages the patient to look at the process of managing personal needs from within. As a result, the patient is capable of exploring the problem, analyzing the options that they have, and embrace their role in the recovery process. Orem challenges the patients into participating in the nursing process actively, which helps them gain the necessary skills and knowledge, thus, learning to identify their needs successfully As a result, the communication process between a nurse and a patient becomes reciprocal (Raille-Algood, 2014).

Dorothea Orem’s Nursing Philosophy


From the perspective of Orem’s philosophy, the person for whom the therapy is designed is viewed as a whole, i.e., a combination of social, physical, and psychological elements that define their uniqueness. Although all properties that characterize a particular person are important when viewed through the lens of the self-care nursing theory, the actual ability to perform self-care is interpreted as one of the greatest importance. Therefore, the patient is assessed based on their inclination toward caring for themselves independently.


From the tenets of Orem’s theory, the environment is not merely a combination of factors that define the patient’s health rates – far from it, the author states that the subject matter is comprised of two essential levels, i.e., the physical and the socioeconomic ones. The framework suggests that the patient’s ability should be assessed at each level, thus, helping get the full picture of the problem and select the strategy that will help engage the target audience in the activities involving self-directed care. As a result, the customer is enabled to define the physical threats (e.g., the pollutants, the sources of allergy, etc.) and the ones that come from their socioeconomic background (e.g., poor living conditions, cultural issues, the current perspective of gender roles, etc.).


The interpretation of the concept of health is one of the things that make Omen’s nursing framework unique. According to the author, the phenomenon should be perceived as not a goal to be pursued but, instead, an element of the natural order of things. Differently put, health is assumed to be a part and parcel of any living being, be it an animal or a human being.

By claiming that health is a natural state of being, Omen sets premises for the creation of a nursing framework that will help one to sustain the identified condition in a patient at all times. To make sure that the members of the community remain healthy without the consistent supervision of a nurse, the latter must make sure that the target audience is capable of engaging in self-directed care activities, which returns one to the main tenets of Omen’s philosophy.

Thus, the definition of health suggested by the author works in tandem with the rest of the concepts listed above, creating a coherent nursing framework aimed at attending to the needs of the community.


As stressed above, Omen’s philosophy revolves around the idea of providing the patient with more independence, thus, encouraging them to take better care of themselves. Furthermore, the approach suggested by Omen allows resolving one of the most controversial aspects of modern nursing, i.e., the diversity concern. Although meeting the unique needs of every single patient is essential to the success of the therapy and the treatment provided, it is hardly possible for a nurse to embrace the cultures of all members of the community with the due care and detail. As a result, some of the needs that patients have may be left unattended.

The philosophy suggested by Omen, in its turn, states quite clearly that patients should be aware of the characteristics that make them unique. As a result, the target audience will be able to share their crucial information with nurses. As a result, not only the quality of care but also the communication process will be improved significantly, encouraging nurses to implement a patient-centered approach. The latter, in turn, will trigger an immediate rise in the interventions’ success rate (Queirós, Vidinha, & Filho, 2014).

The Concepts that Should Be Added


The issue of successful communication is in the focus of my nursing philosophy. Although Omen’s model partially implies that a conversation between a nurse and a patient is necessary, the theory does not state explicitly that the subject matter is of utmost importance. In my opinion, though, communication must be added to the list of the crucial concepts that the theory should be based on. As stressed above, it is imperative to make sure that the community members should be aware of their needs and the health concerns that they may have. Consequently, deploying the most efficient communication tools is necessary. Luckily, with the recent technological breakthrough, reaching out to the patients has become astonishingly easy.

For instance, modern social networks can be used successfully as platforms for sharing essential information, providing patients with detailed instructions and guidelines, inviting people to participate in the process of increasing awareness rates, etc. Therefore, communication, in general, and the use of IT tools as the means to improve it, in particular, must be included in the nursing paradigm. Granted that some of the participants may have problems accessing the network, the system will still have a tremendous effect on the overall awareness rates in the community. As far as the underprivileged and disabled population members are concerned, they may be invited to participate with the help of the traditional information management tools, such as booklets, magazines, events for raising awareness, etc. By using all data management tools possible, one will also be able to collect the necessary data from the patients within a relatively short amount of time (e.g., using online surveys), as well as offer people guidelines for engaging in self-directed care (Wong, Ip, Choi, & Lam, 2015).

Quality Improvement

Another essential element that makes the basis of my nursing strategy, the concept of quality needs to be addressed. While providing the patient with the tools that will help manage the problem at the earliest stages of its development and increasing awareness rates is important, a nurse must not lose their grip on the tasks such as diagnosing the problem, defining the means of addressing it, designing an appropriate intervention or a therapy, and monitoring the patient’s progress. Furthermore, a nurse must improve their skills regularly, learning new information and strategies.

The process of quality improvement can be carried out based on the existing models, such as Pyzdek’s DMAIC as a part of the Six Sigma framework (Pyzdek & Keller, 2014), the Total Quality Management approach (Keating, 2014), etc. As soon as the prerequisites for a consistent improvement are created, fast progress can be expected. By making sure that the nurse should be able to communicate with the patient successfully and explore new opportunities in information management (including its acquisition, sharing, and processing), one will be able to create a sustainable model that can be used in all domains of nursing.


Keating, S. B. (2014). Curriculum development and evaluation in nursing (3rd ed.). New York, NY: Springer Publishing Company.

Pyzdek, T., & Keller, P. (2014). The Six Sigma handbook (2nd ed.). New York, NY: McGraw-Hill.

Queirós, P. J. P., Vidinha, T. S. D. S., & Filho, A. J. D. A. (2014). Self-care: Orem’s theoretical contribution to the Nursing discipline and profession. Revista de Enfermagem Referência, 4(3), 157-163.

Raille-Algood, M. (2012). Nursing theorists and their work. New York, NY: Elsevier.

Raille-Algood, M. (2014). Nursing theory; Utilization and application. New York, NY: Elsevier.

Wong, C. L., Ip, W. Y., Choi, K. C., & Lam, L. W. (2015). Examining self-care behaviors and their associated factors among adolescent girls with dysmenorrhea: An application of Orem’s Self-Care Deficit Nursing Theory. Journal of Nursing Scholarship , 47(3), 219-227. Web.

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IvyPanda. (2020) 'Dorothea Orem's Philosophy of Self-Directed Care'. 1 August.

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