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Florence Nightingale and Dorothea Orem’s Nursing Theories Essay

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Updated: Oct 25th, 2020

Nursing Theory

To meet the needs of patients in the diverse contemporary community, one must focus on creating consistent communication between a nurse and a patient based on the latter’s environment and background. Furthermore, patient education must be enhanced to ensure patients’ ability to identify a health concern and use appropriate healthcare services. Therefore, a combination of Florence Nightingale’s theory and Dorothea Orem’s approach is used as the basis for my nursing theory (Cherry & Jacob, 2016; O’Shaughnessy, 2014).

Excellent Nursing Practices

Florence Nightingale’s theory is typically applied in a nursing environment to enhance the process of knowledge acquisition and education among nurses (Cherry & Jacob, 2016). Therefore, the application of the identified theoretical framework implies. In other words, a set of rigid criteria for meeting the needs of patients must be set for nurses to follow. Furthermore, enhancement of communication within a diverse community with the following development of new skills must be regarded as a necessity (Cherry & Jacob, 2016).

Professional Practice Nursing Theory

The environmental theory promoted by Nightingale aligns with my professional practice perfectly since, as an APRN, I will have to both cater to the needs of patients from multicultural backgrounds and manage the work of teams of nurses. Therefore, the issue of cross-cultural communication and multidisciplinary collaboration will have to be addressed. Nightingale’s theory will serve as the platform for building the standards for efficient nurse-patient dialogue and the consistent improvement of nurses’ skills (Awalkhan & Muhammad, 2016).

Contributions of 19th or 20th Century Historical Nursing Figures

As stressed above, Florence Nightingale and Dorothea Orem will be viewed as key role models whose examples will be followed closely. Nightingale cemented her image of a leader who contributed to the increase in nurse education levels, whereas Orem’s philosophy helped nurses to encourage independence and awareness among patients.

Difference in Contributions

Orem placed a very powerful emphasis on the necessity to provide patients with independence and enhance their education process. Nightingale, in turn, focused on engaging nurses in the process of lifelong learning (Cherry & Jacob, 2016). Therefore, each helped enhance education, yet the recipients of knowledge and the relevant information were different in each case (Cherry & Jacob, 2016).

Description of Historical Figures

Both Nightingale and Orem helped me shape my mission as a nurse precisely. For instance, Nightingale’s philosophy helped me realize the necessity of acquiring new skills on a regular basis in the ever-changing realm of the global community (Cherry & Jacob, 2016). Orem’s theory, in turn, helped me recognize patients as active agents of the nursing process, who must be encouraged to gain new knowledge as well.

State Board of Nursing versus ANA

To provide proper nursing services, one must also keep in mind that there is a massive difference between the State Board of Nursing (SBN) and ANA. SBN operates within a particular state, whereas ANA works on the nationwide level. Moreover, SBNs deal with licensing, while ANA designs programs aimed at improving nursing (Cherry & Jacob, 2016).

Roles of Organizations

Both types of organizations play huge roles in advancing the quality of nursing. SBNs keep the quality of nursing services consistent by allowing only people that meet the set requirements to get a nursing license. ANA, in turn, sets the bar for the quality of services even higher by identifying contemporary issues in nursing and creating programs for managing the specified concerns (Cherry & Jacob, 2016).

Influence of the State Board of Nursing and ANA

As a result, both ANA and SBNs contribute to the process of unceasing development in nurses. Consequently, members of nursing facilities are enabled to adapt to the ever-changing realm of global nursing and meet the needs of multicultural communities. Thus, a gradual rise in healthcare service efficacy and the number of positive patient outcomes becomes a possibility.

Requirements for Professional License Renewal

As a rule, to retain the right to practice nursing, one must renew one’s license every two years. Although requirements for the process of license renewal may vary depending on state-specific laws and the type of license required, general guidelines include providing specific nursing services. The test does not include financial compensation (Cherry & Jacob, 2016).

Failure to Maintain License Requirements

In case of a nurse’s inability to maintain a license, further practice is deemed illegal. If a nurse does not file the required documents before the registration expiration date or takes any other steps that lead to a failure to maintain license requirements, a nurse cannot legally practice as an RN or APRN. The failure to maintain license requirements will also lead to a significant lapse in a nurse’s practice, thus, affecting their professional record and impeding their ability to grow as a professional (Minnesota Board of Nursing, n.d.b).

Compact versus Non-Compact State

The mutual recognition model creates opportunities for nurses to practice their licenses across compact states. Nurses are entitled to be licensed by endorsement. In addition, a further education process is mandatory. However, the specified standards are not applicable to non-compact states, where licensing may be restricted to the specified state. However, enhanced Nurse Licensure Compact (NLC) standards are currently becoming increasingly common for both compact and non-compact states (Cherry & Jacob, 2016).

Agencies Functional Differences

There is a significant difference between the functions of regulatory nursing agencies. For example, the U.S. Food and Drug Administration (FDA) serves the purpose of ensuring the quality and safety of food, drinks, and medications consumed by the U.S. population (U.S. Food and Drug Administration, n.d.). The Centers for Medicare and Medicaid Services (CMS), in turn, focus on providing Medicare and Medicaid services by cooperating with state authorities (Centers for Medicare and Medicaid Services, 2015).

CMS also encourages cooperation between patients and therapists. Therefore, while both organizations pursue quality improvement in healthcare, CMS addresses interpersonal relationships between patients and healthcare professionals, as well as explores the tools for improving access to healthcare services, whereas FDA is concerned primarily with the quality of consumed products.

Influence on Professional Practice

Seeing that FDA defines the safety of medications and devices used by nurses when addressing patients’ needs, FDA affects nurses’ professional practice by helping them choose the tools that can be used to attain optimal patient outcomes (U.S. Food and Drug Administration, 2018).

CMS, in turn, increases the access to healthcare insurance for a large number of people that do not have an opportunity to pay for health insurance on their own (Centers for Medicare and Medicaid Services, 2015). Due to the provision of essential data about the quality of food and medications, as well as the promotion of Medicare and Medicaid standards, the specified agencies allow increasing patient safety rates extensively (Cherry & Jacob, 2016).

Nurses’ Role as a Patent Advocate

Because of the necessity to encourage patient education, a nurse plays a huge role in the process of advocating patient’s rights and needs. The quality of nursing services can be advanced significantly by introducing a set of rigid guidelines into the environment of a nursing facility (Cherry & Jacob, 2016). In addition, the process of communicating with patients must be enhanced to ensure that all of their needs are met respectively. As a result, a nurse plays the role of a patient’s advocate in case the latter chooses alternative treatment options. By supporting a patient’s decision and giving them the required information, nurse advocates for patients’ rights (Cherry & Jacob, 2016).

Purposes of the Nurse Practice Act

Allowing establishing quality standards and, thus, measuring the quality of nursing services, the Nurse Practice Act plays a huge role in advancing healthcare and improving patient outcomes. Furthermore, opportunities for detecting and preventing the instances of violating the set nursing standards can be created with the help of the Nurse Practice Act (Cherry & Jacob, 2016). The Nurse Practice Act also defines the scope of a nurse’s personal and professional practice by outlining the practices that can be defined as violations and, therefore, may result in a nurse’s license becoming invalid (Cherry & Jacob, 2016).

Scope of Practice

For an APRN, the scope of practice ranges from ensuring the quality of services provided to patients to encouraging nurse and patient education to addressing the issues associated with nursing management (Cherry & Jacob, 2016). Particularly, the roles that a registered nurse (RN) may perform in Minnesota include assignment of nursing tasks, a delegation of authorities, the introduction of the intervention, monitoring, and supervision of patients (Minnesota Board of Nursing, 2013).

Rules for Effective Delegation

Delegation is traditionally defined as the process of transferring specific authority or functions to another nurse (Cherry & Jacob, 2016). The Minnesota Board of Nursing (MBoN) follows the guidelines for delegation set by the National Council of the State Board of Nursing (NCSBN) (Minnesota Board of Nursing, n.d.a). NCSBN, in turn, states that to delegate responsibilities successfully, a nurse must focus on training and education, ensure two-way communication, and communicate relevant information accordingly (National Council of the State Board of Nursing, 2015).

Application of Nursing Roles

As an APRN, one must play the role of a nurse as a detective by scrutinizing the environment of a particular community and isolating the factors that may pose a threat to patients’ well-being. As a result, subordinates can be instructed about the means of meeting target demographics’ needs. In addition, as a scientist, an APRN must explore the effects that proposed evidence-based techniques have on patients’ well-being. Finally, as a manager of the environment, an APRN must contribute to the enhancement of the communication between nurses and patients, as well as the patient education process, with a close focus on cultural competency enhancement (Western Governors University, 2013).

ANA code of Ethics Provisions

As an APRN, one must also focus on meeting the requirements for accountability and the code of ethics. For instance, it is necessary to respect patients’ dignity, which is stated in Provision 1. The specified step implies addressing their culture-specific needs, providing them with empathy, and recognizing their human rights, which is Provision 2, according to the ANA Code. The necessity to be committed to a patient, whether the latter is represented by an individual or a community, should also be listed among the key objectives (Cherry & Jacob, 2016).

Analysis of Provisions

Respect for patients’ dignity, which is Provision 1, affects the nursing practice directly by improving the communication process between a nurse and a patient. As a result, the needs of the latter are identified faster and more efficiently, leading to a rise in a nurse’s ability to meet target demographics’ needs. Commitment to patients and communities, which is Provision 2, leads to the development of the ability to adopt a patient-centered approach, thus, engaging in multicultural dialogue and developing a better understanding of patients’ needs. As a result, the quality of the nursing practice improves since a nurse learns to identify patients’ needs successfully (Cherry & Jacob, 2016).

Clinical Practice Error

Provision 1 will help reduce the threat of a clinical practice error by making a nurse respect patients’ dignity and, thus, recognize their needs as essential and strive to meet them accordingly. Provision 2 will allow humanizing patients and encouraging nurses to recognize their role as patients’ advocates by reinforcing the code of ethics, thus, leading to better control of nursing services quality and, consequently, a drop in the chances of a clinical practice error (Cherry & Jacob, 2016).

Application of ANA Provisions

The recognition of patients’ rights (Provision 1) will help make nurses develop empathy toward their target demographics and accept ethical standards based on meeting patients’ needs, thus, managing patients’ personal data more carefully. Combined with the commitment to patients and communities, which is Provision 2, it will help design a framework for managing patients’ personal data more carefully, which will help prevent the instances of negligence causing medication errors and errors in diagnosing health issues (Cherry & Jacob, 2016). Provision 2, in turn, will also allow for a multicultural approach based on recognizing patients’ diversity.

Leadership Qualities or Traits

The significance of leadership can hardly be overrated for an APRN in a healthcare setting. An APRN must deploy team-building skills to provide the basis for multidisciplinary cooperation. In addition, the ability to plan and organize will help get the priorities straight. The capability to implement change will allow adjusting to the ever-changing environment of global healthcare. Finally, the propensity toward learning will promote the active knowledge and skills acquisition among nurses (Cherry & Jacob, 2016).

Demonstration of Nursing Leadership Qualities or Traits

Like a detective, a nurse must use learning strategies to study the specifics of target communities and health-related factors, thus, gaining essential information about patients’ characteristics that will help at the bedside by building an intercultural dialogue and addressing possible instances of misunderstanding. As an explorer, a nurse will also need to focus on the means of adjusting to changes in the target environment, including both technological and cultural aspects of change to enhance interdisciplinary cooperation.

The specified step will also include the enhancement of education among nurses and patients alike, which is crucial in an interdisciplinary setting (i.e., in a team of nurses). Finally, as a manager, a nurse must organize the work of a team efficiently, avoiding the instances of workplace burnouts and keeping motivation levels high, thus, leading to better management of team tasks (Cherry & Jacob, 2016). The identified change helps improve the quality and speed of transferring information at the bedside, as well as within an interdisciplinary team.

Work Environment

To attain the goals listed above, an APRN must create an appropriate workplace environment. The use of a transformational leadership style will have to be considered. For instance, the focus on education and quality improvement can be kept by empowering nurses to engage in lifelong learning and professional development. Thus, nurses will develop leadership qualities that will help them manage their responsibilities more efficiently. Identification of changes will be managed by imparting meaning to work and encouraging nurses to be passionate about their job. Finally, changes in mission and vision will allow adjusting to changes efficiently and make decisions based on appropriate ethical and professional standards (Cherry & Jacob, 2016).


The contemporary nursing environment demands that nurses engage in the process of unceasing self-education, as well as maintain the connection with target communities. Therefore, the active use of the theories promoted by Florence Nightingale and Dorothea Orem must be viewed as a necessity. The specified approaches help upgrade the quality of nursing on a regular basis, as well as enhance patient education and promote knowledge acquisition among nurses.


Awalkhan, A. & Muhammad, D. (2016). Application of Nightingale nursing theory to the care of patient with colostomy. European Journal of Clinical and Biomedical Sciences, 2(6), 97-101.

Centers for Medicare and Medicaid Services. (2015). . Web.

Cherry, B., & Jacob, S. (2016). Contemporary nursing: Issues, trends, and management (7th ed.). St. Louis, MO: Mosby Elsevier.

Minnesota Board of Nursing. (n.d.a). National guidelines for nursing delegation. Web.

Minnesota Board of Nursing. (n.d.b). . Web.

Minnesota Board of Nursing. (2013). . Web.

National Council of the State Board of Nursing. (2015). . Web.

O’Shaughnessy, M. (2014). Application of Dorothea Orem’s theory of self-care to the elderly patient on peritoneal dialysis. Nephrology Nursing Journal, 41(5), 495-498.

U.S. Food and Drug Administration. (n.d.). . Web.

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Western Governors University. (2013). Conceptual model, nursing programs: Journey to well-being. Web.

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