School of NeedsGoup Members:Pia Ellis Chris Kokkola

Zrinko Vranjes Jouni Sopanen

Dr. Dorothea E. OremRN BSN, Ed. MSN, Ed.Born: 1914, Baltimore, Maryland.Education: Diploma (early 1930's), Providence Hospital School of Nursing, Washington, DC; BSN Ed. (1939) and MSN Ed. (1945) from the Catholic University of America, Washington, DC.Honorary Doctorates: Doctor of Science from Georgetown University (1976) and Incarnate Word College in San Antonio, Texas (1980); Doctor of Humane Letters from Illinois Wesleyan University, Bloomington, Illinois (1988); Doctor Honoris Causae, University of Missouri-Columbia (1998).Dr. Orem continues to be active in theory development. She completed the 6th edition of Nursing:Concepts of Practice, published by Mosby in January 2001

Orem’s Theory of Nursing

Person

•Able to reflect, symbolize, and use

symbols

•Can function biologically, symbolically,

and socially

•Patient is a person who is deficient in

universal, developmental, or health-

related self-care

Environment

Orem had a limited view of its

usefulness as a helping

environment.

Health

•Health and healthy are terms used to describe living things, in their structure and function as a whole or in a sound way

Nursing

•It’s an art, a helping service and a technology

•Actions are deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments.

•Includes patient’s perspective of health conditions as well as the physician’s perspective and nursing perspective.

•Universal developmental, and health deviation self-care requisites.

Orem vs. Abdellah

•In the School of needs there are 3 main theorists, we choose to compare Faye Glenn Abdellah to Dorothea Orem.

Definitions or nursing:

• Abdellah: Uses a problem solving approach to deal with problems related to needs of a patient.

• Orem: Self-care agency to meet individual’s need for self-care action in order to sustain life and health, recover from disease or injury, and cope with the effect.

Focus of Nursing•Abdellah: Problem solving approach to

nursing activities sustenal, remedial, restorative, preventative, self-help, need deficit or excess.

•Orem: Deficit between self-care capabilities and demand.

Goals of nursing

•Abdellah: Help individual meet health needs and adjust to health problems.

•Orem: Eliminate deficit between self-care capabilities and demand.

Nursing Problems

•Abdellah: Condition faced by patient for which a nurse can assist, overtly or covertly.

•Orem: Deficiency in 8 universal, 2 developmental, and 6 health deviation requisites/needs.

Nursing Therapeutics: Abdellah

•Preventative care (hygiene, safety, exercise, rest, sleep, body mechanics).

•Sustenal care (psychosocial care)•Remedial care (provision of oxygen, fluid,

nutrition, elimination)•Restorative Care (coping with illness and

life adjustments)

Nursing Therapeutics: Orem

•Wholly Compensatory (Nurse performs all self-care for patient)

•Partly Compensatory (Nurse and patient perform patient self-care)

•Supportive-educative System (Nurse helps in overcoming any self-care limitations)

Characteristics of School of Needs

• May be refered to as the need or deficit school of thought

• Not medical in orientation but based on Maslow’s hierarchy of needs and influenced by Erickson’s stages of development.

• The focus of this school of thought then is on problems and needs of patients as seen by the health-care providers, and on the role of nurses to assess these needs to fulfill the need requisites.