Course Catalog

Level Objectives

Junior Level Outcomes

At the conclusion of Junior Level courses the student is a/an:

Senior Level Outcomes

At the conclusion of Sevior Level courses the student is a/an:

Orem’s Conceptual Framework

The faculty, at Saint Anthony College of Nursing, has selected the theory of Dorothea Orem as the organizing framework for the nursing curriculum.

Orem’s theoretical framework is expressed through her understanding of what nursing is and the relationship of nursing to society. Orem has stated that nursing is “…a world of experiences with people, of information seeking, of making judgments and decisions and acting to achieve foreseen results that fulfill existent or projected requirements of people for nursing (Orem 1995).” The following demonstrates Orem’s model as it is perceived and implemented by the College as a framework for curriculum development. This model begins with the understanding of three constructs essential to the model: Universal self-care requisites, developmental self-care requisites, and health deviation self-care requisites. These constructs are essential for normal functioning, development, and personal well being. The first of these constructs, universal self-care requisites is defined as the essential needs of the person for the intake of food, water and air, for the living conditions that support life processes, and the formation and maintenance of structural integrity and the promotion of activities that contribute to normal life processes. The second construct is that of developmental requisites. Orem describes this construct as essential elements required by the human body for normal growth and development from intrauterine life through infancy, childhood, adulthood, and old age. A health deviations self-care requisite is the third construct. This third construct is defined as genetic and conditional deviations from normal. The individual is able to work toward prevention of the condition, and/or control the extension of the condition. Human beings by their very nature take responsibility for actions that constitute self-care. The need to be responsible leads directly to therapeutic self-care demand, which Orem describes as essentially a prescription for continuous self-care action through which self-identified self-care requisites can be met with various degree of effectiveness. When the individual has made the specific decisions through therapeutic self-care demand, the implementation of these decisions is made through self-care agency. Self-care agency is described by Orem as a complex acquired capability to meet one’s continuing requirements for care of self. This self-care agency varies with individuals and depends on development, health state, and any factors that influence educability, cultural aspects and use of resources in daily living. Adequacy of self-care agency must be measured against therapeutic self-care demand. Self-care agency is conceptualized by Orem as having acquired the ability to make decisions concerning care of self and being able to operationalize these decisions. Ability to do self-care is determined mainly by the person engaged in the activity. The College curriculum is constructed around the constructs of self-care and the need the person has to engage in self-care systems of individuals. Nursing recognizes that self-care agency at particular times and under some conditions cannot be exercised adequately by the individual. Such conditions under which the person cannot wholly or can only within limitations exercise self-care agency may require nursing care.

Students learn to recognize common needs of the person and assess self-care abilities of the individual. The person is regarded throughout the curriculum as a rational being capable of self-care. When self-care agency is insufficient for self-care, self-care deficit occurs and the nursing agency is activated by the nurse.

Nursing agency is a concept understood as a power developed through special education and development of special skills in nursing practice. This power has been defined by Orem as nursing agency, which in turn refers to the special attributes that define nursing and practice. Nurses, through nursing agency exercise care for individuals or groups in nursing practice. Nursing agency can be further defined as the care given by the professional nurse; the clinical practice afforded the person by nursing students under direct supervision of advanced practitioners, or by the advanced practitioners themselves. The College defines the advanced practitioner as the nurse with an advanced degree and one qualified to teach students in specific areas in which students practice.

The curriculum is focused on development of nursing students in acquisition of knowledge and skills. Students gain opportunities to acquire social, interpersonal, and technologic abilities that define nursing agency. To employ nursing agency, the nurse will act through nursing systems. Nursing systems assume the nurse will employ the nursing process to diagnose the patient self-care deficits, calculate the patient therapeutic self-care demands, identify self-care capabilities, and plan for appropriate nursing intervention. Nursing systems assume appropriate nursing intervention will be performed followed by evaluation of the intervention.

Basic to employment for nursing systems is recognition of three types of nursing systems. These systems are: (1) wholly compensatory nursing systems, (2) partly compensatory nursing systems, and (3) supportive-educative systems. These three systems are methods used within the curriculum to operationalize nursing education. Although no one nursing course employs only one type of nursing system, the level of acuteness of the individual nursing care will dictate the nursing system employed by the nursing student.

Wholly compensatory nursing will require students to act for the patient, because the patient is unable to care for the self, make reasoned judgments, or any way contribute to his/her own care. The partly compensatory system is for situations in which both patient and nurse perform actions that are for the benefit of the patient’s health and/or well-being. Ideally, the patient and nurse work together to plan and implement the nursing process for the benefit of the patient. In the supportive-educative system, the nurse is present in a supportive role, educating the patient and offering the patient support in self-care and self-care decisions of the patient. The nurse is in a consultant role. (Orem, D. 1995).

OREM’S ADOPTED FRAMEWORK