Nursing Theories and Practices: Orem's and Neuman's Models Analysis

This essay delves into two prominent nursing theories: Orem's Self-Care Deficit Theory and Neuman's Systems Model. It begins with an introduction to nursing, emphasizing its role in health promotion, illness prevention, and patient care. The essay then explores the core principles of each theory, detailing Orem's focus on self-care, self-care deficits, and nursing systems, as well as Neuman's holistic approach to patient care, considering internal and external stressors. The essay compares and contrasts these theories, highlighting their strengths, weaknesses, and applicability in modern healthcare settings. It underscores the importance of nurses adapting these models to meet the diverse needs of patients, considering both physical and psychological well-being. The discussion includes the theories' limitations and benefits, and how they can be applied to solve health-related problems.

Running head: NURSING- THEORIES AND PRACTICES
NURSING- THEORIES AND PRACTICES
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Introduction
Nursing in a broader sense deals with the protection promotion and the optimization of
the health. It involves the preventive activities relating to illnesses and injuries suffered by a
person. The nursing is the management of the health issues in a way, which facilitates healing,
and recovery of the illness and the problems relating to the health faced by the people.
Globalization has posed a major threat to the lives of the people and therefore nursing practices
had to undergo certain changes in this century. It involves the management of the health issues
faced by the individuals, families and communities. The practices help in making the life of the
individuals sustainable through the continuous efforts and care.
In this context, nursing is being judged based on the models and theorems that are being
proposed for the better functioning of the practices. The practices are being formulated as per the
requirements of the society and thereby it helps in determining the major functions undertaken
by the nurses (McCormack, Manley and Titchen 2013). The applicability of the services as per
the requirements of the models is based on the common criteria of the requirements of the
clients. The requirements of the clients and the health issues faced by the people influences the
approach that is being undertaken by the nurses. in order to adhere to the interests of the clients,
the nurses are required to adhere to the models that will be enumerated in the report (Alligood
2013). The Systems model of Neuman provides a system based approach to nursing which
includes flexibility in its operations. The flexibility of the nursing activities helps in undertaking
the efficient course of action. It helps the individuals in undertaking the best possible practice
based on the requirements of the health care (Im and Ju Chang 2012). It inhibits the primary
secondary and the tertiary nursing practices based on the maintenance of the patient. On the other

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hand, Self-care deficit theory of nursing prepared by Orem is based on the concept of
developing the nursing practices and monitoring over the quality of the services that are being
delivered by the nurses on the same. The most important consideration undertaken by the model
is based on the wide range of requirements of the patients (Masters 2014). It stresses more on the
quality of the services rendered by the nurses. The wide acceptance of the theory makes it more
convenient to adopt in the circumstances of the crisis.
The discussion aims at understanding the theories and the manner in which are applied on
the issues in order to solve them. The most important consideration that is being undertaken
while evaluating the principles is based on the criteria of the outcomes of the practices. The
practices help in sustaining the life of the patients (Smith and Parker 2015). Determining the
needs of the patients and application of the theories based on the requirements is the important
decision that the nurses are required to take. The diversity in the modern world have resulted to
several health related issues (Masters 2015). Nursing helps in enumerating the issues and solve
them according to the requirements of the health care needs of the patients. The purpose of
undertaking this discussion is to underline the important limitations and benefits of the theories
and the applicability of the theories in the health related problems faced by the patients. The
discussion also includes a case study, which enumerates the credentials of the theories, and the
models involved in nursing.
Theories of Nursing
The models that are being enumerated are based on the practices that are being
undertaken in order to resolve the health related issues of the patients. The management of the
issues is being based on the principles of nursing (Rich 2013). The aim of the theories and the

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models is to enhance the effectiveness of the actions taken by the individuals based on the health
related requirements of the patients. The basics of nursing is based on the principles that are
being enumerated by Orem and Neuman in addition to the classic principles formulated by
Nightingale. The transition of the principles took place based on the requirements of the
circumstances that are being faced by the people at that time. The most interesting fact is that the
models and theories are still applicable, even in this modernized world (Alligood 2014). There
might be certain modifications in the practices undertaken then and now, but the basics remained
the same. This section of the discussion will be focusing on the principles and theories of
nursing that are being enumerated in order to make the nursing services more efficient. The
discussion will also include the limitations and the benefits of the applicability of the theories
and enumerate the circumstances at which they are better applicable.
Theory 1 - Orem’s Self-Care Deficit Theory
The major assumptions of Orem’s self-care deficit theory are based on the responsibility
of the patient and the family members other than the healthcare professionals. It includes
communication as nursing is a practice based on the interaction between the patient and the
nurse. The patient communicates the issues to the nurse, and the nurse communicates to the
patient on the problems faced by the patient. It is a profession, which requires integration
between the nurse and the patient. The theory by Orem comprises of three interrelated parts,
which helps in the understanding of the health related issues faced by the people. The theory of
self-care, the theory of self-care deficit and the theory of nursing system are the parts on
which the theory proposed by Orem is established (Grove, Burns and Gray 2012). According to
the self-care system, Orem outlined the essentials for the individuals to undertake the care for
their own self (Refer to Appendice 1). Therefore, self-care is the first step to nursing. It includes

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the individual’s own needs care for the self. On the other hand, the self-care deficit theory
enumerates the ways in which the actions of the nurses are required. This happens when an adult
is incapable to take care of the issues faced by the person. The issues might be due to the
inefficiency of the person or the nature of illness. The continuous maintenance of the issues are
being undertaken through the principles as the nurse takes up the responsibility of adhering to the
health related requirements of the individual. The nursing systems underlined by Orem helps in
understanding the procedures of the nursing practices where the actions of the nurse are being
defined based on the varied requirements of the patients (Cherry and Jacob 2016). The theory
proposed by Orem gives a totality to the profession of nursing. It provides the very pathway for
undertaking the actions in order to sustain the life of the patient at the time of the individual’s
incapability.
Theory 2 - System Model by Neuman
On the other hand, the system model proposed by Neuman helps in understanding the
effectiveness of the precautionary actions in nursing. It is a holistic approach to nursing which
not only deals with the body of the organism but also the mind and the spirit (Papathanasiou,
Sklavou and Kourkouta 2013). It believes in the integrated functioning of the body mind and the
spirit for keeping a person healthy. It regards the stressors and the stress response factors as the
only reason for an individual’s illness (Lachman 2012). Therefore, it supports the views of
preventing the stress factors to affect the patient by changing the environment and the habits of
the patient (Refer to Appendice 2). The major consideration undertaken by this approach is based
on the environment- both internal and the external sources in order to determine the well living
of the individual. The basic consideration undertaken by the concept is based on the
requirements of the patient as to the type of approach being chosen. The nurses are required to

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stress more on the environmental stressors that surrounds the individuals (Barker 2012). It helps
in determining the changes that the nurse might undertake in order to prevent the stressors from
affecting the patient’s livelihood. The System model is being balanced with the wellness of the
person. The patient’s system moves towards the unrequited end when there is an energy lag and
a lack of the life force. On the other hand, the excess of the life force helps the individuals to live
the life.
The most intriguing theory of nursing
The approaches that are being discussed in this section have its individual strengths and
weaknesses, which determine the applicability of the theories on the patient’s life. The most
important consideration undertaken by the nurse is based on the requirement of the patient and
the applicability of the theories in practice (Townsend 2014). The nursing practices undertaken
by the nurses help in recovering the patient to the natural environment and recovery from the
illness or the disorder that the patient is facing. Based on the requirements of the disease the
nurse inculcates the theories and thereby helps in making significant progress in the life of the
patient. The theories help in determining the duties of the nurse in dealing with the incapability
of the patient (Reed and Shearer 2012). The other aspects undertaken by the nurse is based on the
objectives of nursing. Nursing includes supporting the patient in the individual’s inabilities.
According to Orem’s theory, the three parts help in determining the functions of the nurse in
dealing with the problem faced by the patient. The self-care helps in maintaining a continuous
health care of the individual. The individuals in order to keep themselves fit and active undertake
it. On the other hand, the self-care deficit theory determines the circumstances where the patient
is incapable to take care of the individual and the intervention of the nurse into the process is
craved (Rice 2012). The last part of the theory deals with the responsibilities of the nurse in order

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to deal with the issues faced by the patient. The most important part to be enumerated in this
context is based on the patient’s requirements of treating the incapability. The theory helps in
determining the wholeness of the nursing care and the duties of the nurses are therefore
enumerated in this context (Stanhope and Lancaster 2013).
On the other hand, the theory proposed by Neuman is based on the holistic approach of
the nursing. It helps in undertaking the activities that determine the efficient care undertaken in
order to cure the patient of the issues faced relating to the mind, spirit and body. The theory
believes in the environmental circumstances that affects the health of the individuals. The
individual’s health is dependent on the factors of the stressors that are present in the
environment. Certain situations that put a stress on the human brain can be harmful for the body,
mind and the spirit of the person (Raingruber 2016). Therefore, the principle of this theory is
based on removing the stressors from the environment in order to cure the person of the
inabilities. The most important consideration undertaken by the theory is based on the holistic
approach that is being identified with the concept. It helps in judging the situation of the patients
and thereby helps in avoiding the stressful situations. In the modern days, the therapists and the
psychologists are using this approach in order to implement the wholeness of the actions taken.
The theories that are being enumerated ion the above discussions helps in determining the
most feasible and effective approach of nursing (McCabe and Timmins 2013). In the modern
days, both of the concepts are applicable based on the requirements of the patients. The
wholeness of the theories overlaps one on another in order to make use of the situations. The
most applicable theory of the modern day is based on the wholeness of the practices, which is
identified by the model of Orem. It helps in undertaking the events to minute concepts and

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thereby helps in making the improvements in the life of the patients. It also helps the nurse by
enumerating the functions in an emergency.
Case study
The case opens with the appointment of a home care nurse for an elderly woman, named
Jessica, who is suffering from the pains of osteoarthritis. The nurse is supposed to assist the lady
and make improvements in the style of living in order to cure her of the painful situation. At the
first step, the nurse undertakes a communication with the woman, which helped the nurse in
understanding the situation of the woman and the amount of pain she is into (Scribd.com 2017).
The steps taken by the nurse will be based on the theory of Orem, which enumerates and defines
the functions that the nurse might undertake in order to rehabilitate the woman to her previous
state. The applicability of the theory helped the nurse in understanding the situation and thereby
frames the course of action that are required to be undertaken. The woman is suffering from the
joint pains that seemed to cease her actions for the days and is slowing her down. She is facing a
depression due to her incapability and therefore the nursing is required as the self-care practices
cannot be undertaken by the woman.
The steps taken by the nurse will be based on the requirements of the patient, and the
kind of attention required by the inability faced by the patient. The course of action undertaken
by the nurse cannot be holistic and therefore only by meagerly changing the environment or the
removal of the stressors from the environment would not be working for the patient. The nurse
therefore chooses the Orem’s theory over Neuman’s in order to attend the needs of the patient.
The steps taken by the nurse in enhancing the condition of the patient is based on the
methods enumerated by the theory proposed by Orem, which states the responsibilities of a nurse

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to act or serve for the patient and thereby make the patient aware of the steps that would be
reducing the pain (Alligood, Wood and Alligood 2013). The information that is being
transmitted by the nurse will be helping the patient to cope up with the similar situations in the
future. According to the ethics, the nurse must undertake steps in order to improve the
environment. The environment is just a factor under nursing that must be undertaken by the
nurse for the fast recovery of the patient. As the case suggests the requirements of the client is
based on the disability faced by the patient and therefore the theory enumerates the action of the
nurse as a therapist for the patient.
The action of the nurse in this context will be based on the requirements of the patient in
order to cope up with the pain faced by the patient. Reducing the pain that is suffered by the
patient will be helpful in this context. Therefore, the nurse is required to bring about a change in
the process in order to make the patient feel better. Moreover, the pain suffered by the patient is
based on the depletion of the cartilage that can be enhanced through physiotherapy and a healthy
diet (Howatson-Jones 2016). The actions that are being enumerated by the nurse is based on the
theory that is being followed in order to adhere to the attention that is required by the client. The
holistic approach that is being suggested by Neuman would not work with the present scenario as
the change of the environment cannot bring in much change in the patient’s life or the pain
suffered by the patient (Alligood 2013). It might distract the patient’s attention for an amount of
time but it cannot be used as a remedy for the problem faced by the client. The most important
step that is being undertaken by the nurse is based on the assumptions of the change./ the change
that is being brought in the life of the patient is based on the food habits and the proper exercises
that are being enumerated by the nurse to cure the patient.

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The practices undertaken by the nurse is believed to help the patient with the incapability
and make the patient aware of the problems and the remedies in order to ensure the future
capabilities of the patient to take care of herself. The nurse ensures that the patient is aware of
the necessities to adjust herself to the pain and thereby take steps in order to reduce the pain
through several activities. Te nurse is required to motivate the patient in order to make her
adjusted with the issue faced by the client. Primary Osteoarthritis affects the livelihood of
women after the age of 65, and the client being elder must be motivated. The nurse keeps a
record of the issues faced by the client and the activities that the patient undertakes after the
completion of which she faces the fatigue. The major function undertaken by the nurse is advised
by the theory, which enumerates a long lasting solution to the issues that are being faced by the
patient. The most common factor that is being raised by the client might be due to the
ineffectiveness of the strategies undertaken by the nurse on the pain that is subduing the
activities. The problems faced by the patient based on the inabilities helps in understanding the
requirements of the patient to be recovered.
The practices that are being undertaken by the nurse, which helps in the reduction of the
pain experienced by the patient. The patient experiences the pain, which is again based on the
criteria of the disease that is being faced by the patient. The theory defines the job of the nurse as
a therapist in order to reduce the suffering of the patient through the activities and the physical
exercises that the patient is required to undertake. However, the patient being an elderly woman
cannot fully undertake the activities that are required to be undertaken in order to reduce the
pain. The reduction of the pain therefore, can be undertaken through the proper diet and the
physiotherapy that the nurse is required to deliver. The strategies enumerated by the nurse in this
context will be based on the inability of the patient to take care of the suffering. The proper

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communication of the issues faced by the patient and the proper implementation of the strategies
enumerated by the nurse helped in reducing the pain of the patient finally.
The applicability of the theory proposed by Orem in this case proved to have a valuable
outcome with the reduction of suffering of the patient (Sargent 2012). The steps that are being
undertaken by the nurse are based on the requirements of the patient in order to deal with the
sufferings. The primary osteoarthritis faced by the patient reflects upon the steps that are being
enumerated by the nurse. The theory by Orem has helped in adhering to the correct needs of the
patient and thereby helped the nurse in identifying the required steps to deal with the issue. The
nurse helps the patient in identifying the probable causes for the suffering and ratifies the patient
needs as to the issues that the patient might face while undertaking the self-care activities in
future (Chadwick and Gallagher 2016). The nurse is supposed to motivate the patient to take rest
after the completion of the activities and the engagements of the patient in various activities and
exercises that might help the patient in reducing the pain. The nurse is also supposed to help the
patient with the usage of the non-pharmacological instruments through demonstrations, which
will be facilitating the self-care addressed by the theory proposed by Orem (Joel 2017). The most
important consideration undertaken by the family mates of the patient is to help the patient in
undertaking the activities in the absence of the nurse. Therefore, the nurse might demonstrate the
activities to the family members in order to make sure that the family members are monitoring
over the exercises of the patient (Kaakinen et al. 2014). The medication of the patient is again an
important step that the nurse must undertake in order to relieve the patient of the sudden rise of
the pain. The self-care and the self-care deficit theory enumerated by Orem help in the
understanding and the functioning of the nursing in both ends (McCrae 2012). Nursing is a two
way process where the patient is required to cooperate with the nurse. In this context, the

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cooperation of the patient is an important consideration in order to make the nurse aware of the
issues faced by the patient.
Conclusion
Therefore, from the above discussion of the theories that are being enumerated in nursing
practices it can be stated that the relevant actions that are being designed by the nurses is based
on the healthcare needs of the individuals. The theories state the observance of the actions
undertaken by the nurse in order to deal with the issues faced by the patients relating to
healthcare. The assistance of the healthcare professionals helps in assessing the required point of
action. The theory proposed by Orem helps in enumerating steps in order to cure the patient of
the disabilities that are being faced. The most important consideration undertaken by the theory
is based on the requirements of the patient based on the disability faced by the patient. On the
other hand, the theory proposed by Neuman helps in determining the environment, which has
caused the patient’s disability and the removal of the stressors in order to ring improvements in
the life of the patient. It is useful while considering the mental and the psychological limitations
that are being faced by the patient. The most important consideration undertaken by the theory is
based on the requirements of the patient and the type of recovery program that the disease
requires. The research of the theories are being supported by a case study which deals with the
pains of a elderly woman suffering from osteoarthritis and the application of the theories of
nursing in order to deal with the pain. The discussion helps in the understanding of the theories
and their application in the profession.