NURSING EDUCATION
Education is important. It is something that can be acquired thru school and experience. It is so important that working students and scholarships are invented, especially in our beloved country. In which almost all colleges and universities in our country had that kind of program. Yes, we are part of the “under develop” countries here in Asia. Wherein education is so precious that some families are willing to take risks, like working aboard and selling their live hood like carabaws and horses. Yes, it happens. I know because my dad is an OFW. I know because I lived in a province and some of our neighbors did sold their carabaws and horses for the hoped of a better education. Its sad right? But when you think about it, how about our less fortunate fellow man that had nothing at all? No jobs and no carabaws and horses to sold? Yes, they can gain knowledge thru everyday experience, but there are some tings that can only be taught in school. Things that only a person with higher acquired education can.
Believe me when I say that I seen a lot of patients with knowledge deficit. Sometimes you can run out of patience for their idiocy. Sometimes you feel sorry for them. I been working in a Rural Health Center for 11 months now. In the peaceful province of Laguna. Our town just turned a 4th class municipality this year. A 4th class municipality earns P20 million but less than P 30 million annually. Imagine that, we are still so far away from being a good town. Some of my fellow townsmen still believed in some “Dr. Quack-Quack”, they only go to the center when the symptoms are in their peak. It’s a pain in the ass I tell you, because we cannot do anything anymore. It’s too late for our little health center, all we can do is too refer it to the nearest hospital. That’s why Heath teaching is an everyday routine of mine.
Let me share some of my experience regarding Orem’s theory of Self Care Deficit. I will classify it according to individual, family and community. In the individual, I encountered this patient late February. She had a large mass on her left breast and was complaining of pain and difficulty of breathing. She was then scheduled to PGH for further management and treatment. After a month, she had a successful operation, her mass was removed and she never had an episode of difficulty of breathing. After that, I never heard and seen her for months. Surprise, surprise, she visited us again with her foul smelling, pus filled, non healing wound. What happened?! When I asked the patient what happed, she told me that she didn’t know she had to clean it and change the dressing. What?! She didn’t change it for a month. Imagine the smell and the condition of the wound. After cleaning, changing the dressing and a lot of scolding, I conduct a mini heath teaching. While I was cleaning it, I was telling the patient that this is the proper way, that it is important to clean it to prevent infection. That she is welcomed on our center if her stock of sterile gauze is limited. She was also given Cloxacillin 500mg capsule which will be taken 3 times a week. And I also instructed her to come back after 1 week. After one week, the wound is healing fast and the condition of the wound is much better. She also followed all the instructions I given her.
Next is the Family. Our health center had this Family Program. Wherein we teach different kinds of Family planning, the do’s and don’t and the more convenient way. Its a little embarrassing especially when we teach them the proper way of using a condom. Anyway, health teaching on family planning only happens once a week.
Lastly is the community. Every Wednesday afternoon, we conduct pre-natal check up, our community of pregnant mothers in our town ranges from 40-50. Imagine the line! So in order to save time, we conducted a health teaching regarding Proper Breastfeeding. Its a good thing because July is the month Nutrition and we just had a program called, “Isulong ang Breast feeding, SAPAT, SAKTO at EKSKLUSIBO”. Health teaching regarding breastfeeding is important especially to those 1st timer mothers. They learned the proper way and the benefits to the baby and as well as to the mothers.
Knowledge deficit is a common problem particularly to those areas wherein education is less prioritized. That is way we nurses, must to our best to eliminate such problems thru the used of Health teaching. We are there to teach and assist those people who are lacking in self care abilities.
NURSING PRACTICE
A. Orem's general theory of nursing, referred to as the self-care deficit nursing theory, is described as a theory that can be used for organizing and structuring nursing knowledge and nursing practice. The goal of nursing theory is helping the patient perform self-care. According to Orem (1971), nursing care is necessary when the client is unable to fulfill biological, psychological, developmental, or social needs. The nurse determines why a client is unable to meet the needs, what must be done to enable the client to meet them and how much self-care the client is able to perform. Orem included skilled observation as one of the guidelines for elements in the nursing situation and the emphasis on intellectual aspect of nursing so that she can learn to function effectively and in nursing situations where the patient’s requirements are more complex.
Orem’s theory received a world wide acceptance and recognition especially to nursing practice. There have been various articles which proved the use of Orem’s Theory as a basis for clinical practice. As early as 1971, Lucille Kinlien established an independent nurse practice in College Park Maryland, claiming that she was stimulated by Orem’s Theory. In John Hopkins Hospital in Baltimore, the Self- Care Theory was used in several outpatient clinics. It was later used in other outpatient clinics in the united Stated States. Orem’s theory was also applied in nursing home. It was also applied by Virginia Mullin within the acute care setting, although she recognized many constraints. Later, it was translated in different languages and utilized worldwide (Marriner- Tommey, 1994).
Although there is still a gap between many nursing theories and actual nursing practice at the bedside, Orem's self-care deficit theory has been widely adopted in a variety of clinical settings. It has particular appeal in settings like rehabilitation nursing, with its focus on addressing self-care deficits in patients with physical disability or chronic illness, and home health nursing, which is aimed at making patients as safe and independent as possible in their own homes.
One of Orem's focuses was to diffuse the theory into nursing in a variety of settings. The comprehensive development of the self-care concepts enhances the usefulness of the Self-care Deficit Nursing theory as a guide to nursing practice situations involving individuals across the life span that are experiencing health or illness, and to nurse-client situations aimed at health promotion, health restoration, or health maintenance (Parker, 2005, p. 149).
B. Many articles document the use of Orem's Self Care Deficit Theory as a basis for practice in varied settings such as hospital, outpatient clinics and also applied in nursing homes.The main object of nursing practice is the individual in a variety of contexts. Orem included skilled observation as one of the guidelines for nursing practice-observation not only in patient but also of other elements in the nursing situation.Orem delineated the professional and tecnical levels of nursing practice. For the professionally educated nurse,emphasis is on the intellectual aspect of the art of nursing so that she can learn to functionn effectively in nursing situations where the patient's requirements are more complex and where techniques for assisting are well develop. The technical level develops the intellectual aspect in relation to nursing situations where selected assisting techniques are known to have a high degree of effectiveness.
NURSING PROCESS
