Orem model of nursing

The Orem model of nursing was developed between 1959 and 2001 by Dorothea Orem and is also known as the 'Self Care' Model of Nursing. It is particularly used in rehabilitation and primary care settings where the patient is encouraged to be as independent as possible.

Central philosophy
The Orem model is based upon the philosophy that all "patients wish to care for themselves".

Self care requisites
Self care requisites are groups of needs or requirements that Orem identified. They are classified as either:
 * Universal self care requisites - those needs that all people have
 * Developmental self care requisites - those needs that relate to development of the individual
 * Health deviation requisites - those needs that arise as a result of a patient's condition

Self care deficits
When an individual is unable to meet their own Self care requisites, a Self Care Deficit occurs. It is the job of the Registered Nurse to determine these deficits, and define a support modality.

Support modalities
Nurses are encouraged to rate their patient's dependencies or each of the self care deficits on the following scale:


 * Total Compensation
 * Partial Compensation
 * Educative/Supportive

Universal Self Care Requisites (SCRs)
The Universal self care requisites that all patients have, regardless of age or health are:


 * Air
 * Water
 * Food
 * Elimination
 * Activity and Rest
 * Solitude and Social Interaction
 * Hazard Prevention
 * Promotion of Normality

The nurse is encouraged to assign a support modality to each of the self care requisites.

Example nursing assessment
This patient is entirely fictitious and any likeness to any person, alive or dead, is purely coincidental.

'J' is a 50-year-old male who has just been diagnosed with type-two diabetes mellitus. He has a history of hypertension, and is a chronic smoker, smoking around 30 cigarettes daily.


 * AIR: Educative/Supportive - Provide education on the risks associated with smoking particularly for the diabetic patient.
 * WATER: Educative/Supportive - Ensure access to adequate hydration - risk of polydipsia due to hyperglycaemia.
 * FOOD: Partial Compensation - Education and provision of a diet that is suitable for his new diagnosis of diabetes, blood sugar monitoring after meals.
 * ELIMINATION: Educative/Supportive - May require monitoring.
 * ACTIVITY AND REST: Educative/Supportive - Educate patient as to the benefits of cardiovascular exercise, especially for the diabetic
 * SOLITUDE AND SOCIAL INTERACTION: Partial Compensation - Nurses may provide social interaction as hospital admission will cause change is social behaviour and interactions.
 * HAZARD PREVENTION: Partial Compensation - Nurses will need to educate regarding the medication that he may be taking, and administer this medication initially. Particularly relevant if J is taking insulin injections.
 * PROMOTE NORMALITY: Partial Compensation - Nurses will need to facilitate a return to normal lifestyle. This will involve advocating for the patient in a multi-disciplinary team, in order to achieve a medication regime that will fit with the patient's life.