NURSING CONCEPTUAL MODELS

Nursing Conceptual Models
Lisa Pagliarulo-Freni
Salem State University

Upon my review of the nursing models by several theorists, two of those models jumped out at me. Dorothea Orem’s Self-Care Model and the American Association of Critical-Care Nurses Synergy Model for Patient Care. Dorothea Orem’s Self-Care Deficit Theory of Nursing. Self-care is “the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and wellbeing” (as cited in Cardinal Stritech University Library, 2011). She has 3 theories that she bases this on: 1. Theory of Self-Care. Orem’s general theory of self care basically states that when a person is unable to provide their own care, then that care can be provided by nurses. Now the amount of nursing care and intervention depends on what capacity a person can care for themselves. 2. Theory of Self-Care Deficit. There are 5 methods used: a) acting for or doing for another, b) guiding and directing, c) providing physical or psychological support, d) providing and maintaining an environment that supports personal development, teaching (Johnson & Webber, 2010; Orem 1995, 2001). 3. Theory of Nursing Systems. There are 3 systems used: a) wholly compensatory system which the patients cannot perform any self care, b) partially compensatory system wherein the nursing care starts to shift from the nurse to the patient, and c) Supportive-educative system, wherein the patient is basically caring for themselves but may need assistance with some decision making areas with their care. Additionally, there are 4 major concepts identified by Orem which include the person, health, environment and nursing. Combining the 3 sub-theories with the 4 major concepts creates a self-care model in which Orem’s nursing process is produced. Her nursing process has only 3 steps: Assessments, Nursing Diagnosis, and Implementation and Evaluation. (sites.google.com/site/oremstheory/description-of-the-model). Orem’s theory, in summary, examines how people can achieve a healthy well-being through self-care, either independently or with the aid of nursing care. The American Association of Critical-Care Nurses’ (AACN) Synergy Model for Patient Care.
The synergy model is a conceptual framework for designing practice competencies to care for critically ill patients with a goal of optimizing outcomes for patients and families. (Masters p.73). It was developed in 1995 and incorporated into all AACN certification exams. The AACN synergy model was developed to link clinical practice with patient outcomes (aacn.org). The model consists of 8 characteristics of a person the critical care setting, each one with 3 different levels of function that vary from a “non-functioning” to “functioning”. Those characteristics are: resiliency, vulnerability, stability, complexity, resource availability, participation in care, participation in decision making and predictability. These characteristics reflect on how the nurse