Early in her career, Orem gained experienced as a staff nurse in a variety of hospitalclinical settings. While serving as director of nursing service at a Detroit hospital, she recallsthat she was asked a substantive question and didn’t have an answer because she “had noconceptualization of nursing” (McLaughlin-Renpenning & Taylor, 2002, p. xii).Orem goes on to say while working at Indiana University where her goal was to upgradethe quality of nursing in general hospitals throughout the state, she noted that nurses haddifficulty articulating needs to hospital administrators in the face of demands made upon themregarding such issues as length of stay, scheduling admissions and discharges, etc.(McLaughlin-Renpenning and Taylor, 2002). As a
She has developed her ideas to extend beyond the individual, withincreasing emphasis on multiperson situations, family and community groups in our society.Orem describes her theory as a general nursing theory, and indeed it has influenced nursingresearch and practice not only in the United States, but internationally (Taylor et al, 1998).In her theory, Orem defines the four concepts that constitute nursing’s metaparadigm, as proposed by Fawcett: human beings, environment, health, and nursing (Fawcett, 2005). In1971, Orem described a human being
(humanity) as “…an integrated whole composed of aninternal physical, psychologic, and social nature with varying degrees of self-care ability” (Chinn& Kramer, 2004). Orem later defines a human being as “a substantial or real unity whose partsare formed and attain perfection through the differentiation of the whole during the process of development.” (Orem, 1985, cited in Meleis, 1997). A human being has the capacity to reflect,symbolize, and use symbols. When referring to humans , Orem uses the terms individual, patient, multiperson unit, self-care agent, dependent-care agent (Fawcett, 2005).
In addressing the concept of health , Orem (1980, cited in Meleis, 1997, p. 396) says“health and healthy are terms used to describe living things… [it is when] they are structurallyand functionally whole or sound…includes that which make a