This will give her a good idea of the level of understanding the patient has and then she can tailor her teachings to fit the patient's level of understanding.
It is also a good idea for the nurse to give the patient as much printed information on the topic as she can because the patient can always use these materials as a reference in case the nurse is not readily available. If he teaching is about following a menu plan that will assist the patient in a speedy recovery, the nurse can have the patient keep a food journal of what he ate for a week or so and they can go over it together to determine what is working and what isn't. The same goes for the patient needing to be educated on any type of physical activities he must perform in order to improve and maintain his health. A weekly journal of the patient's planned physical activity should be kept and shared with the nurse at perhaps weekly intervals to determine what else is needed.
Another example would be a patient who needs to be taught wound care and how to change the dressing on his wound. The nurse can explain and teach him over and over again, but the best test is to allow the patient to clean and change the wound in her presence. This way she can guide him if he is doing something wrong and encourage him if he is doing a good job. Once the patient learns to care for himself properly and sees that his recovery is progressing smoothly, he is more apt to further engage in the self-care process. The nurse along with the patient must make sure the lines of communication are always open.
The safe environment and teaching portion of the self-care theory would more than work well with adult patients who are willing to actively participate in their own healing and recovery process. However, Orem's self-care theory may not always be applicable to adolescents. Children and younger people sometimes do not possess the level of understanding or maturity that an adult would. This is not to say that the adult patients are more qualified to follow the self-care theory, but sometimes children will need more guidance. Most children also have very little control over the environment that they live in, so it is up to the parents or other responsible adult care giver to step in and work with the nurse to make sure the recovery process is on track.
This does not absolve the child from taking some responsibility for his recovery. Baker and Denyes note that the younger the child, the more difficult it is to get him involved in his own self-care routine. The children may perform some takes, but not as efficiently as they should be. They suggest getting children into the habit of self-care early on so that it will become routine in their lives (2008). At some point, the child may even be able to care for himself fully without the help of an adult.
Orem's self-care theory is important because it encourages patients to take ownership and responsibility for the aspects of their healthcare that they can manage themselves. This can cut down on the length of the hospital stay and in the long run, it can save the patient from being responsible for the rising costs of a hospital stay. The values contained within this theory are relevant to the theory itself because each one ties into the fact that although the patient will be caring for himself, support, training and guidance will be provided every step along the way. There will be dilemmas with each of the values in Orem's theory, but the skilled nurse will know how to find ways to make those dilemmas manageable so that they do not pose any problems. The self-care theory is not a means of putting the patient out on his own, but it is a way to provide open communications between the nurse, the patient and all family members involved. If everyone involved work together, the patient can be assured of a smooth and fast recovery.
Baker, Lois K. And Denyes, Mary J. (2008). Predictors of self-care in adolescents with cystic fibrosis: A test of Orem's theories of self-care and self-care deficit. Journal of Pediatric Nursing, 23(1), 37-48.
Cleary, Michelle and Freeman, Adele. (2006). Enhancing nurse care partnerships: A self-
directed learning approach. Nurse Education in Practice, 6, 224-231.
Griswold-Pierce, Anne and Smith, Jennifer A. (2008). The ethics curriculum for doctor of nursing practice programs. Journal of Professional Nursing, 24(5), 270-274.