[The nursing process according to Orem. A concrete very simple example explains how to follow this nursing process]

The author shows how Orem's theory, based on self care, can be applied to the nursing care of a patient with severe cardiac illness. To do so, she explains in detail what is looked for in the patient's history to delineate problems, and then uses a systematic care plan approach to solve them. In the patient's history, the nurse looks for information on each need, and on the specific factors in the patient's life and health history that will have an impact on the patient's capacity to meet Orem's goal of self care. Inabilities are labelled self care deficits. When the self-care deficit is well understood, it is important then to determine the source of the patient's difficulty. Orem states that there are two main phases to self-care: the decision and the action. The author illustrates this through a discussion of the patient's difficulty to stop smoking. She then explains a particular method to write a nursing diagnosis that directs the nurse to work, not on the deficit itself, i.e. in this case smoking, but rather on the patient's lack of knowledge. The "SMART" approach to writing nursing care objectives (specific to the patient and the current situation, measurable, attainable by the client in a reasonable period of time, realistic for the current situation, and truthful or having clear significance for the patient at the moment) is detailed along with interventions that respect Orem's concept of nurse-patient contracts. The nursing process based on Orem's conceptual framework is not difficult to manage.(ABSTRACT TRUNCATED AT 250 WORDS)