The School of Nursing frames its philosophy and programs within the theoretical structure of Dorothea Orem’s Self-Care Deficit Nursing Theory. Orem identifies Self-Care Deficit Nursing as “a general theory of what nursing is and should be in concrete nursing practice situations” (Orem, 2001, p.136).
The School of Nursing’s philosophical definitions of person, environment, health, nursing and nursing education are infused with Orem’s terminology. Agency refers to an individual’s capabilities and is used in the context of both the nurse and patient.
A person has the actual or potential attribute of self-care agency. This agency, or capability, allows the person to deliberately learn and perform actions for survival, health and well-being. Factors affecting learning include age, mental capacity, culture, societal conditions, and a person’s developmental or emotional state.
People dynamically move toward maturation and achievement of their full human potentials by integrating physical, psychological, interpersonal and social aspects of their lives. To do this they must reflect upon themselves and their environments and provide input into both self and environment. People use both symbols and words to express their ideas to communicate with others.
People gather in groups or structured relationships. These relationships both define and support self-care.
People have the power to act deliberately to identify their own and others’ needs. The way people meet self-care needs is not instinctual, but is a learned behavior. If any person is unable or unwilling to learn, others must learn for and or provide for that person’s self-care. Likewise, when a person has therapeutic self-care demands that he or she cannot meet, others with knowledge and skill must provide the means to meet those demands. If neither the person, the family nor a group to which the person belongs is able to supply therapeutic health care requisites, that person needs professional nursing care. (Orem, 2001)
Environment is the domain in which people exist. The interaction between the environment and people affects health, well-being, growth and development positively or negatively throughout the life cycle. The reciprocal relationship between the person and environment is influenced by both internal and external factors. Internal factors include the biological, psychological and spiritual attributes of the person, while external factors comprise physical, chemical, socio-cultural, economic, political, legal, ethical, and organizational elements.
The environment can be analyzed and understood. In some instances environment can even be regulated and controlled especially through community health efforts (Orem, 2001).
The term health is used to describe living things when they are structurally and functionally whole or sound. The physical, psychological, interpersonal and social aspects of health are inseparable in the individual.
When “health” or “healthy” are used as descriptive terms for an individual, a judgment is being made on the basis of data about that person and his or her ability to maintain self-care. A person’s overall state of health is not necessarily modified by temporary changes in the state of wellness. The individual with an injury, for example would be considered injured and/or disabled, rather than sick or unhealthy, but would, for a short time require assistance with self-care. Ideally, health is the responsibility of both a society and its individual members and not of any one segment of that society.
“Nursing is a direct human service provided by a qualified person to help persons to continuously know and meet their own or their dependents’ therapeutic self-care demands and to regulate the exercise or development of their self-care or dependent-care agency whenever their limitations for action are associated with their own health states or that of their dependents” (Orem, 2001, pp. 517-518).
Professional nursing rests upon the characteristics of nurse agency (communication, teaching, cultural competence, leadership, professional behavioral, legal understanding, professional technological skills) and is operationalized in the nursing systems of wholly compensatory, partially compensatory, and supportive-educative care. Nursing care is always tempered by the art and prudence of nursing. Art is the “intellectual quality . . . that allows . . . creative investigations, analysis, and synthesis” (Orem, p. 293). Prudence is selecting “the right reason about things to be done”; “a virtue of the mind and of the character of individuals” (p.293). “Art and prudence serve nurses in their performance of the interrelated operations of nursing practice” (p. 294).
Nursing care is based on professional standards, ethics, competencies and knowledge drawn from the natural, social, medical sciences, and the humanities, as well as nursing’s own body of knowledge. Professional nursing supports research and education to expand nursing knowledge and its use.
The UTC School of Nursing prepares an educated person who nurses. Nursing education focuses on the development of nursing agency, the development of capabilities needed to provide professional nursing care.
Education encompasses both teaching and learning. Learning is a deliberate and dynamic process characterized by the acquisition of knowledge, self-awareness, breadth and depth in critical thinking, and by cognitive, affective and psychomotor skills all of which change the behavior of the learner. Learning is an individualized process which occurs best when learner’s rights are respected and when the learner accepts responsibility for self-direction and for decisions. The outcome of learning is an enriched outlook, a new perspective.
Teaching is a transaction involving both learner and teacher where the teacher acts as a facilitator, a role model and a resource person using multiple modes of instruction. Teachers guide the learner by developing, organizing, and structuring knowledge; by fostering a spirit of inquiry, a sense of discovery and a desire for life-long learning.
Undergraduate Nursing Education focuses on developing nursing agency through didactic and clinical experiences that build upon the student’s foundation in the liberal arts curriculum.
Graduate Nursing Education is based on a sound baccalaureate program of studies. Graduate studies immerse the student in nursing practice, supported with a theory, research and policy core of graduate-level nursing courses in concert with courses in the concentration specialty area.
Approved by Faculty, 03/20/2012
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-- The University of Tennessee at Chattanooga Handbook & Campus Directory 2005-2006