Charlotte D. McKamie
In Orem’s theory of self care, she presents the precept that the nurse’s role in helping the chronically ill patient is to assist them to achieve an optimal level of health and wellness, and to give them the tools they need to maintain it. Orem believed that the nurse should act as an advocate, redirector, support person, and teacher, and, thereby, guide the patient to therapeutic development. Her theory is of interest to me because I currently work as a field infusion nurse, and treat only chronically ill patients. I have chosen Ralph for my case study because of that parallel and also because I identify with him in regard to my own family history. Obesity is the norm, and my lineage is plagued with type two diabetes. A big part of my personal and professional life is spent working as a partner with patients and family. I provide intervention for problems that they don’t have the skills to address, while incessantly teaching them everything I can to enable them to take the best possible care of themselves. I tell every patient that my motto regarding chronic illness is that “you will handle it, or it will handle you.”
I am an advanced practice nurse working in a rural health clinic serving an economically depressed area. Our patients have an array of problems associated with being unwilling, or unable, to apply health maintenance practices to their lives. Today I am meeting at our physicians request with Mr. Ralph Chubber and his family. Mr. Chubber has been recently diagnosed with type II diabetes. He has not been compliant with the management principles that were outlined for him for controlling his disease. The doctor is concerned that Mr. Chubber doesn’t understand serious nature of his diagnosis, and what non-compliance will ultimately mean to his health. Circumstances relating to the other members of Mr. Chubber’s family suggest that they too may be at risk for diabetes. Given...