Universal Requisites Page 1
Dorothea Orem’s universal requisites consist of those physiological needs that are imperative to life itself. Nursing is the intervention for those self care deficits that the patient cannot perform for themselves in order to maintain the physiological needs (Comley, 1994).
The key to this process in the nursing home facility is the reduction of nurse dependency and the reinforcement of finding ways for patients to do as much for themselves as possible (Faucett, Ellis, Underwood, Naqvi, & Wilson, 1990). Due to staffing issues and time constraints, it has been demonstrated by action, that is appears to be easier to “do” for the resident rather than encouraging them to “do” for themselves. This has lead to many resident’s feeling institutionalized. By adopting Dorothea Orem’s theory of self care, the goal is to have the residents do as much for themselves as possible, giving them a sense of self and independence.
Air-though a patient cannot be totally responsible for ensuring they have air to breath, there are ways to encourage patients to be aware of the needs they may have in regards to oxygenation. Teaching the residents about oxygen requirements, signs and symptoms of decreased oxygen levels, and oxygen equipment such as oxygen tanks, nasal cannula’s, or C-pap machines, enables the resident to have a sense of control and responsibility for their oxygen needs.
Food and Water-instead of feeding and holding cups for the residents, emphasis should be placed on allowing a resident to feed themselves. Occupational therapy should be involved in providing assistive devices for self feeding. For the resident that cannot feed themselves care should be given to include the resident in food selection choices, and the order of consumption. Even with the tube feedings the staff should inform the patient of feeding times and discuss with them the nutritional plan that has been developed specifically to their needs.
Elimination-Residents who have problems with incontinence should be offered toileting every 2 hours and should be allowed to do as much for themselves as possible. Privacy needs to be ensured for all patients. Bowel and bladder programs are available and may even assist some residents with gaining control of elimination and eliminating the need for assistance. Though some patients may be difficult to assist with toileting, never should the resident be told to relieve themselves and staff will clean them afterwards. This will create feelings of humiliation and decrease the residents desire to do things for themselves.
Activity vs. Rest-Residents should be encouraged to participate in activities. The wheel chair bound resident can be involved in activities such as arts and crafts where they can utilize their hands in activities that can bring them fulfillment. Those residents that can move about freely should be encouraged in activities such as nature walks or exercise classes to maintain that level of movement. The bed ridden residents should have activities that stimulate their minds and keeps their minds active.