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CHAPTER 14 Dorothea E. Orem 243

“Deliberate action refers to actions performed by indi- sciences, Orem stated, “the isolation, naming, and
vidual human beings who have intentions and are description of the two sets of sciences are based on
conscious of their intentions to bring about, through my understanding of the nature of the practical
their actions, conditions or states of affairs that do sciences, on my knowledge of the organization of
not at present exist” (Orem, 2001, pp. 62–63). When subject matter in other practice fields, and on my
engaging in deliberate action, the person acts as an understanding of components of curricula for edu-
agent. The view of person-as-agent is also reflected in cation for the professions” (pp. 174–175).
the SCDNT’s conceptual elements of the nursing care In addition to the two components or types of prac-
and dependent care. In relation to the view of person- tical science, scientific knowledge necessary for nurs-
as-agent and the idea of deliberate action, Orem cited ing practice includes sets of applied sciences and basic
a number of scholars, including Arnold, Parsons, non-nursing sciences. In the development of applied
and Wallace. She identified seven assumptions regard- sciences, theories from other fields are used to solve
ing human beings that pertain to deliberate action problems in the practice field. These applied nursing
(Orem, 2001, p. 65). These explicit assumptions, while sciences have yet to be identified and developed.
addressing deliberate action, rest upon the implicit Box 14–1 depicts the structure of nursing science.
assumption that human beings have free will. Orem’s articulation of the form of nursing science
The SCDNT represents Orem’s work regarding the provided the framework for the development of a
substance of nursing as a field of knowledge and as a body of knowledge for the education of nurses and for
field of practice. She also put forth a position regard- the provision of nursing care in concrete situations
ing the form of nursing as a science, identifying it as of nursing practice. The SCDNT with its conceptual
a practical science. In relation to her ideas about the elements and four theories identifies the substance or
form of nursing science, Orem cites the work of content of nursing science.
Maritain (1959) and Wallace (1979), philosophers
who were associated with the moderate realist tradi-
tion, . In practical sciences, knowledge is developed BOX 14-1 Speculatively Practical Nursing
for the sake of the work to be done. In the case Science
of nursing, knowledge is developed for the sake of Nursing Practice Sciences
nursing practice. Two components make up the prac-
tical science: the speculative and the practical. The Wholly Compensatory Nursing
speculatively practical component is theoretical in Partly Compensatory Nursing
nature, while the practically practical component Supportive-Developmental Nursing
is directive of action. The SCDNT represents specula- Foundational Nursing Sciences
tively practical knowledge. Practically practical nurs-
ing science is made up of models of practice, standards The Science of Self-Care
of practice, and technologies. The Science of the Development and Exercise of
Orem (2001) identified two sets of speculatively Self-Care Agency in the Absence or Presence
practical nursing science: nursing practice sciences of Limitations for Deliberate Action
and foundational nursing sciences. The set of nursing The Science of Human Assistance for Persons
practice sciences includes (1) wholly compensatory with Health-Associated Self-Care Deficits
nursing science, (2) partly compensatory nursing Applied Nursing Sciences
science, and (3) supportive developmental nurs-
ing science. The foundational nursing sciences are Basic Non-Nursing Sciences
(1) the science of self-care, (2) the science of the Biological
development and exercise of the self-care agency in Medical
the absence or presence of limitations for deliberate Human
action, and (3) the science of human assistance Environmental
for persons with health-associated self-care deficits. From Orem, D. E. (2001). Nursing: Concepts of practice (6th ed.).
In relation to this proposed structure of nursing St. Louis: Mosby.