A design of a system of nursing assistance is a plan for nursing in its essential outline. If we accept that a nurse may contribute to (1) accomplishing the self-care of the patient in a therapeutic manner when a patient limitation must be compensated for and (2) overcoming a patient's present limitations, it is possible to narrow action down to four types. By the arrangement of these types we can come up with four basic designs for nursing action: wholly compensatory, partly compensatory (supportive), supportive-educative, and compensatory-educative (see Figure 8.1).
A deterrent to the development of nursing system plans has been a lack of understanding of a framework for planning as well as lack of organization providing for it, time, and the conviction that it is a nursing requirement (see Figure 8.2).
Nurses utilize scientific facts and theories in describing and explaining the above. For example, this is illustrated when a totally blind elderly male patient directs a nursing student in arranging his bedside table and the food on his tray so that he can eat. This man has developed the capability for directing and guiding others. The recognition of the compensator technique that patients have worked out is important. Furthermore, we need to collect data to describe how individuals do compensate when they have a limitation.
This paper was originally presented in a series of workshops at the Catholic University of America,
Washington, DC, on July 23, 1969.