What distinguishes a middle-range theory from a grand theory of nursing?

What the facility states should have been done in that situation:
Facilities have their own policies and procedures that guide the staff. While these are important for ensuring consistent care and safety, they might not always align perfectly with the evolving standards of practice or individual patient needs. Legal standards are more broadly based on what is reasonable and prudent in the specific situation.

What the public expectations of what is to be done in the same situation:
Public expectations might vary widely and can be influenced by individual beliefs, cultural factors, or misconceptions. Legal standards are established by the profession and are based on specialized knowledge and training, ensuring that they reflect the best practices and evidence-based care.

What a reasonable and prudent nurse would have done in the same situation:
This is the key standard in legal contexts, known as the standard of care. It means evaluating the nurse's actions against what a hypothetical, reasonably competent nurse with similar training and experience would have done under similar circumstances. This standard is based on professional expertise, current evidence, and the specific needs of the patient, making it the most relevant and fair measure in cases of professional negligence.

What the general practice of colleagues at the time, in the same situation:
While professional norms and guidelines do consider the practices of colleagues, they also leave room for individual judgment and critical thinking. Just because a practice is common among colleagues does not necessarily mean it meets the standard of care. The legal standard considers what a reasonably prudent nurse would have done, which may involve a more careful evaluation of the situation than simply following common practice.

The nurse helps the client adapt to his or her illness: This statement refers to the nursing role in supporting patients in coping with their illnesses. Nurses provide education, emotional support, and strategies for adaptation, helping clients adjust to their health conditions. However, this statement does not capture the essence of the Orem Self-Care Model, which focuses on the individual's responsibility for their own health and self-care.

The primary goal of healthcare is a cure for the client: While curing diseases is a fundamental goal in healthcare, not all conditions are curable. The Orem Self-Care Model goes beyond the curative aspect and emphasizes the individual's active involvement in maintaining their health, whether they are ill or not. It places importance on the daily activities and routines that individuals can perform to enhance their well-being.

Healthcare is the responsibility of each individual: This statement reflects the core principle of the Orem Self-Care Model. It emphasizes that individuals have a personal responsibility for their own health and well-being. This responsibility includes taking actions to maintain health, prevent illness, and manage existing health conditions. The model provides a framework for understanding and assessing self-care abilities and needs.

Healthcare goals must be established for each client: While setting healthcare goals is an essential part of nursing care, the Orem Self-Care Model focuses more on empowering individuals to establish and achieve their own self-care goals. It emphasizes the individual's ability to identify their needs and develop strategies to meet those needs. The model guides nurses in assessing a person's self-care abilities and helping them improve their self-care skills.