Dorthea Orem believed that people have a natural ability for self care, and nursing should focus on affecting that ability. Using a literature search of studies involving adults receiving hemodialysis for end stage renal disease (ESRD) in an outpatient dial ysis setting and self-care/management publications in peer-reviewed journals and dis sertations, this article explores the implementation of Dorthea Orem’s Self Care Theory in the hemodialysis setting, considering the ways it relates to a population in which selfmanagement is critical for patients’ positive quality of life, nurses’ ability to promote self care for this population, and potential health outcomes. In order to maximize the health of patients with ESRD, considerable lifestyle changes must be made. As health care professionals who provide direct care, nurses can assist with these changes by pro viding educational opportunities and strategies that increase self-care agency, thus making a positive impact on patient quality of life.