In this column the author presents an examination of Orem's conceptualization of environment as a metaparadigm concept, the role of environment in the theoretical structure of the self-care deficit nursing theory, and the creation of a developmental environment as one of the ways of helping another. Suggestions for further work related to the conceptualization of environment and the organization of existent knowledge are provided. Application of the concept of nursing agency and the environmental factor of healthcare system illustrate the utility of self-care deficit nursing theory in relation to the recommendations for changes in nursing education and for redesign of the healthcare system.