Professional Documents
Culture Documents
Person { Human
Being}
A developmental being with
needs.
Nursing clients are patients
who under medical care and
who cannot deal with their
needs or who cannot carry
out medical treatment alone.
Health
Asenseofadequacyorwell
being.
Fulfilledneeds.
Senseofcomport
Environme
nt
Not Defined
Sense of comport.
Fulfilled needs
Nursing
Is a dynamic nurse patient relationship.
Is a responsive to individuals who suffer or
anticipate a sense of helplessness.
The goal of nursing is increased sense of well
being, increase in ability, adequacy in better
care of self and improvement in patients
behavior.
Nursing are composed of direct function,
disciplined and professional activities and
automatic activities.
CHARACTERISTICS OF
THE THEORY
Orlando's theory interrelate concepts.
Orlando's theory has a logical nature.
ThemajordimensionsofOrlandos
NursingProcessTheory
Professionalnursingfunction-organizing
principle.
Thepatientspresentingbehavior
-Problematicsituations.
Immediatereaction-internalresponse.
Deliberativenursingprocess-reflective
inquiry.
Improvement-resolution.
1.Professional Nursing
Function
Finding out and meeting the patients immediate needs for
help{Orlando, 1972}
Organizing
Principle
The nurses unique function is finding out and meeting the
patients immediate needs for help.
mustfirstrecognizethesituationasproblematic.
Thepresentingbehaviorofthepatient,regardlessof
theforminwhichitappears,mayrepresentaplea
forhelp.
Thepresentingbehaviorofthepatient,thestimulus,
causesanautomaticinternalresponseinthenurse,
andthenursesbehaviorcausesaresponseinthe
patient.
3.
Immediate
reaction
- internal
response
4.Deliberative Nursing
Process
- Reflective
The nurses behavior
affects the patient and
the nurse is affected by the patients behavior.
ToInquiry
be successful the nurses focus must be on
By determining of this
The meaning of patients behavior
The help required by the patient
Whether the patient was helped by the nurses action.
The nurse will find more efficient to find out what the patients
immediate need for help is by first exploring and understanding
the patients.
Feeling come from the thought about the perception. The nurse
must state the perception that evoked the thought from which
the feeling was derived.
Example:
Nurse: Im concerned that you keep asking for the bedpan, But I
dont think you really need it. I am right or not.
Patient: Yes, But Im afraid I might have chest pain again and
then I wouldnt be able to call for the nurse.
If Nurses do not resolve their feelings with patients, these same
feelings occur each time they are in contact with the patient.
A nurses past experiences are not sufficient as the basis for
understanding the patients immediate behavior.
5. Improvement re
It is not the nurses activity that is
evaluated but rather its result. When the
patients immediate need for help have
been determined and met, there is
improvement.
It is not the nurses activity that is
evaluation but rather its the result.
When a situation becomes clear, it loses
its problematic character and a new
equilibrium is established.
In each contact the nurse repeats a
process of learning how to help the
individual patient.
Assumptions
The theory assumes that a patient who cannot cope
with their medical needs without assistance will become
distressed and begin feeling helpless. At the base level,
nursing can contribute to this distress. However, Orlando
theorized that the nurse/patient relationship is one that
is decided by both parties. The patient cannot
appropriately convey their needs or fears without first
establishing a close relationship with the nurse. As such,
nurses exist to offer patients a motherly and nurturing
presence to relieve distress.
Theactionprocessinaperson-toperson
contactfunctioninginsecret.
Theperceptions,thoughtsandfeelings
ofeachindividualarenotdirectly
availabletotheperceptionoftheother
-Theactionprocessinaperson-topersoncontact
functioningbyopendisclosure.
Theperceptions,thoughts,andfeelingsofeachindividualare
directlyavailabletotheperceptionoftheotherindividual
throughtheobservationaction
Assessing
a Patient by
using Orlandos Theory
to Guide the Nurses
Process
1.Guidingprinciple
Findingoutandmeetingthepatients
immediateneedforhelp
Thenursesfocusisonthepatient.
Thenursesmindisfreeofdistracting
thoughts.
2.Problematicsituationandimmediate Thenurserecognizesthatapatient
reaction
problemmayexistbeforethenext
stepintheprocess.
Thenurseidentifieshisorherimmediate
perception,thoughtsandfeelings.
3.Inquiry-problemdetermination
Thenurseusetermsthepatientcan
understandandexploresimmediate
reactionswiththepatienttodiscover
physical/non-physicalproblems.As
theproblemisidentified,thenurse
asksthepatienttoconfirm.
Thenurseexploresthe
disagreementtodeterminebasis.
4.Identifyingspecificplansfor
eachproblem
Withthepatient,thenursedetermination
actionsneededanddevelopsplansforeach
problem.
Thenurseexploreswhetherthepatients
agreewithorrefutestheplan.Thenurse
exploresandresolvesthebasisof
disagreement.Thepatientverballyandor
nonverballyagrees.Ifnot,thenurse
continuestheinquiryforthebasis.
5.Implement
Ifthepatientisunable,thenurse
implementstheplanandasksthe
patientwhethertheactionIhelpful.If
itisnot,thenurseexploresthebasis.
Thenursehelpsthepatientifheor
sheisunabletodoitaloneand
exploreswhetherthepatientwas
helped.Thenurseinquiresabout
Hisorherresults.
6.Improvement
Thenurseasksthepatient
whethertheactionhelpedand
observesthepatientsverbal
andnon-verbalbehavior.Ifhe
orshehasimproved,theneed
forhelpwasmet.Ifnot,the
nursecontinuestousethe
contentofimmediatereaction
toexplorewiththepatient
untilapositivechangeis
evident.
Nursing
Process Theory
TheNursingProcesswasbasedonatheory
developedbynurseIdaJeanOrlando,Thistheory
delvesintothepurposeofnursesandtheir
requirementsinthemedicalfield.Orlando'stheory
wasdevelopedinthelate1950sfromobservations
sherecordedbetweenanurseandpatient.Despite
herefforts,shewasonlyabletocategorizethe
recordsas"good"or"bad"nursing.Itthen
dawnedonherthatboththeformulationsfor
"good"and"bad"nursingwerecontainedinthe
records.Fromtheseobservationssheformulatedthe
deliberativenursingprocess.
ADeliberatenursingprocesshas
elementsofContinuousreflectionasthe
nursetriestounderstandthemeaning
tothepatientofthebehaviorshe
observesandwhatheneedsfromherin
ordertohelped.
Responsescomprisingthisprocessare
stimulatedbythenursesunfolding
awarenessoftheparticularsofthe
individualsituation.
Theroleofthenurseistofindoutandmeetthe
patient'simmediateneedforhelp.Thepatient's
presentingbehaviormaybeapleaforhelp,
however,thehelpneededmaynotbewhatit
appearstobe.Therefore,nursesneedtouse
theirperception,thoughtsabouttheperception,
orthefeelingengenderedfromtheirthoughtsto
explorewithpatientsthemeaningoftheir
behavior.Thisprocesshelpsthenursefindout
thenatureofthedistressandwhathelpthe
patientneeds.Orlando'stheoryremainsonethe
ofthemosteffectivepracticetheoriesavailable.