Abstract
Nursing Process Theory as deliberated by Orlando looks at the interaction existing between a patient and a nurse, validation of perception and how the nursing process can be used to come up with outcomes that are positive or improvement in patients. The main focus that Orlando had in mind was to provide a clear definition of the function of nursing. The theory has been one of the most effective theories that can be practiced by nurses. The use of this theory enables the nurse to keep her focus on the patient alone. It comes out as a very concise, clear and a theory that is easy to use. Although the Orlando’s theory does provide an overall nursing framework, the use of this theory does not restrict the nurses from using the other available theories while offering care to their patients. When compared with other theories, this theory provides a clear approach of focusing on the patient alone. The theory takes the integrity of a nursing care that is individualized, and this strengthens the function of a nurse as an advocate for the patient.
Ida Jean Orlando was born in the year 1926 to an immigrant from Italy. She grew up in the time of the great depression. She did her nursing diploma in the New York Medical College and later did her bachelor’s degree in public health nursing at the St. John’s University in New York in 1951 and master’s degree in mental health nursing in 1954 from the Columbia University (Kungle, 2011). She worked as an associate professor at the Yale school of nursing and was among the nursing theorists who wrote about the process of nursing (Faust, 2002).
In 1950’s Orlando developed her theory following the observations that she recorded between a patient and nurse. She categorized the records that she made as either good or bad nursing. From these observations, Orlando came up with the thoughtful nursing process. The theory describes the role of the as finding out the immediate needs for patients and be able to meet them. The presenting behavior of the patient may represent a plea for help although the help that is needed may not the one that it appears to be. There is, therefore, the need for the nurses to use their own perceptions or feelings that are engendered from the thoughts they have in exploring with the patient what their behavior means. This process enables the nurse to understand the nature of distress and the needs of the patients (Cardinal Stritch University, 2013).
Orlando made several assumptions while coming up with this theory. First, the theory made the assumption that patients who are not able to handle their medical needs with no assistance mat become distressed resulting to a feeling of helplessness. The nursing are thus in a position to offer their contribution in such a distress. The relationship that is developed between the nurse and a patient comes out of the decision that both parties make. There is no possible way that a patient may convey their needs in an appropriate manner without having established a relationship with the nurse. Therefore, nurses are there to offer patients with a nurturing and motherly presence in relieving distress. Nursing provides patients with nursing and mothering care similar to that offered by adult mothers to their children. The other assumption was that nurses deal with people health and the environment. The theory also assumed that patients require assistance while communicating their needs and are not comfortable with dependency needs. The other assumption was that human beings have the capability of being secretive about their perceptions, needs and feelings.
The nursing process refers to the problem-solving and deliberate approach that is taken to meet the nursing and health care needs of patients. The process involves five steps, which are assessment or data collection, diagnosis step, planning process, implementation step, and evaluation. The process also involves subsequent modifications, which are used as feedback mechanisms to promote nursing diagnoses resolution. In general, the process is cyclical, and the steps are interdependent, interrelated, and recurrent (Nursing Process, 2013).
In the assessment step, nurses use a way that is dynamic and systematic in the collection and analysis of data concerning the client. This is the initial step in the process of providing nursing care to patients. The step includes collecting physiological, sociocultural, psychological, economic, as well as life-style factors. For instance, the assessment of a patient who is hospitalized in pain may include the physical causes, pain manifestation and the response of the patient such as the inability to leave the bed, failure to eat, anger towards hospital staff, request for pain relieving medications and fear (ANA, 2013).
The diagnosis step refers to the clinical judgment that is done by a nurse about the response given by a patient to potential or actual health needs or condition. Diagnosis reflects on the fact that the patient is in pain as well as the fact that the pain has resulted to other problems like poor nutrition, anxiety, and conflict in the family. Diagnosis also focuses on the fact that pain has the potential of causing complications such as respiratory infections. The step of diagnosis makes up the basis for the care plan of a nurse (ANA, 2013).
The other step of the nursing process is planning or the outcomes. This is mainly done based on the diagnosis and assessments that have been done. The nurse may, therefore, set short and long-term goals that are achievable and measurable for the patients. The goals may include moving from the bed and going to a chair several times every day, keeping proper, dealing with conflicts through counseling and pain management through the use of proper medication. All the data collected through assessments, the diagnosis that is made and the goals set are usually written in the care plan of the patient to enable the health professionals who are taking care of the patient have access.
In the implementation step, the nursing care is translated into practice, and this is done in accordance with the care plan. This ensures that care for the patients while in hospital is continued as well as when they are being prepared for discharge. The documentation of care is usually done for the record of the patient.
In the evaluation stage of the nursing process, the status of the patient and the effectiveness of the process of nursing care are evaluated continuously. The evaluation is based on the goals or outcomes that were set during the previous phases. If the progress of attaining the goal is slow, the care plan may then be modified accordingly (ANA, 2013).
The theory indicates that the nurse has a role of finding out what are the immediate needs for the patient and thus fulfill them. Although the patient may not express the distress that they have in a way that they can be understood, the nurse has an obligation of the nurse to use perception, thought and intuition to get what are the actual needs of the patient. It is important for the nurse to recognize initially that the present situation as a situation that is problematic before taking any action. The nurse must comprehend that whatever actions that the patient is doing are a way of communicating a call for help. This is regardless of the manner in which the actions appear. Those nurses who do understand the theory may experience an internal reaction to the pleas that are made by the patients and thus exhibit behaviors that will result into a trigger a sign of relief from the patient. When the needs of the patient are not met, most patients show signs of distress.
Nurses use the observations that are shared with the patient and those analyzed through the nursing process to determine whether the patient needs assistance or not. The nurses are also encouraged not to assume that the actions as well as reactions towards the patient are helpful or appropriate until the patient has indicated signs of relief. The nurses should get used to a pattern of finding out how the patients react to their actions and reactions. This is important as once the nurse has stopped deriving and identifying meanings from the behaviors shown by the patient there is a breakdown in the communication that exists between nurse and a patient.
Some of the strong characteristics of the Orlando’s theory include being able to interrelate concepts, having a logical nature, being simple, add to the professional knowledge and being applicable in daily and clinical practices. The theory has several strengths, which include its use assures that the patient has a chance of being treated individually. The patients also have a chance of having active and constant input being made into their own care. The use of this theory also prevent nurses from making inaccurate diagnosis or use plans that are not effective since the nurse will have to evaluate the plan used. The theory also helps the nurse to do an evaluation of the care given to the patient in terms of the outcome that is observed in a patient. The weaknesses of the theory include the lack of operational definition of the environment or society. This offers limitation to the development of the hypothesis of the research. In addition, the theory puts more focus on the care that is given to those individuals who are aware and conscious.
Currently, the nursing process is still being used especially in the regulation of patient care and the interaction between nurses and patients. The process is also used currently to enable nurses identify the things they need to do in order to offer care to a patient by following the five major steps. The nursing process is also fetal currently in enabling the nurses keep a good track of the care they give to patients in terms of keeping a record. A number of nursing models that are being used by nurses deal with the nursing process directly by helping the nurse deal with a patient from assessment step to evaluation step. There other theories used today that use a modified nursing process and others that do not apply the process at all (Nursing Theory, 2011).
Reference List
ANA. (2013). The Nursing Process. Retrieved August 10, 2013, from American Nurses Association: http://nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html
Cardinal Stritch University. (2013). Ida Jean Orlando - Theory of Nursing Process Discipline. Retrieved August 10, 2013, from http://www.stritch.edu/Library/Doing-Research/Research-by-Subject/Health-Sciences-Nursing-Theorists/Ida-Jean-Orlando---Theory-of-Nursing-Process-Discipline/
Faust, C. (2002). Orlando's deliberative nursing process theory: a practice application in an extended care facility. Journal of gerontological nursing, 28(7), 14-18.
Kungle, B. (2011). Ida Jean Orlando-Pelletier. Retrieved August 10, 2013, from http://prezi.com/7bvmljaxlsgr/ida-jean-orlando-pelletier/
Nursing Process. (2013). An In-Depth Look into the Nursing Process. Retrieved August 10, 2013, from http://www.nursingprocess.org/
Nursing Theory. (2011). The Nursing Process. Retrieved August 10, 2013, from http://nursing-theory.org/articles/The_Nursing_Process.php
