Nursing Theory and Theorist Dynamic Nurse Patient Relationship Ida Jean Orlando Term Paper

Excerpt from Term Paper :

Ido Jean Orlando and analyzes how her contribution has impacted the nursing profession. It has 3 sources.

The field of nursing requires the utmost care on the part of nurses if they are to understand their patients. Nurses are an integral part of the medical care provision because they provide patients both physical and emotional care. Even doctors cannot succeed in reaching the level of emotional contact that nurses can achieve with their patients. According to Ida Jean Orlando, this kind of close relationship is dependent on the communication that nurses establish with the patients. This communication, whether verbal or non-verbal, plays a vital role in dealing out the most appropriate treatment as quickly as possible. Ida Jean Orlando's The Dynamic Nurse-Patient Relationship: Function, Process, and Principles, is a book that has had an immense impact on the field of nursing, popularizing Orlando's theory.

The Theorist:

Ida Jean Orlando was born in 1926, and belonged to the first generation of Americans of Italian descent. She achieved her diploma for nursing from New York Medical College, Lower Fifth Avenue Hospital, School of Nursing. In addition to this, Orlando received her BS in public health nursing from St. John's University, Brooklyn, NY, and also completed her MA in mental health nursing from Teachers College, Columbia University, New York. Ida Jean Orlando Theorist (2003)

Education and Influence of the Theorist:

After completing her education in nursing from these prestigious institutions, Orlando became an Associate Professor at Yale School of Nursing. Here she became Director of the Graduate Program in Mental Health Psychiatric Nursing. At Yale, Orlando was project investigator of a National Institute of Mental Health. The research that she became involved with aided her in developing her theory that shaped the field of nursing from her time onwards. It was as a result of her investigations at Yale that Orlando published 'The Dynamic Nurse-Patient Relationship' in 1961. Ida Jean Orlando Theorist (2003)

Orlando ameliorated her theory when she worked at McLean Hospital in Belmont, MA as Director of a Research Project. This project was entitled: Two Systems of Nursing in a Psychiatric Hospital. The findings that Orlando arrived at from this research led her to releasing 'The Discipline and Teaching of Nursing Process' in 1972. Ida Jean Orlando Theorist (2003)

The Theory:

Orlando's 'The Dynamic Nurse-Patient Relationship' which she published in 1961, was developed during the late 1950s. These were achieved through her observations of the nurse-patient relationship, which she recorded, worked on, and developed in order to recreate an environment which could be used to further develop the nurse patient relationship.

At first Orlando only recorded her findings category-wise as 'good' or 'bad', but later realized that formulations for "good" and "bad" nursing were contained in the records and were not subjective enough to prove valuable. Thus, she later developed, on the basis of these observations a deliberative nursing process.

In accordance with what Orlando uncovered through her research and deductions, it was realized that the role of the nurse is to determine a patient's immediate need for help. This can only be achieved by the best communication between the nurse and the patient. [Orlando 2003]

Orlando ascertained that the behavior of a patient could indicate what help is required immediately. As opposed to that, a patient's behavior towards a nurse may not be visibly comprehensible due to the pain and state of physical health that the patient is in, that is why it is necessary for a nurse to comprehend the behavior of patient properly, and the only way to do this is through understanding the types of communication that exist in these relationships.

Orlando also emphasizes the need for nurses to be able to use their perception, their thoughts about their perception or emotions created by the emotions of these thoughts, in order to investigate behavior of patients. Such investigation aid nurses in uncovering the nature of distress in patients and what kind of help the patients need. Ida Jean Orlando Biography (2003)

Boundaries of Practice:

According to the Orlando's theory, the practice of nursing is limited to the healthcare provision or the location of the patient. This is because the theory refers to a relationship, and this relationship is such that it requires time from both side; the patient and the nurse. This time can only be given when the nurses are on duty. Though the patient would still have thoughts about a particular nurse who attends to him or her, the relationship only blossoms when time is given. In the event of emergency treatment, time is never on anyone's side, and reading what victims try to say is difficult and thus there can be no real development of a nurse-patient relationship.

Orlando suggests that nurses should aid patients to "express the specific meaning of his behavior in order to ascertain his distress," and aid them to "explore the distress in order to ascertain the help he requires so that his distress may be relieved." (Lego, 1999)

Emergency cases are ones in which the nurses are almost alone in understanding and dealing with the patient. This may be because of the communication lacking between the nurse and the patient at that precise moment. However, what Orlando urges nurses to do is analyze their experiences to unearth what exactly the patients situation is. This would aid them in acquainting themselves with patient responses and also help them understand the manner in which they (the nurses) respond. "Any observation shared and explored with the patient is immediately helpful in ascertaining and meeting the need or finding out that there is no need at the time." (Lego, 1999)

Major Phenomena of the Theory: Orlando's theory is one that has helped the field of nursing make ground-breaking progress. The main reason for this progress is the concept of communication that Orlando has emphasized on.

Focus of the Theory:

The basis of the theory is the communication and understanding that the nurse has to develop with her patient. Sometimes a nurse may have to act independently in order to provide the right treatment in time, especially in emergency cases or when patients are far too traumatized to speak up. This is when non-verbal communication is of utmost importance, and is a stage at which a nurse has to use common sense or perception to carryout treatment. [Ida Jean Orlando Biography (2003)]

Misperception on the part of a nurse could easily lead one to administer the wrong treatment and waste valuable time. A nurse's emotions are also encouraged as guides to nursing and dealing with patients. Orlando has asserted in her theory that feelings are essential, and advises all nurses to take time out and consider their emotions regarding their perceptions. "The nurse does not assume that any aspect of her reaction to the patient is correct, helpful, or appropriate until she checks the validity of it in exploration with the patient." (Lego, 1999) This is important because a nurse can only know if an action or treatment is correct if it serves the patient positively.

The Purpose of this Theory:

Orlando's theory aids nurses in using their judgment in emergency and regular treatment. In the case of regular treatment nurses may easily ascertain what actions are appropriate, but in the case of an emergency nurses need to be able to take charge of a situation and treat a patient appropriately, even if the patient cannot communicate effectively. This is the reason why the theory also includes non-verbal communication, as an integral part of the treatment process.

It is clear enough that by ameliorating verbal and non-verbal communication, nurses can provide better care to patients. This is because of the fact that their relationships would automatically be strengthened. This relationship between nurses and their clients is strongly related to communication in this…

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