Ida Jean Orlando's nursing process theory and deliberative nursing practice

¶ … Orlando's Nursing Process Theory

The Grand Theory chosen for this assignment is the Orlando's Nursing Process Theory. This theory was formulated by Ida Jean Orlando. The theory was based on inductive reasoning and is still considered one of the most followed nursing practice theories. The theory is based on the most basic principles of interaction between the patient and the nurse practitioner. This theory highlights how a patient makes a conversation about his needs and how a nurse provides care to him.

Background of the Theorist-Ida Jean Orlando

The grand theorist was born in the year 1926 and got her Nursing diploma from the New York Medical College. She did her Bachelor's degree in public health from St. John's University, New York. She did not stop here and got her Master's degree in Mental Nursing from Columbia University, New York. About her work experience, it is interesting to note that she attained her first job as an Associate Professor at the Yale School of Nursing and was later declared the Director of the Graduate Program in Mental Health Psychiatric Nursing. She many books published, which focus on the nursing theories and their implementations in the nursing practices (Logan, 2013).

In the latter half of the 1950s, Ida Jean Orlando formulated the Orlando's Nursing Process Theory. This theory was inductive in nature and was developed by conducting an empirical study on the nursing study and practice. During her practice as a nursing professional, she categorized the good and bad aspects of nursing practice. For almost three consecutive years, she observed 2000 interactions between the nursing practitioner and the patient.

She defined the good nursing practice where the prime focus of the nurse was on the non-verbal and verbal behavior of the patient that he might have shown immediately. It is observed from the commencement of the contact until the end of the conversation. On the other hand, the bad nursing practice highlights the nurse's focus on the documented or learned activity instead of observing the patient's immediate verbal and non-verbal behavior. These documentations lead the theorist is formulating the Deliberative Nursing process. This was published in the year 1961.

Contribution to the Past and Present Literature

The Orlando's theory is still considered and followed as the most effective and relative nursing practice theories, which are available to the nursing schools at the present moment. This theory has been translated and transcribed into six different languages for distribution all over the world. The theory has been utilized as the building ground for many other researches (Olson, 1997; Faust, 2002).

Phenomenon of Concern

Orlando used the conception of nurse- patient interaction with the prime focus on the nursing practice. Orlando does not specify the term "Health" in her theory but implies it. Hence, the therapeutic goals of nursing practice are also dependent on the interaction and behavior of the nurse practitioner and the patient. However, the interaction is concentrated on a specific time and space. Unless the patient does not feel comfortable in the presence of a nurse, the therapeutic activity will not be as effective as it is required (Abdoli, 2010).

Description of Orlando's Nursing Process Theory

The Orlando's Nursing Process Theory proves as an interrelating bond between the interaction of nurse and the communication of the patient. This theory has more of a logical nature and contributes to the daily nursing practice equally. The theory is also easy to understand and is simple in nature. Its contribution to the professional knowledge is enhanced by its application to the clinical practice (Faust, 2002).

Inductive Reasoning

Orlando's theory was developed in the late 1950s based on an empirical study. It was based on inductive reasoning because for approximately 3 years, Orlando observed 2000 interactions between the patients and nurses. At the end of the empirical study, she was able to categorize her results in two distinct categories. In order to prove and validate her findings, a research was conducted at the McLean Hospital. In this research, continuous tape recordings were studied. These recordings were an interaction between the nurses and patients. Some interactions were also between the patients and other health care members. Hence, it was inductive reasoning.

Major Concepts of Orlando's Theory

Human

In her theory of Nursing Process, Orlando uses the human nature concept. She pays special attention to the dynamic nature and individuality of concept of human. Operationally, she places the needy humans as the prime focus of nursing practice. She does not significantly emphasize on the health issue. On the other hand, she replaces health with the helplessness that requires the nursing.

Nursing

The second major concept of Orlando's theory is nursing itself. She explains it to be an independent and unique practice that is based on the concern and emotion for the help. This help is provided to a human who is in need of the help. Operationally, nursing practice that caters to the need of a human requires proper training and adequate learning.

Need

The third major concept of her theory is Need. She defines need as "a requirement of the patient which, if supplied, relieves or diminishes his immediate distress or improves his immediate sense of adequacy or well-being" (Meleis, 2011). She implies that the humans who do not require help can take care of their own needs. Such people do not call for nursing care. On the other hand, humans who cannot cater to their own needs and require nursing care are the humans who build the basis of this theory.

Immediacy

Immediacy of nursing care in an emergency situation is another major factor of Orlando's nursing theory. The assessment of the patient behavior is an important step in this concept. Operationally, the nursing practice should be designed to provide immediate care with best possible quality. In the case of ambulatory situations such as child delivery or car accident, properly trained nursing staff is required and interaction plays a slight role in it.

Examination of the Relationship between Different Major Concepts

Human and nursing is quite interdependent major concept. On the other hand, Need and Nursing makes a stronger bond. Meanwhile, Immediacy is dependent on the interaction level that is not in the major concepts of Orlando's theory (Kim, 1994).

Person

1. A person is the recipient of quality care. This care can be psychological, physical, spiritual and in terms of sociocultural elements. Orlando's Nursing Theory addresses this metaparadigm by referring to it as a patient. In her theory, the patient is in need and if care is not provided to him by a nurse, he will feel helpless.

2. It can also be Individual, family, or community. Orlando's theory only refers to person as a patient. There no significant mention of any community or family.

Environment

1. All the conditions, which include external and internal factors. These conditions influence the person directly or indirectly. Orlando's theory refers to the environment vaguely.

Health

1. It is the degree of illness or wellness felt by the person. It is not properly defined in Orlando's theory. Health is the freedom of a patient from physical or mental disability. He is healthy if he does not need anyone's help.

Nursing

2. Attributes, actions and characteristics of another person giving quality care. This is the main factor in Orlando's theory. Nursing is considered as mothering a child (Orlando, 1972).

Clarity of Orlando's Nursing Theory

The clarity of Orlando's theory can be assessed by categorizing its strengths and weaknesses.

Strengths of Orlando's Theory

1. If Orlando's theory is incorporated into nursing practice, it will ensure that the patients are treated individually. Moreover, the patients will actively participate into their own care.

2. This theory also helps in the accurate diagnosis and keeps the practitioners away from ineffective planning. This is because, the theory enables nurse to timely checking the reaction of the patient towards treatment and care.

3. Orlando's belief of making nursing profession independent based upon the theoretical framework makes it unique.

4. Orlando's theory has set a guideline for the nurse so that they can evaluate outcome of patient (Schmieding, 1984).

Limitations of Orlando's Theory

Orlando's Nursing theory is highly interactive in nature. The inclusion of highly physical and technical or specialized care is quite hard. Secondly, this theory is not very strong at the point of authorizing the core function of nursing profession. Neither does it signify the commitment of an institution to public well-being (Orlando, 1961).

Application of Orlando's Theory

Orlando's Nursing Theory is applicable in many situations that require immediate actions. A perfect example of applicability is an event of accident. The affected person will be in need and ask for help. The nurse will interact with the person and inquire as to where he is feeling the pain. Upon his indication, the nurse can provide him with care. The patient can assist the nurse by informing about the intensity of pain.

The application of Orlando's theory is not very successfully applied in a long-term care. This is because the patients may or may not be in coma. Moreover, the patient conversation skills are also doubtful in elderly homes. This is the reason the application of Orlando's theory is limited to immediacy (Orlando, 1972).

Contribution of Orlando's Theory to Nursing

In comparison to other nursing theories, Orlando's theory is to-the-point and clear cut. It gives effective contribution to the patient oriented nursing practice. This theory has uplifted the honor of customized quality care. Her theory has enabled nurse practitioners to be nurse advocates as well (Schmieding, 1983). The nursing practice in the present world has gained significantly by the dynamic concept of nursing. It has highlighted the concept of patient- nurse interaction and has also given importance to the patient's contribution in care.

Prevention of inaccurate diagnostic errors and ineffective planning is also a virtue of Orlando's Nursing Theory. However, theory is not very well applicable to the long-term care settings. Additionally, the idea of patient-nurse interaction is also compromised in the case of patients who are unable to interact (Schmieding, 1987).

Utilization of Orlando's Theory in Nursing

The utilization of Orlando's theory in nursing practice is quite vast. It has been implemented in the past and is still being used. The four most important sectors that will use this theory are as follows:

Practice

Nursing Practice that requires immediate attention will gain the most from this theory. However, I would refrain from applying this theory to long-term care. This is because the theory is based upon patient and nurse interaction. While the patients in long-term care not usually conversing. Orlando's theory has contributed effectively in Education of nurses ever since its inception. I would like to implement this theory and its concept of interaction in my clinical sessions with patients. I have understood from this theory that patient and nurse interaction increases the therapeutic efficacy of care and treatment. This is because the patient can contribute the treatment as well as in the therapy.