Ida Jean Orlando Nursing Theory

IDA JEAN ORLANDO'S NURSING THEORY

Ida Jean Orlando

Orlando was a first generation Irish American born on August 12, 1926. She dedicated her life studying nursing and graduated in 1947 ans received a Bachelor of Science degree in public health nursing from St. John's University, New York in 1951. In 1954, she completed her Master of Arts in Mental Health consultation from Columbia University, New York. While studying she also worked intermittently and sometimes concurrently as a staff nurse in OB, MS, ER as a supervisor in a general hospital, and as an assistant director and a teacher of several courses. in 1961, she was married to Robert Pelletier and lived in the Boston area. As for being a respectable and credible role-model, Orlando was well educated with many advanced degrees in nursing.  After all the great works of Orlando her good works ended on November 28, 2007 when she died at the age of 81.

DESCRIPTION

      Orlando's theory was developed in the late 1950s from observation she recorded between a nurse and patient. Despite her efforts, she was only able to categorize the records as "good" or "bad" nursing. from these observations she formulated the deliberative nursing process. In 1961 her first book about the theory of  "The  Dynamic Nurse-Patient Relationship was published. She furthered the development of her theory when at McLean Hospital in Belmont, MA as director if a Resea; there she publishes are second book titled " The Discipline and Teaching of Nursing Process" in 1972.

THE FOUR METAPARADIGMS 

PERSON

• A patient’s behavior can be verbal or nonverbal.
• Patients are “individuals who suffer or anticipate a sense of hopelessness.
• Sometimes people cannot meet their own direct needs.
• Patients experience distress when they cannot cope with unmet needs.
• A person’s needs can change at anytime.
• A patients behavior no matter how insignificant it may seem, may be a cry for help.
• Patients have their own meanings and interpretations of situations

HEALTH

• The basis for nursing action is the distress experienced and expressed by the patient.
• The goal of the nurse is to determine and meet patient’s immediate needs and to improve their situation by relieving distress or discomfort ” it's done by “ observing, listening, and confirming.

NURSING

• Nurses use direct and indirect observations of patient behavior to discover distress and       meaning.
• Nurses help patients express and understand the meaning of behavior.
• The basis for nursing action is the distress experienced and expressed by the patient.
• The human transaction between the nurse and the patient in any setting holds the greatest   value.
• Patients have their own meanings and interpretations of situations and therefore   nurses must   validate their inferences and analyses with patients before drawing conclusions.

ENVIRONMENT

• Patients who require nursing care when they have needs for help that cannot be met independently because they have physical limitations, have negative reactions to an environment, or have an experience that prevents them from communicating their needs.
• Concerned with providing direct assistance to individuals in whatever setting they are found for the purpose of avoiding, relieving, diminishing or curing the individuals sense of helplessness.

NURSING PROCESSES

THE DYNAMIC NURSE-PATIENT RELATIONSHIP

        This model explain that the role of the nurse is to find out and meet the patient's immediate needs for help. The patient's presenting behavior might be a cry for help. However, the help the patient needs may not be what it appears to be. Because of this, nurses have to use their own perception, thoughts about perception, or the feeling engendered from their thoughts to explore the meaning of the patient's behavior. This process helps nurses find out the nature of the patient's distress and provide the help he or she needs. The concepts of the theory are: function of professional nursing, presenting behavior, immediate reaction, nursing process discipline, and improvement.

FUNCTION OF PROFESSIONAL NURSING

The function of professional nursing is the organizing principle which is finding out and meeting the patient's immediate needs for help. 

PRESENTING BEHAVIOR

The role of the nurse is to find out and meet the patient's immediate need for help, by doing so the nurse must first recognize the situation as problematic.

THE IMMEDIATE REACTION

This which is the internal response to the situation so the immediate response reflects how the nurse experiences his or her participation in the nurse-patient relationship.

THE NURSING PROCESS DISCIPLINE 

This process is where the nurse investigate the patients's needs was effective. The nurse should not assume that any aspect of his or her reaction to the patient is correct, helpful, or appropriate until he or she checks the validity of it by exploring it with the patient. 

IMPROVEMENT 

The resolution of patient's situation. During this, the nurse's actions are not evaluated, but the result of his or her actions are evaluated to determine whether his or her actions served to help the patient's needs. 

DELIBERATIVE

Deliberative nursing process is a term that Orlando uses for process where there is ongoing validation of nurse’s actions together with the patient. Basically that process consists of four steps that are: patient action, nurse reaction, nurse-patient validation and nurse action. Automatic nursing process term describes a process where the nurse’s response to the need of help is done according only to the perceptions of the nurse, leaving the role of the patient quite passive in his own care. One way to describe the nursing process is usually six steps linear mode which are:

          ASSESS:              Gather information about the patient's condition.

          DIAGNOSE:       Identify the patient's problem, nurse diagnose a patient with the use of                                                    NANDA (North American Nursing Diagnosis Association).

          PLAN:                  Set goals of care and desired outcomes and identify appropriate nursing                                                actions.
         
          IMPLEMENT:    Perform the nursing actions identified in planning.

          EVALUATE:        Determine if goals and expected outcomes are achieved.

EVIDENCE-BASED PRACTICE

The evidence-based practice are the trusted, respected and credible nursing resources to enable best practices leading to optimal patient outcome. Before making decisions the nurse should use knowledge based on her expertise, patient’s individual view, and the research based evidence. According to Polit & Beck (2008, 28, 30) refine as one of the cornerstones of evidence-based practice to be critical thinking. 

THE GENERAL ASSUMPTIONS

1. When patients are unable to cope with their needs on their own, they become distressed by feelings of helplessness.
2. In its professional character, nursing adds to the distress of the patient.
3. Patients are unique and individual in how they respond.
4. Nursing offers mothering and nursing analogous to an adult who mothers and nurtures a child.
5. The practice of nursing deals with people, environment, and health.
6. Patients need help communicating their needs; they are uncomfortable and ambivalent about their dependency needs.
7. People are able to be secretive or explicit about their needs, perceptions, thoughts, and feelings.
8. The nurse-patient situation is dynamic; actions and reactions are influenced by both the nurse and the patient.
9. People attach meanings to situations and actions that aren’t apparent to others.
10. Patients enter into nursing care through medicine.
11. The patient is unable to state the nature and meaning of his or her distress without the help of the nurse, or without him or her first having established a helpful relationship with the patient.
12. Any observation shared and observed with the patient is immediately helpful in ascertaining and meeting his or her need, or finding out that he or she is not in need at that time.
13. Nurses are concerned with the needs the patient is unable to meet on his or her own.

RESEARCH STUDY

A research study under Orlando nursing was done by Anne Haapoja in the year 2014, she titled he Nursing Process, a Tool to Enhance Clinical Care – a Theoretical study.  

Her aim of this project is to gain deeper knowledge and understanding about the nursing process as a tool of ensuring safety and quality in delivering nursing care. The main questions considering this thesis were: can the nursing process be a tool for enhancing nursing care and can the nursing process function as a tool to insure safety in delivering care to the patient? The theory is based on Ida Jean Orlando’s Nursing Process theory since Orlando as well as the Finnish Care Classification uses the term ‘need’ to describe patient problems. Qualitative content analysis was used to find out whether the nursing process has the probability to lead for a better nursing care. The data was consisted of selected articles. The respondent found out that the nursing process has positive effect on both safety and the quality of nursing care by increasing nurses’ reflective thinking, promoting effective communication and better quality documentation. 

REFERENCES

https://nurseslabs.com/ida-jean-orlandos-deliberative-nursing-process-theory/

https://nurseslabs.com/ida-jean-orlandos-deliberative-nursing-process-theory/

https://pdfs.semanticscholar.org/96f6/8a29a6ec4561e625cd3b5e0d5c2ab0deae0a.pdf