Ida Jean Orlando Theory: Essay Introduction
Nursing theory development has a long history, including significant changes and improvements that occurred in the middle of the 20th century. The progress of the nursing profession is evident today and its success can be explained by a deep understanding of nursing theories and philosophies. The purpose of this paper is to describe, evaluate, and discuss the application of one of the nursing theories that can be recognized as a grand or middle-range theory. The theory chosen for the analysis is the Deliberative Nursing Process Theory developed by Ida Jean Orlando in 1961 to underline the importance of the nurse-patient relationship (Bunkers, 2012).
Ida Jean Orlando Theory and Background
Ida Jean Orlando is the author of a middle-range nursing theory about the worth of the deliberative nursing process in practice. The description and analysis of this theory is a significant contribution to the development of nurse-patient relationships and the explanation of how Orlando’s ideas and concepts may guide nursing actions.
Background
Ida Jean Orlando, an American of Italian descent, was born in 1926 (Masters, 2014). In 1947, she received her diploma in the field of nursing at New York Medical College. In 1951, she got her Bachelor of Science degree in public health nursing in Brooklyn St. John’s University (Masters, 2014). Finally, in 1954, Orlando completed her Master of Arts degree at the Columbia University Teachers College and got an opportunity to teach in different faculties, including the Yale School of Nursing (Pokorny, 2014). She investigated the field of nursing and observed the experiences of patients, nurses, students, and instructors.
The peculiar feature of her investigations was the necessity to integrate mental health concepts and nursing standards to create appropriate conditions for patients. Her observations helped her conclude that patients had to develop their interpretations of situations and create meanings of nursing practice. In 1961, Orlando published her first book, The Dynamic Nurse-Patient Relationship believing that the goal of nursing was to respond to all individuals and their needs and support them in case they suffer from helplessness (Raingruber, 2016). Observing nursing practice and the level of knowledge students can get at schools and colleges, Orlando decided to analyze the relations between nurses and patients and create a guide to support nurses and patients equally.
Literature Review
The Deliberative Nursing Process Theory’s uniqueness can be explained by the fact that its author was one of the first theorists who discussed a nursing process using the results of her investigation (Sampoornam, 2015). It was an empirical study with the help of which Orlando discovered an easy way to identify and meet patients’ needs.
The point is that patients’ behaviors may not represent their true needs, and it is the task of nurses to investigate different situations and validate their understandings of patients. Raingruber (2016) states that a nurse can hardly know if the chosen approach of care is correct and helpful. It is necessary to get a confirmation from a patient about the appropriateness of the approach and learn what various assumptions can mean.
Bunkers (2012) identifies Orlando’s theory as a framework that can define professional nursing and investigate nurse-patient relationships from different perspectives. It was used for about 40 years as a systematic approach and recognized as a theory with a historical significance today (Adeyemo & Olaogun, 2013). In the investigations of Pokorny (2014), Orlando’s nursing theory is identified as a framework for the development of reciprocal relations when understandings and meanings developed by patients and nurses can affect all of them. Orlando was one of the first theorists who identified the role of a patient’s participation in the nursing process and the necessity to divide medicine from care to improve patient’s understanding of a curing process (Sitzman & Eichelberger, 2015).
There are five main stages of the nursing process discussed in the chosen theory (Bunkers, 2012). The theorist also defines main concepts and develops clear explanations for each of them. Still, some authors find this Nursing Process Theory difficult for understanding and using due to the necessity to deal with a list of tasks and divide the roles in regards to the existing hierarchy of nurses (Al-Ftlawy, 2014). Patients have to realize that each nurse may demonstrate different attitudes to personal and health problems of patients, and nurses should understand that patients may have different interests in treatment. The Deliberative Nursing Process Theory developed by Orlando is a framework in terms of which it is possible to the relations between patients and nurses can be properly established.
Problems Addressed by Deliberative Nursing Process Theory
The main nursing problem that is addressed by Orlando’s theory is distress caused by the impossibility to meet patients’ needs because of some physical limitations, adverse reactions, and poor communication of health problems. In her theory, Orlando identifies a list of problems that have to be solved in cases appropriate patient-nurse relationships can be developed. Many patients are ready to admit their helplessness when the time to share their health concerns comes. Not all patients have enough knowledge or even interest to discuss their health problems with someone except their doctors because they believe that only this group of medical workers has to be aware of an actual state of affairs.
Therefore, communication between nurses and patients has always been a problematic area, and medical workers, as well as students and instructors, have to improve their knowledge and identify the methods that can be used to improve a nursing process (Sitzman & Eichelberger, 2015). When patients do not know how to cope with their needs, they become helpless and distressed. Nurses should recognize such situations and know when to offer their help regarding the environment, health, and patients’ expectations (Sampoornam, 2015).
Deliberative Nursing Process Theory Description
The Deliberative Nursing Process Theory is rooted in the interactions that have to be developed between a nurse and a patient under specific conditions. It is not enough to follow certain rules and learn special standards. Understanding and application of the theory depend on its successful understandings. In this section, the main concepts of the Nursing Process Theory and reasoning used in the theory will be discussed.
Types of Reasoning Used in Deliberative Nursing Process Theory
Orlando’s theory was developed based on an empirical study and has to be characterized as a good example of the theory with inductive reasoning (Pokorny, 2014). Approximately 2000 nurse-patient contacts were chosen by Orlando for observations and analysis. Observations lasted three years, and positive results were achieved. The theorist offered several categories that could be used to explain the relations between patients and nurses and the roles these participants had to perform. Certain premises were chosen to support the conclusions made and prove their probable nature.
In comparison to deductive reasoning when the theorist has no doubts or concerns about the offered idea, inductive reasoning presupposes the possibility of false conclusions and the necessity to make corrections or choosing a new direction. Regarding the fact that Orlando did not use any peer-reviewed articles or other evidence expect the analysis of personal observations, it is correct to say that her theory uses inductive reasoning and includes the possibility to combine various nursing concepts from different perspectives.
Major Concepts of Ida Jean Orlando Theory
Orlando defines several main concepts in her theory to explain the worth of nursing care and the relations that can be developed between nurses and patients. Such concepts as nursing, immediate care, human, health, and need can be operationally defined. For example, operationally, a human is introduced as a prime focus of nursing practice. It is necessary to recognize human needs, another important concept, that can be operationally defined as a requirement established by patients when they ask for nursing care. According to Orlando, nursing is an independent practice that may be characterized by emotions, help, and personal concerns. Finally, the immediate provision of help by nurses is the concept of Orlando’s theory the design of which promotes immediate care and explanations.
How Concepts are Defined
Taking into consideration the fact that Orlando introduced several important concepts in nursing and tried to define the quality of the relations between patients and nurses, it is possible to say that all concepts are implicitly defined. Though all concepts remain to be clear and informative, some doubts may occur, and additional explanations are required. For example, human needs have to be properly identified in terms of nursing to prepare nurses for possible expectations and standards to be followed. Helplessness and distress may gain different forms, and Orlando failed to recognize that every individual may have unique traits and attitudes.
The relationship among Major Concepts
Certain attention should be paid to the relationship that is developed between concepts of the theory. In the chosen theory, such concepts as human (patient) and nursing (care) turn out to be interdependent issues because it is important to recognize nurses and patients as unique contributors to the development of effective nursing care. At the same time, the relations between need and nursing cannot be neglected because as soon as the needs of patients are identified, the required portion of nursing care may be offered. Patients have to understand that their ability to develop communication with nurses influences their further treatment, the immediateness of services, and the presence/absence of the feeling of helplessness and distress.
Evaluation
In this section, certain attention will be paid to the evaluation of the main concepts of the Deliberative Nursing Process Theory and clarifications of the standards of nursing care. The nursing metaparadigm in Orlando’s theory has its specifications that have to be discussed.
Implicit and Explicit Assumptions
Orlando’s theory contains several important assumptions that can be explicitly and implicitly defined. For example, one of the main ideas includes the fact that patients may be not able to cope with their needs that lead to the development of distressing feelings and helplessness. Such an assumption is implicit because it is hard to understand what needs have to be recognized and when the feeling of distress can be observed. Another implicit assumption is connected with the role of nursing in patient care and the possibility to add to the distress professionally. Still, no clarifications are given on the steps that nurses should or should not take to avoid complications.
Finally, it is stated that nurses are concerned with their patients’ needs in case patients cannot meet them independently. Such implicit assumption requires additional explanations of needs and the level of concern. At the same time, some assumptions are explicit by nature. For example, Orlando states that patients are unique, and nurses have to understand that their uniqueness is the key to nursing care. Besides, a mothering analog can be offered to nursing care. Finally, the communication of needs may be uncomfortable and ambivalent. Still, it has to be developed to find a solution and promote effective and easy nurse-patient relations.
Ida Jean Orlando Metaparadigm of Nursing
Out of four concepts of the nursing metaparadigm, only three concepts are explicitly defined. According to Orlando, nursing is a process of care in an immediate experience in terms of which it is possible to avoid or decrease the feeling of helplessness (Pokorny, 2014). A person is a being with certain needs that have to be recognized and met. Health is well-being when all needs are fulfilled, and the sense of comfort is achieved. The environment does not have a direct clarification and remains to be an implicitly defined concept.
Clarity of Ida Jean Orlando Theory
In general, the theory is clear due to the possibility of Orlando to define the main concepts at a minimum during their first introduction and discuss their peculiar features through books and examples taken from real-life situations. There is a nursing client, a patient, who is not able to meet needs and ask nurses for additional help. There is a problem that is based on poor communication developed between patients and nurses. Finally, a clear description of a nursing process is giving underlying the possible behavior of patients and nurses, the importance of nurses’ reactions, and the role of nurses in patient’s helplessness avoidance.
Application of Deliberative Nursing Process Theory
The Deliberative Nursing Process Theory has its own strong and weak points. On the one hand, Orlando helped nurses comprehend what steps should be taken in the promotion of effective relations with patients. Each patient has to be ready to contribute to their health and care. Besides, nurses can evaluate their actions and identify what kind of help has to be offered to avoid complications, stress, and disappointment. This theory can be used as a guide for both, nurses and patients. They are direct participants in nursing care, and patients have to understand that the quality of health care depends on their ability to explain problems and identify their own needs. Nurses can hardly guess what patients and their families want to achieve. Communication is the method of data exchange that has to be properly developed. Orlando’s theory contains information that may be used in different hospitals and other facilities.
It is possible to use this theory in education. This area of nursing touches upon the fundamental aspects of care. Nurses have to learn their perspectives, understand their roles, and be ready to assist patients in different ways. Still, patients have to understand their roles and the importance of their participation in nursing care. Patients have to be properly educated by their nurses on how to contribute their treatment.
Ida Jean Orlando Theory: Essay Conclusion
In general, this paper contains enough information about the Deliberative Nursing Process Theory and its developer, Ida Jean Orlando. Though some concepts are implicitly developed in the theory, Orlando’s books can be used to promote an explicit understanding of the terms. The main lesson that has been obtained is the recognition of the role of patients in nursing care and the necessity to develop reciprocal relationships between nurses and patients to achieve positive results in care. Each piece of information presented by a patient may affect a nurse and a patient in equal terms and vice versa. Orlando proves that thinking abilities and communicative skills are important for patients and nurses in the same way.
References
Adeyemo, F.O., & Olaogun, A.A.A.E. (2013). Factors affecting the use of nursing process in health institutions in Ogbomoso Town, Oyo State. International Journal of Medicine and Pharmaceutical Sciences, 3(1), 89-96.
Al-Ftlawy, D.M.H. (2014). The knowledge of students in nursing college about nursing process. Kufa Journal for Nursing Sciences, 1(3), 178-186.
Bunkers, S.S. (2012). Presence: The eye of the needle. Nursing Science Quarterly, 25(1), 10-14.
Masters, K. (2014). Nursing theories: A framework for professional practice. Burlington, MA: Jones & Bartlett Publishers.
Pokorny, M.E. (2014). Nursing theorists of historical significance. In M.R. Alligood (Eds.), Nursing theorists and their work (pp. 42-59).St. Louis, MO: Elsevier.
Raingruber, B. (Eds). (2016). Contemporary health promotion in nursing practice. Burlington, MA: Jones & Bartlett Publishers.
Sampoornam, W. (2015). Nursing process and Orlando process discipline – A case scenario. Asian Journal of Nursing Education and Research, 5(2), 212-216.
Sitzman, K., & Eichelberger, L.W. (2015). Understanding the work of nurse theorists. Burlington, MA: Jones & Bartlett Publishers.