Nursing theory. Nursing process.

1. Nursing Process Theory:
Orlando
Presented by:
Abdelrahman al kilani
15906012

2. Objectives
By the end of this seminar, you’ll be able to
 Discuss the nursing process theory
 Describe the major concepts nursing according to Orlando
 Define the assumptions of Orlando’s theory
 Discuss the propositions of Orlando’s theory
 Explain Orlando’s theory as a framework for nursing practice
 Explain The nursing process and Orlando’s theory

3. Background
 Ida Jean Orlando (1926-2007)
 1947- Diploma in nursing from New York Medical College,
Flower Fifth Avenue Hospital School of Nursing
 1951- Bachelor of Science in Public Health from St. Johns
University, Brooklyn.
 1954- Master of Arts in Mental Health consultation in
Columbia University Teachers College.

4. Orlando’s Experience
During her study:
various clinical nursing positions in OB, medical, surgical,
and ER.
Assistant director of nursing and a teacher of several
courses in the hospital-based school of nursing.

5. Orlando’s Experience
After her master
 Yale School of Nursing for 8 years.
 Research associate and principal investigator on a grant-
funded project examining the integration of mental health
concepts into the basic nursing curriculum.

6. Orlando’s Experience
 1961- Her first book,
The ideas in this book provided the foundation for Orlando’s
theory of deliberative nursing process
The Dynamic Nurse-Patient Relationship: Function, Process
and Principles of Professional Nursing practice

7. Orlando’s Experience
 1962- she became a Clinical Nursing Consultant at McLean
Hospital.
 1972- Her second book; The Discipline and Teaching of
Nursing Process: An Evaluation Study
 1987- Assistant director of Nursing for Education and Research
at Metropolitan State Hospital.
 1992- Retired from nursing.

8. Overview of Ornaldo’s Nursing Process Theory
 This theory stresses the reciprocal relationship between the
patient and the nurse
 What the nurse and patient say and do during their interaction
affects both of them
 The function of the professional nurse is to discover and meet
the patient’s immediate need for help.
 The theory focuses on producing improvement in the patient’s
behavior.

9. Major concepts of nursing
Person Patient or individual with unmet needs
Environment
• Doesn’t define it.
• Assumes that nursing situation occurs when
there is a nurse-patient contact
Health
• Doesn’t define it.
• Assumes that feelings of adequacy and well-
being from fulfilled needs contribute to health.
Nursing
A distinct profession that functions
autonomously, the function of which is to find out
and meet the patient’s immediate need for help

10. Assumptions
• Nursing is a distinct profession, separate from other
disciplines.
• Professional nursing has a distinct function and
product (outcome)
• There is a difference between lay and professional
nursing.
• Nursing is aligned with medicine.
Assumptions
about nursing

11. Assumptions
• Each patient’s needs for help are unique.
• Patients have an initial ability to communicate their
needs for help.
• When patients cannot meet their own needs, they
become distressed.
• The patient's behavior is meaningful.
• Patients are able and welling to communicate verbally
(and nonverbally when unable to communicate
verbally)
Assumptions
about patients

12. Assumptions
• The nurse’s reaction to each patient is unique.
• Nurses should not add to the patient’s distress.
• The nurse’s mind is the major tool for helping
patients.
• The nurse’s use of automatic responses to prevents
the responsibility of nursing from being fulfilled.
• The nurse's practice is improved through self-
reflection.
Assumptions
about nurses

13. Assumptions
• The nurse-patient situation is a dynamic whole
• The phenomenon of the nurse-patient encounter
represents a major source of nursing knowledge
Assumptions
about nurse-
patient situation

14. Propositions
 patient’s presenting behavior and the presence of patient
distress.
 Using of Orlando's distinct nursing function and the nurse’s
ability to identify the problem.
 The more competent in immediate reaction, the more apt to
find out the nature of distress
 Nurse’s immediate reaction lessen the patient distress.
 Using deliberative nursing process is less costly than
personal responses.

15. Critique of Orlando’s Theory
 Developed inductively and is logical and applicable to nursing
practice.
 Simple because it contains few concepts and relationships.
 Internally consistent and meet the criteria for testability for a
middle range theory
 one of the most effective practice theories and especially
helpful to new nurses as they begin practice

16. Orlando’s theory as a Framework for
nursing practice
5 interrelated concepts:
 The organizing principle or professional nursing function.
 The problematic situation or the patient’s presenting behavior.
 The internal response or immediate reaction
 Reflective inquiry or deliberative nursing process.
 Resolution or improvement.

17. The nursing process and Orlando’s theory
• Deliberative
nursing
process
used to
share and
validate the
nurse’s
direct and
indirect
observation
Assessment
• Planning
occurs with
participation
from the
nurse and
the patient
Planning
• Both direct
help and
indirect help
occur in the
implementati
on phase
implementat
ion
• Focus on
change in
the patient’s
behavior
• If no
change,
nurse
continues
the process
until
improvemen
t occur
Evaluation

18. Case Study
Mrs. Laila is a 45 years old patient in surgical ward in Saqer
Hospital. She is asking the nurse for analgesic. The nurse ask
her about pain score and Mrs. Laila states it 7 out of 10.
The nurse asked her if there is anything annoying her beside her
pain. The patient cried and said that she is thinking about her
kids in home. The nurse suggested to call them which the
patient consider it a good idea. She called them and thanked the
nurse and said that she is not in need for analgesics anymore.

19. Analysis of the previous case
 Nurse will focus on the patient. Her mind should be free of
distracting thoughts
 The nurse recognizes cues that the patient problem may
exist before the next step of the process. She identifies
immediate perception thoughts, and feelings.
 The nurse share with the patient and confirm the problem
 Together with patient, they make the plan
 The nurse helped the patient in implementation.
 the evaluation is if the need for help met.

20. Summary
 Background of Orlando
 Overview of the nursing process theory
 The major concepts nursing according to Orlando
 Assumptions of Orlando’s theory
 Propositions of Orlando’s theory
 Orlando’s theory as a framework for nursing practice
 The nursing process and Orlando’s theory

21. Conclusion
 Orlando's Theory remains on of the most effective practice
theories available which stresses the reciprocal relationship
between the patient and the nurse

22. References
 Kathleen Masters. 2nd edition(2015). Nursing Theories A
Framework For Professional Practice. Jones & Bartlett
Learning.