Using APA format, write a minimum 1500 words, maximum 2000 words including title page and body. Reference page not included in word count.
Minimum of four non-text resources. Text should be referenced when used, however.
Introduction should also be included, although its heading is the title of your paper, not “Introduction”.
Use the following Level One headings (the italicize sentences is to help guide your writing and thinking) Method and Results- just like the first assignment instructions: see above
Use Level Two headings in Discussion to organize your paper: (these topics below are to help guide you, you do not have to label your discussion topics the same)
Identify a nursing theorist- describe the background and history of a chosen theorist.
Describe the theory- Provide an overview of the theory. How did this nurse theorist come to create their respective theory? Discuss the metaparadigms within their theory. What are the main conceptual concepts that are within their theory?
Relate the nursing theory to your personal practice and philosophy- describe why a nurse would chose this theory. How would a nurse incorporate the metaparadigms of a chosen theory into his/her nursing practice and philosophy?
Importance of having a personal philosophy- explain why a nurse should maintain a personal philosophy. Provide an example of how your personal philosophy is being demonstrated in your own nursing practice today.
Conclusion: concisely summarize your paper and findings.
Ida Jean Orlando
Ida Jean Orlando-Pelletier highly regarded in the nursing profession for her work on the Deliberative Nursing Process, which tries to explain the behavior of patients try to understand their needs. Ida was an internationally recognized psychiatric nurse and researcher who came up with the ‘Deliberative Nursing Theory.’ The theory helped nurses come up with effective nursing care plans that are flexible to meet the patient’s needs. Orlando’s theory emphasized the reciprocal relationship between patients and nurses.
Ida Jean Orlando was born on August 12, 1926, a first-generation Irish American. Ida dedicated her life to the study of nursing from 1947 and went to graduate with a Bachelor of Science degree in public health nursing by 1951. Ida proved to her commitment to the profession by completing her Master of Art in Mental Health consultation. During her studies, Ida often worked part-time as a staff nurse in OB, MS, ER; she assumed the role of a supervisor in a general hospital and an assistant director and teacher of some courses.
Apart from being the ideal role model and a respectable woman, Ida had a good education with several advanced certifications in nursing. By 1947 she had received a nursing diploma from the Flower Fifth Avenue Hospital School of Nursing situated in New York. Orlando was awarded a Bachelor of Science degree in public health nursing from St. John`s University in Brooklyn. Ida was also awarded a Master of Arts degree in mental health consultation from Teachers College, Columbia University, in 1954.
Orlando had a productive career working as a consultant, researcher, practitioner, and nursing. She dedicated her career life to mental health, working as a clinical nurse. Upon receiving her master’s degree, Orlando moved to the Yale University School of Nursing, where she worked as an associate professor of mental health and psychiatric nurse for about eight years. While at Yale, Orlando was awarded a federal grant to become a researcher and the chief project investigator of the National Institute of Mental Health Institute of the United States Public Health Service’s grant titled ‘Integration of Mental Health Concepts in a Basic Curriculum.’ The research project was carried out to identify factors relevant to the integration of psychiatric-mental health principles.
Between 1958-1961, Orlando was the director of the graduate initiative in mental health, applied her proposed nursing model as the basis of the curriculum for the program. Orlando served as a clinical nurse consulting at the Mclean Hospital in Belmont, Massachusetts. While in at Mclean, Orlando took an interest in studying interactions of nurses with patients, other staff members, and how they affected the nurse`s ability to attend to clients. Orlando managed to convince the management of the hospital on the importance of an educational program for nurses. Mclean Hospital started a nursing education program based on her model.
Orlando served on the board of the Harvard Community Health Plan in Boston from 1972-1984. In 1981, Ida went on to be an educator at Boston University School of Nursing, holding an administrative role from 1984 to 1987 at Metropolitan State Hospital in Waltham. In September 1987, Orlando became the assistant director of Nursing for Education and Research. She was a consultant for the Mental Health Project for Associate Degree Faculties introduced by the New England Board of Higher Education. Orlando retired in 1992, and she awarded the Nursing Living Legend award by the Registered Nurse Association, Massachusetts.
Deliberative Nursing Process Theory
Orlando engineered her theory from the research conducted at the Yale University School of Nursing, and the project was aimed at integrating mental health concepts into a primary nursing curriculum. According to Orlando, patients had their interpretations of circumstances, and nurses had the responsibility to validate their analyses of patients to make informed conclusions (Tesh, 2019). The theory was first published in The Dynamic Nurse-Patient Relationship: Function, Process, and Principles (NLN Classics in Nursing Theory) in 1961. The book focused on the nurse-patient relationship, the nurse’s functions, and the knowledge development in the nursing profession.
The theory emphasized the reciprocal relationship between nurse and patient. Remarks from both patients and nurses have a direct impact on their lives. According to Orlando, the professional function of nursing is to establish the type of help needed by the patient and providing it as fast as possible (Sitzman, 2017). She designed her model to revolve around five major interconnected concepts; immediate reaction, nursing process discipline, professional nursing, and improvement. Presenting behavior can sometimes prove to be problematic for patients. The nursing process discipline is based on the ability to investigate the patient’s needs. Improvement refers to the ability to resolve the patient`s condition.
The Deliberative Nursing Process comprises five stages; assessment, diagnosis, planning. Implementation and evaluation. Nurses are encouraged to apply the Orlando’s Nursing Process Discipline Theory to realize positive outcomes (Alligood, 2017). Ida’s primary focus is on the definition is the function of nursing. The model offers a blueprint for nursing and encourages nurses to use other nursing theories when attending to patients.
Aim of the Deliberative Nursing Theory
Orlando’s goal was to develop a theory for effective nursing practice. Based on the theory, the primary role of the nurse is to establish and attend to the client`s immediate needs (Mattingly, 2018). From the theory, all manner of patient behavior can be called for help, and the nurse has a job to figure out the nature of the patient`s discomfort and provide the help needed.
Assumptions of the Deliberative Nursing Process Theory
The nursing theory model by Ida Orland considered several assumptions they include:
Patients who are incapable of coping with their needs by themselves have overcome feelings of helplessness. The model believed in professional character can also cause the patient to feel distressed. According to the study, patients respond in a unique way to medication. Nursing as a profession involves dealing with the environment, health, and people. The study assumed individuals were explicit about their needs, feelings, and perceptions. It was also assumed that the patients were unable to express their needs. The patient-nurse relationship is unique, and their actions influence each other. The nurses are too focused on the patient`s wants that they hardly attend their own. The researchers were under the impression that the patients were unable to express their needs to the nurses without having established a meaningful relationship.
Major Concepts of the Deliberative Nursing Theory
The nursing metaparadigm includes; person, environment, health, and nursing. Ida Jean Orlando decided to include only three in the theory of Nursing Process Discipline they are; health, nursing, and individual.
According to Orlando`s theory, helplessness is used in place of health to create a sense of urgency for the need for nursing. She believed that nursing as a practice deals with people who need help.
Orlando spoke of nursing as independent in its care for a person`s need for help in an emergency. The process of attending to people`s needs involves a lot of interactions in a manner that demands professional and skilled training.
In the theory of Nursing Process Discipline, Orlando used the concept of humans to emphasize individuality in a dynamic manner considering the nurse-patient relationship. According to her, people in need were the focus of nursing practice.
Reflection on Orlando`s Theory in Nursing
Though it encompasses and standardizes the nursing practice, the previous version of the practice was linear and paid little attention to the patient’s involvement in the process. Nurses take the nursing diagnosis for each discomfort, establish the established intervention measures, and proceed to implement and evaluate the results. The patients are only in a very minimal manner with almost no chance to contest the report of the nursing process.
From research and studies by Orlando, the linear nursing process was filled with many assumptions, which meant the patient`s needs were not addressed. The nursing process did not provide room for nurses to use their thoughts, and inferences they conceived were factual and justified on the grounds of nursing action. If these thoughts are voiced rather than withheld may prove to be useful or even vital in the patient assessment and treatment. It should be noted that most nurses may not have developed the critical thinking skills necessary to improve their effectiveness.
How, with think, proves to be more important compared to what we think, regardless of the thoughts, they can be used to understand the patient`s condition and behavior. Critical thinking is a skill developed through reflective processes that are patient-centered and improves the nurse`s performance in a complex work environment. Reflective thinking consists of doubt, perplexity, hesitation, and mental difficulty by thinking on the issue one can engage in searching and inquiring information to resolve all doubts and come up with a solution to the perplexity.
In Orlando`s theory, determining the patient`s immediate needs and attending to them is the first step to the application of the critical thinking process. If the diagnosis is wrong, the treatment is applied, the problem may become unresolved the needs unattended due to misinformation. Orlando`s theory place a firm emphasis on the need for patient involvement in all aspects of the nursing process (Akhtar, Hussain, 2018). The theory also highlighted that patient improvement is assessed through positive changes in verbal or non-verbal behavior of the patient; this forms the evidence of the effectiveness of the process.
Orlando`s research holds the assumption the nurse’s mind is a crucial tool and the reflective process in part of the deliberative nursing process. Inherently our thoughts dictate our actions, hence in the nursing profession, understanding the thought process is essential in determining the value of life. In a real-life, situation a nurse has to combine the knowledge from previous encounters, previous knowledge and theories, nursing and other work experiences, and skills.
The goal of the model and the main reason it is recommended for nurses is that it encourages them to act deliberately rather than automatically. By employing this theory, a nurse will be responsible for every action on the patient, which involves making sure they get quality medical care to meet their every need (Prince-Clark, 2019). The nursing process is unique since it is quite adaptable to care for different patients with varying conditions and is flexible depending on the patient`s response to intervention measures, making it universal and applicable for the whole nursing field.
Nursing practice has to easily modifiable. Nursing care shouldn`t be limited to the condition of the patient at the time of admittance, the level of care should be modified if any complications arise during the treatment and recovery process (Toney-Butler, & Thayer, 2019). Ida Jean Orlando`s Deliberative Nursing Process emphasizes the urgency of the flexibility to assist the nurses in providing the needed attention on the patient over the stick to nursing care plans and overruling personal judgment. The Deliberative Nursing Process assists nurses in attaining successful patient outcomes such as fall reduction.
In conclusion, Deliberative Nursing Process is a nursing patient-care theory. The theory is based on the modification of the client’s environment to improve their health. According to Orlando, the patient-nurse relationship should be open and transparent for ultimate nursing care for the patient can be administered. The actions of the nurse and patient are correlated and impact each other. In essence, the nurse`s actions can be evaluated to determine the level of care offered to a patient. The essential part of nursing is the caring and guiding patient back to recovery, and it supersedes all other nursing opportunities. The theory by Orlando is focused on coming up with a mechanism of improving the patient`s behavior. Some modern experts are under the impression that Orlando facilitated the development of nurses as logical thinkers. In light of recent changes and technological advancements, improvement measures should be in place to address emerging challenges in the nursing practice.
Toney-Butler, T. J., & Thayer, J. M. (2019). Nursing process.
Tesh, A. (2019). Nursing Theory: The Basis for Professional Nursing. Professional Nursing E-Book: Concepts & Challenges, 198.
Sitzman, K. (2017). Understanding the work of nurse theorists: A creative beginning.
Alligood, M. R. (2017). Nursing theorists and their work-e-book. Elsevier Health Sciences.
Mattingly, M. S. (2018). Implementation of a New Practice Plan for Preoperative Communication in a Preoperative Testing Unit (Doctoral dissertation, Drexel University).
Akhtar, S., Hussain, M., Afzal, M., & Gilani, S. A. (2018). Barriers and facilitators for execution of nursing process among nurses from medical and surgical wards in a public hospital Lahore. International Journal of Social Sciences and Management, 5(3), 170-186.
Prince-Clark, L. (2019). An Interprofessional Collaborative Approach to Fall Prevention Education.