NURSING PROCESS IN PRACTICE

Nursing Process in Practice

Nursing Process in Practice

Introduction

Orlando's theory was developed in the late 1950s from observations she recorded between a nurse and patient. Despite her efforts, she was only able to categorize the records as "good" or "bad" nursing. It then dawned on her that both the formulations for "good" and "bad" nursing were contained in the records. From these observations she formulated the deliberative nursing process. The role of the nurse is to find out and meet the patient's immediate need for help. The patient's presenting behavior may be a plea for help, however, the help needed may not be what it appears to be. Therefore, nurses need to use their perception, thoughts about the perception, or the feeling engendered from their thoughts to explore with patients the meaning of their behavior. This process helps the nurse find out the nature of the distress and what help the patient needs. Orlando's theory remains one the of the most effective practice theories available. (Extract from: Ida Jean Orlando's Nursing Process Theory Site by Dr Norma Jean Schmieding. University of Rhode Island College of Nursing)

Orlando is known for her ideas about the nursing process. She published The Dynamic nurse-patient relationship: Function, process and principles, an important contribution to ideas on nurse-patient communication, in 1961; the work was reprinted in 1990. This book resulted from a study she conducted at Yale on integrating mental health concepts into nursing and was derived inductively from the field notes for this study.

She then published the discipline and teaching of nursing process in 1972. She identifies nursing as "concerned with providing direct assistance to individuals in whatever setting they are found for he purpose of avoiding, relieving, diminishing, or curing the individual's sense of helplessness" (Orlando, 1972, p. 22). She feels that nurses practice independently on behalf of their patients.

The purpose of the nursing process (alternately called deliberative nursing process or nursing process discipline by Orlando) is to meet a patient's immediate needs. The nursing process begins with a patient behavior, either verbal or nonverbal, that indicates a need for help. This behavior results in a reaction from the nurse in which the nurse perceives a need, applies thought to the need, and produces a feeling about the need, such as concern or anxiety. The nurse then confirms her perception, thought, and feeling with the patient. Note that this description of ...