NURSING PROCESS THEORY
SECRET
IDA JEAN ORLANDO PELLETIER
 August 12, 1926 born
 November 28, 2007 died
5 MAJOR CONCEPTS
1. FUNCTION OF PROFESSIONAL NURSING
 Includes identifying the needs of patients,
responses of the nurse, and nursing action.
2. PRESENTING BEHAVIOR (PROBLEMATIC
SITUATION)
 Through the presenting behavior, the nurse
finds the patient’s immediate need for help. To
do this, the nurse must first recognize the
situation as problematic.
 Distress - The patient’s behavior reflects
distress when the patient experiences a need
that he cannot resolve, a sense of helplessness
occurs.; tension
3. IMMEDIATE REACTION (INTERNAL RESPONSE)
 The patient perceives objects with his or her
five senses. These perceptions stimulate
automatic thought, and each thought
stimulates an automatic feeling, causing the
patient to act.
IMMIDIATE RESPONSE
1. Nurse Reaction - The patient behavior
stimulated a nurse reaction, which marks the
beginning of the nursing process discipline;
wala pang ginagawa pero may plan na
2. Nurse’s Action - When the nurse acts, an action
process transpires. This action process by the
nurse in a nurse-patient contact is called
nursing process; pag ginawa na ni nurse
2.1. Automatic Nursing Actions - are nursing
actions decided upon for reasons other than the
patient’s immediate need.
2.2 Deliberative Nursing Actions - are actions
decided upon after ascertaining a need and
then meeting this need
4. NURSING PROCESS DISCIPLINE (INVESTIGATION)
 Any observation shared and explored with the
patient is immediately useful in ascertaining
and meeting his need or finding out that he is
not in need at that time
 The nurse does not assume that any aspect of
her reaction to the patient is correct, helpful or
appropriate until she checks the validity of it in
exploration with the patient
a.
 The perceptions, thoughts, and feelings of
everyone are not directly available to the
perception of the other individual through
the observable action.
 Di sinasabi tunay na nararamdaman; takot
ma-diagnose; 3 mos. nang sumasakit ang
tiyan, after 3mos. din nagpa-consult,
tinanong kalian pa sumasakit ang tiyan sabi
kanina lang. Di mabibigyan ng right medic
b. OPEN DISCLOSURE
 “” directly available “”
 Nung nararamdaman pa nung bata pa siya
sinabi rin, wala pang tanong sinagot na
lahat ng info na gusto malaman; may
improvement
5. IMPROVEMENT (RESOLUTION)
 It is not the nurses’ activity that is evaluated but
rather its result: whether the activity serves to
help the patient communicate her or his need
for help and how it is met.
 Each contact the nurse repeats a process of
learning how to help the individual patient.
5 STAGES OF THE DELIBERATIVE NURSING PROCESS
Assessment – subjective – symptoms (feelings, pain)
 Objective – signs (observable,
measurable; temp, PR, vital signs, bp, RR)
Diagnosis – Nursing diagnosis (to enhance self-care)
 Medical Dx (PTB; identifies a disorder)
Planning – goals/objectives; must be SMART
Implementation – nsg intervention; independent; action
Rationale – ba’t yun yung ginawa mo?; justification
(scientific based)
Evaluation – reassessing your patient; not done pag di
pa galing si patient; overdose pag di mo na-
document at mawawala lisensya mo
ADPIRE ang sasalba sayo at sa lisensya mo
4 METAPARADIGMS
 Hildegard Peplau
NURSING
 as unique and independent in its concerns for
an individual’s need for help
 manner that requires proper training; how r u
going to answer questions ‘pag galit na
relatives ni patient; at the end of the day ikaw
pa rin mali; bldg rapport
PERSON
 she uses the concept of human as she
emphasizes individuality and the dynamic
nature of the nurse-patient relationship.
 Pag di pinakain patient; distress
ENVIRONMENT
 completely disregarded environment in her
theory, only focusing on the immediate need
of the patient, chiefly the relationship and
actions between the nurse and the patient
(only an individual in her theory, no families
or groups were mentioned).
HEALTH/SENSE OF HELPLESSNESS
 as the initiator of a necessity for nursing
 deals with individuals who are in need of help
MAJOR ASSUMPTIONS
1. When patients are unable to cope with their
needs on their own, they become distressed by
feelings of helplessness.
2. Nurses are concerned with the needs the
patient is unable to meet on his or her own.
 4. THERAPEUTIC USE OF SELF
3. Patients are unique and individual in how they
respond.
 Pwede ung masakit sayo ay hindi masakit
sakanya. Di mo siya pwede i-judge.
 Sensitive & insenstiveness
 Hypertension di pareparehas ang
medication. (Losartan or Amlodipine)
4. The nurse-patient situation is dynamic; actions
and reactions are influenced by both the nurse
and the patient.
 ADPIRE
HUMAN-TO-HUMAN RELATIONSHIP MODEL
JOYCE TRAVELBEE
 Born in 1926, she was a psychiatric nurse,
educator and writer.
 1973 died
MAJOR CONCEPTS
1. SUFFERING
 “An experience that varies in intensity, duration and
depth ... a feeling of unease, ranging from mild,
transient mental, physical or mental discomfort to
extreme pain…”
 Subjective; paano nag-suffer
 Ex. Namatayan at na-byudo, yung isa nakapag-
asawa agad ng bago at nakapag-move on. Yung
isa 10yrs na wala pang bagong asawa
 Physical/Mental discomfort – sinweruhan,
depende sa pain tolerance, yung isa umiyak
yung isa hindi; sensitive & open minded
 Not observable, no priori reasoning
2. HOPE
 A faith that can and will be a change that would
bring something better with it.
 How u see the future; nag-alarm bago matulog
kasi alam mong kinabukasan gigising ka pa
 How do u see yourself 10yrs from now?
 Human to human interactions
3. COMMUNICATION
 A strict necessity for good nursing care.
 Best way to know the needs of patient
 Effective/right communication; no problem
dapat sa tone of voice
 The ability to use one’s personality consciously and
in full awareness in an attempt to establish
relatedness and to structure nursing interventions.
 Jean Watson’s 10 Carative Factors; altruistic or
being selfess
4 METAPARADIGMS
NURSING
 An interpersonal process where nurse assists an
individual, family or community to prevent or
cope w/ experience of illness & suffering & to
find meaning in these experiences.
 Hirap ipaintindi; may rason si God bat
nanyayari sa taong yun ang sitwasyon niya; mas
napalapit kay God nung na-expirience nya yon
 Self-care deficit theory ni Dorothea Orem kasi
family nag-aalaga
PERSON
 Defined as human being, a unique,
irreplaceable individual who is in the
continuous process of becoming, evolving, and
changing.
 As time passed by, dati hindi ka naman high
blood, kakakain ng bulalo HB ka na ngayon
 You are not pre-judged, kung anong ginawa mo
ngayon, yun ang iju-judge nila
ENVIRONMENT
 Human conditions and life experiences
encountered by all men as sufferings, hope,
pain and illness are associated to the envi
 Overcoming, changing, disappointment,
frustration, hope, inspiration
 Anxiety – socmed; kung kaya mo, kaya ko rin
 Illness & pain – dahil sa dynamic environment,
pabago bago panahon magkakasakit ka
HEALTH
 SUBJECTIVE HEALTH
 an individually defined state of well being
in accord with self-appraisal of physical-
emotional-spiritual status.
 kung anong pinagdaanan
 OBJECTIVE HEALTH
 an absence of discernible disease, disability, or
defect as measured by physical examination,
laboratory tests, assessment by a spiritual
director, or psychological counselor.
 lab results; numbers, measurable; nakikita
 Psychological counselor – psych test
assessment, may pinagdadaanan,
psychopath, anxious, depress, behavior,
observation
INTERACTIONAL PHASES
1. ORIGINAL ENCOUNTER
 The first impression by the nurse of the sick
person and vice-versa. The nurse and patient
see each other in stereotyped or traditional
roles.
2. EMERGING IDENTITIES
 The nurse and patient perceiving each other as
unique individuals. At this time, the link of
relationship begins to form.
3. EMPATHY
 The ability to share in the person’s experience.
 Paparamdam mo na nandon ka; comfort or
counsel
4. SYMPATHY
 Nurse wants to lessen the cause of the
patient’s suffering.
 Nurse uses disciplined intellectual approach
together with therapeutic use of self to make
helpful nursing actions
 Umiyak patient, umiyak ka rin
 After empathized -> sympathized
 Family turingan; mas nabubuild ang ..
5. RAPPORT
 Nursing interventions that lessen the patient’s
suffering.
 Both nurse and patient are relating as human-
being to human-being.
 Trust
Habang tumatagal, mas nagiging close
Compared to Peplau’s Orientation Phase
CORE, CARE, AND CURE MODEL
Lydia Hall
 September 21, 1906 born in New York City
 nurse
 1969 died
MAJOR CONCEPTS
NURSING
 Is identified as consisting of participation in the
care, core and cure aspects of patient care
INDIVIDUAL
 individual human who is 16 years of age or
older and past the acute stage of long-term
illness is the focus of nursing care in Hall’s work.
 unique, capable of growth and learning, and
requiring a total person approach
SOCIETY AND ENVIRONMENT
  developing the concept of Loeb Center because she
assumed that the hospital environment during
treatment of acute illness creates a difficult
psychological experience for the ill individual.
 Loeb Center focuses on providing an
environment that is conducive to self-
development.
HEALTH
 can be inferred to be a state of self-awareness
with a conscious selection of behaviors that are
optimal for that individual
 same as Travelbee’s
SUBCONCEPTS
CORE – patient
natin siya pero need ng doc’s order. Pag walang
doc’s order hindi pwede magbigay ng gamot
kasi hindi tayo well-trained or well-educated sa
pagpe-prescribe ng gamot, nagbibigay tayo
pero hindi nagpe-prescribe.
 Independent nursing intervention
 Hindi pwedeng ito ka pa lang, ang interventions
mo ay medication agad. Ex. Doctors
bumabagsak sa board exam kasi di nila
interventions ng nsg
 Autonomous nsg intervention – self-directed or
independent
Core patient receiving care, si care si nurse, si core si
doctor
 LYDIA HALL focuses on rehabilitation
 LOEB CENTER – aka primary care/primary nsg
 PRIMARY nsg – ikaw lahat gagawa or loeb plan ;
vital signs, medication etc.; mas advantageous
than functional kasi pag tinanong ka ni doc
anong gamot ni patient, kilala mo na patient mo
hindi mo na need hanapin ung medication
nurse para magtanong.
 FUNCTIONAL nsg – pag medications ka natapat,
wala kang ibang gagawin kundi medications
lang, hindi magchacharting; kung anong sinabi
ni charge nurse, tsaka ka pa lang gagalaw

 is the patient receiving nursing care

CARE – nurse
 represents the role of nurses and is focused on
performing the task of nurturing (care and
comfort) patients
CURE – doctor part
 aspect of nursing which involves the
administration of medications and treatments.
 shared by the nurse with other health
professionals, such as physicians or physical
therapists.
 Di kata gawin ni nurse mag-isa; like di allowed
mag-prescribe ng gamot
 To improve/promote nursing care
 INTERDEPENDENT – pwedeng dependent and
independent at the same time
 Independent - bathing the patient, di kailangan
ng doctors order para paliguan si patient, di
need ng doc’s order para turuan si patient ng
ganto ganyan.
 Dependent – si doc kailangan lang pag
treatment kasi di natin siya ginagawa. Gagawin