KOLEHIYO NG LUNGSOD NG

Course Module
Theoretical Foundations in Nursing

Prepared by:
 Institute of Nursing

MODULE 1
Overview

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Learning Outcomes
Given definite concepts, the students will be able to:

1. Identify the concepts of Nursing Theory (Deliberative Nursing

Process theory) by Ida Jean Orlando
2. Discuss the significance of this theory to the Nursing profession

OUTLINE OF TOPICS
1. Deliberative Nursing Process
2. Five (5) major interrelated concepts
a. Function of professional nurse
b. Presenting behaviour
c. Immediate reaction
d. Nursing process discipline
e. Improvement

LESSON PROPER
Development of the lesson:

Motivation.

1. Ask the students about their idea about Deliberative Nursing Process
2. Ask the students what are five major interrelated concepts

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IDA JEAN ORLANDO

Ida Jean Orlando developed her theory from a study conducted at the Yale University
School of Nursing, integrating mental health concepts into a basic nursing curriculum. She
proposed that “patients have their own meanings and interpretations of situations and
therefore nurses must validate their inferences and analyses with patients before
concluding.”

The Dynamic Nurse-Patient Relationship: Function, Process, and Principles (NLN Classics
in Nursing Theory), published in 1961, contained the theory. Her book made a contribution
to the discussion of issues pertaining to the nurse-patient interaction, the professional role
and identity of nurses, and the development of nursing-specific knowledge.

Orlando's nursing theory emphasizes the partnership between the nurse and the patient.
Both the patient and the nurse are impacted by what they say and do. She sees the job of a
nurse as determining the patient's immediate need for assistance and providing it.

Additionally, she stated that the five main, interconnected themes that center her model
are: improvement, discipline in the nursing process, presenting behavior, prompt reaction,
and the role of professional nursing. The organizing premise is professional nursing's
function. The patient's troubling behavior is the circumstance. The internal response is the
first thing that happens. The examination of the patient's needs is a component of the
nursing process discipline. Finally, the resolution of the patient's condition represents
improvement.

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The Deliberative Nursing Process has five stages: assessment, diagnosis, planning,
implementation, and evaluation. According to Orlando's Nursing Process Discipline Theory,
nurses employ the conventional nursing procedure to enhance patient outcomes. Orlando's
main area of interest was the description of the role of nursing. Her idea does not preclude
nurses from employing other nursing theories when providing care for patients, but it does
provide a framework for nursing.

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Orlando’s Deliberative Nursing Process Theory

Ida Jean Orlando developed her Deliberative Nursing Process that allows nurses to formulate
an effective nursing care plan that can also be easily adapted when and if any complexity
comes up with the patient.

Ida Jean Orlando’s nursing theory stresses the reciprocal relationship between patient and
nurse. It emphasizes the critical importance of the patient’s participation in the nursing
process. Orlando also considered nursing as a distinct profession. He separated it from
medicine, where nurses determining nursing action rather than being prompted by physician’s
orders, organizational needs, and past personal experiences. She believed that the physician’s
orders are for patients and not for nurses.

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Major Concepts

Human Being

Orlando uses the concept of human as she emphasizes individuality and the dynamic nature
of the nurse-patient relationship. For her, humans in need are the focus of nursing practice.

Health

In Orlando’s theory, health is replaced by a sense of helplessness as the initiator of a necessity

for nursing. She stated that nursing deals with individuals who require help.

Environment

Orlando completely disregarded the environment in her theory, only focusing on the patient’s
immediate need, chiefly the relationship and actions between the nurse and the patient (only
an individual in her theory; no families or groups were mentioned). The effect that the
environment could have on the patient was never mentioned in Orlando’s theory.

Nursing

Orlando speaks of nursing as unique and independent in its concerns for an individual’s need
for help in an immediate situation. The efforts to meet the individual’s need for help are
carried out in an interactive situation and in a disciplined manner that requires proper
training.

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Subconcepts

Ida Jean Orlando described her model as revolving around the following five major
interrelated concepts: the function of professional nursing, presenting behavior, immediate
reaction, nursing process discipline, and improvement.

The function of Professional Nursing

The organizing principle is how professional nursing serves a purpose. This entails
determining the patient's immediate assistance needs and attending to them. Orlando
claims that nurses are receptive to those who are suffering or who fear being powerless. It
is concentrated on the immediate experience of the care procedure. In order to prevent,
ease, lessen, or cure a patient's sense of helplessness, it is important to directly support
them wherever they may be. The Nursing Process Discipline Theory describes nursing as
providing the assistance a patient requires in order for their needs to be addressed. The
goal of nursing is accomplished if the nurse recognizes and responds to the patient's urgent
need for assistance.

Presenting behavior

The patient's challenging situation is reflected in their behavior. The nurse recognizes the

patient's urgent need for assistance from the patient's outward behavior. The nurse must first

identify the circumstance as problematic in order to do this. No matter how the presenting

behavior appears, it can be the patient's cry for assistance. The nurse automatically experiences

an internal response in response to the patient's presenting behavior, which is referred to as the
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stimulus.

Distress

The patient’s behavior reflects distress when the patient experiences a need that he cannot
resolve, a sense of helplessness occurs.

Immediate Reaction

Internal response is the initial response. The patient uses all five of his or her senses to perceive
objects. These impressions trigger automatic thought, which in turn triggers automatic
sensation, which prompts the patient to act. The patient's quick response is shown by these
three items. The quick reaction reveals how the nurse feels about their involvement in the
nurse-patient interaction.

Nurse Reaction

The patient’s behavior stimulated a nurse’s reaction, which marks the nursing process
discipline’s beginning.

Nurse’s Action

When the nurse acts, an action process transpires. This action process by the nurse in a nurse-
patient contact is called the nursing process. The nurse’s action may
be automatic or deliberative.

Automatic Nursing Actions are nursing actions decided upon for reasons other than the
patient’s immediate need.

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Nursing Process Discipline

The examination of the patient's needs is a component of the nursing process discipline.
Any observation that is discussed with the patient and shared with them is immediately
helpful in determining and addressing their wants or determining that they don't have any
needs at that moment. Before confirming the accuracy, helpfulness, or appropriateness of
any component of their response to the patient, the nurse must verify it by having a
conversation with the patient. This investigation is started by the nurse in order to learn
how their actions and words effect the patient. Automatic responses are ineffective because
the nurse's response is based on factors other than the urgency of the patient's need for
assistance or the meaning of the patient's conduct. When a nurse fails to inquire about the
patient's reaction with him or her, it is reasonably certain that effective communication
between nurse and patient stops.

Together with the patient, the nurse determines the best course of action to address the
need. After this action is completed, it is assessed. The procedure is finished and the
activity was successful if the patient behaves better. The process is repeated with new
attempts to explain the patient's behavior or the proper nursing intervention if there is no
improvement or the conduct worsens.

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5 Stages of the Deliberative Nursing Process

The Deliberative Nursing Process has five stages: assessment, diagnosis, planning,
implementation, and evaluation.

Assessment

In the assessment stage, the nurse completes a holistic assessment of the patient’s needs. This
is done without taking the reason for the encounter into consideration. The nurse uses a
nursing framework to collect both subjective and objective data about the patient.

Diagnosis

The diagnosis stage uses the nurse’s clinical judgment about health problems. The diagnosis
can then be confirmed using links to defining characteristics, related factors, and risk factors
found in the patient’s assessment.

Planning

The planning stage addresses each of the problems identified in the diagnosis. Each problem
is given a specific goal or outcome, and each goal or outcome is given nursing interventions
to help achieve the goal. By the end of this stage, the nurse will have a nursing care plan.

Implementation

In the implementation stage, the nurse begins using the nursing care plan.

Evaluation

Finally, in the evaluation stage, the nurse looks at the patient’s progress toward the goals set
in the nursing care plan. Changes can be made to the nursing care plan based on how well (or
poorly) the patient is progressing toward the goals. If any new problems are identified in the
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evaluation stage, they can be addressed, and the process starts over again for those specific
problems.

Essential - As a student, how do you view deliberative nursing

Question
process?

Useful
https://nurseslabs.com/nursing-theories/#h-components-of-
nursing-theories

Links

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