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Ida Jean Orlando Slides
Ida Jean Orlando Slides
B S i n p u b l i c h e a l t h n u r s i n g - S t . J o h n ' s University, NY
A s s o c i a t e P r o f e s s o r a t Y a l e S c h o o l o f Nursing and Director of the Graduate Program in Mental Health Psychiatric Nursing. P r o j e c t i n v e s t i g a t o r o f a N a t i o n a l I n s t i t u t e of Mental Health grant entitled: Integration of Mental Health Concepts in a Basic Nursing Curriculum.
p u b l i s h e d i n h e r 1 9 6 1 b o o k , T h e D y n a m i c Nurse-Patient Relationship and revised 1972 book: The Discipline and Teaching of Nursing Processes A b o a r d m e m b e r Health Plan. of Harvard Community
Case Scenario
Nurse, can you give me my morphine, cried out Mrs. So. Can you tell how painful it is using the 0 10 pain scale, where 0 being not painful and 10 being severely painful?replied the nurse. Ummm... I think its about 7. Can I have my morphine now?
Mrs. So, I think something is bothering you besides your pain. Am I correct?
IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP
Mrs. So cried and said, I cant help it. Im so worried about my 3 boys. Im not sure how they are or whos been taking care of them. Theyre still so young to be left alone. My husband is in Yemen right now and he wont be back until next month.
Why dont we make a phone call to your house so you could check out on your boys? Mrs. So phoned his sons. Thank you nurse. I dont think I still need that morphine. My boys are fine. Our neighbour, Mrs. Yee, shes watching over my boys right now.
2. Presenting Behavior of the Patient (Problematic Situation) Orlando stresses that: the presenting behavior of the patient, regardless of the form in which it appears, may represent a plea for help. When a patient experiences a need that he cannot resolve, a sense of helplessness occurs. The patients behavior reflects this distress.
Patient behavior stimulates a nurse reaction, which marks the beginning of the nursing process discipline. The perceptions stimulate automatic thought
Each thought stimulates an automatic feeling Then the person acts
IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP
4. The Nursing Process Discipline (Investigation) The nurse does not assume that any aspect of of her reaction to the patient is correct, helpful or appropriate until she checks the validity of it in exploration with the patient (Orlando, 1961)
Orlando (1972), also provides 3 criteria to ensure that the nurses exploration of her reaction with the patient is successful:
1) What the nurse says to the individual in contact must match any or all the items contained in the immediate reaction, and what the nurse does nonverbally must be verbally expressed and the expression must match items contained in the immediate reaction.
2) The nurse must clearly communicate to the individual that the item being expressed belongs to herself. 3) The nurse must ask the individual about the item expressed in order to obtain correction or verification from that same individual
IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP
Once the nurse has validated or corrected her reaction to the patients behavior, she can complete the nursing process discipline with the nurses action.
The nurse can act in two ways: automatic or deliberative
Criteria for deliberate actions a. Result from correct identification of patients needs by validation of the nurses reaction to patient behavior b. The nurse explores the meaning of the action with the patient and relevance to meeting his need c. The nurse validates the actions effectiveness immediately after completing it. d. The nurse is free of stimuli unrelated to the patients need when she acts.
IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP
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 In each contact the nurse repeats a process of learning how to help the individual patient.