Ida Jean Orlando:

Case Study

After surgery, a rushed nurse deals with a geriatric patient harshly. The first time the patient complained of pain, the nurse reacted flippantly, stating that some pain was normal after the hip surgery he had endured. Afterward, the patient felt intimidated to mention his increasing levels of pain, resulting in his pain level spiking rapidly. Later that day the patient needed to use the restroom, and was unable to do so on his own. When the urge finally became too strong to ignore, the patient hesitantly pressed the call button for assistance. The nurse, however, ignored the call, remembering she was scheduled to check on him in the next half hour. Unfortunately, the patient resorted to soiling himself.

How could this have been avoided?

Nursing Metaparadigm

• Environment
• Patient
• Nursing
• Health

References

Deliberative Nursing Process

Abdoli, S., & Safavi, S. (2010). Nursing students’ immediate responses to distressed clients based on Orlando’s theory. Iranian Journal of Nursing and Midwifery Research, 15(4), 178-184. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093185/

Gonzalo, A. (2011). Ida Jean Orlando, the Dynamic Nurse-Patient Relationship. Theoretical Foundations of Nursing. Retrieved from http"//nursingtheories.weebly.com/ida-jean-orlando.html

Ida Jean Orlando - theory of nursing process discipline. (n.d.). Cardinal Stritch University Library. Retrieved from http://www.stritch.edu/Library/Doing-Research/Research-by-Subject/Health-Sciences-Nursing-Theorists/Ida-Jean-Orlando---Theory-of-Nursing-Process-Dicipline/

Schmieding, N. J. (1984). Putting Orlando's theory into practice. American Journal of Nursing, 84(6), 759-761. Retrieved from http://www.jstor.org.lib-ezproxy.tamu.edu:2048/stable/3463720

Tyra, P. (2008). In Memoriam: Ida Jean Orlando Pelletier. Journal of the American Psychiatric Nurses Association, 14(231). doi: 10.1177/1078390308321092

Understanding Distress

Verbal Reactions of Patients

Understanding Ways to Alleviate Stress

• A patient may experiencing distress if a nurse fails to tend to that individual's needs in a timely manner.
• Moreover, Orlando's Deliberative Nursing Process Theory focuses on the patient's need and the immediacy in which that need is responded to.
• If the nurse ignores or does not recognize verbal and nonverbal cues , the patent is doomed to experience distress.

• Human interaction and individuality form the basis of the relationship between nurses and their patients
• Verbal cues and interactions with patients can prevent depression in patients
• Informing patients of their conditions and treatment options can help manage environmental issues

• Use Deliberative Nursing Process
• Evaluating: nurse and patient decide together the plan of care
• Nurses have an immediate response of physical caring and assuring
• Recognize patient's emotions and feelings and then have the patient validate them
• Nurse-Client interaction: need to understand that the patient should participate in their own care-giving

Nonverbal Reactions of Patients

Deliberative Nursing Process

• This nursing process uses the concepts listed below to solve health problems through patient-nurse interactions. Immediacy in problem solving is also central to this nursing theory.
• Verbal reactions of patients
• Nonverbal reactions of patients
• Understanding distress
• Understanding ways to alleviate distress

• Exchange of nonverbal cues is useful during communication to improve upon a patient's health problem.
• Cues take place in a back-and-forth exchange between nurse and patient until the health problem has been resolved from the patient's perspective.
• If patient-nurse relationship improves as a result of these cues, they are considered successful cues that should be utilized in future patient interactions.
• Ability to interpret an react to nonverbal cues is considered skilled nursing behavior.

Ida Jean Orlando:

Deliberative Nursing Process