Ida Jean Orlando (Pelletier) is a significant contributor to the introduction of theoretical medical knowledge. According to Fitzpatrick and Whall (1989) and Marriner -Tomey (1989), Orlando was born August 12, 1926. In 1947, she received a diploma in medical from NY Medical College, Flower Fifth Avenue Hospital School of Medical. She received a B. S. degree in public areas Health Nursing from St. Johns College or university in Brooklyn, NY, in 1951, and an M. A. in Mental Health Appointment from Columbia University Teacher's University in NY to 1954. While pursuing her education, Orlando was applied as an employee nurse in obstetrical, medical, operative and emergency nursing.
After receiving her master's degree in 1954, Orlando went to the Yale University School of Nursing in New Haven, Connecticut, for eight years. As a co-employee professor of mental health insurance and psychiatric medical at Yale, she was granted a federal give and became a study associate and the principal project investigator of a Country wide Institute of Mental health Institute of america Public Health
Service's offer entitled "Integration of Mental Health Ideas in a Basic Curriculum. " The job sought to recognize those factors relevant to the integration of psychiatric-mental health key points into the medical curriculum.
During 1958-1961, Orlando, as an associate teacher and the director of the graduate program in mental health and psychiatric medical at Yale University, used her proposed conceptual medical model as the building blocks for the curriculum of this program. From 1962-1972, Orlando served as a medical nurse consultant at McClean Clinic in Belmont. Massachusetts. In such a position, she examined the interactions of nurses with clients, other nurses and other workers and how these interactions afflicted the process of the nurse's help to clients. Orlando convinced the administration an educational program for nurses was needed, whereupon McClean Hospital initiated an educational program predicated on her nursing model (Marriner-Torrey, 1989).
Orlando's Medical Process Theory
As indicated recently, based on her psychiatric-mental health medical education and practice, Orlando inductively suggested her conceptual medical model in her first e book, The Active Nurse-Patient relationship, publicized in 1961 and it focuses on the task of the professional nurse and provides a foundational knowledge of Orlando s conceptualization of medical. It also discusses Orlando's deliberative nursing process and examines problems encountered in nursing situations and presents client case studies to demonstrate how Orlando's model can be applied immediately with clients in medical practice.
Intent of Theory
The central focus of Orlando's proposed conceptual medical model is nurse-client conversation. Orlando recognizes that "because the nurse and patient are both people, they communicate, and an activity continues on between them" (p. 8). Orlando further areas, "learning how to comprehend what is going on between herself and the individual is the central key of the nurse's practice and includes the basic framework for the help she lives to patients" (p. 4).
Concepts and propositions of the theory
The to begin the four metaparadigm ideas, person or patient (customer) is explicated in Orlando's model. Conceptualizing person as a behaving, real human organism that has needs, Orlando asserts that nurses should be concerned only with those people who are unable to meet their needs. Focusing on the average person person, Orlando identifies the client of nursing as "someone who becomes distressed, when without help, he cannot meet his needs" (p. 11). The stress experienced by your client may result from physical limitations, effects to the environment or experience that prevent clients from conversing their needs. Implying that nursing would depend on medicine, Orlando state governments, "the doctor places the individual under the can of the nurse for either or both of the next reasons: (1) the individual cannot deal using what he needs, or (2) he cannot carry out the prescribed treatment or diagnostic plan by itself" (p. 5). Subsequently, the physician identifies the client for medical. Thus, the customers of nursing, according to Orlando, are individuals, who are distressed from the inability to meet their needs, who are starting some type of treatment or guidance and who've been identified by the medical professional as necessitating nursing.
Orlando perceives the next metaparadigm concept, nursing, as a strong, deliberative, situationally unique process, in which the nurse ascertains the client's needs and initiates a process to meet these needs. She differentiates nursing in the general sense from professional nursing.
Nursing in the general sense occurs when any individual carries, in whole or part, the responsibility of responsibility for what the individual cannot yet or can no longer do alone. On the other hand, the professional nurse, aligned with the practice of remedies, offers whatever help the patient may necessitate to meet his needs while he is going through some type of treatment or guidance (Orlando, 1961, p. 5).
The goal of nursing "is to supply the help a patient requires for his must be achieved" (p. 8). Thus, "the required outcome of nursing can be an improvement in the patient's sense of well-being or a change for the better in his condition, which contributes all together to the patient's physical and mental health" (p. 9).
Orlando contends that the nun: achieves the goal and desired final result of medical by "initiating a process which ascertains the patient's immediate need and really helps to meet up with the immediate need immediately or indirectly"(p. 8). The nurse satisfies the need directly when patients cannot meet their own needs. Needs are fulfilled indirectly when the nurse helps patients have the services of the person, agency or resource by which their needs can be achieved.
Using the four basic medical techniques of observation, confirming, recording and actions completed with as well as for the client, Orlando proposes that the nurse "initiates an activity of helping the individual express the specific meaning of his action in order to ascertain his stress and helps the patient explore the distress in order to see the help he requires so that his stress may be relieved" (p. 20). This technique is unique for each nursing situation.
Orlando (p. 36) postulates that three basic elements comprise a medical situation: (1) the tendencies of the individual; (2) the result of the nurse; and (3) the medical actions that are created for the patient's profit. The interaction of the three elements comprises Orlando's deliberative medical process. The first component of the process, the patient's action, is what is noticed by the nurse in an immediate nurse-patient situation and is determined by the nurse's perceptions. The patient's tendencies may be nonverbal, such as motor activity or physiological manifestations, or may be verbal. The delivering behavior of the patient, whatever the form where it appears, presents a plea for assist in getting together with unmet needs.
According to Orlando (p. 40), the next clement of the deliberative medical process, the nurse's effect, consists of three aspects: (1) perceptions of the patient's patterns; (2) the thoughts stimulated by the perceptions; and (3) emotions in response to these perceptions and thoughts. In essence, the nurse, based on her/his perceptions, attaches a interpretation or interpretation to the patient's behavior. Orlando cautions, however, that the "nurse will not believe that any aspect of her a reaction to the patient is correct, helpful or appropriate until the nurse validates her interpretation of the patient's Tendencies with the individual" (p. 56).
The third element, the nurse's activity, is any action the nurse carries out. It offers only the particular nurse says or does with or for the benefit for the individual. Orlando (p. 60) proposes two sorts of medical activities: (1) deliberative actions, which contain those activities that ascertain or meet up with the patient's immediate need for help and (2) computerized activities or those activities decided on for reasons apart from the patient's immediate need. Although both types of medical activities have goal, Orlando (p. 65) concludes that only activities completed deliberatively by the nurse are effective since only these medical activities meet the patient's immediate need and complete the goal of nursing.
Usefulness of the theory in medical practice
Several propositions that are obvious in the nursing model include the following:
When the individual can meet his own needs and can carry out approved measures unaided, he is not dependent on the nurse for help (pp. 5-6).
In order for the nurse to build up and keep maintaining the professional personality of her work, she must know and also validate how her activities and reactions help or do not help the patient or know and also validate that the individual will not require her help at confirmed time (p. 9).
In order to meet up with the patient's needs, the nurse (1) initiates an activity of helping the individual express the specific meaning of his action in order to ascertain his stress and (2) helps the individual explore the distress in order to see the help he requires so that his distress may be relieved (p. 29).
The deliberative nursing process is obviously related to the nurse's professional function of supporting the individual because she actually is in the position of knowing what is happening and whether or not she is being helpful. The nurse recognizes if she has achieved the patient's dependence on help by noting the presence or absence of improvement in his delivering behavior. In the lack of improvement, the nurse is aware of the patient's need has not yet been met, and, if she remains available, she starts off the process yet again with whatever delivering action is then detected (p. 68).
Although Orlando identifies that the success of utilizing the deliberative nursing process is dependent on the communication capacity of the nurse, she will not define or identify communication.
Self evaluation
In analyzing the way the principles of Orlando's deliberative medical process model are related. Orlando generally identifies and explains the major principles, somewhat than depicting associations among the principles. The ideas in Orlando's conceptual Model are related sequentially. A time dimension is integrated in the connections among the ideas. One of these is Orlando's deliberative medical process. The client's action initiates the process. Predicated on the action of the client, the nurse reacts. The blend of understanding, thought and sensing ends up with the nurse's immediate response. The nurse's immediate reaction then precipitates the client to do something and an interactive process occurs between your nurse and consumer, with each redefining the actions and reactions of the other.
Another sequential relationship that can be identified in the model is
Orlando's contention that the shortcoming of individuals to meet their own needs or carry out prescribed medical actions must precede the requirement for medical. The major disciplines that Orlando appears to use in the introduction of her model are sociology, psychology and remedies.
Orlando uses an interactional process orientation to develop and structure her model. Her view of nursing as an connections process, with the give attention to understanding the connection between nurse and customer, is consistent with an interactional process orientation.
