Nursing Theories

BACKGROUND * In the late 1950s, Orlando developed her theory inductively through an empirical study of nursing practice. * For 3 years, she recorded 2000 observations between a nurse and patient interactions. She was only able to categorize the records as "good" or "bad" nursing. * According to records: Good Nursing nurses focus was on the patients immediate verbal and non verbal behavior from the beginning through the end of the contact * Bad Nursing nurses focus was on a prescribed activity or something that had nothing to do with the patients behavior * From these observations, she formulated the Deliberative Nursing Process which was published in 1961. * Her formulations were validated, thus she extended her theory to include the entire nursing practice system which then evolved as Nursing Process Discipline. * Orlando’s theory remains one the of the most effective practice theories available. Many theory scholars utilized her concept as basis for their further studies. * Her work has been translated into six languages and was contained in the international section. * A web page about her theory, developed by Schmieding in 1999, is updated periodically and contains extensive references.
ASSUMPTIONS AND ASSERTIONS * Assumptions about Nurses: The nurse’s reaction to each patient is unique. Nurses should not add to the patients distress * The nurse’s mind is the major tool for helping patients * The nurses use of automatic responses prevents the responsibility of nursing from being fulfilled * Nurses practice is improved through self-reflection * Assumptions about Patients: Patients needs for help are unique * Patients have an initial ability to communicate their needs for help * When patients cannot meet their own needs they become distressed * The patients’ behavior is meaningful Patients are able and willing to communicate verbally (and non- verbally when unable to communicate