Nursing Process Theory

Hampe (1975) used her theory to talk about grieving families in a hospital setting. This paper will analyze the theory and try to understand what it means in the context of community health nursing.
Orlando developed her theory in the 1950’s. It was published the first time in her book, The Dynamic Nurse-Patient Relationship. Her theory was one of the first actually published on nursing process. She later continued her concepts in her second book, The Discipline and Teaching of the Nursing Process. Her original motivation for the work was to discover what the purpose of nursing was. To accomplish that she looked at nurse patient interactions both in the chart and during actual care episodes to determine what the outcomes of those actions were (Faust, 2002). These observations helped her formulate the basic thoughts behind her theory which are that the nurse has the role to discover and meet the patient’s immediate needs. The most basic concept is "the nursing process describes the nurse’s reactions to patient’s behavior as generating a perception, thought and feeling in the nurse and then action by the nurse" (Sheldon &amp. Ellington, 2008, pg1).
This theory seems so well designed for nursing. It was when it was written and it seems it would be now. Many researchers as we have noted, have studied it and used it to build their own theory. However, there is nothing in the literature that indicates that the theory has ever been transformed into an actual nursing process. In 1961 Orlando wrote, "the purpose of nursing is to supply the help a patient requires in order for his needs to be met"(Orlando, 1961, pg 8). When you break it down as a nursing process, it becomes behavior of the patient, reaction of the nurse, and nursing action used to benefit the need of the patient. This writer believes that she is still right, that is what nursing is.
At the same time, we must realize that Ida Jean Orlando came from a period in which education was only for those who had money and that included nursing education. This made their paradigms meet the needs of education more than the needs of the bedside nurse. She also used retroductive reasoning because she applied what she observed to what she already suspected (McEwen &amp. Wills, 2007). Today it is still evident in some ways as we note that her theories are used more often by education than nursing itself. Her theory is noted among the Grand Theories considering her background and education as well as the time in which she worked. It also does not seem to meet all of the four nursing paradigms (Chinn &amp. Kramer, 2008). She was quite explicit about individuals and nursing but she very briefly mentioned health as a state of well being and considered the environment only in the sense of now.
Earlier it was noted that many nursing researchers of today study Orlando’s nursing theory and it’s applicability to specific types of nursing. The patient in the community may be in great distress and it may not be seen by anyone but the community health nurse. Orlando says that distress comes from unmet needs. Patient behavior needs to be assessed when it occurs. Any behavior may mean a plea for help. The relief of this stress depends on the caring nurse who is willing to participate in the solution of the need. The Community Health Nurse is confronted with this daily and responds

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