The Orlando Nursing Process Theory - Essay Example

Interview Critique Checklist Your name Course name Instructor’s name Date of submission Interview Critique Checklist Introduction My critique of the You tube video is based on Ida Jean Orlando’s nursing process theory. I will in this critique take a look at nursing practice of Sheldon and whether or not it conforms to the Orlando Nursing Process Theory. I will focus on the negative aspect of nursing as portrayed by Sheldon towards his patient Mandy and the positive aspect as portrayed in the second part. According to Orlando the nurse’s first role is to establish and resolve the patient’s urgent need of help. The behavior of the patient may be a plea for help, yet the help that the patient needs may not at all times be what it seems to be. Nurses are as such required to make use of their perception, deliberation about the perception and the feelings that come from their deliberations in order to establish the meaning of behavior exhibited by the patient. The process is particularly helpful in assisting the nurse establish the nature of patient distress and what is required to help the patient. Brief Description of You Tube Scenario In the first part of the video, Mandy who is a patient comes in to see Sheldon who is a nurse at a local. She has complaints of chest pain which she whose cause she wants diagnosed and treatment offered. Sheldon proceeds to take a medical history from the patient in a manner that would seem to suggest a kind of disconnect between him and the patient Mandy. He seats himself across from Mandy on a long table and his voice and tone are abrasive and show certain disinterestedness in the patient. Sheldon does not seem to make any headway in the diagnosis of the real problem that is afflicting Mandy as he does his history taking with a routine ness that leaves the patient in distress. In the second part of the video, Sheldon takes a different approach from the one used in part one. He comes into the room, cheerfully greets Mandy and asks what ails her. His tone of voice, manner and body language are friendly and convey a sense of empathy and interest in what the patient is feeling. Explanation of Checklist Creation The creation of the checklist was based on the functions of nursing as laid down by Orlando. The functions included the organizing principle, problematic situation or the behavior that is presented by the patient, internal response or immediate reaction, investigation or nursing process discipline and lastly the resolution of the patient’s need or improvement. The organizing principle has to do with the establishing and meeting of the immediate needs of the patient. The fundamental purpose of nursing is the provision of assistance in the meeting of patient needs. It is crucial for the nurse to consider whether the patient need of assistance is immediate or not. If the nurse finds out that the patient is in need of immediate help and provides that help he has met the function of professional nursing. Presenting behavior refers to the plea for help that the patient exposes to the attending nurse. It is sometimes referred to as the problematic situation. There needs to be recognition of the situation of the patient as being problematic. The presented behavior though appearing in many forms may represent a plea for help which the nurse must recognize. Usually the presented behavior of the patient results to an automatic internal reaction from the nurse. How the nurse responds will also determine the reaction of the patient. Immediate reaction refers to the instantaneous reaction of the nurse to the presenting behavior of the patient. Perception is usually by any of the five senses in relation to a certain object. The perception is usually followed by automatic thought which is subsequently followed by a stimulation of an automatic feeling. Consequently there is a reaction to all these by the nurse. The culmination of all these is what is referred as the nurse’s immediate reaction. This is what usually portrays what the nurse feels of his influence in the patient nurse situation. The nursing process discipline involves the investigation of the information that has been explored and shared with the client and which is at that point helpful in establishing and responding to the need of the need of the patient or ascertaining that the patient is not in need of urgent help at the moment. The nurse usually has his opinion though he can not assume the accuracy of her reaction without consulting the patient for validity of her reactions. Subsequently the nurse has to initiate a process of exploration in order to establish the effect on the patient on his actions and words. Automated responses are usually not effectual as the action of the nurse is settled upon for reasons besides the immediate need of the patient for assistance or the behavior of the patient. Lack of exploration of the nurse with the patient to find the reason for her reaction would lead to a communication disconnect between them. After the ascertainment of the need of the patient and its immediacy or lack of, follows the resolution or improvement of the condition of the patient. The last part is the evaluation of the result of the nurse patient interaction. The process of interaction is evaluated to ascertain whether it helps the patient in better communicating her need and how the nurse meets it. The nurse has to in each encounter with a new patient repeat a process of helping each patient as an individual as each person communicates their needs differently. Critique and Rationalization of the Checkpoints Sheldon in part one of the video goes against the organizing principle as he does not really establish or meet the needs of the patient. The fundamental purpose of offering assistance to the patient in meeting his needs is thus left only to the patient as Sheldon acts in a disinterested manner. He does not see the need to establish the immediacy of the patient’s needs. Sheldon has established that the Mandy is in need of immediate help but he is incapable of offering that help due to a lack of professionalism in getting a diagnosis. In the second part however he is more in sync with his patient and thus is able to draw out what really ails Mandy. His being interested in his patient enables the patient to trust him and open up making it easier to diagnose her problem. Mandy the patient presents behavior that represents a plea for help for a chest pain she does not know the cause of. Mandy situation is identified as problematic as she painfully massages her chest. In the first part of the video, Sheldon does not seem to notice this problem or even if he does he does not seem to care. Sheldon’s reaction makes the patient to withdraw from him and thus he stands no chance of getting a diagnosis leaving him and the patient frustrated. In the second part he is more connected and interested and her word make him to make some observations which he then channels into his questions. The atmosphere of trust he creates by his body language enables the patient to open up to him and he thus makes a correct diagnosis. In the first part of the video Sheldon is fixated with theoretical approaches and therefore he cannot connect with his patient. Sheldon’s immediate reaction is that the patient has a medical history and condition and he pursues this relentlessly leaving him and the patient frustrated. In part two the immediate reaction of Sheldon to the need of Mandy his patient is as a result of his keen sense of perception. Sheldon perceives that the patient is really hurting and thus sees a need for a close relation and as such he sits near her and pats her for encouragement. The reaction of the patient makes Sheldon believe that her problem is emotional rather than physical. Through taking an approach of being interested in Mandy, he is able to draw her out and finally get her to open up to him. In the first part, Sheldon is incapable of investigating the information given to him as it mostly does not tie in with the need of his patient. He has ascertained the immediacy of Mandy’s need for help though he has no opinions of his own which he can follow up in consultation with the patient. Sheldon hits a dead wall as he does not have access to other information which requires more than he is offering the patient. His exploratory method simply leads to frustration as his patient does not have any of the conditions he is exploring. The lack of communication leads to frustration of both Sheldon and his client Mandy. In the second part, Sheldon changes tact and investigates the information given by the patient and deliberates on it. He explores his thoughts based on the information given to him by the patient and her body language. He is thus able to make headway in diagnosing Mandy’s illness to be as a result of emotional distress and anxiety. How Sheldon interacts with his client in the first part of the video is very different from how he reacts in the second part. In the first part the interaction between the patient and nurse is very superficial and hence does not attain the purpose of nursing. In the second part, the nurse creates an atmosphere of trust through body language his voice and his stance. This makes the patient more open thus allowing her to communicate her need of needing people around her which leads Sheldon an accurate diagnosis. Conclusion Sheldon’s conduct in part one and two portray a picture that is in line with Orlando’s Nursing Practice theory. The video showed that in instances of patients not getting help with their needs, they are distressed and become helpless. It also showed that patients are unique and therefore it is important for the nurse to tailor his relationship according to individual patients. Patients require assistance in communicating their need to the attending nurse as humans may close up about needs of dependency unless a favorable atmosphere and relationship is created. It also established the dynamism of nurse patient relationships and the influence of the patient and the nurse on the actions and reactions. Appendix Part A of YOUTUBE Video Checklist Points Scored out of 10 Function of Professional Nursing-Organizing Principle 5 Presenting Behavior-Problematic Situation 4 Immediate Reaction-Internal Response 3 Nursing Process Discipline- Investigation 5 Improvement Resolution 3 Part B of YOUTUBE Video Checklist Points Scored out of 10 Function of Professional Nursing-Organizing Principle 8 Presenting Behavior-Problematic Situation 9 Immediate Reaction-Internal Response 9 Nursing Process Discipline-Investigation 8 Improvement Resolution 10 Bibliography Meleis, I., 1997, Theoretical Nursing: Development & Progress, Philadelphia, USA: Lippincott Potter, A., Perry, G. 1992, Fundamentals Of Nursing –Concepts Process & Practice, London, UK: Mosby Year Book Reed, P., 2006. The force of nursing theory guided- practice. Nurs Sci Q. Jul;19 (3):22 Taylor, C., & Lillis, C. 2001, The Art & Science Of Nursing Care, Philadelphia, USA:  Lippincott Tomey, A., & Alligood, M., 2002, Nursing theorists and their work, Mosby,  Philadelphia, USA: Mosby. Wills, M., & McEwen, M. 2002, Theoretical Basis for Nursing, Philadelphia; USA:Williams& wilkins. Read More