Ida Jean Orlando (Pelletier

)
The Dynamic Nurse-Patient Relationship

g e n e r a t i o n A m e r i c a n descent was born in 1926. •N u r s i n g College diploma New of Italian York Medical •B S i n p u b l i c h e a l t h n u r s i n g . New York.C o l u m b i a University. NY •M A i n m e n t a l h e a l t h n u r s i n g .About the Theorist •a f i r s t . IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP .S t . J o h n ' s University.

•P r o j e c t i n v e s t i g a t o r o f a N a t i o n a l I n s t i t u t e of Mental Health grant entitled: Integration of Mental Health Concepts in a Basic Nursing Curriculum. •p u b l i s h e d i n h e r 1 9 6 1 b o o k .•A s s o c i a t e P r o f e s s o r a t Y a l e S c h o o l o f Nursing and Director of the Graduate Program in Mental Health Psychiatric Nursing. “ T h e D y n a m i c Nurse-Patient Relationship” and revised 1972 book: “The Discipline and Teaching of Nursing Processes” •A b o a r d m e m b e r Health Plan. of Harvard Community IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP .

• The process by which nursing resolves this helplessness is interactive and is pursued in a disciplined manner that requires training. in an immediate situation.Introduction to the theory ORLANDO’S KEY CONCEPTS • Nursing is unique and independent because it concerns itself with an individual’s need for help. IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . real or potential.

“Ummm. I think something is bothering you besides your pain. So..” cried out Mrs. So.Case Scenario “Nurse.. Can I have my morphine now?” “Mrs. can you give me my morphine. where 0 being not painful and 10 being severely painful?”replied the nurse. Am I correct?” IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . I think it’s about 7. “Can you tell how painful it is using the 0 ‐10 pain scale.

I’m not sure how they are or who’s been taking care of them. Our neighbour. So cried and said. I’m so worried about my 3 boys. Yee. They’re still so young to be left alone. Mrs. “Thank you nurse. I don’t think I still need that morphine. My husband is in Yemen right now and he won’t be back until next month.” IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP .Mrs. My boys are fine. she’s watching over my boys right now. So phoned his sons.” “Why don’t we make a phone call to your house so you could check out on your boys?” Mrs. “I can’t help it.

(Schmieding. Function of professional nursing (Organizing principle)  Nurses must be constantly aware that their “activity is professional only when it deliberately achieves the purpose of helping the patient” (Orlando. 1961)  If the patient has an immediate need for help and the nurse finds out and meets that need .the function of professional nursing is achieved IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . 1986) 1.NURSING PROCESS DISCIPLINE Orlando describes her model as revolving around the 5 major interrelated concepts/dimensions.

may represent a plea for help. regardless of the form in which it appears. IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP .2.”  When a patient experiences a need that he cannot resolve. a sense of helplessness occurs. The patient’s behavior reflects this distress. Presenting Behavior of the Patient – (Problematic Situation)  Orlando stresses that: “the presenting behavior of the patient.

 The perceptions stimulate automatic thought Each thought stimulates an automatic feeling Then the person acts IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . Immediate or Internal Response of the Nurse .3. which marks the beginning of the nursing process discipline.(Internal Response)  Patient behavior stimulates a nurse reaction.

also provides 3 criteria to ensure that the nurse’s exploration of her reaction with the patient is successful: IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . helpful or appropriate until she checks the validity of it in exploration with the patient” (Orlando. 1961)  Orlando (1972). The Nursing Process Discipline – (Investigation)  “The nurse does not assume that any aspect of of her reaction to the patient is correct.4.

3) The nurse must ask the individual about the item expressed in order to obtain correction or verification from that same individual IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . 2) The nurse must clearly communicate to the individual that the item being expressed belongs to herself.1) What the nurse says to the individual in contact must match any or all the items contained in the immediate reaction. and what the nurse does nonverbally must be verbally expressed and the expression must match items contained in the immediate reaction.

The nurse explores the meaning of the action with the patient and relevance to meeting his need c. d. Result from correct identification of patient’s needs by validation of the nurse’s reaction to patient behavior b.  The nurse can act in two ways: automatic or deliberative  Criteria for deliberate actions a. The nurse is free of stimuli unrelated to the patient’s need when she acts. The nurse validates the action’s effectiveness immediately after completing it. IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . Once the nurse has validated or corrected her reaction to the patient’s behavior. she can complete the nursing process discipline with the nurse’s action.

Improvement – (Resolution)  It is not the nurses activity that is evaluated but rather its result : whether the activity serves to help the patient communicate her or his need for help and how it is met  In each contact the nurse repeats a process of learning how to help the individual patient. IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP .5.

is not included in her theory. Nursing  The fourth concept. IDA JEAN ORLANDO (PELLIETER) THE DYNAMIC NURSE-PATIENT RELATIONSHIP . Human 2.ORLANDO’S THEORY AND METAPARADIGM  Orlando includes material specific to three (3) of the four major concepts: 1. Health 3. society.

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