Implementation Of Orlando 's Dynamic Nurse Patient Relationship Model

Not all patients are capable of independently identifying and articulate their care needs, so the nurse also adapts the role as an advocate. Clarity and continuity in a trusting environment enables good communication. Progressive identification of needs takes place as nurse and patient communicate with one another in the interpersonal relationship (Peplau 1988, p. 84). Being considerate to the needs and vulnerability of patients is a moral attribute, as nurses are accountable for the care they deliver.

Hildegard Peplau’s middle-range theory, Interpersonal Relations, established in 1948 and highlighted the nurse-patient relationship as the groundwork of nursing practice. Peplau supports each role individually, the nurse and the patient, by ensuring that equal participation is implemented to reach a mutual goal. For example, the role of the patient reflects vulnerability and the expectation to be open to the health care providers throughout care and treatment plan. Subsequently, the nurse is supposed to facilitate a reciprocated relationship by noting the client’s behavior, defining the client’s illness, creating the most proper care for the client, understanding the physician’s treatment plan and confirming it, and intervening when required (Sue Penckofer, 2013).

McCabe C. (2004) Nurse-patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing. 13, 41-49.

Creating a safe environment, promoting trusting nurse-patient relationship, and increasing patient’s quality of life are result of implementing this theory in practice. Even though creating a change in nursing practice might be challenging, but it is doable by identifying the goal, pathway to reach the goal, education, trainings, and using evidence based practice. The main point of creating a therapeutic communication is to build a trusting nurse-patient relationship, decreasing nurse and patient’s anxiety level, increasing the level of care and patient’s quality of life. (Jasmine,

In her theory of deliberative nursing process, she describes the interaction between nurse and patient. Communication between nurse and patient is described in three concepts: the ‘Patient Behavior’, the ‘Nurse’s Reaction,’ and the ‘Nurse’s Activity’ (Sheldon & Ellington, 2008). The patient sends a cue in the form of behavior (Patient Behavior) and the nurse responds to the behavior (Nurse’s Reaction). ‘Nurse’s Activity’ is categorized into two stages: non-observable and observable. The nurse’s thoughts, perceptions, or feelings related to behavior are non-observable and the final action or response to the ‘Patient Behavior’ is observable (Sheldon & Ellington, 2008). Orlando labels ‘Nurse Activity’ as automatic or deliberative, allowing the nurse to identify the patient’s needs and then help the patient (Sheldon & Ellington, 2008). In patient care, this theory asks nurses to identify their perceptions, feelings, and thoughts as a basis for nursing actions. Orlando then takes it a step further by advocating that the nurse explore their assumptions with the patient to identify

Acute psychiatric inpatient nursing is primarily focused on the assessment and treatment of patients admitted in times of crisis. To effectively assess a patients needs a nurse requires an overview of the patient’s interactions with their external & internal environment. Fundamental to this been successful is the nurse patient relationship, forming a trusting relationship and maintaining this throughout the patient’s care. The nurse’s ability to listen, talk and understand are identified as key to positive patient experiences of feeling supported and cared for (Gilburt et al 2008).

Caring can mean different things to different people, however, there are a few principles that are important to all such as empathy, compassion, respect and trust. The act of caring is shown initially by our exterior presence but our actions and personality is what portrays our caring ways. Growing up in a family with morals and beliefs, has taught me to be an approachable friendly person, having strong qualities of respect and compassion for others. Knowing one 's self, the acceptance of others comes naturally and eases formation of relationships. Understanding the caring needs of others, I will establish the nurse-patient relationship. Jean Watson, and many other nursing theorist, have defined caring as the central concept of nursing. Despite the unique and personal needs of each individual patient – there are key characteristics that the profession upholds. Throughout this paper, I will talk about what caring is and how it is different in the nursing industry.

The building of a positive relationship is described as showing warmth, respect and empathy however to provide effective communication between nurse and patient the nurse needs to be aware of and identify the patient’s physical, social and psychological barriers. A nurse can use these tools to build trust, mutual respect and confidence with the patient as these are needed for

A nurse-patient relationship is the basic requirements in all practice settings. Its usage is to manage communication between an organization and a public while maintaining boundaries in the therapeutic relationship. Based on Peplau’s interpersonal theory, communication takes place in a nurse-client relationship where therapeutic process occurs involving complex factors such as environment, attitudes, practices, and beliefs in the dominant culture (seu.edu, 2015). The actions of each person in a nurse-patient relationship is measured on the collaboration of their thoughts, feelings, and experiences. Nurse’s work to attain, maintain, and restore the patient’s health until patient have fulfilled the health care needs. Patient must be guided and provided a well-respected environment until a better health and specific needs are fully considered in the relationship. In this kind of setting, nurse’s must create relationship with patients by communicating receptivity, assimilating the concepts of empathy, trust, genuineness, respect, and confidentiality into their interactions.

Orlando’s Nursing Process Discipline Theory explains that the role of the nurse is to find out and meet the patient’s immediate needs for help. The patients’ presenting behavior might be a cry for help. However, the help the patient needs may not be what it appears to be. Because of this, nurses have to use their own perception, thoughts about perception, or the feeling engendered from their thoughts to explore the meaning of the patients’ behavior. This process helps nurses find out the nature of the patients’ distress and provide the help he or she needs. The concepts of the theory are: function of professional nursing, presenting behavior, immediate reaction, nursing process discipline, and improvement.

The therapeutic nurse-patient relationship is known as a close and consistent connection approaching during patients’

Nursing theory is the backbone of nursing. It is very important in the application of evidence-based practice (EBP). The functions of a theory are to narrow and provide specific information for the analysis of initially confusing behaviors, situations, and events (Fawcett & Madeya 2013). Moreover, nursing theory helps to improve not only the quality of care that we are providing to our patients but, they also help us make better clinical decisions. As a matter of fact, nursing theory gives the nurse a framework for organizing and analyzing information as well as a base for identifying with their patients throughout the nurse-patient relationship (Schick, 2015). I am very much interested in all the theories. The one that I relate to the most is Hildegard Peplau’s theory. It is a middle range theory that focuses on interpersonal relations. This theory teaches us about how to interact with our patients so that they feel more in control of their treatment. In this paper, I will be talking about the importance of nursing, the summary of Peplau's theory, and how as future nurse practitioners, we can apply it.

Within nursing, there is a very delicate balance between a nurse and her patient that must be maintained if the patient is to receive the care that he or she is entitled to receive. The patient must feel comfortable trusting his nurse to hear his needs and respond to them appropriately and in order for this to be the case, the nurse must first provide therapeutic communication effective enough to elicit such a response in her patient. There are both verbal and non-verbal components within the nurse-patient relationship. These components greatly influence how a nurse and patient will relate to each other and, ultimately, greatly influence the care that the patient receives.

Therapeutic Communication has a huge impact on patients, whether, we, as nurses, see it or not. It is very important for a nurse to gain a patient’s trust. Many patients are already filled with sadness, nervousness and unsure thoughts of their current situation. Such thoughts may make a person scared to trust or open up to a nurse or doctor. Developing a close rapport with a patient can help to create a safe, warming environment, resulting in a positive experience throughout their time in the hospital or even nursing home. In “Therapeutic Communication”, Anna Lauria opens saying, “What we say or do not say can influence whether a client is able to quiet his mind, relax his body and initiate a healing response” (Lauria). Being a nurse, we automatically have the opportunity to create a strong influence on patients’ lives during, and even after, their hospital experience.

Nursing process discipline is a nursing theory developed by nursing theorist, Ida Jean Orlando. This theory, one of the first written about the nursing process, was written to help establish nursing as an independent function in providing health care for a patient. Through this independent nursing function, Orlando developed her theory on the concept of the nurse-patient interaction. During that interaction the nurse recognizes a patient behavior as an “… immediate need for help” (George, 2011, p. 165). This “immediate” need must be correctly identified by the nurse, so the nurse may provide care to relieve the need for help experienced by the patient. Orlando’s creation of the nursing process discipline helped to further establish