The Theoretical Basis Of Advanced Practice

Rebekah Reed

Chamberlain College of Nursing

NR501: Theoretical Basis of Advanced Practice

Fall 2012

Application of Theory

Nursing communication has an important role in patient behavior such as anxiety, compliance with care, and patient satisfaction, I chose to apply Orlando’s theory to resolving communication problems and to promote a patient-nurse relationship that will help create a specific care plan individualized for each patient. In this paper I will briefly discuss Orlando’s theory and how it can be applied with its concepts and principles to a resolve a problem in communication.

Nursing is responsive to anyone who suffers or anticipates suffering a sense of helplessness.   The role of nursing is to discover and meet the client’s immediate needs (George, 2011). One of my favorite nursing theories is Orlando’s Theory. For me her theory’s focus is basic nursing. Orlando’s theory hinges on the major tenets of nursing and the concept of the person as a developmental human being with needs.   Individuals possess their own perceptions and personal beliefs that one may or may not observe on the surface.   Her definition of health is implied only as a sense of wellbeing that one achieves when needs are met resulting in a sense of comfort. Ida Orlando bases her deliberative nursing process theory on the interpersonal relationship between the nurse and the patient.   This helps to identify the immediate need of the patient and assess the nature of distress.   Orlando provides the nurse an interpersonal approach to either simple or complex situations.   Within the deliberative nursing process, the nurse continuously observes patient behavior and assesses needs to help with each situation (Sheldon & Ellington, 2008).

According to Sheldon & Ellington (2008), Orlando’s theory provides a solid base for communication within the nurse-patient relationship. According to these studies, immediate distress reduces when Orlando’s nursing theory is applied (p. 349). However, their studies concluded that nurses’ cognitive processes are not clearly outlined in her theory.   Recent models of social information processing such as the Crick and Dodge model stem directly from Orlando’s theory.   These models add cognitive processes to Orlando’s nursing processes to react to specific clues within the social context of patient behavior (p. 390). These studies reveal that applying Orlando’s theory in nursing practice helps achieve positive patient-centered outcomes by improving decision-making and differentiating between nursing and non-nursing tasks.   Orlando’s nursing theory provides guidelines to nursing staff regarding how and when to approach a patient.

Nursing Issues

In the home care setting, the nurse educator has a responsibility to educate nursing on their roles as it relates to their patients and families in order to ensure positive patient and family outcomes.   In an effort in doing so, using Ida Jean Orlando’s theory, the Dynamic Nurse-Patient Relationship provides the nursing perspective that focuses on quality of life and human dignity from the perspective of patients, families, and communities.   In our home care office we have had several complaints from patients and families about how the nurses respond to their questions and their interactions with the patients. This theory allows the educator to demonstrate to nursing the importance of allowing patients and families to decide what’s best for them while supporting their decisions with dignity and respect.


The application of Orlando’s theory is clear, concise, and easy to use and the process has been proven effective with a variety type of patients and settings.   The basis of the theory is for nurses and patients to identify the need for help and provide that help individually to ensure the meeting of the patient’s needs.   In my future role as a nurse leader, I can educate nurses that through the use of Orlando’s theory, nurses can control and evaluate the effectiveness of their practice and patients can decide on the action(s) that will increase their sense of adequacy and well-being.

In conclusion, practicing nurses must manage health issues that focus not only on the patient, but those that focus on the family and broader society. Nurses also have a primary role in patient and family health education. Through the use of nursing theories, which has provided the foundation for understanding nursing, patients, families and health has led to widely used innovations in patient care, nurse experiences, nurse-patient relationships, and nursing administration.   The evolution of nursing is not a new process or concept; however, we must continue to utilize nursing theory to conduct research to develop the professional boundaries for the continued growth of the profession.   By joining in a common effort to advance the profession, as we ensure the best interest of the patients (andfamilies) we serve, the nursing profession can seek to build a new identity for itself and claim its place in a challenging health care environment.

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