Theoretical Basis Of Advanced Practice Nursing Essay

As nurses enter into the practice of nursing, they recognize the importance of using their education to guide their actions within the clinical setting. The greatest aspect about nursing is that is never going to be just a job and is even more than a merely profession. Instead, it is a belief system or way of life and not a discipline that can simply be practiced then abandoned to the dictates of a time clock. Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. Then environment must attune to that wholeness for healing to occur. Healing must be total or holistic health must be restored or maintained. The theorist that best supports my views is Ida Orlando’s Nursing process theory. In this paper I will discuss the importance of nursing theories to the nursing profession. I will discuss the key concepts for Ida Orlando’s theory and I will show how this theory views leadership, education and health policy.

Nursing Theory Importance

Nurses are often the face of the healthcare community. They are the most accessible and are who the patients see day in and day out in the hospital environment. Comparing theories allows the core structure of the theories to be brought to light, as well as display the merits of using a particular theory while practicing nursing. Theory-guided practice provides nurses with a framework for their clinical decision making and ensures accountability by increasing transparency of their actions. Theories and models are useful for organizing, classifying, and interpreting the data used to guide those actions. Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice.(McCurry, et al, 2010)

Key Concepts

Ida Orlando’s nursing process theory is based on the nursing metaparadigm concepts of person and nursing. The term person, not only meaning the patient, but also families and social groups and nursing meaning caring or hands on care of the patient. Ida Orlando’s theory remains today as one of the most effective theories. She wrote that “what a nurse says or does in the exclusive mode thought which she serves the patient. (Orlando, 1990). The main concepts of this theory are the function of professional nursing, presenting behavior, immediate reaction, nursing process discipline and improvement. In my professional experience in both the hospital and home setting I have used this particular nursing process without realizing it. The focus in hospice and home care is the primarily the patient, but also the family and home situation. You have to be able to use all your senses to find out what the primary problem is for that particular patient. This theory looks to the treatment of the patient as a whole and incorporates them into the plan of care.

“Nursing….is responsive to individuals who suffer or anticipate a sense of helplessness, it is focused on the process of care in an immediate experience, it is concerned with providing direct assistance to individuals in whatever setting they are found for the purpose of avoiding, relieving, diminishing or curing the individuals sense of helplessness.”(Orlando, 1990) The purpose of this theory is as previously stated to meet and stay focused on the patient’s needs and focuses on the interaction between the patient and the nurse.

An example Orlando gave was a patient asking for pain medication. The nurse felt something else was going on and after asking what her pain level was and asking the patient is something else was going on to which the patient opened up and stated she was worried about her children. The nurse in the situation assisted the patient with calling her children and when the patient was done she stated she wasn’t painful and didn’t need the pain medication. The scenario identifies the four concepts of patient presenting behavior, the reaction, the professional response and improvement of the situation.

Theory Views

Leadership is an important role in life and even more important role in the success of a nurse. Efficient clinical leaders are able to help others to see and learn from situations and effective clinical nurse leaders must be able to find new ways of performing tasks. Often a leader is mistaken to have the same title as “manager.” A leader deals with people while a manager deals with paper. Leadership is considered a natural element in nursing practice because the majority of nurses work in a group or unit.

Nurses can use the theory that is modeled after Ida J. Orlando. This theory concentrates on the process nurses’ use to identify a patients immediate needs and more specifically to reach those objectives it draws on cues in the interpersonal process. Using Orlando’s theory as the framework, Laurent (2000) proposes a dynamic leader-follower relationship model. Identifying a issue that has occurred on the job, or highlighting, is an important attribute from a leaderships point of view. This enables one to share issues and promotes a reflective outlook which team members would all gain from. While nurses are finding their spot in healthcare, they can simultaneously develop basic leadership philosophies assisted by interaction with established nursing managers.


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