Middle Range Nursing Theory

Running head: MIDDLE RANGE NURSING THEORY
MIDDLE RANGE NURSING THEORY
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1MIDDLE RANGE NURSING THEORY
Introduction
The profession of nursing has evolved over time, and along with the changes, transition
has also come in the development of the different nursing theories. The theories provide the
foundation of the nursing practice, especially in the assessment, intervention and the evaluation
(Fawcett & Desanto-Madeya, 2012).. The formulation of the nursing theories also offers a
framework for generating new nursing concepts and the ideas. Frederick Suppe, a philosopher of
science from the United States of America, have stated that with the maturity of science, the
development of the knowledge has moved from the grand nursing theories to the more narrower
and specific middle range theories (Smith & Liehr, 2018). The middle range theories are more
concrete than the grand theories, as they are made up of limited number of concepts and
propositions written at a specific level. One of the widely used middle range theories is the
Orlando’s theory of the deliberate nursing procedure. This paper will critically discuss and
analyze the Orlando’s deliberate nursing process by linking it to a specific clinical scenario in
their nursing practice.
Orlando’s Nursing Process Theory
According to this theory, it is the expressed duty of the nurses to find out the immediate needs of
the patient and to fulfill the. The patient might not always express their distress in a way that
determines their needs. But it is the duty of the nurse to use the insight, intuition and perception
for figuring out the true needs of the patient (Sampoornam, 2015). Other assumptions state that
the nurse patient situation dynamic, actions and the reactions are influenced by the patient and

2MIDDLE RANGE NURSING THEORY
the nurses. Some of the important concepts of this theory is function of professional nursing- the
organizing principle, presenting behavior, the immediate action, the nursing process discipline
and improvement. Orlando has postulated, that there are three main elements that comprised of a
nursing situation- the patient’s behavior, the nursing actions designed for the benefit of the
patients and the reaction of the nurse. Orlando’s deliberate nursing process is made up of these
basic three elements.
Presenting behavior- It is the duty of the nurses to recognize the situation as problematic. The
presenting behavior of the patient might represent a plea for the help. The presenting behavior of
the patient causes an automatic internal response in the nurse and the behavior of the nurse
causes a response in the patient (Sampoornam, 2015)..
Nursing process discipline- an observation shared and explored with the patient is immediately
useful in ascertaining and meeting the needs or finding out that he is not in need at time. A nurse
normally initiates to explore how the patient is affected (Sampoornam, 2015).
Improvement- It is actually not the activity of the nurse that has to be evaluated but is actually the
result.
Analysis of the theory’s application to professional, clinical practice
There are very few studies that investigated how the nurses’ responds to the clients with
the problematic situations based on the nursing theories and the interactions. An exploratory
study involving 60 nursing students was conducted in order to analyze the immediate response of
the nurses to the distressed client’s behavior focusing on the
Orlando’s theory (Abdoli & Safavi, 2013). It is found that Orlando’s theory in clinics can