Nursing students’ immediate responses to distressed clients based on Orlando’s theory

BACKGROUND Nowadays, problem solving skills, clinical decision making ability and making a proper relationship to clients are essential necessities for nursing graduates; however there are few studies which investigated nursing students' responses to clients with problematic situations based on nursing theories addressing interactions. The purpose of this study was to analyze the nursing students' immediate responses to distressed clients' behaviors focusing on collaborative Orlando's theory. METHODS This exploratory study was assessed 60 nursing students' responses to a simulated clients' questionnaire based on Orlando's theory in 2008. All of the students were enrolled in bachelor degree of nursing. The data were analyzed by dimensional content analysis to specify the key categories, according to concepts of Orlando's theory. RESULTS According to Orlando's theory, students' immediate responses to physical and mental problems of distressed clients were classified into 6 main categories: physical caring, uncertainty, assuring, recommending, asking information and explaining. The most frequent responses to clients' behaviors were physical caring, assuring and recommending and most of the students were unable to respond to mental problems. CONCLUSIONS Nursing students responded to clients' needs automatically and they did not consider clients' ability in decision making. Medical diagnosis, physical caring and assuring were their main concerns and they were confused in responding to mental problems. Orlando's theory emphasizes on nurse-client interactions and considers nurses' perceptions, thoughts, and feelings. It views clients as a participant in care giving, so teaching this theory can enhance students' communication skills and improve quality of nursing care.