Ida Jean Orlando¶s Theory of the Deliberative Nursing Process

By Mrs. Rosaline Rachel Omayal Achi College of Nursing

S and MA (In Mental Health ) She held positions in Nursing care .Introduction on  Ida Jean Orlando    She did her Diploma in Nursing in New york Medical college. later did her B.Teaching and Research She was the principal investigator in a project ³ integration of Mental Health concepts in basic curriculum (Nursing ) Her finding was released as book (1961) as ³Dynamic Nurse ±Patient Relationship: Functions. Process and Principles of Professional Nursing´   This forms basis for her theory Further research led to publication of ³the Doctrine and Teaching of the Nursing Process´ (1972) .

Concepts      Functions of Professional Nursing Presenting behavior of the patients Immediate ( internal) response of the Nurse Nursing process discipline Improvement .

Deliberative Nursing Process    Orlando¶s Nursing process is based on Individual's action Meeting patient¶s need improves patient¶s behavior This process can also be used by the other health care workers .

Components of Orlando¶s Nursing process . Patient¶s Behavior Nurse Reaction Nurse Activity .

Patient¶s Behavior    It sets the Nursing process in motion Irrespective of the significance and seriousness. patients behavior in any form makes an application for help A patient who cannot full fill his need feels helpless and insecure .

Patient¶s Behavior Non-Verbal Verbal ‡Complaints ‡ Request ‡ Demands ‡ Refusal (Manifested ) ‡Heart Rate ‡Edema ‡ Motor activity ‡A cry If the communication is good ± better Nurse ± patient relation ship .

Nurse Reaction N u r s e R e a c t i o n It forms the basis to determine how a Nurse Acts ‡Perception ‡Thoughts ‡Feelings These reactions are automatic and simultaneous (Secret & Explicit) ‡Nurse perception must match with the patients reaction/ response ‡Perception should be the self assessment ‡Perception must be confirmed by a question to the patient and the feed back from the patient .

Nurse Activity    Activity .in the form of words or deed to be to the benefit of the patient Activity .after the assessment and interpretation of patient's behavior Activity can be automatic or instinctive Deliberative action Automatic action ‡Giving medication ‡Performing routine care ‡Exploring the meaning of patient¶s behavior ‡To relieve patient¶s anxiety by.explaining the procedure .


Orlando's theory (Four concepts of Nursing ) (Metaparadigm )     Person Environment Health Nursing .

Person    Is human being who exhibits verbal and non verbal behavior Has individual abilities to deal with the situations Has individual needs to deal with the situations .

Environment     Is not defined It is a situation between a nurse and the patient Any patient¶s behavior to be viewed as a signal of distress Nursing system in an institution is defined as environment ‡ It does not speak about the other environmental influences on the patient ± nurse activity .

Health   Is not defined Inference can be made as  Health as Sense of comfort Feeling of adequacy Feeling of wellbeing Feeling from mental discomfort Feeling from physical discomfort .

Nursing    A distinct profession Functions autonomously Concerns itself with individuals  In real and potential need ‡ To help a patient ‡ Uses Nursing sufferings processprocess- to relive .

Nursing       Attempt to relieve patient's discomfort (mental & Physical) Attempt to enhance the patient's sense of well being To improve patient's self care abilities Holistically views the patients Brings dynamic and responsive changes in patient's situation Involves continuous exchange of actions and information It is triggered by patient¶s behavior.which led to nurse to react Then Nurse to act & patients to respond/ give feed back .

Nursing Process Comparison Assessment Nurse Reaction (Explored with patient) Diagnosis R e a s s e s s m e n t Outcomes Planning Implementation Nurse Action Evaluation Need for help patient .

Thank you .

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