ORLANDO’S

NURSING
PROCESS
THEORY
 THEORIST’S BACKGROUND
• Ida Jean Orlando was an American nurse theorist who was born in 1926 in New York City.

• She received her nursing degree from New York Medical College in 1947 and her Master of Arts in Mental Health Nursing
from Teachers College, Columbia University in 1954.

• Orlando worked in various clinical settings including mental health, medical-surgical, and community health nursing.

• She is best known for her Nursing Process Theory, also known as the Deliberative Nursing Process Theory, which was
published in 1961.

• This theory emphasizes the importance of the nurse-patient relationship in the nursing process and aims to improve patient
outcomes through the use of deliberate, purposeful nursing actions.

• Orlando’s work has had a significant impact on nursing practice and education, and she is recognized as one of the most
influential nursing theorists of the 20th century.

• A board member of Harvard Community Health Plan

METAPARADIGMS
PERSON, HEALTH, ENVIRONMENT
AND NURSING
 PERSON

Orlando uses the concept of human as she

emphasizes individuality and the dynamic nature
of the nurse-patient relationship. For her,
humans in need are the focus of nursing practice
 HEALTH

In Orlando’s theory, health is replaced by a sense

of helplessness as the initiator of a necessity for
nursing. She stated that nursing deals with
individuals who require help
 ENVIRONMENT
Orlando completely disregarded the environment in
her theory, only focusing on the patient’s immediate
need, chiefly the relationship and actions between the
nurse and the patient (only an individual in her
theory; no families or groups were mentioned). The
effect that the environment could have on the patient
was never mentioned in Orlando’s theory
 NURSING
Orlando speaks of nursing as unique and independent
in its concerns for an individual’s need for help in an
immediate situation. The efforts to meet the individual’s
need for help are carried out in an interactive situation
and in a disciplined manner that requires proper
training.
KEY CONCEPTS
Ida Jean Orlando described her model as revolving
around the following five major interrelated concepts:
the function of professional nursing, presenting
behavior, immediate reaction, nursing process discipline,
and improvement.

www.traditionalmedicine.com
 THE FUNCTION OF
PROFESSIONALNURSING
In Orlando’s theory, health is replaced by a sense
of helplessness as the initiator of a necessity for
nursing. She stated that nursing deals with
individuals who require help
 PRESENTING BEHAVIOR
Presenting behavior is the patient’s problematic situation.
Through the presenting behavior, the nurse finds the patient’s
immediate need for help. To do this, the nurse must first
recognize the situation as problematic. Regardless of how the
presenting behavior appears, it may represent a cry for help from
the patient. The patient’s presenting behavior, which is
considered the stimulus, causes an automatic internal response in
the nurse, which in turn causes a response in the patient.
  DISTRESS
The patient’s behavior reflects distress when the
patient experiences a need that he cannot
resolve, a sense of helplessness occurs
 IMMEDIATE REACTION
Immediate reaction is the internal response. The patient perceives
objects with his or her five senses. These perceptions stimulate
automatic thought, and each thought stimulates an automatic
feeling, causing the patient to act. These three items are the
patient’s immediate response. The immediate response reflects
how the nurse experiences his or her participation in the nurse-
patient relationship.
 NURSE REACTION
Patient’s behavior stimulated a nurse’s reaction, which marks the nursing
process discipline’s beginning.

 NURSE’S ACTION
When the nurse acts, an action process transpires. This action process by the
nurse in a nurse-patient contact is called the nursing process. The nurse’s
action may be automatic or deliberative.

 AUTOMATIC NURSING ACTIONS

Are nursing actions decided upon for reasons other than the patient’s
immediate need.
 DELIBERATIVE NURSING ACTIONS
are actions decided upon after ascertaining a need and then meeting this need.

The following list identifies the criteria for deliberative actions:

• Deliberative actions result from the correct identification of patient needs

by validating the nurse’s reaction to patient behavior.
• The nurse explores the meaning of the action with the patient and its
relevance to meeting his need.
• The nurse validates the action’s effectiveness immediately after completing
it.
• The nurse is free of stimuli unrelated to the patient’s need when she acts.
 NURSING PROCESS DISCIPLINE
The nursing process discipline is the investigation into the patient’s needs. Any
observation shared and explored with the patient is immediately useful in
ascertaining and meeting his or her need or finding out they have no needs at
that time. The nurse cannot assume that any aspect of his or her reaction to
the patient is correct, helpful, or appropriate until he or she checks its validity
by exploring it with the patient. The nurse initiates this exploration to
determine how the patient is affected by what they say and do. Automatic
reactions are ineffective because the nurse’s action is determined for reasons
other than the meaning of the patient’s behavior or the patient’s immediate
need for help. When the nurse doesn’t explore the patient’s reaction with him
or her, it is reasonably certain that effective communication between nurse
and patient stops.
 IMPROVEMENT

Improvement is the resolution to the patient’s situation. In the resolution, the

nurse’s actions are not evaluated. Instead, the result of his or her actions is
evaluated to determine whether their actions served to help the patient
communicate his or her need for help and how it was met. In each contact, the
nurse repeats learning how he or she can help the patient. The nurse’s own
individuality and that of the patient require going through this each time the
nurse is called upon to render service to those who need him or her.
 APPLICATION
Ida Jean Orlando was a prominent nursing theorist known
for her work in the field of nursing practice, education, and
research. Her nursing theory, often referred to as the
"Orlando Nursing Process," has had a significant impact in
these areas:
Nursing Practice:

Orlando's theory emphasizes the importance of the nurse-patient relationship

and the nurse's role in helping patients meet their immediate needs. It
promotes a holistic approach to patient care, focusing on understanding and
responding to patients' unique experiences and concerns. Nurses can apply
Orlando's theory in their daily practice by actively listening to patients,
assessing their needs, and providing individualized care.
Nursing Education:

Orlando's theory has been integrated into nursing education programs to

teach students about the importance of patient-centered care and effective
communication. Educators use her framework to help students develop
critical thinking skills and enhance their ability to provide compassionate and
patient-focused care.
Nursing Research:

Orlando's work has inspired research in the field of nursing. Researchers have
explored various aspects of her theory, such as its application in different
healthcare settings, its effectiveness in improving patient outcomes, and its
relevance in contemporary nursing practice. Research studies based on her
theory contribute to the evidence-based practice of nursing.
 CRITIQUE
Clarity, Simplicity, Generality,
Empirical Precision, Derivable Consequences
• Clarity – clear; involves defining concepts minimally at first and then developing
them throughout her books.
• Simplicity – simple; few concepts and relationships; able to make some predictive
statements as opposed to just description and explanation.
• Generality – focuses on a limited number of situations; it could be adapted to other
nursing situations and other professional fields.
• Empirical Precision – benefited research application; 2/3 of her second book is a
report of a research project designed to test the validity of her nursing formulations.
• Devirable Consequences – beneficial in achieving valued outcomes; Research
demonstrated that the use of a disciple professional response enables the nurse to
ascertain and meet the patient’s needs; the study of what the patient say and do in
their practice and the resulting effect is valuable content for nursing education.
CASE STUDY
Ms. Ann is agitated sitting, awaiting surgery for her carpal tunnel. She is clutching the
blankets, eyes wide and lips pressed firmly together. The nurse comes to the bedside;
she asks if there is anything that she can do to make Ms. Ann feel more comfortable.
Ms. Ann responds “Nothing, I’m fine!” If you are the attending nurse, will you leave
her alone after you received her answer?
 REFERENCES
References and sources for this study guide about Ida Jean Orlando:

 George, J.B. (2011). Nursing theories: The base for professional nursing practice (6th ed.). Philadelphia:
Pearson.com/nursing_theory/Orlando_nursing_process.html

 Orlando, I. J. (1972). The discipline and teaching of nursing process. In George, J. (Ed.). Nursing theories: the
base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.

 Orlando, I. J. (1990). The dynamic nurse-patient relationship: Function, process, and principles. In George, J.
(Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.

 Potter, P.A., & Perry, A.G. (2012). Fundamentals of nursing (8th ed.). St. Louis, MO: Mosby Elsevier.

 Schmieding, N. (1990). An integrative nursing theoretical framework. Journal of Advanced. Nursing, 15(4), 463-
467.You are not allowed to:
THANK YOU !