NURSING THEORIST GROUP
PRESENTATIONS
By: Tara Braun, Nathan Buchinger, Leah Mueller, Elisabeth Vander Zwaagas
Ida J.
rlando
Ida J. Orlando’s Nursing Process Theory
Theory of the Deliberative Nursing Process
“How nurses process their observations of
patient behavior and also about how they react to
patients on the basis of inferences from patients’
behavior, including what they say” (Chitty & Black,
2011, p. 315).
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What is Nursing Theory?
“Refers to a group of related concepts,
definitions, and statements that
describe a certain view of nursing
phenomena from which to describe,
explain, or predict outcomes” (Chitty &
Black, 2011, p. 303)
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What is a Nursing Conceptual Model?
•“Provide comprehensive, holistic,
perspectives of nursing by
describing the relationships of
specific concepts” (Chitty & Black,
2011, p. 310)
•Are more formalized than a
philosophy but more abstract than a
theory (Chitty & Black, 2011, p.310)
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Ida Jean Orlando - Pelletier
(1926 – 2007)
Achievements
Received her Nursing Diploma at New York Medical College in 1947
Earned her BS in Public Health at St. John’s University in 1951
Received her MA in Mental Health at Columbia University in 1954
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(Tyra, 2008)
As the National Institute of Mental Health (NIMH) principle
investigator worked on a grant in which she worked to identify factors
relevant to the integration of psychiatric mental health principles into a
nursing curriculum
• Published her results in: The Dynamic Nurse-Patient Relationship:
Function, Process, And Principles in 1961
First nurse in the United States to obtain an applied research grant from
NIMH. Allowed her to conduct the first ever scientific nursing study of
the teaching and use of the nursing process.
• Published her results in: The Discipline and Teaching of Nursing
Process: An Evaluation Study in 1972
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(Tyra, 2008)
Motivation
Length
1:31
7
(Ida Jean Orlando)
Based on the nurse-patient
relationship focusing on
communication (Sheldon &
Ellington, 2008)
“The role of the Nurse is to
find out and meet the patient’s
immediate need for help”
(Nursing Theory: Orlando
Nursing Process)
“The patient’s presenting
behavior may be a plea for
help, however, the help needed
may not be what it appears to
be” (Nursing Theory: Orlando
Nursing Process)
Primary goal of Orlando’s
theory is the “identification of
the nature of the patient’s
distress and is or her
immediate needs for help” (D.
Venes, 2010)
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Nurses are expected “to use their
perception, thoughts about the
perception, or the feeling
engendered from their thoughts to
explore with the patients the
meaning of their behavior”
(Nursing Theory: Orlando Nursing
Process)
“This process helps nurses find out
the nature of the distress and what
help the patient’s needs” (Nursing
Theory: Orlando Nursing Process)
Orlando felt the purpose of her
theory was to allow nurses “to get to
the bottom line more quickly when
observing, listening to, and
confirming with patients…saves
time and energy for both the patient
and the nurse” (Chitty & Black, 2011,
p. 316)
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Nursing Process
Theory
Stated
perception,
thought, or
feeling
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Patient asked
a question
about same
perception,
thought, or
feeling
Good
Nursing
(Ida Jean Orlando)
Three basic aspects of Orlando’s Nursing
Theory
Patient Behavior
- verbal and nonverbal communication relating to
the nurse what the patient immediately needs
The Nurse’s Reaction – An active thought process by the nurse in
which he/she observes the behavior, interprets them, and formulates a plan
to meet the patient’s needs. The nurse also communicates with the patient to
validate whether the patient’s behavior was correctly perceived by the nurse
before deciding on an appropriate intervention.
The Nurse’s Activity – An interactive process with the patient
whereby the nurse performs actions for and with the patient to meet the
patient’s observed needs.
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(Sheldon & Ellington, 2008)
How did
Ida J.
Orlando
develop
her theory
– In her own
words.
Length 1:44
12
(Ida Jean Orlando)
Patient’s
needs being
met more
effectively
Improved
Nursing
Identity
Benefits
Improved
critical
thinking
Enhanced
nurse –
physician
relationship
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(Tyra, 2008)
Deliberate action, as opposed to automatic
action, involves critical thinking as well as
constant interaction with the patient.
Orlando heavily emphasizes a strong and
dynamic nurse-patient relationship
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(Chitty & Black, 2011)
Relationship Between Orlando’s Theory and
the 4 Global Concepts
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Human
Beings
Environment
Health
Nursing
Human Beings
Patients are human beings who cannot meet their specific, immediate
health needs without intervention by the nurse (Alligood & Tomey,
2006).
Patients are interactive, dynamic, and constantly make inferences about
their needs. Nurses are to observe inferences made by them in order to
provide deliberate nursing care that will “relieve distress or discomfort”
(Chitty & Black, 2011, p. 315).
Patient’s are relational beings who, through both verbal and nonverbal
communications, work with the nurse to meet their immediate needs
(Chitty & Black, 2011)
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Environment
Because inferences are taken from the patient as to what the nurse can
do immediately to meet his/her needs, the nurse also takes into account
how the environment may need to be adjusted to help meet patient
outcomes. Since patients exist within the environment they are currently
in, and “all patient behavior is meaningful and may reflect distress,” the
nurse must actively take action based on his/her observations and meet
the patient’s needs (Schmieding, 1993). This may include adjusting the
patient environment.
“This distress is related to the inability to meet one's own needs because
of injury or disease, the inability to recognize or accurately communicate
one's own needs, or the reaction to the confusing, new, painful, or
exhausting care environment” (emphasis added, Orlando, 1987, as
paraphrased by Potter & Bockenhauer, 2000, para. 6).
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Health
Through the deliberative nursing process, a patient’s immediate health
needs are met. A patient will then experience feelings of adequacy and
wholeness. Meeting patient outcomes is the goal of Orlando’s process
theory in general
(Alligood & Tomey, 2006)
Nursing
Nurses work autonomously, use critical thinking, establish a working
patient relationship, and effectively communicate with patients
determine proper interventions.
Nurses exist to “meet patients’ immediate needs and to improve their
situation” (Chitty & Black, 2011, p. 315).
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Evaluation of Global Concepts
Orlando’s theory does address these concepts as shown on the previous
slides. However, the primary foci of her theory is on the patient and
nursing. Although environment is included, it is assumed that the nurse
will make changes if that is what is required to meet patients’ needs.
Health is also addressed, though less emphasized, and it is assumed that
meeting immediate needs will contribute to patients’ long-term health
achievement.
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How can this model be used?
●
Concrete theory based on needs of the patient
●
Specific to nurse patient relationship
●
Used in OR or OB setting
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
Nurse must monitor patient needs during and after surgery

Nurse must be able to adapt care based on patient needs

Postoperatively the patient will have different needs than preoperatively

The laboring patient will have different needs than during delivery and
then postpartum
(Citation?)
Highly regarded and still used and
taught today
Centered on patient care
Similarities
between Orlando &
Peplau’s Theories
Focus is on the Nurse –Patient
Relationship
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Patient behavior is an essential tool
in patient care
(Chitty & Black, 2011, p.
314-315; Bunkers, 2012)
Situations where Orlando’s theory has been
used in…
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End of Life
Issues
• Must assess patient needs
• Including comfort both physically and emotionally
• Closure for the family and patient, facing fears, and
closing resolved issues
Emergency
Situations
• Solve the immediate problem, meet immediate needs
while planning for future needs
• Listen to both verbal and nonverbal communication
Long-term
Care
• Each patient is an individual with individual needs and
values
• Don’t assume how a patient will react to different
situations
• Level of need will change as disease process progresses
(Citation ?)
Examples of other fields where Orlando’s
theory may be useful…
Customer
Service
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• Need to always listen to the customer to satisfy their
needs
• Follow their verbal and nonverbal cues to determine
their satisfaction
Business
• Can be used in any client interaction to determine the
steps to moving forward
• Similar to the principles of Lean Manufacturing
Teaching
• Review the assignments done by the students to
assess their understanding of the material
• Assess the flow of discussion as new material is
presented to determine if clarification is necessary
Case Study
A patient just recovering from surgery is complaining
of pain. He has already had the maximum dose of his
pain medications and is continually using his call light
to make demands on the nursing staff. He has made
several complaints that his pain is not being taken
care of and other patients are receiving better care.
1) How can you deal with this patient using Orlando’s
theory?
2) What are some questions you should ask this
patient?
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Case Study Answers
1) How can you deal with this patient using Orlando’s theory?
• Ask the patient what his concerns are and listen to both verbal
and nonverbal answers.
• Attempt to discuss with the patient different methods of pain
relief.
• Discuss with the patient why he feels others are receiving better
care.
• Assess the patient’s needs and take care of the needs promptly
2) What are some questions you should ask this patient?
• What is your pain level? Where is your pain?
• What are we doing for the other patients differently than we are
doing for you?
• What are your main concerns about your health?
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References
Abdoli, S., & Safavi, S.S. (2010). Nursing Student’s Immediate Responses to
Distressed Clients Based on Orlando’s Theory. Iranian Journal of Nursing
and Midwifery Research, 15(4), 178-184. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/21589792
Alligood, M.R., & Tomey, A.M. (2006). Nursing Theorists and Their Work. St
Louis, MO: Mosby.
Bunkers, S.S. (2012). Presence: The Eye of the Needle. Nursing Science Quarterly,
25(1), 1-14. Retrieved from doi: 10.1177/0894318411429074
Chitty, K.K., & Black, B.P. (2011). Professional Nursing: Concepts and Challenges
(6th ed.) Maryland Heights, MO: Saunders.
Ida Jean Orlando. (n.d.). Retrieved February 22, 2012 from You Tube:
http://www.youtube.com/results?search_query=ida+jean+orlando
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Nursing Theories. (2012). A Companion to Nursing Theories and Models. [Data
file]. http://currentnursing.com/nursing_theory/Watson.html
Potter, M.L. & Bockenhauer, B.J. (2000). Implementing Orlando’s Nursing Theory:
A Pilot Study. Journal of Psychosocial Nursing and Mental Health Services,
38(3), 14-21.
Sheldon, L.K. & Ellington, L. (2008). Application of a Model of Social Information
Processing to Nursing Theory: How Nurses Respond to Patients. Journal
of Advanced Nursing,64(4), 388-398.
Schmieding, N.J. (1993). Ida Jean Orlando: A Nursing Process Theory (Notes on
Nursing Theories), (Vol. 12). Newbury Park, CS: Sage Publications.
Tyra, P.A. (2008). In Memoriam: Ida Jean Orlando Pelletier. Journal of the American
Psychiatric Nurses Association, 14(3), 231-231. Retrieved from doi:
10.1177/1078390308321092
Venes, D. (Ed.). (2010). Tabor’s Cyclopedic Medical Dictionary 21st ed. Philadelphia,
Pennsylvania. F. A. Davis Company.
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