Ida Orlando’s Nursing Theory
Presented by:
Mary Duncan
Karin Mogren-Kuzma
Brianna Hall
Orlando’s Background
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Born in New York in 1926 (Chitty & Black, 2011, p. 315- 316).
Initially graduated from a diploma nursing program (Chitty & Black, 2011, p.
315- 316).
1951 received her BS in public health nursing (Chitty & Black, 2011, p. 315316).
1954 graduated with a MA in mental health nursing from Columbia University
(Chitty & Black, 2011, p. 315- 316).
Professor at Yale School of Nursing as well as Director of the Graduate Program
in Mental Health Psychiatric Nursing (2012, Orlando’s Nursing Process Theory).
1961 published her book, The Dynamic Nurse-Patient Relationship (Chitty &
Black, 2011, p. 315- 316).
1972 published The Discipline and Teaching of Nursing Process (2012,
Orlando’s Nursing Process Theory).
Harvard Community Health Plan board member (2012, Orlando’s Nursing
Process Theory).
Historical Background
Nursing practice involved assisting physicians to provide medical
care when Ida Jean Orlando’s theory was evolving.
Orlando recognized that for nursing to be its own profession, it
needed its own distinctions and goals. She believed that because
the profession lacked defined objectives and nurses functioned as
paraprofessionals to medicine, nurses were left without a clear
concept of patient outcomes should be.
In the late 1950’s, Orlando was the principal investigator of the Yale
School of Nursing Project. The outcome from a research project on
mental health concepts was Orlando’s book, published in 1961,
The Dynamic Nurse-Patient Relationship.
Historical Background cont.
The focus of the book was on the nurse-patient relationship, the
nurse’s professional role and identity, and knowledge development
distinct to nursing.
Orlando was one of the early thinkers in nursing who proposed that
patients have their own interpretations of situations, and therefore
nurses must validate their analysis with patients before drawing a
conclusion.
In the years to come, Orlando refined her theory by assessing its
relevance, testing the validity, and training and evaluating nurses.
In Orlando’s second book, The Discipline and Teaching of Nursing
Process, Orlando had extended her formulations into a definition of
the entire nursing practice, known as the nursing process. The
nursing process is the central framework of practicing nurses today.
Theory Evaluation
It has been said that “one of the most important tests of a theory is
its applicability in practice” (Barnum, 1989, p. 19). Orlando’s theory
is profound yet simple enough to comprehend and apply to
practice.
Identifying the nature of the patient’s distress, their immediate need
for help, the nurse’s reaction, and the nurse’s activity is an
interpersonal process based on a reciprocal relationship between
nurse and patient, known as the nursing process.
The nursing process is widely used in modern nursing, and its
concept is concrete enough to function as a framework to nurse’s
actions regardless of the unit, or setting the nurse might work in.
Theory Evaluation cont.
Orlando’s theory have been tested and used in variety of situations
and settings. The theory’s range of utility, the beneficial impacts on
patient outcomes, and patient nurse relationship has been
demonstrated from extended care facilities to operating rooms.
By using Orlando’s approach, the nurse is able to identify patient’s
needs and consequently provide timely and therapeutic nursing
interventions.
Web Links
http://nursing-theory.org/nursing-theorists/Ida-JeanOrlando.php
http://currentnursing.com/nursing_theory/Orlando_nursing_
process.html
References
Barnum, B. S. (1989). Nursing theory: analysis, application, evaluation (3rd
ed.). Glenview, IL: Little, Brown.
Chitty, K. K., & Black, B. P. (2011). Professional Nursing Concepts and
Challenges (6th ed.). Maryland Heights, MS: Saunders.
Noakes, S. R. (1990). The dynamic nurse-patient relationship. RN, 53(11),
96. Retrieved from: Academic OneFile
Schmieding, N. J. (1995). Ida Jean Orlando a nursing process theory. In C.
M. McQuiston & A. A. Webb (Eds.), Foundations of nursing theory
contributions of 12 key theorists (pp. 563-613). Thousand Oaks,
CA: Sage.
Case Study
Orlando’s theory is based upon a shared communication process between
nurse and patient in order to identify with the patient what the meaning of
the patient’s behavior is, so needs can be met and distress can be
relieved.
From the case study scenario, describe how Orlando’s deliberative
process is used by identifying the meaning of the patient’s behavior, the
nurse’s reaction to the behavior, and the nurse’s action to relieve distress.
A 39- year old diabetic patient who was 4 months pregnant was admitted
with vomiting. She spoke only when spoken to and remained in the bed
even though she could be up. She said she had vomited, but the nurses
had not observed it. During reports, nurses speculated, “I don’t think she
really is vomiting” and “I don’t think she really wants this baby.”
Case Study cont.
These remarks were passed from shift to shift and eventually these
speculations were passed in as fact even though no one had confirmed
them with the patient. One nurse was shocked to learn that the patient did
not want her baby. Although apprehensive, the nurse decided to express
her feeling to the patient. She stated, “I’m shocked because I hear that you
don’t want this baby. Is that true?” Immediately the patient’s eyes began to
well over with tears and she sobbed, “That’s not true. I want the baby, it’s
just that I’m afraid I’ll die in labor. Fifteen years ago when my other child
was born I wasn’t diabetic.” The nurse was stunned by the patient’s remark
and asked, “Does your doctor or anyone know of this?” The patient replied,
“No, I thought if I told people they would think I was a hysterical woman.”
The patient then agreed to discuss this with both her doctor and her family.
Nurses on the unit, when hearing about this, became sympathetic toward
the patient (Schmieding, 1995).