this is nursing process theory of ida jean orlando. it may helps our students, to understand this theory and apply it in their professional career.

1. Jean Orlando
Nursing process discipline
Prepared by
M.IQBAL
SHUMAILA
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4. Objectives..
• At the end of my presentation the student will be able to knows about
…
• Describe who was Jean Orlando.
• Explain Orlando nursing theory
• Identify Orlando nursing process theory.
• Summarize the Nursing paradigm.
• know application of Orlando theory.
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5. History
 Ida Jean Orlando - born in 1926.
 wrote about the nursing process.
 Nursing diploma - New York Medical College
 BS in public health nursing - St. John's University
 MA in mental health nursing - Columbia University, New York.
 Associate Professor at Yale School of Nursing and Director of the
Graduate Program in Mental Health Psychiatric Nursing.
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6. Continued..
 Project investigator of a National Institute of Mental Health grant
entitled: Integration of Mental Health Concepts in a Basic Nursing
Curriculum.
 published in her 1961 book, The Dynamic Nurse-Patient Relationship
and revised 1972 book: The Discipline and Teaching of Nursing
Processes
 A board member of Harvard Community Health Plan.
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7. Deliberative Nursing Process Theory
• Ida Jean Orlando developed her theory from a study conducted at the Yale
University School of Nursing, integrating mental health concepts into a
basic nursing curriculum. She proposed that “patients have their own
meanings and interpretations of situations and therefore nurses must
validate their inferences and analyses with patients before drawing
conclusions.”
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8. Continued..
• Orlando’s nursing theory stresses the reciprocal relationship between
patient and nurse. What the nurse and the patient say and do affects
them both.
• She views the professional function of nursing as finding out and
meeting the patient’s immediate need for help.
• And the organizing principle and Presenting behavior is the patient’s
problematic situation.
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9. Orlando Model concept…
• Her model as revolving around the following five major interrelated
concepts:
• Function of professional nursing
• Presenting behavior
• Immediate reaction
• Nursing process discipline
• Improvement.
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10. Nursing process..
• Nursing process discipline is the investigation into the patient’s needs,
and improvement of patient’s situation.
• The Deliberative Nursing Process has five stages:
• Assessment
• Diagnosis
• Planning
• Implementation
• Evaluation.
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11. Orlando’s Nursing Process
• Nurses use the standard nursing process in Orlando’s Nursing Process
Discipline Theory to produce positive outcomes or patient
improvement.
• Orlando’s key focus was the definition of the function of nursing.
• The model provides a framework for nursing
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12. Continued..
• Ida Jean Orlando’s nursing theory stresses the reciprocal relationship
between patient and nurse. It emphasizes the critical importance of the
patient’s participation in the nursing process.
• She proposed that “patients have their own meanings and
interpretations of situations and therefore nurses must validate their
inferences and analyses with patients before drawing conclusions.
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13. Goal
• Ida Jean Orlando’s goal is to develop a theory of effective nursing
practice. The theory explains that the role of the nurse is to find out
and meet the patient’s immediate needs for help.
• According to the theory, all patient behavior can be a cry for help.
Through these, the nurse’s job is to find out the nature of the patient’s
distress and provide the help he or she needs
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14. Assumptions
• Ida Jean Orlando’s model of nursing makes the following
assumptions:
• When patients are unable to cope with their needs on their own, they
become distressed by feelings of helplessness.
• In its professional character, nursing adds to the distress of the patient.
• Patients are unique and individual in how they respond.
• Nursing offers mothering and nursing analogous to an adult who
mothers and nurtures a child.
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15. Continued..
• The practice of nursing deals with people, environment, and health.
• Patients need help communicating their needs; they are uncomfortable
and ambivalent about their dependency needs.
• People are able to be secretive or explicit about their needs,
perceptions, thoughts, and feelings.
• The nurse-patient situation is dynamic; actions and reactions are
influenced by both the nurse and the patient.
• People attach meanings to situations and actions that aren’t apparent to
others.
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16. Continued..
• Patients enter into nursing care through medicine.
• The patient is unable to state the nature and meaning of his or her
distress without the help of the nurse, or without him or her first
having established a helpful relationship with the patient.
• Any observation shared and observed with the patient is immediately
helpful in ascertaining and meeting his or her need, or finding out that
he or she is not in need at that time.
• Nurses are concerned with the needs the patient is unable to meet on
his or her own
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18. Major Concepts
• The nursing metaparadigm consists of four concepts:
• PERSON
• ENVIRONMENT
• HEALTH
• NURSING
• above four concepts, Ida Jean Orlando only included three in her
theory of Nursing Process Discipline:( person, health, and nursing )
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19. Human Being
• 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.
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20. 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 are in need of help
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21. Environment
• Orlando completely disregarded environment in her theory, only
focusing on the immediate need of the patient, 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.
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22. 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.
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23. 5 Stages of the Deliberative Nursing Process
• The Deliberative Nursing Process has five stages: assessment,
diagnosis, planning, implementation, and evaluation
• Assessment
• In the assessment stage, the nurse completes a holistic assessment of
the patient’s needs. This is done without taking the reason for the
encounter into consideration. The nurse uses a nursing framework to
collect both subjective and objective data about the patient.
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24. Diagnosis
• The diagnosis stage uses the nurse’s clinical judgment about health
problems. The diagnosis can then be confirmed using links to defining
characteristics, related factors, and risk factors found in the patient’s
assessment.
• Planning
• The planning stage addresses each of the problems identified in the
diagnosis. Each problem is given a specific goal or outcome, and each
goal or outcome is given nursing interventions to help achieve the
goal. By the end of this stage, the nurse will have a nursing care plan.
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25. Implementation
• In the implementation stage, the nurse begins using the nursing care
plan.
• Evaluation
• Finally, in the evaluation stage, the nurse looks at the progress of the
patient toward the goals set in the nursing care plan. Changes can be
made to the nursing care plan based on how well (or poorly) the
patient is progressing toward the goals. If any new problems are
identified in the evaluation stage, they can be addressed, and the
process starts over again for those specific problems
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26. Strengths
• The guarantee that patients will be treated as individuals is very much
applied in Orlando’s theory of Deliberative Nursing Process. Each
patient will have an active and constant input into their own care.
• Assertion of nursing’s independence as a profession and her belief that
this independence must be based on a sound theoretical framework.
• The model also guides the nurse to evaluate her care in terms of
objectively observable patient outcomes.
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27. Weaknesses
• The lack of the operational definitions of society or environment was
evident which limits the development of research hypothesis
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• Must assess patient needs
• Including comfort both physically and emotionally
• Closure for the family and patient, facing fears, and closing resolved
issues
End of Life
Issues
• Solve the immediate problem, meet immediate needs while planning
for future needs
• Listen to both verbal and nonverbal communication
Emergency
Situations
• 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
Long-term
Care
Situations where Orlando’s theory has been used are…

29. Examples of other fields where Orlando’s theory may be useful…
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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
Customer
Service
• Can be used in any client interaction to determine the steps to
moving forward
• Similar to the principles of Lean Manufacturing
Business
• 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
Teaching

30. Conclusion
• Orlando’s nursing theory stresses the reciprocal relationship between
patient and nurse.
• What the nurse and the patient say and do affects them both.
• Orlando views the professional function of nursing as finding out and
meeting the patient’s immediate need for help.
• She was one of the first nursing leaders to identify and emphasize the
elements of the nursing process and the critical importance of the
patient’s participation in the nursing process.
• Orlando’s theory focuses on how to produce improvement in the
patient’s behavior.
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31. Continued..
• Evidence of relieving the patient’s distress is seen as positive changes
in the patient’s observable behavior. Orlando may have facilitated the
development of nurses as logical thinkers.
• The Deliberative Nursing Process helps nurses achieve more
successful patient outcomes such as fall reduction.
• Orlando’s theory remains a most effective practice theory that is
especially helpful to new nurses as they begin their practice.
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32. 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
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33. Any
Questions?
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