Ida Jean Orlando's Deliberative Nursing Process Theory emphasizes the dynamic and reciprocal relationship between nurses and patients, highlighting how their interactions affect each other. The theory outlines a four-step interaction process - action, perception, thought, and feeling - to enhance patient care through empathetic communication and individualized responses. In practice, it aids nurses in developing effective care plans by focusing on the patient's immediate needs and fostering stronger therapeutic relationships.

1. Juan Paolo Castro, RN
Ida Jean Orlando
Deliberative Nursing
Process

2. of
contents
01 Introduction
04
02
03 Major Concepts
Importance
Application in
Clinical Practice
The Nursing Process
Theory 05
Table

3. Introductio
n
Ida Jean Orlando-Pelletier (August 12, 1926 –
November 28, 2007) was an internationally
known psychiatric health nurse, theorist, and
researcher who developed the “Deliberative
Nursing Process Theory.” Her theory allows
nurses to create an effective nursing care plan
that can also be easily adapted when and if any
complications arise with the patient.

4. Ida Jean
Orlando
• First Generation Ameican Born in 1962
• Nursing Diploma from New York Medical College
• Bachelorette of Science in Public Health from St.
John’s University.
• Masters of Arts Degree in Mental Health Nursing
from Teachers college Columbia University.
• Director of Graduate Program in Mental Health
Psychiatric Nursing.

5. Nursing
Theory
Theory
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 nursing’s professional
function as finding out and meeting the
patient’s immediate need for help.

6. This diagram represents the
Dynamic Nurse-Patient
Relationship theory
developed by Hildegard
Peplau, often regarded as the
mother of psychiatric nursing.
Peplau's theory emphasizes
the importance of the
interpersonal process
between the nurse and
patient. Here's a breakdown
of how the theory works
according to this diagram:

7. 1. Mutual Interactions:
• The relationship is
dynamic and reciprocal,
involving two parties
(labeled Person A and
Person B in the diagram).
These roles could be
understood as the nurse
(Person A) and the patient
(Person B).
• Both individuals influence
each other's behavior,
thoughts, and emotions
through a series of
actions, perceptions,
thoughts, and feelings.

8. 1. Mutual Interactions:
• The relationship is dynamic and reciprocal, involving
two parties (labeled Person A and Person B in the
diagram). These roles could be understood as the
nurse (Person A) and the patient (Person B).
• Both individuals influence each other's behavior,
thoughts, and emotions through a series of actions,
perceptions, thoughts, and feelings.

9. 2. Four-Step Process of Interaction:
Each person engages in a cycle that consists of Action, Perception,
Thought, and Feeling.
• Action: This step involves one person initiating a behavior, such as a
nurse offering comfort or a patient expressing a concern.
• Perception: The other person perceives or interprets this action. For
example, a patient may interpret the nurse's words or gestures.
• Thought: Based on perception, thoughts are formed about the
meaning of the action. These thoughts could involve reflecting on
what was perceived or understanding the intentions.
• Feeling: Feelings arise from these thoughts, such as feeling
reassured, understood, or, conversely, anxious or misunderstood.

10. 3. Explicit Reaction Process:
• After going through these internal processes, each person expresses
a Reaction explicitly. This reaction is visible to the other person,
prompting further action in return.
• For example, if the patient feels understood, they might express
gratitude, leading the nurse to continue using empathetic
communication.
4. Secret Functioning:
• The phrase “functioning in secret” suggests that many aspects of this
process (thoughts, perceptions, and feelings) occur internally and are
not directly communicated. Each person may be unaware of the
other’s internal reactions unless they are explicitly expressed.
• This hidden, internal process underscores the complexity of human
interactions, especially in sensitive contexts like nursing, where
emotions and unspoken thoughts can heavily influence behavior.

11. 5. Feedback Loop:
• The interaction is depicted as a
loop, with each person’s reaction
triggering a new action in the
other, creating a continuous cycle
of communication and response.
• This feedback loop is essential in
a therapeutic relationship, where
understanding and rapport
deepen as both parties respond
sensitively to each other’s explicit
reactions.

12. Major
Concepts
Assessment Diagnosis
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.
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.

13. Major
Concepts
Planning Implementation
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.
In the implementation stage, the
nurse begins using the
nursing care plan.

14. Evaluation
Summary: Orlando’s theory emphasizes a
responsive, individualized nursing approach.
Takeaway: By focusing on patient behavior and
validating needs, nurses can deliver more effective
care.

15. Conclusions
Finally, in the evaluation stage, the nurse looks at
the patient’s progress 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.

16. Importance of the Theory in
Nursing Practice
In practice, this theory highlights the importance
of empathetic communication, active listening,
and attunement to the patient’s unspoken cues.
Nurses who understand this process can provide
more individualized and responsive care, fostering
a stronger therapeutic alliance and supporting
better patient outcomes.

17. Thank
you! Juan Paolo Llamas Castro, RN