Ida Jean Orlando’s Theory of the
Deliberative Nursing Process
By Mrs. Rosaline Rachel
Omayal Achi College of Nursing
Introduction on Ida Jean Orlando
She did her Diploma in Nursing in New york
Medical college, later did her B.S and MA (In Mental
Health )
She held positions in Nursing care ,Teaching and
Research
She was the principal investigator in a project “
integration of Mental Health concepts in basic
curriculum (Nursing )
Her finding was released as book (1961) as “Dynamic
Nurse –Patient Relationship: Functions, Process and Principles of
Professional Nursing”
This forms basis for her theory
Further research led to publication of “the Doctrine
and Teaching of the Nursing Process” (1972)
Concepts
Functions of Professional Nursing
Presenting behavior of the patients
Immediate ( internal) response of
the Nurse
Nursing process discipline
Improvement
Deliberative Nursing Process
Orlando’s Nursing process is based
on Individual's action
Meeting patient’s need improves
patient’s behavior
This process can also be used by the
other health care workers
Components of Orlando’s Nursing
process
.
Patient’s
Behavior
Nurse Nurse
Reaction Activity
Patient’s Behavior
It sets the Nursing process in
motion
Irrespective of the significance and
seriousness, patients behavior in
any form makes an application for
help
A patient who cannot full fill his
need feels helpless and insecure
Patient’s Behavior
Non-Verbal
Verbal (Manifested )
•Complaints •Heart Rate
• Request
• Demands •Edema
• Refusal • Motor
activity
•A cry
If the communication is good – better Nurse – patient
relation ship
Nurse Reaction
N It forms the basis to determine how a
u Nurse Acts
r •Perception
s
•Thoughts
e
•Feelings
R These reactions are automatic and
e simultaneous (Secret & Explicit)
a
c •Nurse perception must match with the
patients reaction/ response
t •Perception should be the self assessment
i •Perception must be confirmed by a question
to the patient and the feed back from the
o patient
n
Nurse Activity
Activity - in the form of words or deed to
be to the benefit of the patient
Activity - after the assessment and
interpretation of patient's behavior
Activity can be automatic or instinctive
Deliberative action
Automatic action •Exploring the meaning of
patient’s behavior
•Giving medication
•To relieve patient’s anxiety
•Performing routine by- explaining the
care procedure
Orlando's theory
(Four concepts of Nursing )
(Metaparadigm )
Person
Environment
Health
Nursing
Person
Is human being who exhibits verbal
and non verbal behavior
Has individual abilities to deal with
the situations
Has individual needs to deal with the
situations
Environment
Is not defined
It is a situation between a nurse and the
patient
Any patient’s behavior to be viewed as a
signal of distress
Nursing system in an institution is
defined as environment
• It does not speak about the other
environmental influences on the patient –
nurse activity
Health
Is not defined
Inference can be made as
Health as Sense of comfort
Feeling of adequacy
Feeling of wellbeing
Feeling from mental discomfort
Feeling from physical discomfort
Nursing
A distinct profession
Functions autonomously
Concerns itself with individuals
In real and potential need
• To help a patient
• Uses Nursing process- to relive
sufferings
Nursing
Attempt to relieve patient's discomfort (mental &
Physical)
Attempt to enhance the patient's sense of well
being
To improve patient's self care abilities
Holistically views the patients
Brings dynamic and responsive changes in
patient's situation
Involves continuous exchange of actions and
information
It is triggered by patient’s behavior- which led to nurse
to react
Then Nurse to act & patients to respond/ give feed back
Nursing Process Comparison
Assessment
Nurse Reaction
R Diagnosis (Explored with
e patient)
a
s Outcomes
s Need for help
e Planning patient
s
s Implementation
m
e
n Nurse Action
t
Evaluation
Thank
you
