orlando nursing process theory

1. IDA JEAN
ORLANDO
THEORY
PRESENTED BY
MS LISA CHADHA
F.Y. MSC NURSING
BVCON, PUNE

2. About the Theorist
•Ida Jean Orlando - born in 1926.
•wrote about the nursing process.
•Nursing diploma - New York Medical College
•BSC in public health nursing - St. John's University, NY,
•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.
•Project investigator of a National Institute of Mental
Health grant entitled: Integration of Mental Health
Concepts in a Basic Nursing Curriculum.

3. INTRODUCTION TO THEORYINTRODUCTION TO THEORY
O The role of the nurse is to find out and meetThe role of the nurse is to find out and meet
the patient's immediate need for help.the patient's immediate need for help.
O The patient's presenting behavior may be aThe patient's presenting behavior may be a
appeal for help; however, the help needed mayappeal for help; however, the help needed may
not be what it appears to be.not be what it appears to be.
O Therefore, nurses need to use theirTherefore, nurses need to use their
perception, thoughts about the perception, orperception, thoughts about the perception, or
the feeling engendered from their thoughts tothe feeling engendered from their thoughts to
explore with patients the meaning of theirexplore with patients the meaning of their
behaviorbehavior..
O This process helps nurse find out the natureThis process helps nurse find out the nature
of the distress and what help the patientof the distress and what help the patient
needs.needs.

4. Terms
•Distress is the experience of a patient whose need has
not been met.
•Nursing role is to discover and meet the patient’s
immediate need for help.
•Patient’s behavior may not represent the true need.
•The nurse validates his/her understanding of the
need with the patient.
•Nursing actions directly or indirectly provide for the
patient’s immediate need.

5. •An outcome is a change in the behavior of the
patient indicating either a relief from distress or an
unmet need.
•Observable verbally and nonverbally

6. ASSUMPTIONS
When patients cannot cope with their needs without help,
they become distressed with feelings of helplessness.
•Patients are unique and individual in their responses.
•Nursing deals with people, environment and health

7. •Patient need help in communicating needs, they are
uncomfortable and undecided about dependency needs
•Human beings 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 nurse and patient
•Nurses are concerned with needs that patients cannot
meet on their own

8. CHARACTERISTICS OF THE THEORY
•Orlando's theory interrelate
concepts
•Orlando's theory has a logical nature
•Orlando's theory is simple and
applicable in the daily practice.
•Orlando's theory contribute to the
professional knowledge.
•Orlando's theory is applicable in
clinical practice

9. STRENGTHS
•Use of her theory assures that patient will be treated as
individuals and that they will have active and constant input
into their own care
•Prevents inaccurate diagnosis or ineffective plans because
the nurse has to constantly explore her reactions with the
patient
•Assertion of nursing’s independence as a profession and her
belief that this independence must be based on a sound
theoretical frame work
•Guides the nurse to evaluate her care in terms of objectively
observable patient outcome

13. AssessmentAssessment
O Identifying patients need for help.Identifying patients need for help.
O It includes:It includes:
Perception of clientPerception of client
Thoughts and feelings aboutThoughts and feelings about
perceptionperception

14. Perception of clientPerception of client
O VerbalVerbal- what client says- what client says
O Non verbalNon verbal - moaning, groaning, tone- moaning, groaning, tone
,volume.,volume.
Client activities ,pacing,Client activities ,pacing,
runningrunning
O Physiological manifestations:Physiological manifestations: BP, pulse,BP, pulse,
patterns of urinationpatterns of urination

15. Thoughts and feelings aboutThoughts and feelings about
perceptionperception
O Observation of clients behavior (nurse’sObservation of clients behavior (nurse’s
perception ) gives rise to nurse’s thoughtsperception ) gives rise to nurse’s thoughts
and feelings.and feelings.
O A thought is a cognitive process and feelingA thought is a cognitive process and feeling
is an affective process.is an affective process.
O Thoughts about a client’s behavior areThoughts about a client’s behavior are
merely assumptions which should not guidemerely assumptions which should not guide
nursing actions unless validated by thenursing actions unless validated by the
client.

16. Nursing DiagnosisNursing Diagnosis
O Product of analysisProduct of analysis
O Leads to identification of need forLeads to identification of need for
helphelp..

17. Planning phasePlanning phase
O Writing goals and objectives andWriting goals and objectives and
deciding about appropriate actiondeciding about appropriate action ..

18. Nursing actionNursing action
Two types of nursing actions:Two types of nursing actions:
O Deliberative: The nurse initiates believingDeliberative: The nurse initiates believing
that she will help ascertain or meetthat she will help ascertain or meet
client’s immediate need for help.client’s immediate need for help.
O Automatic: Actions which are not focusedAutomatic: Actions which are not focused
on the clients need but other need suchon the clients need but other need such
as nurse’s or physicians.as nurse’s or physicians.

19. ImplementationImplementation
O Final selection and carrying outFinal selection and carrying out
planned actionplanned action..

20. EvaluationEvaluation
O Nurse need to evaluate the processNurse need to evaluate the process
to know that the action taken by herto know that the action taken by her
is appropriate for the patient or not.is appropriate for the patient or not.

21. Application of theoryApplication of theory
O Mrs Reshma Anil Barisode, a 26 yearMrs Reshma Anil Barisode, a 26 year
old nullipara came to infertility OPDold nullipara came to infertility OPD
with history of 6 years of nonwith history of 6 years of non
consanguineous marriage and noconsanguineous marriage and no
history of contraceptives for thehistory of contraceptives for the
treatment of primary infertility.treatment of primary infertility.

22. Objectives of nursingObjectives of nursing
managementmanagement
O Using Orlando’s nursing theory, theUsing Orlando’s nursing theory, the
following objectives were planned forfollowing objectives were planned for
care:care:
 To assess patient condition by use ofTo assess patient condition by use of
theorytheory
 State perception of clientState perception of client
 Find client’s immediate need for helpFind client’s immediate need for help
 Validate immediate need for help.Validate immediate need for help.

23. Reactions:Reactions:
O Verbal: can I able to concieve? My familyVerbal: can I able to concieve? My family
members keep on blaming me …huge familymembers keep on blaming me …huge family
pressurepressure
O Non verbal: anxious, worried depressedNon verbal: anxious, worried depressed
O No eye to eye contact while answering, onlyNo eye to eye contact while answering, only
nodding of headnodding of head

24. Need for helpNeed for help
O Anxiety r/t chances ofAnxiety r/t chances of
conceptionconception
O Knowledge deficit regardingKnowledge deficit regarding
assisted reproductive techniquesassisted reproductive techniques
and treatment of infertilityand treatment of infertility..

25. Nurse actionNurse action
O Identify positive coping behavior andIdentify positive coping behavior and
reinforce them.reinforce them.
O Give positive reinforcement.Give positive reinforcement.
O Reassure the patient.Reassure the patient.
O Clarify the doubts of patient.Clarify the doubts of patient.
O Provide explanation in simpleProvide explanation in simple
understanding terms to patient.understanding terms to patient.
O Involve both couple for counselingInvolve both couple for counseling
O Arrange special meeting with patientsArrange special meeting with patients
who had positive results from infertilitywho had positive results from infertility
treatmenttreatment

26. O Provide psychological support to theProvide psychological support to the
patient.patient.
O Give realistic opinion.Give realistic opinion.
O Encourage patient to take herEncourage patient to take her
decision independently.decision independently.

27. Evaluation
O Evaluate the patient level of anxiety and
stress after clarifying the doubts.
O Re evaluate the patient in next visit

28. Limitations
O Highly interactive nursing theory makes it
hard to include highly technical and
physical care that nurses give in certain
situation.
O Long term care and planning are not
applicable.

29. Conclusion
O Orlando’s nursing theory stresses the
reciprocal relationship between patient
and nurse and finding out and meeting the
patient’s immediate need for help.
O Orlando may have facilitated the
development of nurses as logical thinkers.
O 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

30. Bibliography
George, J.B. (2011). Nursing theories: The base for
professional nursing practice (6th ed.). Philadelphia:
Pearson.
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), 463-46