Ida Jean Orlando(Pelletier) Nursing Process Theory

1926- Ida Jean Orlando, a first-generation American of Italian descent was born.

1947- She received her nursing diploma from New York Medical College, Lower Fifth Avenue Hospital, and School of Nursing.

1951- She received a BS in public health nursing from St. John's University, Brooklyn, New York.

1954- She finished MA in mental health nursing from Teachers College, Columbia University, New York.

HISTORICAL CONTEXT OF THE THEORY

Orlando was an Associate Professor at Yale School of Nursing where she was Director of the Graduate Program in Mental Health Psychiatric Nursing. While at Yale she was project investigator of a National Institute of Mental Health grant entitled: Integration of Mental Health Concepts in a Basic Nursing Curriculum. It was from this research that Orlando developed her theory which was published in her 1961 book, The Dynamic Nurse-Patient Relationship.

She furthered the development of her theory when at McLean Hospital in Belmont, MA as Director of a Research Project: Two Systems of Nursing in a Psychiatric Hospital. The results of this research are contained in her 1972 book titled: The Discipline and Teaching of Nursing Processs.

She is married to Robert Pelletier and lives in the Boston area.

She passed away on November 28, 2007.

NURSES RESPONSIBILITY

Whatever help the patient may require for his needs to be met. It is the nurse’s responsibility to see that “the patient’s needs for help are met, either directly by her own activity or indirectly by calling in the help of others.”

NEED

Situationally defined as a requirement of the patient which, if supplied, relieves or diminishes his immediate distressor and improve his immediate sense of adequacy or well-being.

MAJOR CONCEPTS AND DEFINITIONS

PRESENTING BEHAVIOR OF A PATIENT

Any observable verbal or nonverbal behavior.

IMMEDIATE REACTIONS

Include both the nurse and patient’s individual perceptions, thoughts and feelings.

NURSING PROCESS DISCIPLINE

Includes the nurse communicating to the patient his or her own immediate reaction, clearly identifying that the item expressed belongs to the nurse, and then asking for validation or correction.

Nursing process discipline was called deliberative nursing process in Orlando’s first book, The Dynamic Nurse-Patient Relationship: Function, Process and Principles of Professional Nursing Practice, and also called nursing process and process discipline.

IMPROVEMENT

“Means to grow better, to turn to profit, to use advantage”

PURPOSE OF NURSING

Supply the help a patient requires in order for his needs to be met.

 

AUTOMATIC NURSING ACTION

Those nursing actions decided upon for reasons other than the patient’s immediate need.

 

DELIBERATIVE NURSING ACTION

Those actions decided upon after ascertaining a need and then meeting this need.

Assumptions about nursing:

“Nursing is a distinct profession separate from other discipline”

“Professional nursing has a distinct function and product/outcome”

“There is difference between lay and professional nursing”

“Nursing is aligned with medicine”

MAJOR ASSUMPTIONS

Assumptions about patients:

“Patients’ needs for help are unique”

“Patients have an initial ability to communicate their needs for help”

“When patients cannot meet their own needs they become distressed”

“The patient’s behavior is meaningful”

“Patients are able and willing to communicate verbally (and non-verbally when unable to communicate verbally)”

 

Assumptions about nurses:

 

“The nurse’s reaction to each patient is unique”

“Nurses should not add to the patient’s distress”

“The nurse’s mind is the major toll for helping patients”

“The nurse’s use of automatic responses prevents the responsibility of nursing from being fulfilled”

“Nurses practice is improved through self-reflection”

Assumptions about the nurse-patient situation:

 

“The nurse-patient situation is a dynamic whole”

“The phenomenon of the nurse-patient encounter represents a major source of nursing knowledge”

Nursing

 

-it is a distinct profession that functions autonomously.

 

-nurses should help relieve physical or mental discomfort and should not add to the patient’s distress.

 

-providing direct assistance to individuals in whatever setting for the purpose of avoiding, relieving, diminishing, or curing the person’s sense of helplessness.

METAPARADIGM

Person

 

-persons behave verbally and nonverbally.

 

-people are sometimes able to meet their own needs for help in some situations; however they become distressed when they are unable to do so.

 

-each patient is unique and individual in his or her response

Health

 

-Orlando, does not define health, but she assumes that freedom from mental or physical discomfort and feelings of adequacy and well-being (fulfilled needs) contribute to health.

Environment

 

-she assumes that a nursing situation occurs when there is a nurse-patient contact and that both nurse and patient perceive, think, feel and act in the immediate situation.

 

-any aspect of the environment, even though it is designed for therapeutic and helpful purposes, can cause the patient to become distressed.

THE NURSING PROCESS

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

CHARACTERISTICS OF THE THEORY

THANK YOU FOR LISTENING