Nursing Career of Ida Jean Orlando

Ida Jean Orland was a first-generation American of Italian decent, born 1926. She received her diploma in nursing at New York Medical College in 1947, Bachelor of Science in Public health from St. Johns University in Brooklyn, New York in 1951 and her Master of Arts Degree in Mental Health Nursing from Columbia University. Orlando was an associate Professor at Yale School of Nursing, and while there she served as the Director of the Graduate Program in Mental Health Psychiatric Nursing.

She was the project investigator of a National Institute of Mental Health grant entitled Integration of Mental Health Concepts in Basic Nursing Curriculum.

In 1961, Orlando published her theory, The Dynamic Nurse- Patient Relationship and in 1972 The Discipline and Teaching of Nursing Process. She has served as a board member of Harvard Community Health Plan.

Her theory is explanatory and straightforward, she believes that the role of the nurse is to find out and meet the patients immediate need for help. She describes nursing as it is, the nurse is responsible for gathering all the information directly from the patient and making decisions based on this information.

We as nurses are the Care Plan that we develop, however, we must always be aware that situations change and we must be able to adapt to the change immediately and come up with other ways of treatment without allowing it to interfere with the quality of care that the patient is receiving.

She directly states definition of nursing that can summarize the theory provided by Ida Jean Orlando.

“All patients behavior can be a cry for help, both verbal and non-verbal. It is up to the nurse to interpret their behavior and determine the needs of the patient”.

Nursing differs from medicine according to this theory because based on Orlando’s theory; everything we need to know to provide the best care to the patient is received directly from the patient. Usually with medicine, we use textbook information and trial and error, however, according to the theory of Orlando, it is the nurse’s job to collect all the information directly from the patient and interpret it on our own to provide quality care.

Orlando’s theory definitely relies on the content/knowledge of nursing. It is clearly stated that it is the nurse’s job to use their perception, thoughts about the perception or the feeling engendered from their thought to explore with patients the meaning of their behavior. This process helps the nurses find out the nature of the distress and what help the patient needs. It is the knowledge of the nurse that is being relied on for the best care.

Ida Jean Orlando theory Deliberative Nursing Process was developed in the late 1950’s from an observation she witnessed involving nurse and patient interaction. Orlando’s Deliberative Nursing Process is based on and involves the patient’s behavior and nurse’s reaction. In most cases the patient will exhibit certain behaviors both verbal and nonverbal as a plea for help.

The role of the nurse is to find out and meet the patient’s immediate need for help. The four major concepts of the metaparadigm, the person, environment, health and nursing collectively are one with Orlando’s Theory Stages Assessment, diagnosis, implementation, and the goal. Together they provide the nurse with the data needed to accurately assess and serve the patient.

Ida Jean Orlando uses an assessment as a tool when collecting subjective and objective data in relation to the person/patient hence allowing the nurse to notably assess the disease process. The assessment stage enhances the nurse ability to analyze and interpret the behavior and determine the needs of the patient. The assessment is done without reason. The health of the individual is closely evaluated to determine the patient needs.

During the diagnosis stage the diagnosis can be confirmed using links to classify the characteristics, related factors, and risk factors found in the person/patients assessment .The behavior of the person as well as the disease is well thought-out in this process. The nurse then uses clinical judgment regarding health dilemmas, tackling each one individually.

The environment is an important part of this process. It influences the individuals external as well as the internal aspect of life and well-being. After gathering the diagnosis, interventions can be implemented to help accomplish the goals. In this stage we put everything into action allowing us to carry out the care plan that was created using Orlando’s theory. The nurse is now able to assess whether the person have achieved their goals. Often times the complete set of goals are not met, however Orlando’s theory is adjustable.

Orlando’s theory is universal allowing the nurse to be flexible. It’s also easily adapted when providing service to different person/patients with different diagnosis. With the mutual aid of the person/patient and the deliberate actions of the nurse, the goal put in place by the nurse is attained. Every deed of a nurse has significance.

Ida Jean Orlando Theory focuses on the Dynamic Nurse-Patient relationship. Even though the theory focuses on the communication between the nurse-patient relationships, it makes it clear that the nurse is to assume that the patient’s communication is a plea for help and must be taken as is. This dictates that the primary focus is on the dynamic relationship but does give a secondary focus on the nurse as the modifiable component.

The theory in itself is clear and simple. It describes the interaction between the nurse and patient in a certain time and place and follows a sequence until the patient’s problem is resolved. The sequencing of events results in its clarity. All of the primary duties of a nurse involve interacting with the patient, meaning that Ida Jean Orlando’s Dynamic Nurse-Patient Relationship Theory can applied in almost any setting. Whenever a patient interacts with nurse, the theoretical model can be applied.

It does not need any special tools nor does it require a specific setting. It is derived from the patient, as a whole, interacting with a nurse as a whole. It stages the interaction to happen in a specific sequence. It places special emphasis on the nurses’ role on perceiving the patient behavior and interpreting it beyond its superficial affect. It deals with the immediate context and attempts to find the most complete resolution of the situation. It theory is built on the examination of over 2000 Nurse-Patient interactions.

Her theory has led to deliberative consequences for nurses. It sets principles that have become ingrained in nursing education. It is the principle set on how a nurse’s role should be active rather than passive in a nurse’s interaction with a patient. It is set to give structure to a nurse’s role of performing ongoing assessments with validated results, to treat a person as a whole with feedback as reassurances of her actions and to achieve role and problem clarity so that the patient understands his or her own problems that may have been hidden from his or her own perception.

Ida Jean Orlando’s theoretical is ingrained in all aspects of nursing interaction. It has also been codified in some fields as a standard of practice. When giving medication to a patient, we nurses must explain the medication, its expected effect, purpose, and its possible side effects. It is then standard practice to make note of its actual effect and react to that effect. It is logical, active, and directly follows the model. It is most important with pain medication.

The patient may over exaggerate, misplace direct cause, or maybe misinterpret the pain. To the patient, pain is simply pain. It is the nurse’s role to accept the patient’s complaint and internally analyze it. Using the nursing discipline, decipher the superficial plea in order to see any underlying cause, react appropriately until the underlying cause is exposed and treated. Her theory serves as the basis for any interaction with a patient, arguably, for every health professional.

As an emergency room nurse, we are encouraged to process patients efficiently and with haste. Patient interaction is, however, valued for its quality. We are expected to treat the patient’s most immediate concerns while looking for underlying agitators so that treatment can be administered efficiently. Unfortunately, in a fast pace environment, there may be no time to interpret and internally analyze a patient’s behavior or get their reaction to a certain treatment.

Stabilizing and to processing a patient with an unfortunate consequence of diminished patient interaction quality as a frequent casualty. Without Orlando’s theoretic model, patients become numbers, treated by their symptoms rather than being treated like a person, without it we would end up dehumanizing patients.


  1. Alligood, M. R., & Tomey, A. M. (2010). Nursing Theorist and Their Work seventh edition. Maryland Heights, MO: Mosby. Ida Jean Orlando- Nursing theorist. (2011). Retrieved October 12, 2013, from Nursing- website: Nursing theories a companion to nursing theories and models. (2013, September 9). Retrieved October 6, 2013, from Current nursing website: Orlando, I. J. (1972).
  2. The discipline and teaching of nursing process: An evaluative study. New York: G. P Putnam. Orlando, I. J. (1990). The dynamic nurse-patient relationship: Function, process, and principles. New York: National League of Nursing. Orlando’s Nursing Process Theory. (2013, September 9). Retrieved October 12, 2013, from website: Parker, M. E. (2005). Nursing Theories and Nursing Practice second edition. Philadelphia, PA: F.A. Davis Company.
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