Ida Jean Orlando Nursing Process Theory

Ida Jean Orlando was born in 1926, America, first generation Italian decent. She got her nursing qualification from New York Medical College, graduation from St. John’s University and MA in mental health nursing from University of Columbia, Teachers College. Ida Jean Orlando was a professor and director of Mental Health Psychiatric Nursing graduate program at Yale School. She was also entitled “Integration of Mental Health Concepts in a Basic Nursing Curriculum” at Yale School. Orlando developed her theory for nursing which was available in a form of a book in 1961 namely “The Dynamic Nurse-Patient Relationship.” Moreover, Orlando published another book in which the result of her theories were available namely “The Discipline and Teaching of Nursing Process.” Ida Jean Orlando was also a board member of Harvard Community Health Plan and worked as a consultant both nationally and internationally. (Nursing Theories, July 20, 2008). Orlando is one of the first theorists for nursing who wrote about the process regarding nursing which was based on her own research. Her first book is based upon interaction between patient and nurse, the utilization of nursing process to generate optimistic results and perception validation. Her main focus was to explain the purpose and function of nursing in depth (J Gerontol, July 2002). Ida Jean Orlando was married to Robert Pelletier and was settled in Boston. She was expired on November 28, 2007. (Nursing Theories, July 20, 2008). Key concept of Ida Jean Orlando nursing theories are nurse reaction, patient behavior and nurse action.

Following is the explanation of each theory and the way I will practice it in my nursing career:

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First theory consists of the nursing process that has to be motioned by the behavior of the patient. In this theory, behavior of the patient either verbal which includes usage of language and non-verbal which includes activities such as motor activity, communication that is non verbal and physiological warning signs, should be measured by the expression for the needs to be confirmed and need for a help, no matter how unimportant it is. If a nurse does not give importance to the patient behavior then a major dilemma has given a rise to the failure of nurse and patient relationship. Time by time, it becomes even more difficult to establish understanding with the patient once behavior of the patient is not verified properly. In this theory effective communication with the patient is the vital achievement for a nurse which leads to a cooperation in achieving a proper health care for the patient. In short, when a patient needs help and cannot resolve it without the help of nurse.

Second theory includes patient behavior that motivates reaction of the nurse. According to this theory, initial period of relationship with nurse and patient begins. Over here, it is essential to assess patient behavior properly by using the nurse reaction steps. By these steps, nurse will receive positive response from the patient.

Step One – the nurse distinguish patient behavior through every senses

Step Two – automatic thoughts through the observation

Step Three – generating automatic feeling due to the arising thought

Step Four – sharing reaction with the patient to ensure whether the observation made by the nurse is correct or not.

Step Five – nurse intentionally deliberates regarding the reactions and input of the patient in order to generate a practical action that is based on the measurement of mind rather than automatic reactions.

Over here, Ida Jean Orlando wants to explain about assessing patient with his or her help makes even more easy to confirm patient’s behavior.

Third and the last theory consist of two specific ways to be implemented in nurse action. During the care provided by nurse action, it can be done through either deliberative or automatic reaction process.

Deliberative Reaction

Deliberative reaction is also known as a disciplined professional response. In this process, overall nurse actions are meant to assist the patient and they ought to be considered in a deliberative way. Although, it is necessary to identify correct actions of nurse’s consideration to gain mutual help amid patient’s health and nurse. Following are the conditions that should be considered in this process:

1)      Nurse exploring the measurement of the action among the patient and the significance to meet patient’s need.

2)      Correct identification of patient needs by the nurse reaction through deliberative actions.

3)      After compelling the process, nurse leads to validate the effectiveness of immediate action.

4)      When the action is taken place, nurse is free of incentives that are not related to the patient needs.

Automatic Reactions

Automatic reaction comes under the category of nursing behavior that is performed by the nurse to fulfill an order rather than helping a patient in need. Such as if a nurse gives a sleeping pill every day to the patient as it is ordered by the doctor, with no discussion about the need of this medicine for the patient than this is a sign of automatic reaction. To know the reason for giving any medicine to the patient is essential for the nurse. Following medical orders is an automatic reaction other than giving priority to patient’s need.

Apart from the three theories mentioned above, Ida Jean Orlando also introduced few concepts of nursing known as “METAPARADIGM” concepts which include health, person or human, environment and nursing.


According to Orlando, nursing situation takes place when there’s a contact amid nurse and patient where both of them think, perceive, sense and take actions immediately. Over here, in any kind of environment, this can cause distressfulness for the patient though it is planned for the purpose of help.


Health concept over here is mentioned as devoid of any physical or emotional stress and judgment of comfort contributes to be in a healthy state. Orlando moreover imagined that independency from physical or mental uneasiness and sense of adequacy also contributes to health.

Person or Human

Over here Orlando meant when an individual is in need specially individuals who behave nonverbally or verbally. Theory over here is that when individuals at times are able to assemble their needs but not always.


As quoted by the second book, “Providing direct assistance to individuals in whatever setting they are found for he purpose of avoiding, relieving, diminishing, or curing the individual’s sense of helplessness” (Orlando, 1972). Nursing over here is all about professionalism therefore when a nurse finds out the problem of the patient and helps him out immediately. (Nursing Theories, July 20, 2008).


Nursing Theories (2008), Understanding Ida Jean Orlando-Pelletier’s Dynamic Nurse-Patient Relationship, Accessed on November 10, 2008 from

J Gerontol (2002), Orlando’s Deliberative Nursing Process Theory: A Practice Application in an Extended Care Facility, volume no. 28(7), Accessed on November 10, 2008 from


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Ida Jean Orlando Nursing Process Theory. (2016, Oct 15). Retrieved from