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 nurses responsibility to see that the
patients 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 patients 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 Orlandos 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
patients 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 patients behavior is meaningful
Patients are able and willing to communicate verbally (and
non-verbally when unable to communicate verbally)

Assumptions about nurses:

The nurses reaction to each patient is unique
Nurses should not add to the patients distress
The nurses mind is the major toll for helping patients
The nurses 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 patients distress.

-providing direct assistance to individuals in whatever
setting for the purpose of avoiding, relieving, diminishing,
or curing the persons 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
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