Ida Jean Orlando, an American of Italian descent was born in 1926. She received her nursing diploma from New York Medical College, Lower Fifth Avenue Hospital, School of Nursing, her BS in nursing from St. John’s University, Brooklyn, NY, and her MA in mental health nursing from Teachers College, Columbia University, New York. 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 concept which was published in her 1961 book, The Dynamic Nurse-Patient Relationship. She furthered the development of her theoretical concept 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 System.
Orlando held various positions in the Boston area, was a board member of Harvard Community Health Plan, and served as both a national and worldwide consultant. She is a frequent lecturer and conducted numerous seminars on nursing mechanisms. Orlando’s theory was developed in the late 1950s from observations she recorded between a nurse and patient. Despite her efforts, she was only able to categorize the records as “good” or “bad” nursing. It then dawned on her that both the formulations for “good” and “bad” nursing were contained in the records.
The role of the nurse is to find out and meet the patient’s immediate need for help. From these observations she formulated the deliberative nursing process. The Metaparadigm Concepts include: Human/Person – An individual in need Health – No restricted definition Society/Environment – No restricted definition Nursing – A distinctive profession “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”
The patient’s presenting behavior may be a plea for help, however, the help needed may not be what it shows to be. Therefore, nurses need to use their perception, thoughts about the perception, or the feeling engendered from their perceptions to explore with patients the meaning of their behavior. This process helps the nurse find out the nature of the distress and what help the patient requirements. Orlando’s theory remains one the of the most effective practice theories available. The use of her theory helps keeps the nurse’s focus on the patient.
The strength of the theory is that it is clear, concise, and easier to use. While providing the overall framework for nursing, the use of her theory does not exclude nurses from making use of other theories while caring for the patient. When using Orlando’s theory, the nurse identifies her own perceptions, thoughts, and feelings about the patient’s behaviors, then confirms them with the patient. She then formulates deliberative nursing actions to meet direct patient needs. As a final step, the nurse verifies whether or not she met the patient’s needs and decreased his distress, and determines if further action is required.
The theory merges competent nursing practice and customer satisfaction. A question such as how can one be helped? This clarifies the nurse’s assumptions about patient needs and minimizes resource maltreatment. The nurse concentrates on relieving patient distress. Interventions address the patient’s requirements from the patient’s perspective. Orlando’s patient-focused theory gives nurses a lucid, consistent approach. It’s interpersonal, straightforward, and applicable to both simple and complex situations.
Nurses can apply the theory independently or as an entire department. When nurse leaders initiate the theory’s use in their departments, nurses are given a tool to satisfy patients and themselves. This, in turn, satisfies organizational and staff by providing retention goals. Because nurses can use the method even with time, energy, and financial constraints, they can minimize frustration associated with “doing more with less. ” Also, nurses feel rewarded when they can rediscover their unique contribution to patient care-meeting the patient’s immediate needs.
Cost-effective interventions like using this theory add value to nursing assistance at a time when it’s difficult to increase time with patients. Nurses can maximize their time, creating “magic moments” with patients and providing the best intercession. They can meet immediate patient needs, reduce patient distress, and feel empowered and contended. In all, these concepts by Orlando form the basis for providing nurses an opportunity to understand their relationship with their patients in a better way, so as to give patient care a new and whole hearted meaning.