By J. B. Gregory
Ida Jean Orlando was a nursing theorist who is credited with the nursing process theory. She used her own research to come up with this theory that the nurse’s role is to “find out and meet the patient’s immediate need for help” (Current Nursing). This may seem like a very basic concept for nurses, but the theory goes more into depth of how to go about performing this role. Her theory has helped shape nursing and she is considered one of the important nursing theorists of our time.
Ida Jean Orlando was a first generation American with Italian heritage born in 1926. She earned a nursing diploma in 1947, a bachelor of science in public health nursing in 1951, and a master of arts in mental health nursing in 1954. During her nursing career, she held positions as Associate Professor of Nursing, Director of the Graduate Program in Mental Health Psychiatric Nursing, Clinical Nursing Consultant, director of a research project, and Assistant Director of Nursing for Education and Research. She held these positions at a variety of nursing schools and hospitals in the New England area, and she also worked as a national and international consultant and speaker for nursing. She died in 2007 at the age of 81.
Orlando developed her nursing process theory in the late 1950s while she was the principal investigator at the Yale School of Nursing Project. Her goal was to “contribute to concerns about (a) the nurse-patient relationship, (b) the nurse’s professional role and identity, and (c) knowledge development distinct to nursing” (Schmieding, 1993, p.3). For three years she personally observed over 2,000 nurse-patient interactions. She took notes and classified each interaction as either “good” or “bad” nursing. After reviewing her notes of the “good” nursing interactions, she found that these nurses “found out, from the patient’s viewpoint, what was happening to the patient and identified the patient’s distress. The nurse also determined why the patient was distressed and recognized that the patient was unable to relieve the distress without the nurse’s help” (Schmieding, 1993, p. 6). One of the main themes of her theory was that the nurse-patient interaction was a key factor, and the patient’s participation in the process was essential.
From her research and analysis, Orlando came up with a nursing process with five steps: assessment, diagnosis, planning, implementation, and evaluation. Assessment is figuring out what the patient needs to be helped and is retrieved from the patient’s behavior. Diagnosis is the identification of what is needed for that help. Planning is setting goals to relieve the patient’s distress. Implementation is the carrying out of the planned goals. And evaluation is determining if the need is met and how effective it was.
Orlando’s theory was formulated in a time when the exact role of a nurse was not written in stone, and nurses were often unsure of exactly what objectives they should accomplish. Because of this lack of a clear function, it was hard to evaluate whether a nurse was doing a good or bad job. It also meant that knowing what to teach nursing students was not clear cut. But because Orlando identified the key points of what made an effective nurse and laid out a more defined plan of the nurse’s role, she made a huge impact on the nursing world. “Orlando’s theory radically shifted the nurse’s focus from the medical diagnosis and automatic activities, decided upon without patient participation, to the patient’s immediate experience and whether the patient was helped by the nurse’s action” (Schmieding, 1993, p. 3).
Orlando can be credited with giving nurses a larger role in the wellbeing of patients. Before her theory was put to work in hospitals, nurses were often just focused on going through the processes of caring for a “disease or institutional demands,” (George, 1990, p. 162), but afterwards, the interaction between nurses and patients was considered very important. This meant that a nurse’s intuition came into play much more and nurses were seen as a much larger player in the progression of a patient. It also helped focus nurses in a much more immediate oriented idea of practice. Rather than just caring for the disease or injury of a patient, they were assessing the immediate needs of the patient, which often leads to a faster or better recovery.
I can’t honestly say that I chose Ida Jean Orlando as my nursing theorist because her theory fascinated me. Her name was just the first name on the list that hadn’t been taken yet, so I volunteered to take her. I had never heard of her until I looked at the list, but I think that is a good thing. I will probably learn a lot about Florence Nightingale, Virginia Henderson, and other nursing theorists whether I want to or not while studying nursing, so I kind of enjoyed the idea of taking the time to learn about a lesser known nursing theorist, who I probably wouldn’t have learned much about otherwise. Finding good, detailed information on her was difficult on the internet. I was only able to find the highlights of her theory and brief biographies there, but the library had several good books that were very thorough in detailing her life, her theory, and how she influenced nursing.
I think Orlando’s nursing process theory made a big difference though in the nursing world. The more I learned about her theory, the more I realized how difficult it would be to be a nurse in a world that had not changed because of her research and discoveries. A nurse, who knows his or her role and how to evaluate whether or not they are fulfilling that role, is going to do a much better job than a nurse who doesn’t even know what their job is exactly and whether they are accomplishing their goals. I also feel like I would not want to be a nurse if my job was to work like a robot that hands out medications, checks on patients, and completes tasks assigned by doctors. But because of Orlando, nurses were given much more cause to use their experience and intuition to meet the needs of patients.
A little over a year before she died, Orlando was recognized as a “Nursing Living Legend” by the Massachusetts Registered Nurse Association. After becoming well-educated, researching over 2,000 nurse-patient interactions and coming up with a theory that changed nursing, I think she was very deserving of the honor.
Schmieding, N. J. (1993). Ida Jean Orlando: A Nursing Process Theory. Newbury Park, CA: Sage Publications.
George, J. B. (1990). Nursing Theories: The Base for Professional Nursing Practice (3rd ed.). Norwalk, CT: Appleton & Lance.
Tyra, P. A. (2008). In Memoriam: Ida Jean Orlando Pelletier. Journal of the American Psychiatric Nurses Association, 14. doi: 10.1177/1078390308321092
Current Nursing (2011, February 11). Orlando’s Nursing Process Theory. Retrieved from http://currentnursing.com/nursing_theory