Ida Jean Orlando-Pelletier (August 12, 1926 – November 28, 2007) was an internationally known psychiatric health nurse, theorist and researcher who developed the “Deliberative Nursing Process Theory.” Her theory allows nurses to create an effective nursing care plan that can also be easily adapted when and if any complications arise with the patient.
Orlando was a first generation Irish American born on August 12, 1926. She dedicated her life studying nursing and graduated in 1947 and received a Bachelor of Science degree in public health nursing in 1951. In 1954, she completed her Master of Arts in Mental Health consultation. While studying she also worked intermittently and sometimes concurrently as a staff nurse in OB, MS, ER; as a supervisor in a general hospital, and as an assistant director and a teacher of several courses. And in 1961, she was married to Robert Pelletier and lived in the Boston area.
As for being a respectable and credible role-model, Orlando was well educated with many advanced degrees in nursing.
In 1947, she received a diploma in nursing from the Flower Fifth Avenue Hospital School of Nursing in New York. In 1951, she received a Bachelor of Science degree in public health nursing from St. John’s University in Brooklyn, New York. And in 1954, Orlando received her Master of Arts degree in mental health consultation from Teachers College, Columbia University.
Career and Appointments
Orlando had a diverse career, working as a practitioner, consultant, researcher, and educator in nursing. Orlando devoted her life to mental health and psychiatric nursing, working as a clinical nurse and researcher.
After receiving her master’s degree in 1954, Orlando went to the Yale University School of Nursing in New Haven, Connecticut as an associate professor of mental health and psychiatric nursing for eight years. She was awarded a federal grant and became a research associate and the principal project investigator of a National Institute of Mental health Institute of the United States Public Health Service’s grant entitled “Integration of Mental Health Concepts in a Basic Curriculum.” The project sought to identify those factors relevant to the integration of psychiatric-mental health principles into the nursing curriculum.
During 1958-1961, Orlando, as an associate professor and the director of the graduate program in mental health and psychiatric nursing at Yale University, used her proposed conceptual nursing model as the foundation for the curriculum of the program. From 1962-1972, Orlando served as a clinical nurse consultant at Mclean Hospital in Belmont, Massachusetts. In this position, she studied the interactions of nurses with clients, other nurses and other staff members and how these interactions affected the process of the nurse’s help to clients. Orlando convinced the administration that an educational program for nurses was needed, whereupon Mclean Hospital initiated an educational program based on her nursing model.
From 1972 to 1984, she also served on the board of the Harvard Community Health Plan in Boston, Massachusetts.
In 1981, Orlando became an educator at Boston University School of Nursing and held administrative positions from 1984 to 1987 at Metropolitan State Hospital in Waltham, Massachusetts. In September 1987, she became the Assistant director of Nursing for Education and Research at the said institution. She was also a project consultant for the Mental Health Project for Associate Degree Faculties created by the New England Board of Higher Education. Finally in 1992, Orlando retired and received the Nursing Living Legend award by the Massachusetts Registered Nurse Association.
Deliberative Nursing Process Theory
Main Article: Ida Jean Orlando’s Deliberative Nursing Process Theory
Orlando developed her theory from a study conducted at the Yale University School of Nursing, integrating mental health concepts into a basic nursing curriculum. She proposed that “patients have their own meanings and interpretations of situations and therefore nurses must validate their inferences and analyses with patients before drawing conclusions.”
The theory was published in The Dynamic Nurse-Patient Relationship: Function, Process, and Principles (NLN Classics in Nursing Theory) in 1961. Her book purposed a contribution to concern about the nurse-patient relationship, the nurse’s professional role and identity, and the knowledge development distinct to nursing.
Orlando’s nursing theory stresses the reciprocal relationship between patient and nurse. What the nurse and the patient say and do affects them both. She views the professional function of nursing as finding out and meeting the patient’s immediate need for help.
She also described her model as revolving around the following five major interrelated concepts: function of professional nursing, presenting behavior, immediate reaction, nursing process discipline, and improvement. The function of professional nursing is the organizing principle. Presenting behavior is the patient’s problematic situation. The immediate reaction is the internal response. The nursing process discipline is the investigation into the patient’s needs. And lastly, improvement is the resolution to the patient’s situation.
The Deliberative Nursing Process has five stages: assessment, diagnosis, planning, implementation, and evaluation. Nurses use the standard nursing process in Orlando’s Nursing Process Discipline Theory to produce positive outcomes or patient improvement. Orlando’s key focus was the definition of the function of nursing. The model provides a framework for nursing, but the use of her theory does not exclude nurses from using other nursing theories while caring for patients.
After working as a researcher, she wrote a book on her findings from Yale, entitled “The Dynamic Nurse-Patient Relationship: Function, Process, and Principles.” Her book was published in 1961. A year later, she also continued her research studies published her second book “The Discipline and Teaching of Nursing Process” in 1972.
Awards and Honors
Orlando retired from nursing in 1992. After becoming well-educated, researching over 2,000 nurse-patient interactions, and coming up with a theory that changed nursing, she was recognized as a “Nursing Living Legend” by the Massachusetts Registered Nurse Association.
Orlando died on November 28, 2007 at the age of 81.
- Ida Jean Orlando: A Nursing Process Theory (Notes on Nursing Theories)
- Nursing Theorists and Their Work, 8th Edition
- George, J.B. (2011). Nursing theories: The base for professional nursing practice (6th ed.). Philadelphia: Pearson.
- Potter, P.A., & Perry, A.G. (2012). Fundamentals of nursing (8th ed.). St. Louis, MO: Mosby Elsevier.
- Schmieding, N. (1990). An integrative nursing theoretical framework. Journal of Advanced. Nursing, 15(4), 463-467.