Ida Jean Orlando

Nurse

• Born: August 12, 1926
• Birthplace: New York
• Died: November 28, 2007
• Place of death: New York

Also known as: Ida Jean Orlando-Pelletier

Education: New York Medical College (Flower Fifth Avenue Hospital School of Nursing); St. John's University; Columbia University Teachers College

Significance: Ida Jean Orlando set the standard for effective nursing practices with her theories on the nursing process in the 1960s and 1970s. She spent many years observing thousands of nurse-patient relationships to formulate more successful nursing systems. Orlando's methods found extensive support within the medical community and are still used in modern nursing education.

Background

Ida Jean Orlando was born on August 12, 1926, in New York. Her parents were Italian immigrants, and she grew up during the Great Depression (1929–1939). Orlando began her nursing education at the New York Medical College School of Nursing, earning her nursing diploma in 1947. She then earned a bachelor's degree in public health nursing in 1951 from St. John's University. Orlando continued her education at Columbia University Teachers College, receiving her master's degree in mental health consultation in 1954. Throughout her years of higher education, Orlando held an array of jobs in the nursing field in areas including obstetrics, medicine, and emergency room nursing. After earning her master's, she took a job as a teacher at the Yale School of Nursing in Connecticut.

During the eight years she spent at Yale, she also worked as a research associate and principal investigator for a federal project entitled Integrations of Mental Health Concepts in a Basic Curriculum. The project called for Orlando to collect data from observing students' interaction with patients and members of educational and health care teams. She reported her findings in her first book, The Dynamic Nurse-Patient Relationship: Function, Process, and Principles (1961). The book established what became known as Orlando's nursing process theory.

Life's Work

Orlando's nursing practice and research-based theory blends nursing practices, psychiatric mental health nursing, and nursing education. The theory is based on a mutual nurse-patient relationship that acknowledges how the actions of one affect the other. Orlando stressed the importance of patient participation during nurse questioning. She also outlined a detailed strategy to ensure the most accurate calculations resulted from a nurse's inquiry.

Orlando's nursing process theory can be broken down into three concepts: patient behavior, nurse reaction, and nurse action. In terms of patient behavior, nurses must take into account the patient's verbal and nonverbal behavior when assessing a situation. A nurse's capacity to understand a patient's ability to communicate what is wrong is critical to an effective resolution of the issue. The nurse's reactions and actions are designed around this understanding. A nurse's reaction marks the beginning of the nursing process and consists of a series of steps that lead to an action. First, the nurse observes the patient's behavior and shares his or her thoughts and feelings about the observations with the patient. The patient will either confirm or deny the point of view, at which point the nurse must weigh his or her personal opinion with the patient's input. This focus on mindfulness is meant to ensure the best possible reaction to a situation and produce professional, deliberative action rather than automatic, impulsive action. Nurse actions must be dictated by patient need and not by medical orders. According to Orlando, professional nursing actions are designed to correctly identify the best way to help a patient independent from the input of physicians and other health care providers. Such actions must take into account how the interaction between patient and nurse can affect each other's perceptions, thoughts, and feelings. Correct action can then be verified as effective or ineffective immediately after being implemented.

Orlando spent the next decade honing her theory, which quickly gained popularity within the medical community. The National Institute of Mental Health provided Orlando with funding to develop improved educational methods that would teach nurses how to improve their interpersonal skills when dealing with patients. Orlando later worked as a clinical nurse for the McLean Hospital in Belmont, Massachusetts, where she took advantage of her surroundings to further her studies in nursing practice. She studied the interactions nurses had with patients, hospital staff members, and other nurses. Her observations convinced her that the hospital was in need of a nursing education program. She later established an educational program and nursing service department for McLean, which utilized her nursing practice theory in its daily functions.

The program at McLean helped Orlando conceive her next book, The Discipline and Teaching of Nursing Process (1972). The book redefined parts of her original theory. Her writings continued to stress the importance of the nurse-patient relationship. Orlando served on the board of Harvard Community Health Plan in Boston, Massachusetts, throughout the 1970s and 1980s. She also began teaching at Boston University School of Nursing in 1981. Orlando held various administrative positions at the Metropolitan State Hospital in Waltham, Massachusetts, in the late 1980s before being named assistant director of the hospital's Nursing for Education and Research.

Orlando's The Dynamic Nurse-Patient Relationship: Function, Process, and Principles was reprinted in 1990 and was eventually translated into five languages. Orlando retired in 1992. She was honored with a Living Legends in Nursing award by the Massachusetts chapter of the American Nurses Association in 2006. She passed away on November 28, 2007.

Impact

Orlando's work was the first known theory related to the nursing process. Her nursing theory continues to be widely used within the nursing education community and her texts remain a critical part of nursing process strategy around the world. Orlando is responsible for bringing more awareness to the significance of the nurse-patient relationship. Many scholars believe this focus has brought greater success and discipline to the health care community.

Personal Life

Orlando married Robert Pelletier in 1961.

Bibliography

Alligood, Martha Raile. Nursing Theorists and Their Work. Elsevier, 2014.

Butts, Janie B., and Karen L. Rich. Philosophies and Theories for Advanced Nursing Practice. Jones & Bartlett Learning, 2015.

Fawcett, Jacqueline, and Susan DeSanto-Madeya. Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories. F.A. David Company, 2013.

Meleis, Afaf Ibrahim. Theoretical Nursing: Development and Progress. Wolters Kluwer, 2012.

Sitzman, Kathleen, and Lisa Wright Eichelberger. Understanding the Work of Nurse Theorists. Jones & Bartlett Learning, 2015.

Smith, Marlaine C., and Marilyn E. Parker. Nursing Theories and Nursing Practice. F.A. David Company, 2013.