Orlando's Nursing Process Theory the Grand Theory Essay

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Orlando's Nursing Process Theory

The Grand Theory chosen for this assignment is the Orlando's Nursing Process Theory. This theory was formulated by Ida Jean Orlando. The theory was based on inductive reasoning and is still considered one of the most followed nursing practice theories. The theory is based on the most basic principles of interaction between the patient and the nurse practitioner. This theory highlights how a patient makes a conversation about his needs and how a nurse provides care to him.

Background of the Theorist-Ida Jean Orlando

The grand theorist was born in the year 1926 and got her Nursing diploma from the New York Medical College. She did her Bachelor's degree in public health from St. John's University, New York. She did not stop here and got her Master's degree in Mental Nursing from Columbia University, New York. About her work experience, it is interesting to note that she attained her first job as an Associate Professor at the Yale School of Nursing and was later declared the Director of the Graduate Program in Mental Health Psychiatric Nursing. She many books published, which focus on the nursing theories and their implementations in the nursing practices (Logan, 2013).

In the latter half of the 1950s, Ida Jean Orlando formulated the Orlando's Nursing Process Theory. This theory was inductive in nature and was developed by conducting an empirical study on the nursing study and practice. During her practice as a nursing professional, she categorized the good and bad aspects of nursing practice. For almost three consecutive years, she observed 2000 interactions between the nursing practitioner and the patient.

She defined the good nursing practice where the prime focus of the nurse was on the non-verbal and verbal behavior of the patient that he might have shown immediately. It is observed from the commencement of the contact until the end of the conversation. On the other hand, the bad nursing practice highlights the nurse's focus on the documented or learned activity instead of observing the patient's immediate verbal and non-verbal behavior. These documentations lead the theorist is formulating the Deliberative Nursing process. This was published in the year 1961.

Contribution to the Past and Present Literature

The Orlando's theory is still considered and followed as the most effective and relative nursing practice theories, which are available to the nursing schools at the present moment. This theory has been translated and transcribed into six different languages for distribution all over the world. The theory has been utilized as the building ground for many other researches (Olson, 1997; Faust, 2002).

Phenomenon of Concern

Orlando used the conception of nurse- patient interaction with the prime focus on the nursing practice. Orlando does not specify the term "Health" in her theory but implies it. Hence, the therapeutic goals of nursing practice are also dependent on the interaction and behavior of the nurse practitioner and the patient. However, the interaction is concentrated on a specific time and space. Unless the patient does not feel comfortable in the presence of a nurse, the therapeutic activity will not be as effective as it is required (Abdoli, 2010).

Description of Orlando's Nursing Process Theory

The Orlando's Nursing Process Theory proves as an interrelating bond between the interaction of nurse and the communication of the patient. This theory has more of a logical nature and contributes to the daily nursing practice equally. The theory is also easy to understand and is simple in nature. Its contribution to the professional knowledge is enhanced by its application to the clinical practice (Faust, 2002).

Inductive Reasoning

Orlando's theory was developed in the late 1950s based on an empirical study. It was based on inductive reasoning because for approximately 3 years, Orlando observed 2000 interactions between the patients and nurses. At the end of the empirical study, she was able to categorize her results in two distinct categories. In order to prove and validate her findings, a research was conducted at the McLean Hospital. In this research, continuous tape recordings were studied. These recordings were an interaction between the nurses and patients. Some interactions were also between the patients and other health care members. Hence, it was inductive reasoning.

Major Concepts of Orlando's Theory


In her theory of Nursing Process, Orlando uses the human nature concept. She pays special attention to the dynamic nature and individuality of concept of human. Operationally, she places the needy humans as the prime focus of nursing practice. She does not significantly emphasize on the health issue. On the other hand, she replaces health with the helplessness that requires the nursing.


The second major concept of Orlando's theory is nursing itself. She explains it to be an independent and unique practice that is based on the concern and emotion for the help. This help is provided to a human who is in need of the help. Operationally, nursing practice that caters to the need of a human requires proper training and adequate learning.


The third major concept of her theory is Need. She defines need as "a requirement of the patient which, if supplied, relieves or diminishes his immediate distress or improves his immediate sense of adequacy or well-being" (Meleis, 2011). She implies that the humans who do not require help can take care of their own needs. Such people do not call for nursing care. On the other hand, humans who cannot cater to their own needs and require nursing care are the humans who build the basis of this theory.


Immediacy of nursing care in an emergency situation is another major factor of Orlando's nursing theory. The assessment of the patient behavior is an important step in this concept. Operationally, the nursing practice should be designed to provide immediate care with best possible quality. In the case of ambulatory situations such as child delivery or car accident, properly trained nursing staff is required and interaction plays a slight role in it.

Examination of the Relationship between Different Major Concepts

Human and nursing is quite interdependent major concept. On the other hand, Need and Nursing makes a stronger bond. Meanwhile, Immediacy is dependent on the interaction level that is not in the major concepts of Orlando's theory (Kim, 1994).

Evaluation of Orlando's Theory

The consistency in all the four major concepts is well defined in Orlando's theory. Nevertheless, the requirement of interaction level between patient and nursing staff renders Orlando's theory to hinder the technical nursing practices on today's times. For instance, a patient in coma may not be able to interact with the nurse, but the nurse should understand from his condition or vitals that he requires care. In this example, the interaction level is not significant (Kim, 1994).

Assumptions associated with Orlando's Theory

The main explicit and implicit assumptions associated with the theory are as follows:

1. It is a distressing factor for a patient when they do not receive the required help at the time of need. This results in the feeling of being helpless.

2. Every patient holds an individuality and uniqueness in his response.

3. Nursing is similar to the care a mother provides to her child.

4. Nursing is a professional duty that deals with health, environment and people.

5. Patients are vulnerable so they are unsure about their need to depend on others. Hence, they also require help in communication.

6. It is human nature that they tend to be explicit and secretive regarding their thoughts, needs, perceptions and emotions.

7. The relationship or situation between the nurse and patient is energetic. This situation is under the influence of both patient and the nurse.

8. It is human nature, that they tend to infer meanings from situations or reactions that they tend to least understand.

9. Nurses provide the service by catering to the needs of the patients.

Orlando's theory explicitly stands upon the concept of nurse- patient relationship. This theory implies that the patient has needs that he cannot answer. Hence, it is the responsibility of the nurse to cater to these needs (Butts, 2010).

The Four Metaparadigms Concepts of Nursing

The four metaparadigms of nursing include person, environment, health and nursing. Most of the metaparadigms are effectively indicated in Orlando's nursing theory.


1. A person is the recipient of quality care. This care can be psychological, physical, spiritual and in terms of sociocultural elements. Orlando's Nursing Theory addresses this metaparadigm by referring to it as a patient. In her theory, the patient is in need and if care is not provided to him by a nurse, he will feel helpless.

2. It can also be Individual, family, or community. Orlando's theory only refers to person as a patient. There no significant mention of any community or family.


1. All the conditions, which include external and internal factors. These conditions influence the person directly or indirectly. Orlando's theory refers to the environment vaguely.


1. It is the degree of illness or wellness felt by the person. It is not properly defined…

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