Ida Jean Orlando

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.
Early Life
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.
Education

Ida Jean Orlando

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.

Orlando used to work in a hospital exclusive for childbirth in a short span of time.
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.

Orlando (left) already worked as a nurse before going to St. John’s University in Brooklyn, New York
for her Bachelor of Science degree in public health nursing
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.

Bachelor of Science degree in public health nursing from St. John’s University in Brooklyn, New York
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.”
Class photo during her graduation at St. John’s University in Brooklyn, New York
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.

Master of Arts degree in mental health consultation from Teachers College, Columbia University
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.

Orlando’s second book “The Discipline and Teaching of Nursing Process” published in 1972.
Works
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.
Death
Orlando died on November 28, 2007 at the age of 81

Ida Jean Orlando’s Deliberative Nursing Process Theory

One important thing that nurses do is converse with the patients and let them know what the plan
of care for the day is going to be. However, regardless of how well thought out a nursing care plan is
for a patient, unexpected problems to the patient’s recovery may arise at any time. With these, the
job of the nurse is to know how to deal with those problems so the patient can continue to get back
and reclaim his or her well-being. Ida Jean Orlando developed her Deliberative Nursing Process that
allows nurses to formulate an effective nursing care plan that can also be easily adapted when and if
any complexity come up with the patient.
Description
Orlando’s theory stresses the reciprocal relationship between patient and nurse. It emphasizes the
critical importance of the patient’s participation in the nursing process. Orlando also considered
nursing as a distinct profession and separated it from medicine where nurses as determining nursing
action rather than being prompted by physician’s orders, organizational needs and past personal
experiences. She believed that the physician’s orders are for patients and not for nurses.
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.”
Goal
Orlando’s goal is to develop a theory of effective nursing practice. The theory explains that the role
of the nurse is to find out and meet the patient’s immediate needs for help. According to the theory,
all patient behavior can be a cry for help. Through these, the nurse’s job is to find out the nature of
the patient’s distress and provide the help he or she needs.
Assumptions
Orlando’s model of nursing makes the following assumptions:
1. When patients are unable to cope with their needs on their own, they become distressed by
feelings of helplessness.
2. In its professional character, nursing adds to the distress of the patient.
3. Patients are unique and individual in how they respond.
4. Nursing offers mothering and nursing analogous to an adult who mothers and nurtures a
child.
5. The practice of nursing deals with people, environment, and health.
6. Patients need help communicating their needs; they are uncomfortable and ambivalent
about their dependency needs.
7. People are able to be secretive or explicit about their needs, perceptions, thoughts, and
feelings.
8. The nurse-patient situation is dynamic; actions and reactions are influenced by both the
nurse and the patient.
9. People attach meanings to situations and actions that aren’t apparent to others.
10. Patients enter into nursing care through medicine.
11. The patient is unable to state the nature and meaning of his or her distress without the help
of the nurse, or without him or her first having established a helpful relationship with the
patient.
12. Any observation shared and observed with the patient is immediately helpful in ascertaining
and meeting his or her need, or finding out that he or she is not in need at that time.
13. Nurses are concerned with the needs the patient is unable to meet on his or her own.
Major Concepts
The nursing metaparadigm consists of four concepts: person, environment, health, and nursing. Of
the four concepts, Orlando only included three in her theory of Nursing Process Discipline: person,
health, and nursing.
Human Being
Orlando uses the concept of human as she emphasizes individuality and the dynamic nature of the
nurse-patient relationship. For her, humans in need are the focus of nursing practice.
Health
In Orlando’s theory, health is replaced by a sense of helplessness as the initiator of a necessity for
nursing. She stated that nursing deals with individuals who are in need of help.
Environment
Orlando completely disregarded environment in her theory, only focusing on the immediate need of
the patient, chiefly the relationship and actions between the nurse and the patient (only an
individual in her theory; no families or groups were mentioned). The effect that the environment
could have on the patient was never mentioned in Orlando’s theory.
Nursing
Orlando speaks of nursing as unique and independent in its concerns for an individual’s need for
help in an immediate situation. The efforts to meet the individual’s need for help are carried out in
an interactive situation and in a disciplined manner that requires proper training.
Subconcepts
Orlando 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.
Function of Professional Nursing
The function of professional nursing is the organizing principle. This means finding out and meeting
the patient’s immediate needs for help. According to Orlando, nursing is responsive to individuals
who suffer, or who anticipate a sense of helplessness. It is focused on the process of care in an
immediate experience, and is concerned with providing direct assistance to a patient in whatever
setting they are found in for the purpose of avoiding, relieving, diminishing, or curing the sense of
helplessness in the patient. The Nursing Process Discipline Theory labels the purpose of nursing to
supply the help a patient needs for his or her needs to be met. That is, if the patient has an
immediate need for help, and the nurse discovers and meets that need, the purpose of nursing has
been achieved.
Presenting Behavior
Presenting behavior is the patient’s problematic situation. Through the presenting behavior, the
nurse finds the patient’s immediate need for help. To do this, the nurse must first recognize the
situation as problematic. Regardless of how the presenting behavior appears, it may represent a cry
for help from the patient. The presenting behavior of the patient, which is considered the stimulus,
causes an automatic internal response in the nurse, which in turn causes a response in the patient.
Distress
The patient’s behavior reflects distress when the patient experiences a need that he cannot resolve,
a sense of helplessness occurs.
Immediate Reaction
The immediate reaction is the internal response. The patient perceives objects with his or her five
senses. These perceptions stimulate automatic thought, and each thought stimulates an automatic
feeling, causing the patient to act. These three items are the patient’s immediate response. The
immediate response reflects how the nurse experiences his or her participation in the nurse-patient
relationship.
Nurse Reaction
The patient behavior stimulated a nurse reaction, which marks the beginning of the nursing process
discipline.
Nurse’s Action
When the nurse acts, an action process transpires. This action process by the nurse in a nurse-
patient contact is called nursing process. The nurse’s action may be automatic or deliberative.
Automatic Nursing Actions are nursing actions decided upon for reasons other than the patient’s
immediate need.
Deliberative Nursing Actions are actions decided upon after ascertaining a need and then meeting
this need
The following list identifies the criteria for deliberative actions:
 Deliberative actions result from the correct identification of patient needs by validation of
the nurse’s reaction to patient behavior.
 The nurse explores the meaning of the action with the patient and its relevance to meeting
his need.
 The nurse validates the action’s effectiveness immediately after completing it.
 The nurse is free of stimuli unrelated to the patient’s need when she acts.
Nursing Process Discipline
The nursing process discipline is the investigation into the patient’s needs. Any observation shared
and explored with the patient is immediately useful in ascertaining and meeting his or her need, or
finding out he or she has no needs at that time. The nurse cannot assume that any aspect of his or
her reaction to the patient is correct, helpful, or appropriate until he or she checks the validity of it
by exploring it with the patient. The nurse initiates this exploration to determine how the patient is
affected by what he or she says and does. Automatic reactions are ineffective because the nurse’s
action is determined for reasons other than the meaning of the patient’s behavior or the patient’s
immediate need for help. When the nurse doesn’t explore the patient’s reaction with him or her, it is
reasonably certain that effective communication between nurse and patient stops.
The nurse decides on an appropriate action to resolve the need in cooperation with the patient. This
action is evaluated after it is carried out. If the patient behavior improves, the action was successful
and the process is completed. If there is no change or the behavior gets worse, the process recycles
with new efforts to clarify the patient’s behavior or the appropriate nursing action.

The action process in a person-to-person contact functioning in secret. The perceptions, thoughts,
and feelings of each individual are not directly available to the perception of the other individual
through the observable action.

The action process in a person-to-person contact functioning by open disclosure. The perceptions,
thoughts, and feelings of each individual are directly available to the perception of the other
individual through the observable action.
Improvement
Improvement is the resolution to the patient’s situation. In the resolution, the nurse’s actions are
not evaluated. Instead, the result of his or her actions are evaluated to determine whether his or her
actions served to help the patient communicate his or her need for help and how it was met. In each
contact, the nurse repeats a process of learning how he or she can help the patient. The nurse’s own
individuality, as well as that of the patient, requires going through this each time the nurse is called
upon to render service to those who need him or her.
5 Stages of the Deliberative Nursing Process
The Deliberative Nursing Process has five stages: assessment, diagnosis, planning, implementation,
and evaluation.
Assessment
In the assessment stage, the nurse completes a holistic assessment of the patient’s needs. This is
done without taking the reason for the encounter into consideration. The nurse uses a nursing
framework to collect both subjective and objective data about the patient.
Diagnosis
The diagnosis stage uses the nurse’s clinical judgment about health problems. The diagnosis can
then be confirmed using links to defining characteristics, related factors, and risk factors found in the
patient’s assessment.
Planning
The planning stage addresses each of the problems identified in the diagnosis. Each problem is given
a specific goal or outcome, and each goal or outcome is given nursing interventions to help achieve
the goal. By the end of this stage, the nurse will have a nursing care plan.
Implementation
In the implementation stage, the nurse begins using the nursing care plan.
Evaluation
Finally, in the evaluation stage, the nurse looks at the progress of the patient toward the goals set in
the nursing care plan. Changes can be made to the nursing care plan based on how well (or poorly)
the patient is progressing toward the goals. If any new problems are identified in the evaluation
stage, they can be addressed, and the process starts over again for those specific problems.
Strengths
The guarantee that patients will be treated as individuals is very much applied in Orlando’s theory of
Deliberative Nursing Process. Each patient will have an active and constant input into their own care.
Assertion of nursing’s independence as a profession and her belief that this independence must be
based on a sound theoretical framework.
The model also guides the nurse to evaluate her care in terms of objectively observable patient
outcomes.
Weaknesses
The lack of the operational definitions of society or environment was evident which limits the
development of research hypothesis.
Orlando’s work focuses on short term care, particularly aware and conscious individuals and on the
virtual absence of reference group or family members.
Conclusion
Orlando’s nursing theory stresses the reciprocal relationship between patient and nurse. What the
nurse and the patient say and do affects them both. Orlando views the professional function of
nursing as finding out and meeting the patient’s immediate need for help. She was one of the first
nursing leaders to identify and emphasize the elements of nursing process and the critical
importance of the patient’s participation in the nursing process. Orlando’s theory focuses on how to
produce improvement in the patient’s behavior. Evidence of relieving the patient’s distress is seen as
positive changes in the patient’s observable behavior. Orlando may have facilitated the development
of nurses as logical thinkers.
The Deliberative Nursing Process helps nurses achieve more successful patient outcomes such as fall
reduction. Orlando’s theory remains a most effective practice theory that is especially helpful to new
nurses as they begin their practice.
Ida Jean Orlando’s Deliberative Nursing Process Theory

Satu hal penting yang perawat lakukan adalah berkomunikasi dengan pasien dan membiarkan
mereka tahu apa rencana perawatan untuk hari akan menjadi. Namun, terlepas dari seberapa baik
dipikirkan rencana asuhan keperawatan adalah untuk pasien, masalah tak terduga untuk
kesembuhan pasien mungkin timbul setiap saat. Dengan ini, tugas perawat adalah untuk
mengetahui bagaimana menangani masalah tersebut sehingga pasien dapat terus kembali dan
merebut kembali nya kesejahteraan. Ida Jean Orlando dikembangkan Proses Keperawatan
Permusyawaratan nya yang memungkinkan perawat untuk merumuskan rencana asuhan
keperawatan yang efektif yang juga dapat dengan mudah diadaptasi ketika dan jika setiap
kompleksitas datang dengan pasien.

Deskripsi

Teori Orlando menekankan hubungan timbal balik antara pasien dan perawat. Ini menekankan
pentingnya partisipasi pasien dalam proses keperawatan. Orlando juga dianggap keperawatan
sebagai profesi yang berbeda dan terpisah dari obat mana perawat sebagai menentukan tindakan
keperawatan bukannya diminta oleh perintah dokter, kebutuhan organisasi dan pengalaman pribadi
masa lalu. Dia percaya bahwa perintah dokter adalah untuk pasien dan bukan untuk perawat.

Dia mengusulkan bahwa "pasien memiliki makna dan interpretasi dari situasi mereka sendiri dan
karena itu perawat harus memvalidasi kesimpulan mereka dan menganalisa dengan pasien sebelum
penarikan kesimpulan."

Tujuan

Tujuan Orlando adalah untuk mengembangkan teori praktik keperawatan yang efektif. Teori ini
menjelaskan bahwa peran perawat adalah untuk mengetahui dan memenuhi kebutuhan mendesak
pasien untuk bantuan. Menurut teori, semua perilaku pasien dapat menjadi teriakan minta tolong.
Melalui ini, pekerjaan perawat adalah untuk mengetahui sifat dari marabahaya pasien dan
memberikan bantuan yang dia butuhkan.

Asumsi

Model Orlando keperawatan membuat asumsi sebagai berikut:

1. Ketika pasien tidak dapat mengatasi kebutuhan mereka sendiri, mereka menjadi tertekan oleh
perasaan tidak berdaya.
2. Dalam karakter profesional, keperawatan menambah penderitaan pasien.
3. Pasien yang unik dan individu dalam bagaimana mereka merespon.
4. Keperawatan menawarkan pengasuhan dan perawatan analog dengan seorang dewasa yang ibu
dan memelihara anak.
5. Praktek keperawatan berhubungan dengan orang, lingkungan, dan kesehatan.
6. Pasien perlu bantuan berkomunikasi kebutuhan mereka; mereka tidak nyaman dan ambivalen
tentang kebutuhan ketergantungan mereka.
7. Orang-orang dapat menjadi rahasia atau eksplisit tentang kebutuhan, persepsi, pikiran, dan
perasaan.
8. Situasi perawat-pasien yang dinamis; aksi dan reaksi dipengaruhi oleh perawat dan pasien.
9. Orang melampirkan arti situasi dan tindakan yang tidak jelas kepada orang lain.
10. Pasien masuk ke dalam perawatan melalui obat-obatan.
11. Pasien tidak mampu untuk menyatakan sifat dan makna penderitaan nya tanpa bantuan
perawat, atau tanpa dia pertama setelah menjalin hubungan membantu dengan pasien.
12. Setiap pengamatan bersama dan diamati dengan pasien segera membantu dalam memastikan
dan memenuhi nya kebutuhan, atau mencari tahu bahwa dia tidak membutuhkan pada waktu
itu.
13. Perawat prihatin dengan kebutuhan pasien tidak dapat bertemu pada sendiri.

Konsep utama

The keperawatan paradigma yang terdiri dari empat konsep: orang, lingkungan, kesehatan, dan
keperawatan. Dari empat konsep, Orlando hanya termasuk tiga dalam teori nya dari Proses
Keperawatan Disiplin: orang, kesehatan, dan keperawatan.

Manusia
Orlando menggunakan konsep manusia sebagai ia menekankan individualitas dan sifat dinamis dari
hubungan perawat-pasien. Baginya, manusia membutuhkan adalah fokus dari praktek keperawatan.

Kesehatan
Dalam teori Orlando, kesehatan digantikan oleh rasa tidak berdaya sebagai inisiator dari kebutuhan
untuk menyusui. Dia menyatakan bahwa penawaran keperawatan dengan individu yang
membutuhkan bantuan.

Lingkungan Hidup
Orlando benar-benar diabaikan lingkungan teorinya, hanya berfokus pada kebutuhan mendesak dari
pasien, terutama hubungan dan tindakan antara perawat dan pasien (hanya individu dalam teori
nya, tidak ada keluarga atau kelompok yang disebutkan). Efek bahwa lingkungan bisa saja pada
pasien tidak pernah disebutkan dalam teori Orlando.

Perawatan
Orlando berbicara tentang keperawatan sebagai unik dan independen dalam keprihatinan untuk
kebutuhan individu untuk membantu dalam situasi segera. Upaya untuk memenuhi kebutuhan
individu untuk bantuan dilakukan dalam situasi interaktif dan secara disiplin yang membutuhkan
pelatihan yang tepat.

Subkonsep

Orlando digambarkan Model sebagai berputar di sekitar lima konsep yang saling terkait utama
berikut: fungsi keperawatan profesional, perilaku, reaksi langsung, disiplin proses keperawatan, dan
perbaikan menyajikan.

Fungsi Profesional Nursing

Fungsi keperawatan profesional adalah prinsip pengorganisasian. Ini berarti mencari tahu dan
memenuhi kebutuhan mendesak pasien untuk bantuan. Menurut Orlando, keperawatan responsif
terhadap individu yang menderita, atau yang mengantisipasi rasa tidak berdaya. Hal ini difokuskan
pada proses perawatan di sebuah pengalaman langsung, dan berkaitan dengan memberikan
bantuan langsung kepada pasien dalam pengaturan apa pun yang mereka ditemukan di untuk tujuan
menghindari, menghilangkan, mengurangi, atau menyembuhkan rasa tak berdaya di pasien. Proses
Keperawatan Disiplin Teori label tujuan keperawatan untuk memasok bantuan pasien perlu untuk
nya harus dipenuhi. Artinya, jika pasien memiliki kebutuhan yang mendesak untuk bantuan, dan
perawat menemukan dan memenuhi kebutuhan itu, tujuan keperawatan telah dicapai.
Perilaku menyajikan
Perilaku menghadirkan situasi bermasalah pasien. Melalui perilaku menyajikan, perawat
menemukan kebutuhan mendesak pasien untuk bantuan. Untuk melakukan hal ini, perawat harus
terlebih dahulu mengenali situasi sebagai bermasalah. Terlepas dari bagaimana perilaku menyajikan
muncul, hal itu mungkin mewakili teriakan minta tolong dari pasien. The menyajikan perilaku pasien,
yang dianggap stimulus, menyebabkan respons internal otomatis dalam perawat, yang pada
gilirannya menyebabkan respon pada pasien.

Kesulitan
Perilaku pasien mencerminkan kesusahan ketika pasien mengalami kebutuhan bahwa ia tidak bisa
menyelesaikan, rasa tidak berdaya terjadi.

Reaksi langsung

Reaksi segera adalah respon internal. Pasien merasakan benda dengan lima nya indera. Persepsi ini
merangsang pikiran otomatis, dan setiap pikiran merangsang perasaan otomatis, menyebabkan
pasien untuk bertindak. Ketiga item tanggapan langsung pasien. Tanggapan langsung mencerminkan
bagaimana perawat mengalami partisipasi nya di hubungan perawat-pasien.

Perawat Reaksi
Perilaku pasien dirangsang reaksi perawat, yang menandai awal dari disiplin proses keperawatan.

Perawat Action
Ketika perawat bertindak, proses tindakan transpires. Proses tindakan ini oleh perawat dalam kontak
perawat-pasien disebut proses keperawatan. Tindakan perawat mungkin otomatis atau deliberatif.

Tindakan Keperawatan otomatis menyusukan tindakan diputuskan untuk alasan lain selain
kebutuhan mendesak pasien.

Tindakan Keperawatan deliberatif adalah tindakan diputuskan setelah memastikan kebutuhan dan
kemudian memenuhi kebutuhan ini

Daftar berikut mengidentifikasi kriteria untuk tindakan deliberatif:

 Tindakan deliberatif hasil dari identifikasi yang benar dari kebutuhan pasien dengan validasi
reaksi perawat terhadap perilaku pasien.
 Perawat mengeksplorasi makna tindakan dengan pasien dan relevansinya untuk memenuhi
kebutuhannya.
 Perawat memvalidasi efektifitas tindakan segera setelah menyelesaikan itu.
 Perawat bebas dari rangsangan yang tidak terkait dengan kebutuhan pasien ketika ia bertindak.

Proses keperawatan Disiplin

Disiplin proses keperawatan adalah penyelidikan kebutuhan pasien. Setiap pengamatan bersama
dan dieksplorasi dengan pasien segera berguna dalam memastikan dan memenuhi nya kebutuhan,
atau mencari tahu dia tidak punya kebutuhan pada waktu itu. Perawat tidak dapat mengasumsikan
bahwa setiap aspek reaksi nya untuk pasien yang benar, membantu, atau yang sesuai sampai ia
memeriksa validitas dengan mengeksplorasi dengan pasien. Perawat memulai eksplorasi ini untuk
menentukan bagaimana pasien dipengaruhi oleh apa yang dia katakan dan lakukan. Reaksi otomatis
tidak efektif karena tindakan perawat ditentukan untuk alasan lain selain makna perilaku pasien atau
kebutuhan mendesak pasien untuk bantuan. Ketika perawat tidak mengeksplorasi reaksi pasien
dengan dia, dipastikan bahwa komunikasi yang efektif antara perawat dan pasien berhenti.
Perawat memutuskan tindakan yang tepat untuk mengatasi kebutuhan bekerjasama dengan pasien.
Tindakan ini dievaluasi setelah itu dilakukan. Jika perilaku pasien membaik, aksi itu berhasil dan
proses selesai. Jika tidak ada perubahan atau perilaku semakin memburuk, proses mendaur ulang
dengan upaya baru untuk memperjelas perilaku pasien atau tindakan keperawatan yang tepat.

Proses tindakan dalam kontak orang-ke-orang berfungsi secara rahasia. Persepsi, pikiran, dan
perasaan masing-masing individu tidak langsung tersedia untuk persepsi individu lain melalui
tindakan yang dapat diamati.

Proses tindakan dalam kontak berfungsi orang-ke-orang dengan pengungkapan terbuka. Persepsi,
pikiran, dan perasaan masing-masing individu yang langsung tersedia untuk persepsi individu lain
melalui tindakan yang dapat diamati.
Perbaikan
Perbaikan adalah resolusi untuk situasi pasien. Dalam resolusi itu, tindakan perawat tidak dievaluasi.
Sebaliknya, hasil dari tindakan-nya dievaluasi untuk menentukan apakah tindakannya disajikan
untuk membantu pasien berkomunikasi nya kebutuhan untuk bantuan dan bagaimana hal itu
terpenuhi. Dalam setiap kontak, perawat mengulangi proses belajar bagaimana ia dapat membantu
pasien. Individualitas perawat sendiri, serta bahwa pasien, memerlukan akan melalui ini setiap kali
perawat dipanggil untuk memberikan pelayanan kepada mereka yang membutuhkan dia.

5 Tahapan Proses Keperawatan Permusyawaratan

Proses Keperawatan Permusyawaratan memiliki lima tahap: pengkajian, diagnosis, perencanaan,

pelaksanaan, dan evaluasi.

Penilaian

Pada tahap penilaian, perawat melengkapi penilaian holistik kebutuhan pasien. Hal ini dilakukan
tanpa mengambil alasan untuk pertemuan menjadi pertimbangan. Perawat menggunakan kerangka
keperawatan untuk mengumpulkan data baik subyektif dan obyektif tentang pasien.
Diagnosa

Tahap diagnosis menggunakan penilaian klinis perawat tentang masalah kesehatan. Diagnosis
kemudian dapat dikonfirmasi menggunakan link ke mendefinisikan karakteristik, faktor yang
berhubungan, dan faktor risiko yang ditemukan dalam penilaian pasien.

Perencanaan

Tahap perencanaan membahas setiap masalah yang diidentifikasi dalam diagnosis. Setiap masalah
diberikan tujuan tertentu atau hasil, dan setiap tujuan atau hasil yang diberikan intervensi
keperawatan untuk membantu mencapai tujuan. Pada akhir tahap ini, perawat akan memiliki
rencana asuhan keperawatan.
Pelaksanaan

Pada tahap implementasi, perawat mulai menggunakan rencana asuhan keperawatan.

Evaluasi

Akhirnya, dalam tahap evaluasi, perawat melihat kemajuan pasien terhadap tujuan yang ditetapkan
dalam rencana asuhan keperawatan. Perubahan dapat dibuat untuk rencana asuhan keperawatan
didasarkan pada seberapa baik (atau buruk) pasien mengalami kemajuan ke arah tujuan. Jika ada
masalah baru diidentifikasi dalam tahap evaluasi, mereka dapat diatasi, dan proses dimulai lagi
untuk masalah-masalah tertentu.

Kekuatan

Jaminan bahwa pasien akan diperlakukan sebagai individu yang sangat banyak diterapkan dalam
teori Orlando Proses Keperawatan Permusyawaratan. Setiap pasien akan memiliki input aktif dan
konstan dalam perawatan mereka sendiri.

Sikap tegas kemerdekaan keperawatan sebagai profesi dan keyakinannya bahwa kemerdekaan ini
harus didasarkan pada kerangka teoritis suara.
Model ini juga memandu perawat untuk mengevaluasi perawatan nya dalam hal hasil pasien secara
objektif dapat diamati.

Kelemahan

Kurangnya definisi operasional masyarakat atau lingkungan jelas yang membatasi pengembangan
hipotesis penelitian.

Pekerjaan Orlando berfokus pada perawatan jangka pendek, individu khususnya sadar dan sadar dan
tidak adanya virtual kelompok referensi atau anggota keluarga.

Kesimpulan

Teori keperawatan Orlando menekankan hubungan timbal balik antara pasien dan perawat. Apa
perawat dan pasien katakan dan lakukan mempengaruhi mereka berdua. Orlando memandang
fungsi profesional keperawatan sebagai mencari tahu dan memenuhi kebutuhan yang mendesak
pasien untuk bantuan. Dia adalah salah satu pemimpin keperawatan pertama yang mengidentifikasi
dan menekankan unsur-unsur proses keperawatan dan pentingnya partisipasi pasien dalam proses
keperawatan. Teori Orlando berfokus pada bagaimana untuk menghasilkan perbaikan dalam
perilaku pasien. Bukti menghilangkan kesusahan pasien dipandang sebagai perubahan positif dalam
perilaku yang dapat diamati pasien. Orlando mungkin telah memfasilitasi pengembangan perawat
sebagai pemikir logis.

Proses Keperawatan Permusyawaratan membantu perawat mencapai hasil pasien lebih sukses
seperti pengurangan jatuh. Teori Orlando tetap teori praktek yang paling efektif yang sangat
membantu untuk perawat baru ketika mereka mulai praktek mereka.