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Nursing Theories Comparison: Hildegard Peplau` Theory and Ida Jean Orlando’s Deliberative Nursing Theory


In the modern health care sector nursing can be considered one of the central pillars that support its development, effective functioning, and positive outcomes. Being one of the main caregivers responsible for the appropriate delivery of services and communication with patients, nurses play a critical role in promoting healthy behaviors and improving the health of the nation. At the same time, to perform these activities, they should possess extensive knowledge about how to organize treatment and communicate with patients. The existence of certain nursing theories simplifies the task and suggests certain guidelines.

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For instance, Peplau’s theory of interpersonal relations emphasizes the role of intercourse that emerges between a patient and a nurse during the treatment and its importance for the recovery process (Theory of Interpersonal Relations, n.d.). In accordance with this idea, nursing aims at the promotion of an improved understanding of the current challenges and collaborative work to eliminate them.

Another theory is suggested by Ida Orlando, and it assumes that nurses should play a key role in discovering patients’ problems and provision of the appropriate care as individuals have their own interpretations of situations which can be wrong (Nursing Process Theory, n.d.). This Deliberative Nursing Process theory provides a particular framework that can help nurses to deliver appropriate care.


In the course of its evolution, the healthcare sector managed to elaborate multiple theories that simplify the delivery of care and ensure the achievement of the appropriate result. In the majority of cases, the given theoretical frameworks consider the dominant doctrines and the most topical issues. Thus, the theory of interpersonal relations by Peplau is devoted to the communication between health workers and patients as one of the fundamental elements needed to promote recovery (Theory of Interpersonal Relations, n.d.).

It emerged in 1952 as the result of radical alterations in the healthcare sector. The second half of the 20th century was characterized by the recognition and implementation of new approaches to care delivery that presupposed improved communication (Masters, 2014). For this reason, Peplau managed to create the basis for the further improvement of this aspect and alignment of beneficial relations between all participants of the treatment process.

The theory of the deliberative nursing process emerged later, in 1972. The main cause for its creation was the idea of the necessity to provide in-time care to patients who might be mistaken about the real causes of their problems (Nursing Process Theory, n.d.). The given period is also characterized by the continuous increase of nurses’ contribution to positive outcomes and reconsideration of their authorities (Nursing Process Theory, n.d.).

Their ability to collaborate with patients to determine the existing issues and ensure the on-time delivery of the appropriate care became central for the theory (Nursing Process Theory, n.d.). At the same time, Orlando’s theory emphasizes the necessity to observe the existing rules and recommendations to make the right decisions and assist patients in their recovery. In accordance with this framework, it is the only way to create an environment beneficial for both a patient and a nurse and achieve the main goal.

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Philosophical Underpinnings of the Theories

As with any conceptual framework, nursing theories should have philosophical underpinnings that create a particular approach and ensure its ability to help all actors who implement this theory into practice. For this reason, both Peplau and Orlando’s theories have a certain background that impacted their emergence. The concept of interpersonal relations’ philosophical underpinning is the idea of morality and responsibility.

It assumes that as a morally-upstanding practice, nursing should be focused on the cultivation of patients’ health, satisfaction of their current demands, and guaranteeing care that can help to improve their states (Theory of Interpersonal Relations, n.d.). The enhanced understanding of all these aspects can be achieved only through communication as a potent tool to collect data and align beneficial relations (Butts & Rich, 2017). That is why the theory rests on the idea of recovery as a collaborative process that involves all participants and is performed via communication.

Orlando-Pelletier’s theory has a similar focus as it recognizes the importance of ethical concerns and issues that might emerge during the recovery process. In accordance with the given doctrine, any mistakes in the sphere of nursing are unethical as they might result in the appearance of critical complications, undesired outcomes, or fatal consequences (Nursing Process Theory, n.d.). For this reason, nurses, as the main caregivers responsible for results, should accept this very responsibility and perform actions that precondition positive outcomes.

It can be achieved with the help of discipline and commitment as both patients and nurses should be ready to act regarding the existing guidelines and analyze their steps to avoid deterioration of the situation (Butts & Rich, 2017). Moreover, as far as these groups might have different visions of the problem, communication and collaboration become the key to the observation of all prescriptions.

Major Assumptions, Concepts, and Relationships

The discussed theories are focused on different dimensions of the nursing practice, and that is why there are different concepts peculiar to them. For instance, the idea of interpersonal relations suggested by Peplau assumes that interaction is the central aspect that preconditions outcomes; in other words, success can be attained only if all parties act together and move in the same direction to achieve the common purpose (Theory of Interpersonal Relations, n.d.).

This statement preconditions the increased importance of another concept which is communication. As the theory outlines, it is the most potent tool that helps to create a team characterized by enhanced cooperation and a shared vision of the current needs and problems (McEwen & Wills, 2014). In such a way, applying both these concepts into practice, a nurse should be ready to engage in beneficial interpersonal relations to find solutions to the majority of problems deteriorating the quality of patients’ lives.

Orlando’s theory emphasizes the necessity to correctly realize patients’ ideas and introduce appropriate changes when needed. It means that in many situations the needed help can differ from the expected intervention because of the incongruence between patients’ expectations and care that can really improve the situation (Nursing Process Theory, n.d.). For this reason, nurses’ ability to critically analyze the situation and educate patients about the current health problem acquires the top priority (Nursing Process Theory, n.d.).

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Health workers should be persistent in their attempts to eliminate the existing disillusions regarding the illness and provide patients with care that will help them to recover. These assumptions provide nurses with specific guidelines that can be used in their practice to attain appropriate results.

Clinical Applications

Both these theories can help to achieve positive results through their implementation. Utilizing the concept of interpersonal relations in clinical settings, specialists can engage in improved teamwork to ensure the effective delivery of care and consideration of all aspects of a particular case. At the same time, every health facility is a complex unit with multiple workers who should collaborate to achieve positive results. For this reason, the use of this theory can help to create an environment characterized by a high level of mutual understanding and the absence of conflicts between members of the collective.

Orlando’s theory emphasizes other aspects, however, its positive impact on the functioning of medical units cannot be doubted. According to the framework, all nurses should be ready to work with patients to deliver in-time and effective treatment. It can be achieved only by the constant improvement of skills, knowledge, and competencies (Butts & Rich, 2017). At the same time, the given theory is applied to the clinical practice to educate patients about the existing diseases and eliminate the possibility of mistreatment or inappropriate outcomes preconditioned by individuals’ desire to treat illnesses inappropriately (Butts & Rich, 2017). Nurses should prevent them from performing these activities and explain the need for qualified care.


As it comes from the examples provided above, the given theories can be integrated into the nursing practice in different ways. The first one can be used to align beneficial relations among health workers to ensure their enhanced understanding. Moreover, cooperation between patients and nurses can also be improved by the use of appropriate communicational patterns (Masters, 2014). At the same time, Orlandos theory is mainly focused on relations between clients and nurses. Its implications are focused on the attempts to eliminate the existing discrepancies and ensure that the correct understanding of the current situation can be created. For this reason, it is recommended to utilize both these theories to achieve the desired outcomes.

Application to My Clinical Setting

The discussed theoretical frameworks can be used in my own clinical setting to increase my efficiency and achieve better results. For instance, utilizing the theory of interpersonal communication, better teamwork can be achieved through the cultivation of appropriate communicational patterns and the selection of the needed models. From another hand, Orlando’s theory can be used while working with patients. Poor understanding of prescriptions is one of the main problems impacting the outcomes (Butts & Rich, 2017). For this reason, utilizing this very theory, the most unclear aspects can be explained which is the guarantee of recovery and positive shifts.


Simplicity is one of the factors that precondition the increased importance of these theories and their use in the modern healthcare sector. Interpersonal and deliberative nursing theories contributed to the creation of an environment characterized by improved cooperation and mutual understanding (Smith & Parker, 2015). At the same time, they both can be easily interpreted even by inexperienced specialists who just start working in the sphere. These theories emphasize the importance of traditional values; however, they introduce certain guidelines that help to achieve positive outcomes and guarantee the gradual improvement of the health of the nation.


Altogether, Peplau and Orlando’s theories remain important aspects of the modern nursing sphere as they contribute to the improvement of interpersonal communication between health workers and patients, enhancement of care delivery, and creation of an environment characterized by better cooperation between all parties. They have several differences that impact the sphere of theories’ application; however, their extensive use in the clinical setting is essential for the attainment of success and satisfaction of customers’ basic needs. Their simplicity can be considered one more element that preconditions the high topicality of these frameworks.


Butts, J., & Rich, K. (2017). Philosophies and theories for advanced nursing practice (3rd ed.). New York, NY: Jones & Bartlett Learning.

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Masters, K. (2014). Nursing theories: A framework for professional practice (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

McEwen, M., & Wills, E. (2014). Theoretical basis for nursing (4th ed.). New York, NY: LWW.

Nursing Process Theory. (n.d.). Web.

Smith, M., & Parker, M. (2015). Nursing theories and nursing practice (4th ed.). Philadelphia, PA: F.A. Davis Company.

Theory of Interpersonal Relations. (n.d.). Web.

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