About Hildegard Peplau (1909-1999)
Hildegard E. Peplau is universally regarded as the mother of psychiatric nursing. Her theoretical and clinical work led to the development of the distinct specialty field of psychiatric nursing. Many believe Peplau’s work produced the greatest changes in nursing practice since Florence Nightingale. She coined the term psychodynamic nursing, describing how the nurse-patient relationship changes over time. –Nursing Times
The need for a partnership between nurse and client is very substantial in nursing practice. This definitely helps nurses and healthcare providers develop more therapeutic interventions in the clinical setting. Through these, Peplau developed her “Interpersonal Relations Theory” in 1952, mainly influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elgar Miller. –Nurses Labs
Major Concepts
- Nursing is defined as an interpersonal, therapeutic process that takes place when professionals, specifically educated to be nurses, engage in therapeutic relationships with people who are in need of health services. Peplau theorized that nurse-patient relationships must pass through three phases in order to be successful: (a) orientation, (b) working, and (c) termination.
- During the brief orientation phase, hospitalized patients realize they need help and attempt to adjust to their current (and often new) experiences. Simultaneously, nurses meet patients and gain essential information about them as people with unique needs and priorities. Among the many roles that nurses assume in their interactions with patients, the first role during the orientation phase is that of a stranger. Initially, nurses are expected to greet patients with the “respect and positive interest accorded a stranger”. Patients and nurses quickly pass through this phase and nurses must continue to display courtesy and respect throughout the three phases. Given that characteristics of the orientation phase are continued in the other two phases; in the current study, the orientation phase was not initially hypothesized to be a latent factor.
- The next phase is the working phase, which accounts for the majority of nurses’ time with patients. In this phase, nurses make assessments about patients to use during teaching and when contributing to the interdisciplinary plan of care. During the working phase, the roles of nurses become more familiar to patients; they begin to accept nurses as health educators, resource persons, counselors, and care providers. Nurses practice “nondirective listening” to facilitate patients’ increased awareness of their feelings regarding their changing health. Using this therapeutic form of communication, nurses provide reflective and nonjudgmental feedback to patients for the sake of helping them clarify their thoughts.
Strengths
- Peplau’s theory helped later nursing theorists and clinicians develop more therapeutic interventions regarding the roles that show the dynamic character typical in clinical nursing.
- Its phases provide simplicity regarding the natural progression of the nurse-patient relationship, which leads to adaptability in any nurse-patient interaction, thus providing generalizability.
Weaknesses
- Personal space considerations and community social service resources are considered less.
- Health promotion and maintenance were less emphasized.
- Cannot be used in a patient who doesn’t have a felt need eg.
- Withdrawn patients, unconscious patients. Some areas are not specific enough to generate a hypothesis.
Additional Information & References
- Outline of Concepts/Definitions by Current Nursing
- Diagram and more information by Nursology
- Misc. links are above
