Hildegard Peplau(1909-1999)INTERPERSONAL RELATIONS MODELTHEORY PRESENTED-1952

Interpersonal Relations as a Nursing Process: Man as an Organism That Exists in an Unstable Equilibrium

Client experiences insult that renders them incapable of moving forward because of stressful environmental/causing anxiety

Hildegard E. Peplau was an American nurse and the first published nursing theorist since Florence Nightingale and created the

middle-range nursing theory of interpersonal relations, which helped to

revolutionize the scholarly work of nurses.

Theory Description:

Interpersonal relations model explores:

Interpersonal relationship of the nurse and the client

Identifies the clients feelings as a predictor of positive outcomes related to health and wellness (Cherry and Jacob, 2014)

Concepts & interrelationships-

Peplau’s Psychodynamic Nursing Model

Phases and changing roles in a nurse-patient relationship

Factors influencing orientation phase:NURSE PATIENTValues ValuesCulture race Cultural race Culture race Cultural raceBeliefs BeliefsPast Experiences Past Experiences Expectations ExpectationsPreconceived ideas

~Nurse Patient

Relationship~

Consider these interactions:• Ineffective•Effective

(Cherry & Jacob, 2011)

Peplau’s Six Nursing Roles:Stranger- Receives client/patient in same way one meets a stranger and provides a climate that builds trust

Teacher- Who imparts knowledge in reference to a need or interest

Resource Person- One who provides specific information for problem solving

Counselor- Provides guidance and encouragement to make changes

Surrogate- Helps to clarify domains of dependence, interdependence, and independency, and acts on client’s behalf as an advocate

Leader- Helps client assume maximum responsibility for meeting goals

Nursing Paradigm-Person- Developing organism that tries to reduce anxiety caused by needs

Patient- client (customer), human being!

Environment- Existing forces outside the organism AND in the context of culture(any unpleasant atmosphere causing stress/anxiety)

Health- Implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living.

(optimal physical and emotional wellness (resolution of any obstacles to well-being)

Nursing- A significant therapeutic interpersonal process. It functions cooperatively with other human process that make health possible for individuals in communities.

Resource person, Educator, Mentor, Transfer Agent, Counselor

How Peplau’s Theory Can Guide a Nursing Educational Program:• This theory teaches the nursing student a humanistic way to connect with their

patients(If you don’t learn to connect with your patients in a way that is meaningful to them, you will not teach them anything)

• Is used in conjunction with the nursing process- follows a systematic, logical approach

• Peplau's theory has generated testable hypotheses (Current nursing, 2012)

• Theories can be utilized by practitioners to guide and improve their practice.

What was happening in the world that impacted the development of this theory?Devastating flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of illness and death on families.[

she observed how people behaved under stress

In the early 1900s nursing practice was controlled by medicine few occupational opportunities for women

-

The Use of Peplau’s TheoryIN ACUTE CARE:

• IN ADDITION TO CARING FOR THE PHYSICAL HEALTH OF PATIENTS, CRITICAL CARE NURSES MUST DEAL WITH THE EMOTIONAL HEALTH OF PATIENTS AND THEIR FAMILIES

• COMMUNICATION IS IMPERATIVE IN CRITICAL CARE NURSING

• NURSES MUST BE PREPARED FOR TO ADAPT TO A PATIENT'S CARE QUICKLY BASED ON THE PATIENT'S HEALTH. (NURSING THEORY, 2013)

The Use of Peplau’s TheoryIN LONG TERM CARE:

• Useful to establish trusting relationships

• Useful to establish short and long term communication goals

The Use of Peplau’s TheoryIN AMBULATORY CARE:

Used to-

• Develop rapid goals

• Assess readiness to learn

• Assess patient’s ability to participate in plan of care

Why is this important to me?

This theory provides simplicity in regard to the natural & logical progression of the Nurse/Patient relationship.

Limitations-

•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 hypothesis 

(current nursing, 2011)

And influenced the theorist?

She observed how people behaved under stress, including witnessing people jumping from windows in delirium from the flu

She was determined to rise above the oppressive paternalistic standard and advocate for the nursing profession

“Somewhere, somehow, at some time in the past, courageous nurses determined these skills, learned them, fought for the right to use them, refined them, and taught them to other nurses. All nurses have an obligation to remember that part of nursing’s past, and to keep their own skills in pace with new opportunities for nursing into the next century.” (Peplau, 1989, p.32)

References:

Cherry & Jacob, (2011)

Current Nursing, (2012)

http://www.nursing-theory.org/theories-and-models/critical-care-nursing.php

Nursing theory (2013)

Peplau, (1989), p.32)

Q & A’s