by David chvanov and Wendy Thompson Hildegard Peplau by David chvanov and Wendy Thompson

History Born on September 1, 1909 in Reading, Pennsylvania She graduated from Pennsylvania Hospital School of Nursing in 1931 She graduated from Bennington College, Vermont in 1943 earning a B.A. She earned her M.A. in psychiatric nursing from Teachers College in New York in 1947 Worked in several psychiatric facilities throughout her career along with working in the Army Nurse Corps. She passed away on March 17, 1999

Middle-Range Nursing Theory of Interpersonal Relations Theory created by Hildegard Peplau in 1952 Three phases: Orientation, Working, and Termination Nursing Goal: Nurses must understand their own behavior in order to help others identify their own difficulties. It is an interpersonal relationship because it is an interaction between two or more people with the same goal. According to Petiprin (2016), “The nurse and patient work together so both become mature and knowledgeable in the care process.”

Four Components Person Environment Culture Health

Three Phases Orientation Phase-Patient is in the problem identification phase. Working Phase: Identification/Exploitation- Patient makes a selection for professional assistance. Patient takes advantage of the services offered. Termination/Resolution- Patient has needs met and is ready for discharge.

Orientation Phase Patient reaches a point where they wish to receive help with a medical problem (Deane & Fain 2016) During this phase: 1. Nurse meets with patient and introduces self. 2. Nurse will begin to learn as much about the patient while also taking a look at their own self. 3. Nurse and patient develop a relationship. Key Goal: According to Deane and Fain (2016), “Nurse is to gain the patient’s trust in a short period of time.

Working Phase The work between patient and nurse begins. The nurse will have numerous roles: teacher, interviewer, counselor, observer, and mediator. Peplau reminds nurses that despite their many roles their primary responsibility is as provider of physical care (Deane & Fain 2016). Sub-phases of the working phase are the identification and exploitation phases. The nursing plan is implemented.

Termination/Resolution Phase Patient prepares for discharge. The nurse and patient review the progress they have made. The nurse helps the patient to develop a plan that will allow the patient to return to a normal healthy life. Topics for discharge may include: medication side effects, fall precautions, keeping scheduled appointments, and remembering the resources used to improve the patient’s care. The nurse also gets the benefit of taking this experience and using it for future patient encounters.

Six Roles Involved in Hildegard’s Nursing Theory Stranger- Both are strangers to each other at first meeting. Teacher- Nurse guides the patient by using knowledge to assist in meeting the patient’s needs. Person/Resource- Nurse helps to find the resources the patient needs to help the patient understand the situation at hand. Counselor- Nurse offers the guidance and encouragement needed by the patient to work towards the patient’s goals. Surrogate- Nurse acts as an advocate for the patient. Leader- Nurse will guide the patient to become responsible for meeting all goals set by the nurse.

Limitations of the Theory Some studies showed a lack of emphasis on health promotion and maintenance. The inability of theory to be used without the expressed need from the patient. Intra-family and how do they interact with the patient and nurse. Personal space and nurses knowing when to back off. Community social service resources are not easily available.

How can this theory be used in current health care practice? The elderly is a great place to use this theory in today’s health care. 13% of U.S. population is older than 65 The elderly wanted to be treated with respect and dignity. It is important for them to be understood. There are too many preconceived ideas about the elderly, but by using this theory a whole new relationship with nurses and these patients could develop and improve their care.

How do we relate to this theory? Nurses pass through the phases of this theory on a day to day basis with their patients. As nurses who truly care about their patients, we want nothing more than to see them get well. The best way to make this happen is to develop a trusting patient-nurse relationship. It not only benefits the patient, but the nurse as well.

Conclusion According to Black (2017), “Peplau believed, however, that all nursing is based on the interpersonal process and the nurse-patient relationship”(pg.186). The importance of this theory is that it focuses on the nurse-patient relationship and not just the patient. The theory works when a trusting relationship between nurse and patient is maintained through all three phases.

References Black, B. P. (2017). Professional nursing: concepts & challenges. St. Louis (Missouri): Elsevier. 185-186 Deane, W. H., & Fain, J. A. (2016). Incorporating Peplau’s Theory of Interpersonal Relations to Promote Holistic Communications Between Older Adults and Nursing Students. Journal of Holistic Nursing, 34(1), 35-41 Petiprin, A. (2016). Nursing theory. Hildegard peplau theory. Retrieved from http://www.nursing-theory.org/theories-and- models/peplau-theory-of-interpersonal-relations-php