Nursing Theory: Hildegard E. Peplau
Hildegard E. Peplau was born in Reading, Pennsylvania in 1909. Peplau attended a diploma program in 1931 in Pottstown, Pennsylvania, completed a BA in interpersonal psychology at Bennington College in 1943, and received a MA in psychiatric nursing at Columbia University in New York in 1947. Finally, Peplau earned a Ph.D. In curriculum development in 1953. Hildegard's credentials include professor emeritus at Rutgers University and is known for starting the first post baccalaureate program in nursing. Peplau died at the age of 89 and had 50 years as a practicing nurse and is often acknowledged as the "mother of psychiatric nursing" although her ideas have affected all field of the nursing profession. (Lakeman, nd, p.1)
Peplau completed in 1948 the work entitled "Interpersonal Relations in Nursing" labeled as her "seminal work." (Lakeman, nd, p.1) At the time of the writing of the book, it was considered "too revolutionary for a nurse to publish a book without a medical practitioner as co-author and it was not published until 1952. Peplau's book was published in nine languages. (Lakeman, nd, p.1)
I. Theory of Psychodynamic Nursing
Peplau's theory of psychodynamic nursing involved comprehension of one's own behavior and assist others in difficulties with their identity. The principles of human relations applied to the difficulties that are differentially experienced by the individual are addressed in Peplau's Theory of Dynamic Nursing. Peplau defined nursing as "a significant therapeutic, interpersonal process." (1952, p.16) Nursing was also defined as being an instrument of education, a force that brings maturity and one that has as its objective the promotion of personality "in the direction of creative, constructive, productive, personal and community living." (Lakeman, nd, p.2) There are implicit assumptions in the writings of Peplau including that "the relationship of nurse and patient is influential in the outcome for the patient; People may assume a number of roles and have the capacity for empathy in relationships." (Lakeman, nd, p.2) Peplau held that the individual may "assume a number of roles and have the capacity for empathy in relationships. People tend to behave in ways which have worked in the past when faced with a crisis." (Lakeman, nd, p.2) Peplau held that energy and tension arise from unmet or conflicting needs, and the energy which arises may be harnessed into positive means for defining, understanding, and meeting the problem at hand." (Lakeman, nd, p.2)
II. Nurse-Patient Relationship and Three Overlapping Phases
In addition, Peplau's theory states that the nurse-patient relationship "is characterized by a number of overlapping phases with a number of therapeutic tasks or goals to be accomplished. During each phase the patient expresses needs which find expression and require intervention in unique ways." (Lakeman, nd, p.2) The first of all the phases posited by Peplau is the "Orientation Phase." This is the phase when the patient and nurse meet first and become acquainted and learn the expectations and the roles of one another. The patient should recognize and understand that they need help and that it is part of their role to receive assistance from the professional nurse in the form of services.
Naturally, the patient can be expected to "test limits in order to establish the integrity of the nurse." Stated as tasks in the orientation phase are: (1) building of trust; (2) building of rapport; (3) establishing a therapeutic environment; (4) assessing the strengths of the patient as well as their weaknesses; and (5) establish a mode of communication that is "acceptable to both patient and nurse." (Lakeman, nd, p.2) At the time, the patient is able to identify problems the relationship is reported to progress to the "working phase." (Lakeman, nd, p.3) The second phase or the "Working Phase" is reported to incorporate the "identification and exploitation of sub-phases and the relationship may fluctuate back and forth as new problems are identified. During the identification phase it is reported that trust begins to develop and the patient begins to respond selectively to person who seem to offer help." (Lakeman, nd, p.3)
Peplau...
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