lOMoARcPSD|3634213

Hildegard E. Peplau handout

Nuring (Pamantasan ng Lungsod ng Maynila)

StuDocu is not sponsored or endorsed by any college or university

Downloaded by Kristine Arcueno (karcueno@gmail.com)
 lOMoARcPSD|3634213

Duke, Indiana, Ohio State, Rutgers, and the

Hildegard E. University of Ulster in Ireland. Dr. Peplau was
named one of "50 Great Americans" in Who's
Peplau Who in 1995 by Marquis. She was elected
fellow of the American Academy of Nurse and
1909 - 1999 Sigma Theta Tau, the national nursing honorary
society.
Hildegard E. Peplau, 89, one of the world's
leading nurses and theorists, known to many as Hilda Peplau was born September 1, 1909, in
the "Nurse of the Century," died March 17th, Reading Pennsylvania, the second daughter of
1999, at her home in Sherman Oaks, California. immigrants Gustav and Ottylie Peplau. She was
Dr. Peplau is the only nurse to serve the one of six children, having two sisters and three
America Nurses Association as Executive brothers. As a child, she witnessed the
Director and later as President. She was also devastating flu epidemic of 1918. This personal
elected to serve two terms on the Board of the experience greatly influenced her
International Council of Nurses (ICN). In 1997 understanding of the impact of illness and
she received the world of nursing's highest death on families.
honor, the Christiane Reimann Prize, at the ICN
Quadrennial Congress. This award is given once Peplau began her career in nursing in 1931 as a
every four years for outstanding national and graduate of the Pottstown, Pennsylvania School
international contributions to nursing and of Nursing. She then worked as a staff nurse in
healthcare. In 1996, the American Academy of Pennsylvania and New York City. A summer
Nursing honored Peplau as a "Living Legend," position as a nurse for the New York University
and in 1998 the American Nurses Association summer camp led to a recommendation for
inducted her into the ANA Hall of Fame. Peplau to become the school nurse at
Bennington College in Vermont. There she
Dr. Peplau is universally regarded as the earned a Bachelor's degree in interpersonal
"mother of psychiatric nursing." Her theoretical psychology in 1943. At Bennington and through
and clinical work led to the development of the filed experiences at Chestnut Lodge, a private
distinct specialty filed of psychiatric nursing. Dr. psychiatric facility, she studied psychological
Peplau's seminal book, Interpersonal Relations issues with Erich Fromm, Frieda Fromm-
in Nursing (1952), was completed in 1948. Reichmann, and Harry Stack Sullivan. Peplau's
Publication was delayed for four years, lifelong work was largely focused on extending
however, because at that time it was Sullivan's interpersonal theory for use in nursing
considered too revolutionary for a nurse to practice.
publish a book without a physician co-author.
Peplua's book has been widely credited with the From 1943-1945 she served in the Army Nurse
transformation of nursing from a group of Corps and was assigned to the 312th Field
skilled workers to a full-fledged profession. Station Hospital in England, where the American
Since the publication of Peplau's work, School of Military Psychiatry was located. Here
interpersonal process has been universally she met and worked with all the leading figures
integrated into nursing education and nursing in British and American psychiatry. After the
practices throughout the United States and war, Peplau was at the table with many of these
abroad. It has been argued that Dr. Peplau's life same men as they worked to reshape the
and work produced the greatest changes in mental health system in the United States
nursing practice since Florence Nightingale. through the passage of the National Mental
Health Act of 1946.
Dr. Peplau was awarded honorary doctoral
degrees from universities including: Alfred,

Downloaded by Kristine Arcueno (karcueno@gmail.com)

 lOMoARcPSD|3634213

Peplau held master's and doctoral degrees from of Peplau from previously unpublished papers.
Teachers College, Columbia University. She was Peplau's ideas have, indeed, stood the test of
certified in psychoanalysis by the William time. The archives of her work and life are
Alanson White Institute of New York City. In the housed at the Schlesinger Library at Harvard
early 1950s, Peplau developed and taught the University.
first classes for graduate psychiatric nursing
students at Teachers College. Dr. Peplau was a Theory of Interpersonal Relations
member of the faculty of the College of Nursing
at Rutgers University from 1954-1974. At According to Peplau (1952/1988), nursing is
Rutgers, Peplau created the first graduate level therapeutic because it is a healing art, assisting
program for the preparation of clinical an individual who is sick or in need of health
specialists in psychiatric nursing. She was a care. Nursing can be viewed as an interpersonal
prolific writer and was equally well known for process because it involves interaction between
her presentations, speeches, and clinical two or more individuals with a common goal.
training workshops. Peplau vigorously
In nursing, this common goal provides the
advocated that nurses should become further
incentive for the therapeutic process in which
educated so they could provide truly
the nurse and patient respect each other as
therapeutic care to patients rather than the
individuals, both of them learning and growing
custodial care that was prevalent in the mental
as a result of the interaction. An individual
hospitals of that era. During the 1950s and
learns when she or he selects stimuli in the
1960s, she conducted summer workshops for
environment and then reacts to these stimuli.
nurses throughout the United States, mostly in
state psychiatric hospitals. In these seminars,
Major Concepts
she taught interpersonal concepts and
interviewing techniques, as well as individual, Man
family, and group therapy. Peplau was an
advisor to the the vigorously advocated that Peplau (1952/1988) defines man as an organism
nurses should become further educated World that “strives in its own way to reduce tension
Health Organization and was a visiting professor generated by needs.” The client is an individual
at universities in Africa, Latin America, Belgium, with a felt need
and throughout the United States. A strong
advocate for graduate education and research Health
in nursing, Peplau served as a consultant to the
Health is defined as “a word symbol that implies
U.S. Surgeon General, the U.S. Air Force, and
forward movement of personality and other
the National Institute of Mental Health. She
ongoing human processes in the direction of
participated in many government policy making
creative, constructive, productive, personal, and
groups. After her retirement from Rutgers, she
community living.”
served as a visiting professor at the University
of Leuven in Belgium in 1975 and 1976. There Society or Environment
she helped establish the first graduate nursing
program in Europe. Although Peplau does not directly address
society/environment, she does encourage the
Peplau once said that the test of a good idea nurse to consider the patient’s culture and
was whether or not it had staying power. Her mores when the patient adjusts to hospital
original book from 1952 has been translated routine.
into nine languages and in 1989 was reissued in
Great Britain by Macmillan of London. In 1989, Nursing
Springer published a volume of selected works

Downloaded by Kristine Arcueno (karcueno@gmail.com)

 lOMoARcPSD|3634213

Hildegard Peplau considers nursing to be a 2. Identification Phase

“significant, therapeutic, interpersonal
The identification phase begins when the client
process.” She defines it as a “human
works interdependently with the nurse,
relationship between an individual who is sick,
expresses feelings, and begins to feel stronger.
or in need of health services, and a nurse
specially educated to recognize and to respond
to the need for help.”  Selection of appropriate professional
assistance
Therapeutic nurse-client relationship
 Patient begins to have a feeling of
A professional and planned relationship
belonging and a capability of dealing
between client and nurse that focuses on the
client’s needs, feelings, problems, and ideas. with the problem which decreases the
Nursing involves interaction between two or
feeling of helplessness
more individuals with a common goal. The
attainment of this goal, or any goal, is achieved and hopelessness
through a series of steps following a sequential
pattern. **the patient must identify that she can rely on
Four Phases of the therapeutic nurse-patient the nurse for the nurse is someone who can
relationship:
help.
1. Orientation Phase
Independent
The orientation phase is directed by the nurse
and involves engaging the client in treatment,
Dependent
providing explanations and information, and
answering questions.
interdependent

 Problem defining phase 3. Exploitation Phase

 Starts when client meets nurse as In the exploitation phase, the client makes full
use of the services offered.
stranger
 Defining problem and deciding type of
 In the exploitation phase, the client
service needed
makes full use of the services offered.
 Client seeks assistance, conveys needs,
 Use of professional assistance for
asks questions, shares preconceptions
problem solving alternatives
and expectations of past experiences
 Advantages of services are used is
 Nurse responds, explains roles to client,
based on the needs and interests of the
helps to identify problems and to use
patients
available resources and services
 Individual feels as an integral part of the
helping environment
** nurse needs to be clear so that there will be
no problem in the resolution phase

Downloaded by Kristine Arcueno (karcueno@gmail.com)

 lOMoARcPSD|3634213

 They may make minor requests or  Now they need to terminate their
attention getting techniques therapeutic relationship and dissolve
 The principles of interview techniques the links between them.
must be used in order to explore,  Sometimes may be difficult for both as
understand and adequately deal with psychological dependence persists
the underlying problem  Patient drifts away and breaks bond
 Patient may fluctuate on independence with nurse and healthier emotional
 Nurse must be aware about the various balance is demonstrated and both
phases of communication becomes mature individuals
 Nurse aids the patient in exploiting all
**Physical V.S. emotional independent
avenues of help and progress is made
towards the final step Interpersonal Theory and Nursing
Process
**the patient identified that he/she can
Both Peplau’s Interpersonal Relations Theory
rely/depend on the nurse so he/she get all the
and the Nursing Process are sequential and
services that she can get from the nurse focus on therapeutic relationship by using
problem solving techniques for the nurse and
patient to collaborate on, with the end purpose
demanding & attention getting
Bothe have of meeting the patients needs. Both use
observation communication and recording as
need
interdependent & cooperative basic tools utilized by nursing.

4. Resolution Phase
Subconcepts
In the resolution phase, the client no longer
needs professional services and gives up Roles of the Nurse in the Therapeutic
dependent behavior. The relationship ends. relationship

The primary roles she identified are as follows:

 In the resolution phase, the client no
longer needs professional services and Stranger: offering the client the same
acceptance and courtesy that the nurse would
gives up dependent behavior. The to any stranger
relationship ends.
Resource person: providing specific answers to
 Termination of professional relationship questions within a larger context
 The patients need have already been Teacher: helping the client to learn formally or
met by the collaborative effect of informally
patient and nurse Leader: offering direction to the client or group

Downloaded by Kristine Arcueno (karcueno@gmail.com)

 lOMoARcPSD|3634213

Surrogate: serving as a substitute for another - -The nurse patient interaction can apply
such as a parent or a sibling to the concepts of human being, health,
environment and nursing.
Counselor: promoting experiences leading to Theories must be logical in nature
health for the client such as expression of - This theory provides a logical systematic
feelings way of viewing nursing situations
- -Key concepts such as anxiety, tension,
Technical Expert: providing physical care for the
goals, and frustration are indicated with
patient and operates equipment
explicit relationships among them and
progressive phases
Peplau also believed that the nurse could take Generalizability
on many other roles, including consultant, - This theory provides simplicity in regard
tutor, safety agent, mediator, administrator, to the natural progression of the NP
observer, and researcher. These were not relationship.
defined in detail butt were “left to the Theories can be the bases for hypothesis that
intelligence and imagination of the readers.” can be tested
(Peplau, 1952) - Peplau's theory has generated testable
hypotheses.
Theories can be utilized by practitioners to
guide and improve their practice.
- Peplau’s anxiety continuum is still used
in anxiety patients
Theories must be consistent with other
validated theories, laws, and principles but will
leave open unanswered questions that need to
be investigated.
- Peplau's theory is consistent with
various theories
Assumptions
Major Concepts:  Nurse and patient can interact.
 Peplau stresses that both the patient and
 Person nurse mature as the result of the
 Health therapeutic interaction.
 Environment  Communication and interviewing skills
 Nursing remain fundamental nursing tools.
 Therapeutic Nurse-Client Relationship  Peplau believed that nurses must clearly
Subconcept: understand themselves to promote their
 Roles of the nurse in the Therapeutic client’s growth and to avoid limiting client’s
Relationship choices to those that nurses value.
Peplau’s work and characteristics of
a theory Strengths/Weaknesses
Strengths:
Interrelation of concepts
- Four phases interrelate the different The phases provide simplicity regarding the
components of each phase. natural progression of the nurse-patient
Applicability relationship.

Downloaded by Kristine Arcueno (karcueno@gmail.com)

 lOMoARcPSD|3634213

This simplicity leads to adaptability in any

nurse-patient interaction, thus providing
generalizability.

Weaknesses:

Health promotion and maintenance were less

emphasized.

The theory cannot be used in a patient who

doesn’t have a felt need such as with withdrawn
patients.

Analysis
Peplau conceptualized clear sets of nurse’s roles
that can be used by each and every nurse with
their practice. It implies that a nurse’s duty is
not just to care but the profession encompasses
every activity that may affect the care of the
patient.

The idea of a nurse-client interaction is limited

with those individuals incapable of conversing,
specifically those who are unconscious.

The concepts are highly applicable with the care

of psychiatric patients considering Peplau’s
background. But it is not limited in those set of
individuals. It can be applied to any person
capable and has the will to communicate.

The phases of the therapeutic nurse-client are

highly comparable to the nursing process
making it vastly applicable. Assessment
coincides with the orientation phase; nursing
diagnosis and planning with the identification
phase; implementation as to the exploitation
phase; and lastly, evaluation with the resolution
phase.

Downloaded by Kristine Arcueno (karcueno@gmail.com)