Hildegard Peplau’s theory of interpersonal relationship was first described in her book Interpersonal Relations in Nursing: Offering a Conceptual Frame of Reference for Psychodynamic Nursing published in 1952 (D’Antonio, Beeber, Sills, & Naegle, 2014). She emphasized the commitment to nursing and argued that nurses have to know patients as well as they know themselves. Peplau believed that significant difference in the quality of nursing care can be achieved through the transformation of a nurse’s approach to delivering those services (D’Antonio et al., 2014). She identified self-awareness and personal identity as driving concepts of nursing. According to the nursing theorist, patient care is therapeutic because it is an art of healing; therefore, “the kind of person each nurse becomes” determines the health care outcomes (D’Antonio et al., 2014). Her ideas serve as a basis for such concepts as partnering with patients, patient-centered care and empowering patients and their families (D’Antonio et al., 2014).
Therapeutic nurse-client relationships are described by the interaction between two or more parties that share a common goal. The role of the nurse in this type of alliance is guided by a set of techniques aimed at achieving the end purpose of treatment with the maximum amount of patient’s collaboration. There is a number of stages that can be recognized in therapeutic relationships: assessment, orientation, nursing diagnosis and planning of mutual goals, identification, initiation, implementation, evaluation and resolution (D’Antonio et al., 2014). However, Peplau regarded only four of them as the main phases in the therapeutic nurse-client relationships; those were orientation phase, identification phase, exploitation phase and resolution phase. The nurse role fluctuates at each stage. During the first phase, the nurse is engaged in the process of relaying information to the patient and answering their questions. It is the initial stage of treatment where nurse plays a role of a stranger and has to offer the patient maximum courtesy and acceptance. Identification phase starts when the client of a health care facility collaborates with the medical professional. During exploitation phase, the patient has the ability to take advantage of the available medical services. Resolution is the last phase in the therapeutic nurse-client relationships, and it signifies the end of the treatment (D’Antonio et al., 2014).
Peplau’s theory presupposes a four-pronged approach to the nursing process that helps the patient to achieve personal growth. During this process, the nurse is supposed to develop a personal relationship with the person receiving medical care and even to make some of the treatment decisions along with them. To this end, the nurse has to assume six different roles: stranger, resource person, teacher, surrogate, technical expert and leader (Wayne, 2014). The role of stranger associated with treating the patient with care, politeness and acceptance during the first meeting with them. The resource person serves as a source of information for the individual receiving medical treatment. The teacher offers a more formal approach to the patient’s medical education. The role of a surrogate requires the nurse to substitute for a family member of the patient that is missing during the treatment (Wayne, 2014). The counselor helps the client of a hospital to better express their feelings that might be conducive to the improvement of their health. The role of technical expert requires the nurse to operate medical equipment. The time that they spend in each role differs significantly depending on the medical setting. For example, a critical care unit requires the health care professional to act as a technical expert more than a counselor. On the other hand, the nurse on a postpartum has to assume the role of a surrogate and guide a mother rather than act like a leader (Black & Chitty, 2014).
Black, B., & Chitty, K. (2014). Professional nursing. St. Louis, MO: Elsevier.
D’Antonio, P., Beeber, L., Sills, G., & Naegle, M. (2014). The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nursing Inquiry, 21(4), 311-317.
Wayne, G. (2014). Hildegard Peplau’s Interpersonal Relations Theory. Web.