Peplau provided arguably the most revolutionary and most effective working formula for nurses all over the world known as Peplau’s nursing formula. This nursing theory completely changed the way nurses view their nursing duties as well as the patients they tend to on a near daily basis. In the period between 1943 and 1945, Peplau served as a nurse in the army corps being assigned to the 312th field station hospital in England. Here, she made acquaintance and worked with some of the key leading figures in American psychiatry as well as British psychiatry. After the war, she did extensive work to try to reshape the then not so accommodative and flexible mental healthcare system in the United States of America. It was perhaps her service in the army throughout World War 2, as well as her extensive educational background, and expertise that enabled her to revolutionize the practice of nursing not only in her home but also throughout the globe (Haber, 2003).
Her experiences exposed her to situations where nurses dealt with patients with special needs. However, due to ignorance or lack of an appropriate working, the formula ended up rendering substandard services that actually served the detriment of the patient’s recovery instead of helping them attain a quick recovery both physically and psychologically. In her theory, she described the nurse client relationship as the major foundation of the nursing practice. She emphasized the importance of cooperation between nurses and their respective patients as opposed to patients passively receiving service and nurses doing all the work without any feedback whatsoever from the patients. Her methods also highly discourage nurses from just passively acting out the orders given by the doctor and urges them to engage the patients in a friendly manner so as to develop more than just the traditional nurse patient relationship but a new relationship with a more personal paradigm and elements of friendship (Beeber, 2003).
The theory is of the thought that the main purpose of nursing as a health related practice, and a pivotal one at that is to aid anyone in need to identify the difficulties they feel. This in other words means that nurses are supposed to play an active role in diagnosis and deduction of what the actual problem troubling the patient is. Nurses are thus supposed to shun the old age tradition of nurses taking a back seat as far as ailment deduction is concerned and play an active role in determining each patient’s particular problem with pinpoint accuracy levels. This can be achieved by nurses creating an environment where the patients feel free and indeed encouraged to divulge information regarding their current medical predicament. Nurses can also take up the role of asking simple questions that will enable the patient to divulge information on the full extent of their ailment (Benfer, 2007).
The theory further asserts that as far as nursing is a healing art it is thus by inference also a therapeutic art. The key role of a nurse is thus brought out as the need to ensure a quick recovery of patients and ensure that the patients experience the highest levels of not only physical but also mental relaxation through their transition period. Nurses are supposed to take up roles of therapists as far as patient recovery is concerned and ensure a smooth transition process. Nurses are thus inclined to provide all the necessary assistance to any person in need of healthcare whenever the chance presents itself (Peplau, 2006).
The theory further states that because nursing more often than not involves interaction of two or more people who all share a common goal; it is thus upgraded to an interpersonal relationship. Nursing no longer operates in one-dimensional paradigm as it did previously but adopts a more interpersonal paradigm. The relationship between nurses and their patients is thus upgraded to an interpersonal paradigm, which enables the nurse and patients to interact on a more personal level. Thus, the nurse and patient are no longer just professional service provider and customer in need of professional service, but their relationship is upgraded to a more personal level. This has gone a long way in enhancing levels of communication between nurses and patients. The ability of patients to divulge information to nurses more freely puts the nurses at a better position to render more specialized care and with extremely high levels of professionalism (Peplau, 2006).
The theory further modifies the relationship between the nurse and the patient to a partnership. The theory asserts that the nurses and patients must work together since they are both on the same team and are advocating for achievement of the same goals. This working together between nurses and their patients cultivates high levels of maturity during the process in which, the nurse tends to the particular patient. This enables both the nurse and the patient to be in a better position to gain full comprehension of the process at hand and be able to exercise their scrutiny of the process without fear of reprisals from other quarters since all the involved personalities are aware that they are on the same team, and they all seek the fulfillment of similar goals (Peplau, 2005).
The theory defines nursing as perhaps the most significant interpersonal process. The theory further asserts that nursing as a practice functions in cooperation with other processes attributed to human nature either consciously or subconsciously that tend to enhance the possibility of health for individuals living in communities. This thus states that the main concept behind nursing and the key role of nurses is indeed to provide care for patients that is of a therapeutic nature and will help cover significant ground as far as patient recovery is concerned. Every action taken by a nurse in regard to a patient should be inclined towards the therapeutic recovery of the patient.
The theory defines health as a symbol implying exodus or movement with a foreword orientation in terms of personality as well as other human processes in the direction of productive, creative, constructive and a more personal community living. Health is thus a unidirectional process inclined towards better living conditions not only of the individual but also of the entire community at large. Every member of the community thus has the obligation to seek optimum health conditions for themselves but also for their greater community. The theory also defines a person as an organism in its developmental stage trying to reduce its levels of anxiety that is caused by needs. According to the theory the average person always has needs either of health related type or otherwise, and these needs tend to raise anxiety levels, which In turn greatly raises discomfort levels. The average person is thus always on a quest to seek a reduction of their anxiety levels caused by perhaps their harsh living standards or otherwise and in the process attain better health related results (Peplau, 2005).
The theory further breaks down the roles of nurses into seven roles that seek to enhance their professional performance capability. The first role of a nurse is that of a stranger. The nurse is thus under the strictest of obligations to receive the needy client the same way one receives a stranger in other real life situations. The nurse is obliged to provide a climate that displays acceptance of the patient and works to build trust between the nurse and the patient. This is pivotal to the performance capability of the nurse as well as the recovery rate of the patient as it will enable the patient to feel free and divulge more useful information to the nurse (Benfer, 2007).
The second role of a nurse as outlined in this theory is that of resource. Contrary to popular opinion of secrecy, as far as the medical field is concerned Peplau actually encourages nurses to correctly and accurately answer questions asked by their patients. Nurses are also asked to truthfully interpret data involving clinical treatment to their patients whenever requested to do so by the patients. Nurses are also required to give information on the general welfare of the patient and their level, as well as their rate of recovery (Benfer, 2007).
The third role of nurses as outlined by this theory is that of teaching. Nurses are inclined to give specific and accurate instructions to their patients and provide them with the necessary training that will enhance their recovery process and make the process as least strenuous as possible. Nurses are also supposed to analyze the experience of the patient and be able to tell whether or not progressive gains are being made by the patient on their road to recovery. The nurses are also supposed to be highly capable of synthesizing the patient’s experience and accurately tell whether or not the treatment that is currently being administered is actually helpful to the patient or brings out undesired effects. The fourth role of nurses according to Peplau is that of counseling. Nurses are supposed to be capable of enabling patients to understand and fully integrate the meaning of their current predicament or circumstances. Nurses are also supposed to provide encouragement to their patients and provide guidance that will enable them to make gainful changes (Haber, 2003).
The fifth role of a nurse is that of a surrogate. Nurses are supposed to take up the role of advocate for their clients and act in the best interest of their clients seeking clarification of every procedure involving their client. The sixth role of a nurse is that of active leadership. The nurse is supposed to help the patient understand the importance of maximum adherence to suggested treatment procedures. The nurse is under obligation to help the patient assume the maximum responsibility as far as the fulfillment of treatment goals is concerned. The seventh role of a nurse according to Peplau’s theory of interpersonal relationships is that of technical expert. The nurse is supposed to possess up to date clinical skills and be able to use these clinical skills in assistance of patients on their road to recovery or pursuit of health. The nurse is also supposed to be able to display possession of these clinical skills with extremely high levels of expertise that will ensure a speedy recovery for the patient. The nurse is also supposed to possess technical skills as far as operation of equipment related to the nursing fraternity s concerned. Nurses are expected to be able to operate all medical equipment that they may be required to use with extremely high levels of expertise and professionalism (Haber, 2003).
This theory enhances nursing as an institution since in ensures more interactions between nurses and their patients. High levels of interaction reduce boredom levels and enable nurses to be able to carry out their duties more efficiently as well as enabling patients to feel more at home and free with their nurses. This plays a pivotal role in the recovery process of a patient, as they no longer feel restrained when dealing with their nurses. This theory also enhances the relationship between nurses and their patients band this plays a key role in patient recovery and the nurse’s ability to dispense their professional duty. This theory also enables a sense of personal fulfillment not only for the patient but also for the nurse as well. This personal fulfillment is established because of the personal relationship that develops between the nurse and the patient.
The concepts behind this theory find wide application in the field of psychiatric nursing. Therapeutic nursing necessitates the development of a therapeutic relationship between the nurses and their patients. This theory enables the nurses to build personal relationships with their patients that are of a therapeutic nature and aid in the quick recovery of the patients. The building of this personal relationship enables the nurses to accurately establish the depression and psychosis levels of their patients. The patients on their part learn to trust the nurses and periodically accept the help that is offered to them by their nurses.
References
Beeber, L., Anderson, C. A., & Sills, G. M. (2003). Peplau's Theory In Practice. Nursing Science Quarterly, 3(1), 6-8.
Benfer, B. A., & Schroder, P. J. (2007). Encountering Hildegard E. Peplau. Journal of the American Psychiatric Nurses Association, 6(1), 35-37.
Haber, J. (2003). Hildegard E. Peplau: The Psychiatric Nursing Legacy Of A Legend. Journal of the American Psychiatric Nurses Association, 6(2), 56-62.
Peplau, H. E. (2005). Peplau's Theory Of Interpersonal Relations. Nursing Science Quarterly, 10(4), 162-167.
Peplau, L. A. (2006). Remembering Hilda Peplau. Journal of the American Psychiatric Nurses Association, 6(1), 11-13.
