HILDEGARD PEPLAU

HISTORY
Hilda was born in Reading, Pennsylvania to immigrant parents of German descent, Gustav and Otyllie Peplau. She was the second daughter born of six children. Gustav was an illiterate, hard-working father and Otyllie was an oppressive, perfectionist mother. Though higher education was never discussed at home, Hilda was strong-willed, with motivation and vision to grow beyond traditional womens roles. She wanted more out of life and knew nursing was one of few career choices for women in her day. As a child, she witnessed the devastating flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of illness and death on families. In the early 1900s, the autonomous, nursing-controlled, Nightingale era schools came to an end schools became controlled by hospitals, and formal "book learning" was discouraged. Hospitals and physicians saw women in nursing as a source of free or inexpensive labor. Exploitation was not uncommon by nurses employers, physicians and educational providers. Nursing practice was controlled by medicine. Peplau began her career in nursing in 1931 as a graduate of the Pottstown, PA, School of Nursing. She then worked as a staff nurse in Pennsylvania and New York City. A summer position as nurse for the New York University summer camp led to a recommendation for Peplau to become the school nurse at Bennington College in Vermont. There she earned a bachelors degree in interpersonal psychology in 1943. At Bennington and through field experiences at Chestnut Lodge, a private psychiatric facility, she studied psychological issues with Erich Fromm, Frieda Fromm-Reichmann, and Harry Stack Sullivan. Peplaus lifelong work was largely focused on extending Sullivans interpersonal theory for use in nursing practice. From 1943 to 1945 she served in the Army Nurse Corps and was assigned to the 312th Field Station Hospital in England, where the American School of Military Psychiatry was located. Here she met and worked with leading figures in British and American psychiatry. After the war, Peplau was at the table with many of these same men as they worked to

reshape the mental health system in the United States through the passage of the National Mental Health Act of 1946. Peplau held masters and doctoral degrees from Teachers College, Columbia University. She was also certified in psychoanalysis at the William Alanson White Institute of New York City. In the early 1950s, Peplau developed and taught the first classes for graduate psychiatric nursing students at Teachers College. Dr. Peplau was a member of the faculty of the College of Nursing at Rutgers University from 1954 to 1974. At Rutgers, Peplau created the first graduate level program for the preparation of clinical specialists in psychiatric nursing. She was a prolific writer and was equally well known for her presentations, speeches, and clinical training workshops. Peplau vigorously advocated that nurses should become further educated so they could provide truly therapeutic care to patients rather than the custodial care that was prevalent in the mental hospitals of that era. During the 1950s and 1960s, she conducted summer workshops for nurses throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught interpersonal concepts and interviewing techniques, as well as individual, family, and group therapy. Peplau was an advisor to the World Health Organization and was a visiting professor at universities in Africa, Latin America, Belgium, and throughout the United States. A strong advocate for graduate education and research in nursing, she served as a consultant to the U.S. Surgeon General, the U.S. Air Force, and the National Institutes of Mental Health. She participated in many government policy-making [Link] served as president of the American Nurses Association from 1970 to 1972 and a second vice president from 1972 to 1974. After her retirement from Rutgers, she served as a visiting professor at the University of Leuven in Belgium in 1975 and 1976. She died peacefully in her sleep at home in Sherman Oaks, California.

I N T E R P E R S O N A L T H E O RY
Major Concepts

The theory explains the purpose of nursing is to help others identify their felt difficulties. Nurses should apply principles of human relations to the problems that arise at all levels of experience.

Peplau's theory explains the phases of interpersonal process, roles in nursing situations and methods for studying nursing as an interpersonal process.

Nursing is therapeutic in that it is a healing art, assisting an individual who is sick or in need of health care.

Nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal.

The attainment of goal is achieved through the use of a series of steps following a series of pattern.

The nurse and patient work together so both become mature and knowledgeable in the process.

Definitions

Person: A developing organism that tries to reduce anxiety caused by needs. Environment: Existing forces outside the organism and in the context of culture Health: A word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal and community living.

Nursing: A significant therapeutic interpersonal process. It functions cooperatively with other human process that make health possible for individuals in communities.

Roles of nurse

Stranger: receives the client in the same way one meets a stranger in other life situations provides an accepting climate that builds trust. Just like in the hospital settings, a nurse receive a patient in the admission unit which is in they are both strangers to each other.

Teacher: who imparts knowledge in reference to a need or interest. As a nurse, imparting knowledge to the patient is a vital rule of a nurse, like health teachings, giving some information to the patient regarding a certain disease.

Resource Person : one who provides a specific needed information that aids in the understanding of a problem or new situation. Giving further information which is the patient did not understand to a specific procedure which has been applied to them or before to be applied to them is one of the rule of a nurse. And orienting the patient in his current condition and status of his health.

Counselors : helps to understand and integrate the meaning of current life circumstances ,provides guidance and encouragement to make changes. As a nurse, you always there for the patient specially listening them on their current condition in which they are emotionally affected in their situation.

Surrogate: helps to clarify domains of dependence interdependence and independence and acts on clients behalf as an advocate. A nurse always there for the patient specially during the patients weakest point. The nurse serves as the right hand of the patient when the patient cant perform fully on his or her daily activity.

Leader : helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way. The nurse helps the client to sets goals in which they both aim to a better healthy individual.

Additional Roles include: Technical expert, consultant, health teacher, tutor, socializing agent, safety agent, manager of environment, mediator, administrator, recorder observer and researcher.

THE PHASES OF NURSE PATIENT RELATIONSHIP

FACTORS AFFECTING THE ORIENTATION PHASE

This are the factors affecting the orientation phase. The values, culture race, beliefs, past experiences, expectations, and preconceived ideas are believe to be the factors affecting the orientation phase because each person has their own characteristics and believes, specially in culture aspects.

Exploitation Phase
In this phase the nurse will use the available professional assistance for problem solving alternatives based on the needs and interest of the patient. The patient here feels that they are part of the helping environment in which the nurse and the patient will helping in each other to achieve their goals. In this phase, the nurse must aware the different phases of communication in dealing with patients so that the nurse can explore, understand and can adequately deal with the underlying problem. And the patient will make minor request or attention getting techniques.

Resolution Phase
This is the so called termination phase between the nurse-patient relationship. In this phase the patient drifts away and breaks bond with the nurse and healthier emotional balance is demonstrated and both becomes mature individuals. The goal of the nurse and the patient that was set at the orientation phase has been already met and is said to be the difficult phase for both psychological dependence persist.

APPLYING THE INTERPERSONAL THEORY TO NURSING PROCESS

Assessment

Orientation collection and analysis

Data

Non continuous data collection Felt need Define needs

[continuous]

May not be a felt need

Nursing Diagnosis Planning

Identification

Interdependent goal setting

Mutually set goals Exploitation

Implementation

Plans initiated towards achievement of mutually set goals

Patient actively seeking and drawing help

May be accomplished by patient , nurse or family

Patient initiated

Evaluation

Resolution

Based on mutually expected behaviors May led to termination and initiation of new plans

Occurs

after

other

phases

are

completed successfully

Leads to termination a

HILDEGARD PEPLAU

Nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal. Nursing is therapeutic in that it is a healing art assisting an individual who is sick or in need of health care