Hildegard E. Peplau was born on September 1, 1909. She worked as an American nurse and became the only nurse to serve as the executive director and then, later on as president of the American Nurses Association. Hildegard was also one of the first nurses to do scholarly work since Florence Nightingale. Her Theory of Interpersonal Relations helped to revolutionize nursing.
Nurses around the world value her achievements. She became famously known as the “Mother of Psychiatric Nursing” and earned the title “Nurse of the Century.”
Hildegard’s Early Life
Hildegard Peplau was born in Reading, Pennsylvania, and was raised by her parents, Gustav and Otyllie Peplau, both of German ancestry. She was the second among six children, having three brothers and two sisters. Her persistent father was illiterate, while her mother was an oppressive perfectionist.
Peplau’s eagerness to break out of traditional women’s roles was evident at an early age. Nursing was one of the few career options available to females during her era. She was ten years old when she saw the 1918 deadly flu epidemic, which greatly influenced her perception of disease and death’s impact on families.
The formal “book learning” was abandoned when hospitals assumed control of schools after the autonomous Nightingale era ended in the early 1900s.
Women who worked as nurses were frequently exploited by hospitals and physicians, who saw them as a source of free or inexpensive labor. Exploitation was prevalent among nurse’s employers, practitioners, and educational institutions.
She received her nursing degree from the Pottstown, Pennsylvania School of Nursing in 1931. In 1943, she graduated with a Bachelor’s degree in interpersonal psychology from Bennington College in Vermont.
At Chestnut Lodge, a private psychiatric hospital in Maryland, she studied psychology with Erich Fromm, Frieda Fromm-Reichmann, and Harry Stack Sullivan.
In 1947, Peplau completed his studies at Teachers College, Columbia University, with a master’s and a doctorate.
Hildegard Peplau completed her training in Pennsylvania and subsequently worked as a hospital staff nurse in New York City.
A summer job as a nurse at New York University’s summer camp resulted in Bennington College recommending Peplau for a school nurse position. She earned a Bachelor’s degree in interpersonal psychology from Bennington College, where she served as the school nurse.
Peplau’s major work was extending Sullivan’s interpersonal theory for use in nursing experience.
In the Army Nurse Corps, she served at the 312th Field Station Hospital in England from 1943 to 1945, where the American School of Military Psychiatry was based.
She got to know and collaborate with the most important figures in American and British psychiatry. Peplau was at the table with many of these same men in the years following World War II, as they worked to transform the mental health system in America via the passage of the National Mental Health Act of 1946.
Peplau was a graduate of the William Alanson White Institute in New York City, where she received training in psychoanalysis. She pioneered the first graduate psychiatric nursing education courses at Teachers College in the early 1950s.
Peplau was a professor of nursing at Rutgers University from 1954 until her retirement in 1974. She was an emeritus professor at the university. She developed the first graduate-level program in psychiatric nursing at Rutgers University. She was a prolific author and a well-known lecturer, instructor, and presenter.
Peplau fought tirelessly for nurses to obtain further training to offer genuine therapeutic care to patients rather than the custodial care prevalent in mental hospitals at the time. She directed summer workshops for nurses across the United States during the 1950s and 1960s, particularly in state psychiatric hospitals.
She taught interpersonal concepts and interview processes in these courses, as well as individual, group, and family therapy. She was a consultant at the World Health Organization and a visiting professor at universities in Belgium, Latin America, Africa, and America.
Peplau was an outspoken advocate for advanced nursing education and research. She served as a consultant to the US Surgeon General, the US Air Force, and the National Institute of Mental Health, among others, as a strong supporter of graduate education in nursing.
She was a member of numerous government policy-making organizations.
Peplau was an advocate for nursing education throughout her entire career.
In 1975 and 1976, after she left Rutgers, she served as a visiting professor at the University of Leuven in Belgium. She also played a significant role in establishing the first graduate nursing program in Europe.
She was the ANA’s only executive director and later president. She served on the Board of the International Council of Nurses (ICN) for two terms. She was also a member of the New Jersey State Nurses Association, where she served on numerous committees and task forces. She has left an indelible mark on the field and the mentally challenged people of the United States, having worked in nursing for 50 years.
She was a pioneer in the field of modern psychiatric nursing. She was also a creative teacher and advocate for mentally challenged patients. Peplau was a supporter of more advanced education for nurses, became an Executive Director and then later, the President of the ANA.
As with any other well-known figure, her life was frequently marred by conflict, which she handled with bravery, skill, and conviction.
Hildegard Peplau’s Interpersonal Relations Theory
The foundation of the nursing practice is in the nurse-client relationship, according to Hildegard Peplau’s Interpersonal Relations Theory. This theory, which many consider being a classic revolution, stressed the give-and-take of nurse-client relationships. Peplau developed an interpersonal model in which the nurse’s role is to work in collaboration with her or his patient, rather than simply delivering therapy and executing doctors’ orders.
The four components of them include:
- A person– a developing being that strives to alleviate anxiety caused by needs; time
- Environment- Consisting of forces outside a person that put culture into context.
- Health- is a word that implies a forward movement of personality.
- Nursing- is a vital therapeutic interpersonal interaction that works in tandem with another human process to enable people in communities to live healthy lives.
According to the nursing model, the interpersonal relationship is divided into four phases: orientation, identification, exploitation, and resolution.
The following seven nursing jobs are included in the model:
- Stranger role
- Resource role
- Teaching role
- Counseling position
- Surrogate Job
- Active leadership position
- Technical expert job.
Nursing definition according to Peplau’s theory
Hildegard E. Peplau’s theory defines nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse specially educated to recognize, respond to the need for help.”
The theory perceives nursing as a maturing force and an educative instrument involving interaction between individuals with a common goal.
This shared aim in nursing motivates the therapeutic process, in which the nurse and patient regard each other as individuals, both learning and growing as a result of their interaction.
When an individual interprets stimuli in the environment and responds to them, she or he learns.
Peplau’s Interpersonal Relations Theory’s assumptions include:
- Interaction between the patient and the nurse is possible.
- Peplau remarked that as a result of the therapeutic encounter, both the patient and the nurse mature.
- Communication and interview skills, which are still critical nursing skills, remain intact.
- Peplau thought that nurses must first comprehend themselves to enable their clients’ progress and avoid restricting them to options that nurses care about.
The Key Concepts of the Interpersonal Relations Theory
According to this theory, the purpose of nursing is to assist individuals in recognizing their felt difficulties and that nurses should apply human relations concepts to the issues that arise at all levels of experience.
Man, according to Peplau, is an organism that “strives in its own way to reduce tension generated by needs.” A client is a person who has felt the necessity to be addressed.
The term “health” is used as a sign that implies the forward movement of personality, other human processes, and ongoing activities that lean towards creativity, productivity, personal, and community living.
Society or Environment
Peplau does not expressly discuss society or the environment in this theory. Still, she does urge nurses to consider the patient’s culture and customs when he or she adjusts to the hospital routine.
Nursing, according to Hildegard Peplau, is a “significant, therapeutic, interpersonal experience.” It’s a “human relationship” between a sick or need-of-health-care patient and a specially trained nurse to identify and respond to such needs.
Therapeutic Nurse-client Relationship
A good relationship between a client and a nurse is based on the client’s desires, feelings, issues, and ideas. It involves communication among two or more people with a shared objective. This objective, or any other goal, is achieved through a sequence of stages with a logical progression.
The following are the four phases of the therapeutic nurse-patient relationship:
- Orientation Phase
The orientation phase of the nurse’s education entails interacting with the patient, providing explanations and information, and answering inquiries.
The first stage is the problem definition period, during which the client meets the nurse as a complete stranger. The process of defining the problem and deciding on the sort of service required begins here. The client comes to the nurse for help, communicates his or her needs, inquires about treatment options, and express preconceptions and expectations derived from past experiences. The nurse answers describe responsibilities to the client, identifies issues, and makes use of available resources and services.
2. Identification Phase
The client’s identification phase begins when he or she works interdependently with the nurse, expresses emotions, and develops a sense of empowerment.
Competent professional assistance may be required. The patient develops a sense of belonging and a capacity to deal with the situation, which reduces feelings of helplessness and hopelessness.
3. Exploitation Phase
In the exploitation stage, the client fully exploits the services available. Professional help for resolving issues is offered. The advantages of services are used based on the needs and interests of the patients.
The patient feels like an essential component of the assisting team. They may make modest requests or use attention-seeking strategies to get your attention. The patient’s level of independence might vary.
The techniques of interviews must be applied to investigate, comprehend, and effectively manage the source of the problem. A nurse must know different phases of communication. The nurse assists the patient in taking advantage of all sources of assistance, and the patient makes progress toward the end step.
4. Resolution Phase
The client no longer needs expert aid in the resolution stage, and dependent actions are abandoned. The relationship comes to an end.
The professional relationship between the nurse and the patient is terminated. The collaborative efforts of both parties have already met the patient’s requirements. The nurse may not continue to work together with the patient after this point. They must withdraw from their therapeutic connection and cut any ties that may exist.
The situation may be tough for both individuals because psychological dependence persists.
The patient withdraws and breaks the nurse’s relationship, and a better emotional balance is established, with both reaching maturity.
Sub Concepts of the Interpersonal Relations Theory
Later, nurse theorists and practitioners, in turn, used Peplau’s model to create more sophisticated and therapeutic nursing treatments.
The nurse’s primary function is to create a therapeutic relationship. Peplau identifies the following roles of the nurse in a therapeutic connection:
Responding to a client in the same way that a nurse would respond to any stranger with respect and politeness.
The nurse assists in identifying and locating resources that will aid in the resolution of the problem. Anurse provides answers to questions.
The nurse shares personal experiences, thoughts, and feelings with the client to create a sense of empathy. A therapeutic connection can be established when both individuals share understanding through this authentic contact.
A nurse listens to the client without influencing the individual’s personal expression. A nurse respects and retains confidentiality regarding any personal information shared by a client.
A nurse assesses the affective responses of the client to clarify the situation and offer guidance or an alternative viewpoint. Empathy is also demonstrated when a nurse demonstrates understanding through active listening, not judging the client’s feelings.
A nurse offers instruction and explanation to enhance client knowledge or awareness of self, others, and the environment.
A nurse directs the patient’s efforts to resolve problems and facilitate his or her independence. When leading, a nurse strives to lead by example, not command.
A nurse offers guidance to aid in decision-making or to enhance problem-solving skills. A nurse may also provide emotional support and encouragement.
A nurse provides expert support, guidance, and instruction to aid in the resolution of the client’s problem.
Anxiety is defined as a person’s first response to a psychic danger. The four degrees of anxiety are described below.
Mild anxiety is a healthy mental state characterized by heightened attention and enhanced senses, which allows a person to acquire new habits and solve difficulties. All accessible stimuli can be perceived.
Moderate anxiety entails a limited perceptional field (persons with this type of worry focus on the immediate task and nothing else); learning a new behavior or dealing with difficulties is only possible with assistance. Another individual can redirect the person to the activity.
Severe anxiety is characterized by dread and terror. The individual cannot be redirected to an activity; instead, he or she obsesses on isolated details and has tachycardia, diaphoresis, and chest discomfort as physiologic symptoms.
Panic anxiety is characterized by fear of impending doom, dread of losing control, physical symptoms such as sweating and trembling, and panic attacks. Loss of rational thinking, delusions, hallucinations, and total bodily immobility and silence are possible symptoms. The individual may flee in terror or run aimlessly at risk of harm.
The importance of Peplau’s ideas has been recognized by later nursing theorists and practitioners, who have used them to develop more sophisticated and therapeutic nursing techniques, such as the seven nurse roles.
To put it another way, the nursing role entails that a nurse has responsibility for not just caring but also all activities that may impact the client’s health.
However, with those people who are unfit and powerless in communicating—particularly those who are unconscious and immobile—the concept of nurse-client cooperation becomes restricted.
It’s vital to understand Peplau’s Interpersonal Relations Theory of Nursing, particularly if you want to work in the field.