Friday 12 March 2010

Interpersonal Relations in Nursing: A Conceptual Frame of Reference for psychodynamic Nursing: Hildegard E. Peplau



Modern nursing theorists argue that in the field of Mental Health nursing the model, detailed by Hildegard Peplau, is
still the most appropriate and powerful. Service users and
carers too recognise the style of nursing as the most
benficial and sadly the most lacking.


Dr. Peplau emphasized the nurse-client relationship as the foundation of nursing practice. At the time, her research and emphasis on the give-and-take of nurse-client relationships was seen by many as revolutionary. Peplau went on to form an interpersonal model emphasizing the need for a partnership between nurse and client as opposed to the client passively receiving treatment (and the nurse passively acting out doctor's orders).Peplau was a revolutionary pioneer in the field of modern psychiatric nursing. Her fifty-year nursing career involved prestigious positions and theory development.
Peplau Interpersonal Relations
View more presentations from Ann Sparks.

Clients Perspective

Coatsworth-Puspoky, Forchuk, and Ward-Griffin conducted a study on clients’ perspectives in the nurse-client relationship. Participants in a study were asked about experiences at different stages of the relationship. The research described two relationships that formed the ‘bright side’ and the ‘dark side’. The ‘bright’ relationship involved nurses who validated clients and their feelings. For example, one client tested his trust of the nurse by becoming angry with her and revealing his negative thoughts related to the hospitalization. The client stated, “she’s trying to be quite nice to me…if she’s able to tolerate this occasional venomous attack, which she has done quite well right up to now, it will probably be a very beneficial relationship” (350). The ‘dark’ side of the relationship resulted in the nurse and client moving away from each other. For example, one client stated “the nurses’ general feeling was when someone asks for help, they’re being manipulative and attention seeking” (351). The nurse didn’t recognize the client who has an illness with needs therefore; the clients avoided the nurse and perceived the nurse as avoiding them. One patient reported, “the nurses all stayed in their central station. They didn’t mix with the patients…The only interaction you have with them is medication time” (351). Neither trust nor caring was exchanged so perceptions of mutual avoiding and ignoring resulted. One participant stated, “no one cares. It doesn’t matter. It’s just, they don’t want to hear it. They don’t want to know it; they don’t want to listen” (352). The relationship that developed depended on the nurse’s personality and attitude. These findings bring awareness about the importance of the nurse-client relationship.

Coatsworth-Puspoky, R., C. Forchuk, and C. Ward-Griffin. “Nurse-client processes in
mental health: recipient’s perspectives.” Journal of Psychiatric and Mental
Health Nursing 13 (2006): 347-355. EBSCOHost. McIntyre Lib., UW-Eau
Claire. 12 Nov. 2006

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