Nursing Theory: Interpersonal Theory, Essay Example

Nursing theory is very important to the nursing profession as a whole. Many years ago nurses that began to enter the field began to formalize their insights about why and how individuals needed nursing care and nurses still use a lot of that information today. Nursing theory is significant because it provides nurses on the strategies they can implement to maintain professional boundaries. Although all nurse-patient relationships commence with an initial encounter between the nurse and the patient, some nurses face difficulty in maintaining this professional boundaries and the relationship quickly deteriorates from a nurse-patient relationship to a friend-friend relationship. The switch to friend-friend relationship leads to a deterioration in the quality of nursing care and a breach of the patient’s privacy.
According to one theorist Hildegard Peplau there it have been a century since Nightingale created the nursing middle-range theory of interpersonal relations she also gives her views of interpersonal relations in nursing in 1952. Nursing theory can aid patients to avoid this outcome by providing frameworks that assist them in establishing and maintain professional boundaries throughout their interaction with patients (Smith & Parker, 2010).

Section One: Importance of Theory to Nursing Practice

Nursing theory is very important to nursing practice because it provides the guiding principles that underpin these practices and aid in the generation of new knowledge within the nursing field. Within traditional sciences, a theory is defined as a set of established assertions or premises that can be tested for verification (Hardy, 1978). Unfortunately, there is no consensus in extant scholarly literature regarding nursing theory, which has resulted in many individuals rendering nursing theory obsolete and impertinent to nursing practice. Nursing theory retains the capacity to give nurses a sense of identity, as it assists them in caring for their patients. Moreover, theory provides an important contribution for the delivery of healthcare services (Colley, 2003). Thus, theory retains a prominent position within the nursing professional, which merits a further examination of theory as well as its applicability using real-life scenarios.

Nursing theory has historically been developed concurrently with medical theory and epistemologies. It is significant because it helps nurses and nursing researchers ascertain what is already known and what needs to be discovered or tested to progress the field. It helps extricate what should constitute the basis of nursing practice by definitively describing nursing itself. Having a comprehensive corpus of theory is beneficial because it enhances better patient care in addition to nurses’ professional status; amplifies effective communication amongst nurses and medical personnel; and provides guidance for future education and research (Colley, 2003). Caring, which is the primary exponent in the nursing profession, cannot be quantified or measured, so it is critical the have nursing theory in order to examine and disclose exactly what nurses do. Currently, nurses strive to maintain professionalism, which is evident through the efforts of nurses to create a unique and nuanced corpus of knowledge and epistemologies. With the rise in importance of nurse practitioners within primary care settings, it is evident that the boundaries between medicine and nurses is quite nebulous and never remains static. It is thus important for nurses to have a sense of identity and be able to define their role and position within the healthcare system. Nursing theory provides the avenue through which nursing identity can be firmly established in a constantly evolving healthcare system.

Section Two: Hildegard Peplau and Nurse-Patient Relationship Theory (Interpersonal)

According to Hildegard Peplau (1988), nursing is very therapeutic due to the fact that it is a healing art in which a professional aids a sick patient who needs healthcare. As such, nursing is perceived as an interpersonal process since it necessitates the interaction of various individuals striving for the common goal of wellness. This goal functions as an incentive within nursing for the therapeutic process in which both the patient nurse have mutual respect for one another in order to grow and learn through interaction. Both parties learn when they choose environmental stimuli and react to them (George, 2005). Major concepts operating within this theory require defining certain terms for clarity. Peplau (1988) defines an individual as an organism that endeavors in its own manner to abate any and all tensions that germinate because of their needs. The patient is an individual that possesses a need related to their health. Health is thus defined as a symbol that connotes forward progress and movement of personality in addition to other continuous human processes that relate to the person, the creative, the productive, and ultimately community living. While Peplau does not explicitly expound on the environment and society, she does nonetheless galvanize nurses to take into consideration the culture, customs, and mores of patients when they adjust to life in the hospital.

At the core of this theory is the therapeutic nurse-client relationship that is “planned” and professional and zeroes in on the feelings, problems, needs, concerns and ideas of the patient as client. The aforementioned common goal of the nurse and client/clients is attained through various steps that follow a pattern. This sequential pattern involves four key steps in the nurse-client relationship. The first phase is called the orientation phase which is lead by the nurse who must engage the patient through treatment and disseminate information and explanations to any questions the client has regarding the healthcare process. The second stage is the identification phase in which the client and nurse collaborate, and the client conveys their feelings and ultimately starts to feel healthier and stronger. The third phase is known as the exploitation phase in which the client uses the resources and services available to the fullest extent. The final stage is the resolution phase in which the patient no longer requires professional services and thus no longer conveys any dependent behaviors. As a result, the relationship between nurse and client is severed.

Within this theory there are a handful of sub-concepts with regards to defining the role of the nurse in healthcare settings within the patient-nurse relationship. The nurse is charged with the duty of offering patients the same respect and acceptance that he or she does to strangers. In addition, nurses are critical resources for responding to probing questions of the client within a broader context. As a teacher, nurses help their clients learn both informally and formally. As a leader, nurses provide instruction and direction for patients, thereby functioning as a surrogate for a patient’s sibling or patient. Finally, as counselor, nurses are responsible for promoting certain behaviors and lifestyle suggestions so that the client feels comfortable in expressing his or her feelings and ultimately become healthy (Peplau, 1952). Other roles of the nurse include tutor, mediator, researcher, observer, and consultant. It is evident that this theory proffers a systematic and logical way or perceiving various nursing situations. Key concepts including tension, frustration, and anxiety are expounded on, and they have explicit and complex relationships between them within a progressive stage.

Thus, this theory carried several assumptions within healthcare settings. First, patients and nurses can interact and can collaborate in an interpersonal manner. Peplau underscores that both nurses and patients grow and develop through therapeutic interaction. From the nursing perspective, effective communication and interviewing dexterity are integral nursing tools. It is unequivocal that Peplau believed that nurses must be self-aware in order to promote the growth of patients, thereby eschewing the choices of patients to those that retain currency within nursing circles. Nurses in the present day assess various concepts including socioeconomic forces such as finances; intra-family dynamics; social service resources at the community level; and personal space issues of all clients. These aforementioned concepts give nurses a broader perspective of the environment in which the patient is embedded in over the concepts of conflict, frustration, and anxiety as articulated by Peplau. As such, a further examination of the applicability of Peplau’s interpersonal theory within current nursing contexts is necessary.

Section Three: Nurse Patient Relationship Theory Application

Within the nursing process and practices, Peplau’s interpersonal theory is relevant and shares many similarities as well as differences, which calls for an assessment of the strengths and weaknesses of the theory. Both place currency in therapeutic interactions and are sequential, thereby underscoring their role as helpers for patients who have certain complaints and to clearly identify patient needs. Observation, communication, and recording are utilized in both theory and practice (“Application,” 2011). The strengths of this theory are manifold, as the phases outlined therein help structure the natural progression of the relationship between nurse and client. Moreover, the simplicity of the structure renders it pliable to any interactions between nurse and patient so that it can be generalized and applied broadly. However, there are some weaknesses, as it cannot be applied to patients who are more introverted or withdrawn and thus do not feel a need as well as those whom are unconscious. The promotion of health and maintenance is also deemphasized within this theory.

The concepts within this theory provide clear exposition of the roles nurses have, which can be utilized  by all nurses in their practice. It insinuates that a nurse’s obligation is not only to care but also to oversee all activities that can potentially impact the healthcare of patients. The concepts within this theory are most applicable within psychiatric settings, which makes sense because of Peplau’s background in psychology (George, 1995). However, it is not just limited to that medical field because it can be used in any healthcare settings in which patients want to communicate with nurses. The various phases are aligned with the nursing process, which is why it had broad applicability. The orientation phase and nursing assessment coincide with one another; the identification phase is linked to the diagnosis and planning of a nursing healthcare plan for clients; the implementation of a patient’s healthcare plan aligns with the exploitation stage; and finally, assessment is carried out in the resolution phase.

Conclusion

Nursing theory unequivocally retains currency in the nursing process and was built on the pillar of interaction between patient and client. As a result, it has provided meaningful contributions to nursing in research, clinical practice, and theoretical arenas and has fortified various nursing epistemologies. This theory ultimately proffers a unique perception for the comprehension of the patient-nurse relationship.

References

Application of interpersonal theory in nursing practice. (2011). Current Nursing. Retrieved November 4, 2015.

Colley S. (2003). Nursing theory: its importance to practice. Nursing Standard, 17, 46, 33-37.

Forchuk C. &Reynolds, B.. (1998). Interpersonal theory in nursing practice: Peplau legacy.  Journal Of Psychiatric And Mental Health Nursing, 5(3), 165-166.

George, J. (1995). Nursing theories: The base for professional nursing practice. Norwalk, CT: Appleton & Lang.

Yancey, N.R. (2015). Why teach nursing theory? Nursing Science Quarterly, 28(4), 274-278.