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Running head: PEPLAU THEORY

Peplaus Theory of Interpersonal Relationships
Rebecca Savage RN
Bethel College


Peplaus Theory of Interpersonal Relationships
Hildegard Peplau was a nurse who had a vision. Her vision was to see
nurses form relationships with their clients/patients to improve the overall
quality of care. Peplau was born in 1909 in Reading Pennsylvania. She was
of German decent from immigrant parents. Her father was a fireman who
worked on the railroad and her mother was a homemaker. Education was
never discussed at home but Hilda was strong willed, and had a vision to
grow beyond the traditional roles of women. In 1908 Peplau witnessed the
flu pandemic that greatly influenced her understanding of the impact of
illness and death had on families. Peplau stated, This personal experience
had influence me and this is when the root for nursing began to grow.
(Peplau, 1991).
Peplau began her career in nursing in 1931 as a graduate of Pottstown,
PA, School of nursing. She worked on staff as a nurse in Pennsylvania and
New York City. A summer position as a nurse led to a recommendation for
Peplau to become the school nurse at Bennington College in Vermont.
While here she earned a bachelors degree in Interpersonal psychology in
Running head: PAPLAU THEORY
At Bennington she was involved with several studies at Chestnut Lodge, a
private psychiatric facility. It was here she studied psychological issues with
Erich Fromm, Frieda Fromm-Reichmann and Harry Stock Sullivan.
Peplaus life long work was largely focuses on expanding on Sullivans
interpersonal theory for use in nursing practice.
Peplaus Theory
Peplau believes that he purpose of nursing is to help others identify their felt
difficulties (Fawcett, 2005). Peplau states Healing is an art (Peplau, H.E,
1952). Peplau defines nursing as a significant, therapeutic interpersonal
process, Human relationship between and individual who is sick or in need
of health services and a nurse specially educated to recognize and respond to
the need for help. (Forchuk, C. 2007). Peplaus theory has conceptualized
the patient participation in the nursing processes. Nurses are no longer
doing things to or for the patient but are directly involving them in their care.
Peplau describes four phase of the nurse client relationship. Orientation;
during this phase that the patient has a felt need and seeks professional help,
Identification: this is when the patient identifies those that can help and
participates in goal setting. Exploitation: patient actively seeks and draws

Running head: PEPLAU THEORY
knowledge and expertise of those who can help, Resolution: Occurs after
the other phase are completed successfully (Vandemark, L. 2006).
Discussion of Peplaus Theory
Health care professionals need to maintain an attentive and compassionate
stance when working with patients. They must also create an atmosphere of
trust (J Am Psychiatric 2008). Peplaus concept is used in every aspect of
nursing. Creating relationships is an art. This art, if developed can lead to a
relationship between health care giver and patient the rewards both. The
theoretical concept of Peplaus theory is relationships. She believed that if
you involved the patients and treated them as an individual you would see
better outcomes in their health. She believed that one should not judge a
patient base on appearances, gender, race or class (Peplau, 1994). Peplau
pushed for education that leaned towards therapeutic care instead of
custodial care. In Peplaus era in the mental hospitals where she found her
passion, she noted that once a patient was admitted there, they lost who they
were. Peplau felt that patients became a disconnected when they were cared
for and attended to. She encouraged the staff to get to know the patients as
individuals and have them involved with their care. Peplau has been widely

Running head: PEPLAU THEORY
credited with the transformation of nursing from a group of skilled workers
to a full-fledged profession.
Peplaus theory of interpersonal relationships can be seen in every aspect
of nursing today. Some say that the care of infants does not benefit from
this theory but I think that having a relationship with the family/parents can
contribute to the overall outcome of the infants health.
The application of this theory is seen everyday in my field of practice. In a
long term setting there are residents that are left there by their families.
Often times, the nursing staff becomes the residents family. Every once in
a while you will have the resident that is close off to everyone and this is
generally the resident that we have behavioral problems with. Most of the
time these residents that do not foster relationships with the staff have
underlying psych issues. I have experienced first hand the fulfillment of a
nurse/resident relationship. Willa was a resident that admitted to our facility
3 years ago. Her family experienced a lot of guilt for being unable to care
for her at home and having to place her in a nursing home. This family
had complaints about care, the food, the laundry service, etc. Every day I
had her husband (who was confined to a wheelchair himself because of polio
Running head: PEPLAU THEORY
as a child) in my office with a complaint. Slowly a relationship started to
form between the residents family and our staff. The resident herself never
had complaints but just let the family talk for her. Everyday for the last 3
years, Bob (Willas husband) would come to visit. Do to him being in a
wheelchair he was unable to get out of the van without help. Everyday a
staff member would go out and assist him out of the van. He would bring
his little dog baby with him and they would visit Willa. A few months
ago Willa past away from complications of COPD. My heart broke. My
interpersonal relationship with Willa and her family was so strong that she
was like family. The complaints about the facility and nursing care had been
almost non-existent for the past 2- years. Because of the relationships that
were able to form, the quality of care for the resident was improved. Bob
still comes to the facility every Monday, Wednesday and Friday. We still
help him out of his van and he comes to eat lunch. Because our
interpersonal relationships were so strong with the patient they continued
with the family.
Peplau was also coined as giving a voice to patients who could not speak
out for themselves (Fawcett, 2005). I can see this in my area of practice as I
work with the elderly population. Once the nurse becomes the voice for the
Running head: PEPLAU THEORY
resident, there seems to be a turn in the residents care. The resident begins
to participate and take an active roll, attend care plan events and become
more social with the other residents.
Peplaus interpersonal relationship theory is becoming the new standard of
nursing. It is imperative for the clinical teams working with patients to
recognize that relationships and trust are the basis to any relationship and are
now the basis to healthcare relationships. I think Peplau was trying to
achieve all nurses taking a look at themselves and evaluating what was
inside because that is what is reflected in their nursing care. Peplaus vision
has influenced the advancement of professional education and practice
standards in nursing ( Tomey & Alligood 2002). Her writings are still used
in nursing classes across the United States and abroad (OToole & Welt,
1989). Peplaus theoretical ideas, particularly her definition of nursing and
nursing process, elaboration of learning and psycho therapeutic methods
have become a part of the collective culture of the discipline of nursing
(OToole & Welt, 1989).

Running head: PEPLAU THEORY

Fawcett, J. (2005). Contemporary nursing knowledge (2
Philadelphia PA: F.A. Davis Company.