Hildegard Peplau was born and raised in Reading, Pennsylvania on September 1, 1909. At this period of time in America, career fields considered to be appropriate for women were limited. Peplau consider the field nursing after being influenced by seeing the impact of death and illness during the 1918 flu pandemic (Wayne, 2014). Peplau has been regarded as one of the fifty most influential Americans, the mother of psychiatric nursing, and a ‘Living Legend’ by the American Academy of Nursing (Winship, Bray, Repper, & Hinshelwood, 2009, p. 509).
Educational and Experiential background
Hildegard Peplau graduated from the Pottstown (Pennsylvania) Hospital Training School in 1931. After graduating, she worked as and an infirmary nurse while attending Bennington College in Vermont as a n undergraduate student. In the winter of 1941–1942, Peplau served as an intern at Maryland’s Chestnut Lodge, a private psychiatric hospital (D’Antonio, Beeber, & Naegle, 2014, p.311). After a stint with the military during World War II (WWII), Peplau went on to earn her masters as a student nurse at the Teaching College, Columbia University, and specialized in physchology (D’Antonio, Beeber, ; Naegle, 2014, p.312).
After Peplau’s nursing and teaching career, she spent the remainder of her life traveling and speaking at conferences worldwide. “She continued to rea?rm her commitment to the interpersonal psychotherapies, arguing that the nurse herself was the true agent of change rather than the mechanism of the therapy” (Winship, Bray, Repper, & Hinshelwood, 2009, p. 511).
There were several influential events and people in Peplau’s life. One event occurred after graduating from the Teaching College, Columbia University in 1943. Peplau enlisted in the military and was stationed in Sta?ord, England with the 312th military hospital. During this time, she introduced and utilized social and group therapy activities as therapeutic interactions with shell-shocked soldiers (Winship, Bray, Repper, ; Hinshelwood, 2009, p. 510).
Peplau was also influenced through seminars and lectures that were led by John Bowlby and William Menninger; deepening her psychoanalytic leanings. Likewise, her interest in social science rather than natural science was heavily stimulated through lectures with Eric Fromm and Harry Stack Sullivan. However, her greatest influence came from personal time and lectures on several topics that included dreams, myths and symbols with Frieda Fromm-Reichmann Peplau formed the basis for her Interpersonal Relations in Nursing through these experiences (Winship, Bray, Repper, ; Hinshelwood, 2009, pp. 510-511).
According to Gastmans (1998), “Peplau is convinced that nursing must be conceived as
an independent scientific discipline which attempts to clarify a practical situation in nursing on the basis of nursing itself, though sometimes also with the help of relevant ideas from the natural and social sciences” (p. 1314). Peplau believed that as a scientific discipline, nursing is founded on a cyclical process and cannot be merely an empirical science of objectifiable phenomena, but instead primarily orientated towards values including health, well-being and care. (Peplau 1988, Gastmans, 1998, p. 1314).
Classification of Theory
Peplau’s Theory of Interpersonal Relations is a middle-range theory (Hagerty, Samuels, Norcini-Pala, & Gigliotti, 2017). While this theory does have similarities to a grand theory such as an origin of synthesis of experiences, observations, insights, and research findings; it is more concentrated on a specific concept, reflects practice, and crosses different nursing fields (Meleis, 2012, p. 33). One defining factor that place Peplau’s theory apart as a middle-range theory was that both her and her student’s experiences to gather empirical data that was tested and refined, then compared her findings with practical situations for optimization (Gastmans, 1998, p. 1314).
School of Thought
Peplau believed a patient’s experiences during nursing care were vital, and that nurse-patient relationships have a great impact on the care process. She also emphasized that the focus should be on the patients, their needs, and their perceptions about the care they received from nurses (Gastmans, 1998, Hagerty, Samuels, Norcini-Pala, ; Gigliotti, 2017, p. 160). Another school of thought held by Peplau was that while a nurse does work in an assisting role to physicians, nursing should be considered an autonomous profession, with the execution of medical directives being only a part of one’s tasks. According to one source, Peplau stated that the goal of nursing was, “to promote forward movement of personality in the direction of creative, constructive, productive, personal and community living” (Peplau 1952 p. 16, Gastmans, 1998, p. 1313).
Application in Practice
Peplau’s Theory of Interpersonal Relations is centered on the nurse-client relationship, with an aim to “promote forward movement of personality in the direction of creative, constructive, productive, personal, and community living” (Gastmans, 1998, p. 1313). The theory involves the nurse-patient relationships passing through three phases for success. These phases are the orientation, working, and termination phase. (Hagerty, Samuels, Norcini-Pala, ; Gigliotti, 2017, p. 161). The working phase consists of two components; the identification and exploitative phases.
The orientation phase usually occurs during the first meeting as the nurse introduces themselves, discusses objectives and needs of the patient, gathers information, and assesses the patient’s health and situation. The next phase is the working phase, which begins with the identification sub-phase. During the identification phase the patient identifies with those helping them. The nurse affirms meeting the patient’s needs, understand self, and helps the patient to think through issues as well. The exploitative phase is when a treatment plan is established, priorities are identified, and instruction is provided by the nurse. The process completes with termination phase, which is basically prepares the patient for the end of the relationship (McCarthy, ; Aquino-Russell, 2009).