Hildegard Peplau
Dr. Peplau emphasized the nurse-client relationship as the foundation of nursing practice. The essence of Peplau's theories is the creation of a shared experience. Nurses, she thought, could facilitate this through observation, description, formulation, interpretation, validation, and intervention.
For example, as the nurse listens to her client she develops a general impression of the client's situation. The nurse then validates her inferences by checking with the client for accuracy. The result may be experiential learning, improved coping strategies, and personal growth for both parties.
Orientation Phase
The phase of the relationship, when the nurse and patient first meet is known as the orientation phase. This is a time when the patient and nurse come to know each other as people and each other’s expectations and roles are understood. The tasks of this phase are to build trust, rapport, establish a therapeutic environment, assess the patients strengths and weakness and establish a mode of communication acceptable to both patient and nurse.
Identification Phase
The patient begins to identify with the nurse and identify problems, which can be worked on. The meaning behind feelings and behaviour of the nurse and patient are explored. Peplau states that when a nurse permits patients to express what they feel, and still get all of the nursing that is needed, then patients can undergo illness as an experience that reorients feelings and strengthens positive forces in the personality.
Exploitation Phase
Identification Phase
The patient begins to identify with the nurse and identify problems, which can be worked on. The meaning behind feelings and behaviour of the nurse and patient are explored. Peplau states that when a nurse permits patients to express what they feel, and still get all of the nursing that is needed, then patients can undergo illness as an experience that reorients feelings and strengthens positive forces in the personality.
Exploitation Phase
The patient realistically exploits all of the services available to them on the basis of self interest and need. The nurse assists the patient in their efforts to strike a balance between the needs for dependence and independence.
Resolution PhaseThe resolution phase involves the gradual freeing from identification with helping persons, and the generation and strengthening of ability to stand alone, eventually leading to the mutual termination of the relationship. The patient abandons old needs and aspires to new goals. She or he continues to apply new problem solving skills and maintains changes in style of communication and interaction. Resolution includes planning for alternative sources of support, problem prevention, and the patient’s integration of the illness experience
