INTRODUCTION

Nursing has made phenomenal achievement in the last century that has led to the
recognition of nursing as an academic discipline and a profession. A move towards theory
based practice has made contemporary nursing more meaningful and significant by shifting
nursing’s focus from vocation to an organised profession. The need for a knowledge base to
guide professional nursing practice has been realised in the first half of the twentieth
century and many theoretical works have been contributed by nurses ever since, first with
the goal of making nursing a recognised profession and later with the goal of delivering care
to patients as professionals.

NIGHTINGALE’S ENVIRONMENTAL THEORY

 Florence Nightingale proposed this theory. She was born on 12th May 1820
 She is the founder of modern nursing
 She is the first nursing theorist
 Also known as, “Lady with a lamp”
 She explained her environmental theory in her famous book Notes on Nursing: what
it is, what it is not.
 She was the first to propose that nursing required specific education and training.
 Her contribution during Crimean war is well known
 She was a statistician, using bar and pie charts, highlighting key points
 International Nurses Day, May 12 is observed in respect to her contribution in
nursing.
 Died in 13 August 1910

The core concept most reflective of Nightingale’s writings is that of the foundation of
Nightingale’s theory that is environment. She witnessed in the early 1850’s the filth, vermin
and death within an enormous barracks hospital, would focus so heavily on improving the
environment to assist soldiers to merely survive. Through such emphasis the death rate
went from staggering 42 per 100 to a low of 22 per 1000.

This success gave her a strong data base on which to view nursing in her own unique
way. The environment is viewed as all the external conditions and influences affecting the
life and development of an organism and capable of preventing, suppressing and
contributing to disease or death. Her goal was to help the patient retain his own vitality by
meeting his basic needs through control of the environment.

At this point it is helpful to think of a patient who has had surgery, such as an
appendectomy, and relate what Nightingale proposes. Medicine is seen as functioning to
remove the diseased part where as nursing places the person in an environment in which
nature can assist postoperative patients to reach their optimum health conditions. This
approach to nursing is even valid today as it was over 100 years ago, in spite of the fact that
both in home and hospitals the environment today is more sophisticated in structure.

Nightingale’s Environmental Theory

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing
the environment of the patient to assist him in his recovery.” It involves the nurse’s
initiative to configure environmental settings appropriate for the gradual restoration of the
patient’s health, and that external factors associated with the patient’s surroundings affect
life or biologic and physiologic processes, and his development. Nightingale discussed the
Environmental Theory in her book Notes on Nursing: What it is, What it is Not. She is
considered as the first theorist in nursing and paved the way in the foundation of the
nursing profession we know today.

MAJOR CONCEPTS OF FLORENCE NIGHTINGALES THEORY

The major concepts of Florence Nightingale’s Theory are:

1. HUMAN OR INDIVIDUAL
 Referred to by Nightingale as the ‘ patient ’ in the most of her writings.
 Person is a human being acted upon by a nurse or affected by the anything
 Nightingale envisioned the person as comprising physical, intellectual,
emotional, social and spiritual components.
 Person has reparative powers to deal with disease; recovery is within the
patients power as long as a safe environment for recuperation exists.

2. NURSING
 “What nursing has to do… is to put the patient in the best condition for
nature to act upon him” (Nightingale, 1859/1992)
 Is a discipline distinct from medicine focusing on the person experiencing a
reparative process rather than on the disease of an anatomical structure or
the person’s physiology.
 Nightingale believed nursing to be spiritual calling. She saw nursing as the
“science of environmental management”
 Aims to provide fresh air, light, warmth, cleanliness, quiet and a proper diet.
3. ENVIRONMENT
 Defined as anything that can be manipulated to place a patient in the best
possible condition for nature to act.
 Involve those external conditions that affect life and development of the
individual. The focus is on ventilated, warmth, odours, noise and light.
 Environment serves as the foundation of nightingale’s theory.
 Environment includes everything from person’s food to a nurse’s verbal and
non verbal interactions in the person.

4. HEALTH
Health is maintained by controlling environmental factors to prevent disease; health
and disease are the focus of the nurse, who helps a person through the healing
process. Nightingale wrote “ Health is not to be well, but to be able to use well every
power we have”. From this statement we can infer that she believed in prevention
and health promotion to nursing patients from illness to health.
Conceptual framework of Nightingale’s Environmental Theory. Note that the client , the
nurse, and the major environment concepts are in balance; that is ; the nurse can
manipulate the environment to compensate for the clients response to it. The goal of nurse
is to assist the patient in staying in balance. If the environment of a client is out of balance,
the client expends the unnecessary energy.

SUB-CONCEPTS OF FLORENCE NIGHTINGALE’S ENVIRONMENTAL THEORY

1. HEALTH OF HOUSES: “ Badly constructed houses do for the healthy what badly
constructed hospitals do for the sick. Once insure that the air is stagnant and
sickness is certain to follow”

2. VENTILATION AND WARMING: “keep the air he breathes as pure as the external air,
without chilling him”. Nightingale believed that the person who repeatedly breathed
his or her own air would become sick or remain sick. The importance of room
temperature was also stressed by nightingale. The patient should not be kept too
warm nor too cold. The temperature could be controlled by burning fire and
ventilation from window.

3. LIGHT: Nightingale believed that second to fresh air, the sick needed light. She
noted that direct sunlight was want patients wanted.

4. NOISE: she stated that patients should never be waked intentionally or accidently
during the first part of sleep. She asserted that whispered or long conversation about
patients are thoughtless and cruel. She viewed unnecessary noise, including noise
from female dress, as cruel and irritating to the patient.

5. VARIETY: She discussed the need for changes in colour and form, including bringing
the patient brightly coloured flowers or plants. She also advocated rotating 10 or 12
paintings and engravings each day, week or month to provide variety to the patient.
Nightingale also advocated reading, needlework, writing, and cleaning activities to
relieve the sick of boredom.

6. BED AND BEDDING: Nightingale noted that an adult in health exhales about three
pints of moisture through the lungs and skin in a 24 hour period. This organic matter
 enters the bed sheet and stays there unless the bed sheet is changed and aired
frequently.
She believed that the bed should be kept in the lightest part of the room and placed
beside the window so that patient could see out of it.

7. PERSONAL CLEANLINESS: “ Just as it is necessary to renew the air around the sick
person frequently to carry off morbid effluvia from the lungs and skin, by
maintaining free ventilation, so it is necessary to keep pores of the skin free from all
obstructing secretions.
She stated that “every nurse ought to wash her hands very frequently during the
day”

8. NUTRITION AND TAKING FOOD: Nightingale noticed that individual desired different
food at different times of the day and that frequent little servings may be more
beneficial to the patient than a large breakfast or dinner. She urged that no business
be done with patients while they are eating because this was distraction.

9. CHATTERING HOPES AND ADVICES: Nightingale wrote that to falsely cheer the sick
nurse to heed what is being said by visitors, believing that sick persons should hear
good news that would assist them in becoming healthier.

10. SOCIAL CONSIDERATION : Nightingale supported the importance of looking beyond

the individual to the social environment in which he or she lives.

ENVIRONMENTAL FACTORS IDENTIFIED BY FLORENCE NIGHTINGALE

Florence Nightingale identified five environmental factors as follows:

 PURE FRESH AIR: “ To keep the air he breathes as pure as the external air with
out chilling him”
 PURE WATER: “ Well water of a very impure kind is used for domestic purposes.
And when epidemic disease shows itself, persons using such water are almost
sure to suffer”
 EFECTIVE DRAINAGE: “ All the while the sewer may be nothing but a laboratory
from which epidemic disease and ill health is being installed into the houses”
 CLEANLINESS: “ The greater part of nursing consists in preserving cleanliness”.
  LIGHT ( Especially sunlight ) : “ The usefulness of light in treating disease is very
important.
These factors posed a great significance during Nightingale’s time when health
institutions had poor sanitation, and health workers had little education and
training and were frequently incompetent and unreliable in attending to the
needs of the patients.

NIGHTINGALE DISCUSSED THREE TYPES OF ENVIRONMENT

1. Physical environment
2. Psychological environment
3. Social environment

PHYSICAL ENVIRONMENT: Consists of physical elements where the patient is being treated,
such as ventilation, warmth, cleanliness, light, noise and drainage.

A patient’s bed must be clean, aired, warm, dry and free from odour. One should provide an
environment in which patients can be easily cared by others or self. The width, height,
placement of bed should facilitate the activities of the patient. The bed should be placed in
the best lighted spot, away from sudden noises and the odour from drainage. The position
of the patient on the bed should be viewed in the context of supporting ventilation.

PSYCHOLOGICAL ENVIRONMENT: The effect of the mind on the body was fairly well
accepted in Nightingale’s time. Nightingale recognized that a negative environment could
cause physical stress, thereby affecting the emotional climate. Therefore emphasis is placed
on offering the patient a variety of activities to keep his mind stimulated. The view of
sunlight, the attractiveness of the food and the offering enable the patient to survive
emotionally. Boredom is viewed as painful.

SOCIAL ENVIRONMENT: Social environment involves collecting data on illness and disease
prevention. It includes components of the physical environment as clean air, water and
proper drainage. It may consist of a person’s home or a hospital room, as well as the total
community that affects the patient’s specific environment.

ANALYSIS OF THE ENVIRONMENTAL THEORY

In the era we are in today, we faced with environmental conditions beyond what was ought
to be natural and nurturing. Some of the global environmental issues that we know now are
global warming, nuclear radiation threats, man-made environmental calamities, and
pollution. From these occurrences, Nightingale’s model seemed to be very ideal. Her
concept of providing fresh air to the patients is in question with today’s industrialization
effects.

In addition to the analysis of the concept of ventilation, it is not always beneficial for all
clients to have fresh air. Natural air has its impurities which may turn infect open wounds
and drainages such as in burns.

With the idea of providing sunlight, the light emitted by the sun today is proven to be
harmful already because of the destruction of the ozone layer of the earth, exposing the
patient constantly to direct sunlight may be more destructive to the patient’s betterment
than being beneficial.

 It is true that a healthy environment heals as what Nightingale stated but the
question is now how our environment would remain health amidst the negative
effects of the progress of technology and industrialization.

Since the applicability of some of the concepts to specific situations today is not feasible,
development of this theory is utterly needed to accommodate the changes of the
environment that we currently have. Still above all this, it is very much clear the
Nightingale’s Environmental Theory is superb as a starting point of the progression of our
profession and served as a catalyst for nursing’s improvement.

ASSUMPTION OF FLORENCE NIGHTINGALE’S THEORY

The assumptions of Florence Nightingale in her environmental theory are as follows:

 Florence Nightingale in her environmental theory believed that five points were
essential in achieving a healthful house “ pure air, pure water, efficient drainage,
 cleanliness, and light”
 A healthy environment is essential for healing. She stated that “ nature alone cures”
 Nurses must make accurate observations of their patients and be able to report the
physician in an orderly manner.
 Nursing is an art, whereas medicine is a science. Nurses are to be loyal to the
medical plan but not servile.

STRENGTHS

The language Florence Nightingale used to write her books was cultured and flowing, logical
in format, elegant in style. Nightingale’s Environmental Theory has broad applicability to the
practitioner. Her model can be applied in most complex hospital intensive care
environment, the home, a work site, or the community at large. Reading Nightingale’s
Environmental Theory raises consciousness in the nurse about how the environment
influences client outcomes.

WEAKNESS

In Nightingale’s Environmental Theory, there is scant information on the psychosocial

environment when compared to the physical environment. The application of her concepts
in the twentieth century is in question.

CONCLUSION

The environmental factors affect different patients unique to their situations and illnesses,
and the nurse must address these factors on case by case basis in order to make sure the
factors are altered in a way that best cares for an individual patient and his or her needs.

THEORY OF INTERPERSONAL RELATIONS

Biography of Hildegard E. Peplau

Hildegard Elizabeth Peplau (September 1, 1909 – March 17, 1999) was an American nurse
who is the only one to serve the American Nurses Association (ANA) as Executive Director
and later as President. She became the first published nursing theorist since Florence
Nightingale.

Peplau was well-known for her Theory of Interpersonal Relations, which helped to

revolutionize the scholarly work of nurses. Her achievements are valued by nurses all over
the world and became known to many as the “Mother of Psychiatric Nursing” and
the “Nurse of the Century.” 

INTRODUCTION

The need for a partnership between nurse and client is very substantial in nursing practice.
This definitely helps nurses and healthcare providers develop more therapeutic
interventions in the clinical setting. Through these, Hildegard E. Peplau developed
her “Interpersonal Relations Theory” in 1952, mainly influenced by Henry Stack Sullivan,
Percival Symonds, Abraham Maslow, and Neal Elgar Miller.
HILDEGARD PEPLAU’S INTERPERSONAL RELATIONS THEORY

Hildegard Peplau’s Interpersonal Relations Theory emphasized the nurse-client relationship

as the foundation of nursing practice. It gave emphasis on the give-and-take of nurse-client
relationships that 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.

The four components of the theory are:

1. Person, which is a developing organism that tries to reduce anxiety caused by needs

2. Environment, which consists of existing forces outside of the person, and put in the
context of culture
3.  Health, which is a word symbol that implies forward movement of personality and 
4. Nursing, which is a significant therapeutic interpersonal process that functions
cooperatively with other human process that make health possible for individuals in
communities.

The nursing model identifies four sequential phases in the interpersonal relationship:

 Orientation
  identification,
 Exploitation
 Resolution.

It also includes seven nursing roles:

 Stranger role
 Resource role
 Teaching role
 Counselling role
 Surrogate role
 Active leadership
 Technical expert role.
Description

Hildegard E. Peplau’s theory defined Nursing as:

 “An interpersonal process of therapeutic interactions between an individual who is sick or

in need of health services and a nurse especially educated to recognize, respond to the
need for help.” It is a “maturing force and an educative instrument” involving an
interaction between two or more individuals with a common goal.

In nursing, this common goal provides the incentive for the therapeutic process in which the
nurse and patient respect each other as individuals, both of them learning and growing as a
result of the interaction. An individual learns when she or he selects stimuli in the
environment and then reacts to these stimuli.

Assumptions

The assumptions of Hildegard Peplau’s Interpersonal Relations Theory are:

(1) Nurse and the patient can interact.

(2) Peplau emphasized that both the patient and nurse mature as the result of the
therapeutic interaction.

(3) Communication and interviewing skills remain fundamental nursing tools. And lastly,

(4) Peplau believed that nurses must clearly understand themselves to promote their
client’s growth and to avoid limiting the client’s choices to those that nurses value.

Major Concepts of the Interpersonal Relations Theory

The theory explains the purpose of nursing is to help others identify their felt difficulties and
that nurses should apply principles of human relations to the problems that arise at all levels
of experience.

 The theory explains the purpose of nursing is to help others identify their felt
difficulties.
 Nurses should apply the principles of human relations to the problems that arise at
all levels of experience.
 Peplau’s theory explains the phases of interpersonal process, roles in nursing
situations and methods for studying nursing as an interpersonal process.
  Nursing is therapeutic in that it is a healing art, assisting an individual who is sick or
in need of health care.
 Nursing is an interpersonal process because it involves interaction between two or
more individuals with a common goal.
 The attainment of goal is achieved through the use of series of steps following a
series of pattern.
 The nurse and patient work together so both become mature and knowledgeable in
the process.

DEFINITIONS

Person
Peplau defines person as an organism that “strives in its own way to reduce tension
generated by needs.” The client is an individual with a felt need.

Health
Health is defined as “a word symbol that implies forward movement of personality and
other ongoing human processes in the direction of creative, constructive, productive,
personal, and community living.”

Society or Environment

Although Peplau does not directly address society/environment, she does encourage the
nurse to consider the patient’s culture and mores when the patient adjusts to hospital
routine.

Nursing
Hildegard Peplau considers nursing to be a “significant, therapeutic, interpersonal process.”
She defines it as a “human relationship between an individual who is sick, or in need of
health services, and a nurse specially educated to recognize and to respond to the need for
help.”

THERAPEUTIC NURSE-CLIENT RELATIONSHIP

A professional and planned relationship between client and nurse that focuses on the
client’s needs, feelings, problems, and ideas. It involves interaction between two or more
individuals with a common goal. The attainment of this goal, or any goal, is achieved
through a series of steps following a sequential pattern.

Four Phases of the therapeutic nurse-patient relationship:

1. Orientation Phase

The orientation phase is directed by the nurse and involves engaging the client in treatment,
providing explanations and information, and answering questions.

 Problem defining phase

 Starts when the client meets nurse as a stranger
 Defining problem and deciding the type of service needed

 Client seeks assistance, conveys needs, ask questions, shares preconceptions and
expectations of past experience.
 Nurse responds, explains roles to the client, helps to identify problems and to use
available resources and services

2. Identification Phase

The identification phase begins when the client works interdependently with the nurse,
expresses feelings, and begins to feel stronger.

 Selection of appropriate professional assistance

 Patient begins to have a feeling of belonging and a capability of dealing with the
problem which decreases the feeling of helplessness and hopelessness

3. Exploitation Phase

In the exploitation phase, the client makes full use of the services offered.
  In the exploitation phase, the client makes full use of the services offered.
 Use of professional assistance for problem-solving alternatives
 Advantages of services are used is based on the needs and interests of the
patients
 The individual feels like an integral part of the helping environment
 They may make minor requests or attention-getting techniques
 The principles of interview techniques must be used in order to explore,
understand and adequately deal with the underlying problem
 Patient may fluctuate on independence
 Nurse must be aware of the various phases of communication
 Nurse aids the patient in exploiting all avenues of help and progress is made
towards the final step

4. Resolution Phase

In the resolution phase, the client no longer needs professional services and gives up
dependent behavior. The relationship ends.

 In the resolution phase, the client no longer needs professional services and gives
up dependent behavior. The relationship ends.
 Termination of professional relationship
 The patients needs have already been met by the collaborative effect of patient
and nurse
 Now they need to terminate their therapeutic relationship and dissolve the links
between them.
 Sometimes may be difficult for both as psychological dependence persists
 Patient drifts away and breaks the bond with the nurse and healthier emotional
balance is demonstrated and both becomes mature individuals

SUBCONCEPTS OF THE INTERPERSONAL RELATIONS THEORY

Peplau’s model has proved of great use to later nurse theorists and clinicians in developing
more sophisticated and therapeutic nursing interventions.

The following are the roles of the Nurse in the Therapeutic relationship identified by Peplau:
Stranger: offering the client the same acceptance and courtesy that the nurse would to any
stranger

Resource person: providing specific answers to questions within a larger context

Teacher: helping the client to learn formally or informally

Leader: offering direction to the client or group

Surrogate: serving as a substitute for another such as a parent or a sibling

Counselor: promoting experiences leading to health for the client such as expression of

feelings

Technical Expert: providing physical care for the patient and operates equipment

Peplau also believed that the nurse could take on many other roles but these were not
defined in detail. However, they were “left to the intelligence and imagination of the
readers.” (Peplau, 1952)

Additional roles include:

 Technical expert
 Consultant
 Health teacher
 Tutor
 Socializing agent
 Safety agent
 Manager of environment
 Mediator
 Administrator
 Recorder observer
 Researcher

Interpersonal Theory and Nursing Process

 Both Peplau’s Interpersonal Relations Theory and the Nursing Process are sequential
and focus on the therapeutic relationship
 Both use problem-solving techniques for the nurse and patient to collaborate on,
with the end purpose of meeting the patient’s needs.
 Both use observation communication and recording as basic tools utilized by nursing.

ASSESSMENT ORIENTATION

 Data collection and analysis  Non continuous data collection

( (continuous)  Felt need
 May not be a felt need  Define needs

NURSING DIAGNOSIS IDENTIFICATION

 Planning  Interdependent goal setting

 Mutually set goals

IMPLEMENTATION EXPLOITATION

 Plan initiated towards  Patient actively seeking and

achievement of mutually set drawing help
goals  Patient initiated
 May be accomplished by patient,
nurse or family.

EVALUATION RESOLUTION

 Based on mutually expected  Occurs after other phases are

behaviours completed successfully
 May lead to termination and  Leads to termination
initiation of new plans
PEPLAU’S WORK AND CHARACTERISTIC OF A THEORY.
Interrelation of concepts

 Four phases inter-relate the different components of each phase.

Applicability

 The nurse patient interaction can apply to the concepts of human

being,health,environment and nursing.

Theories must be logical in nature

 This theory provides a logical systematic way of viewing nursing situations

 Key concepts such as anxiety, tension, goals and frustrations are indicated with explicit
relationships among them and progressive phases.

Generalizability

 This theory provides simplicity in regard to the natural progression of the Nurse Patient
relationship.

Theories can be the bases for hypothesis that can be tested.

 Peplau’s theory has generated testable hypothesis.

Theories can be utilised by practitioners to guide and improve their practice.

 Peplau’s anxiety continuum is still used in anxiety patients.

Theories must be consistent with other validated theories, law and principles but will
leave open unanswered questions that need to be investigated.

 Peplau’s theory is consistent with various theories

LIMITATIONS

 Personal space considerations and community social service resources are considered
less.
 Health promotion and maintenance were less emphasised
 Cannot be used in a patient who doesn’t have a felt need e.g With drawn patients,
unconscious patients.
 Some areas are not specific enough to generate hypothesis.

APPLICATION OF INTERPERSONAL THEORY IN NURSING PRACTICE.

 Peplau’s theory focuses on the interpersonal processes and therapeutic relationships
that develops between nurse and client .The interpersonal focus of Peplau’s theory
requires that the nurse attend to the interpersonal processes that occur between the
nurse and client .Interpersonal process include the nurse-client relationship
,communication, pattern integration and the roles of the nurse. Psychodynamic nursing
is being able to understand one’s own behaviour to help able to understand one’s own
behaviour to help other identify felt difficulties and to apply principles of human
relations to the problems that arise at all levels of experience. This theory stressed the
importance of nurse’s ability to understand own behaviour to help others identify
perceived difficulties.

The four phases of nurse patient relationships are

1.Orientation
During this phase the individual has a felt need and seeks professional assistance .The
nurse helps the individual to recognise and understands his/her problem and determine
the need for help.

2.Identification
The patient identifies with those who can help him/her. The nurse permits exploration
of feelings to aid the patient in undergoing illness as an experience that reorient feeling
and strengthen positive forces in the personality and provides needed satisfaction.

3.Exploitation
During this phase the patient attempts to drive full value from what he/she are offered
through the relationships. The nurse can project new goals to be achieved through
personal effect and power shifts form the nurse to the patient as the patient delays
gratification to achieve the newly formed goals.
4.Resolution

The patient gradually puts aside old goals and adopts new goals .This is a process in which
the patient frees himself form identification with the nurse.

The Nursing Process of Mrs. Dulu Singha,68 years, based on Peplau’s theory of
Interpersonal Relations.

Diagnosis: right intertrochanteric fracture of femur.

DATE Sl ASSESSMEN NURSING PLANNING IMPLEMENTATION EVALUATION

AND no T DIAGNOSIS (IDENTIFICATION (EXPLOITATION (RESOLUTION
TIME (Orientation PHASE) PHASE) PHASE)
phase)

1 Mrs, Dulu Impaired physical Goal setting was done Carried out plans Mrs. Dulu Singh
Singh is on mobility related along with the patient. mutually agreed upon. was free to
Patient will have
 skeletal to improved physical express
traction intertrochanteric mobility as evidenced problems
and she is fracture of right by participating in self regarding
bed ridden. femur and care within limits. difficulty in
mobilizing.
The need presence of
Provide active and
for bed rest skeletal traction. passive exercises to all Provided active and
and the extremities to passive exercises to all
immobiliza improve muscle tone the extremities.
tion was and strength.
discussed.
Make the patient
perform breathing Made the patient to
exercises to strengthen perform breathing
respiratory muscle. exercises.

Massage the upper and

lower extremities to Massaged the upper
improve circulation. and lower extremities.

Provide trapeze and

articles near to the bed Provided articles with
and encourage doing the reach of the
activities within normal patient.
limits.

Provide positive
reinforcement for even Provided positive
a small improvement to reinforcement to the
increase the frequency patient.
of desired activity.

ANALYSIS

Peplau conceptualized clear sets of nurse’s roles that can be used by each and every nurse
with their practice. It implies that a nurse’s duty is not just to care but the profession
encompasses every activity that may affect the care of the patient.
The idea of a nurse-client interaction is limited with those individuals incapable of
conversing, specifically those who are unconscious.
The concepts are highly applicable to the care of psychiatric patients considering Peplau’s
background. But it is not elimited in those set of individuals. It can be applied to any person
capable and has the will to communicate.

The phases of the therapeutic nurse-client relationship are highly comparable to the
nursing process making it vastly applicable. Assessment coincides with the orientation
phase; nursing diagnosis and planning with the identification phase; implementation as to
the exploitation phase; and lastly, evaluation with the resolution phase

STRENGTHS
Peplau’s theory helped later nursing theorists and clinicians develop more therapeutic
interventions regarding the roles that show the dynamic character typical in clinical nursing.
Its phases provide simplicity regarding the natural progression of the nurse-patient
relationship, which leads to adaptability in any nurse-patient interaction, thus providing
generalizability.

WEAKNESSES

Though Peplau stressed the nurse-client relationship as the foundation of nursing

practice, health promotion, and maintenance were less emphasized.
Also, the theory cannot be used in a patient who doesn’t have a felt need such as with
withdrawn patients.

CONCLUSION

Peplau’s theory has proved of great use to later nurse theorists and clinicians in developing
more sophisticated and therapeutic nursing interventions including the seven nursing roles,
which show the dynamic character roles typical in clinical nursing. It entails that a nurse’s
duty is not just to care but the profession also incorporates every activity that may affect
the client’s health.
However, the idea of nurse-client cooperation is found narrow with those individuals who
are unfit and powerless in conversing, specifically those who are unconscious and paralyzed.
Studying Peplau’s Interpersonal Relations Theory of Nursing can be very substantial
especially to those who are aspiring to be part of the profession. Having the knowledge of
the seven roles of nursing, future nurses can apply for different roles in different situations,
which will guarantee their patients to acquire the best care possible, and will ultimately
speed along treatment and recovery.
BIBLIOGRAPHY

1. .Basheer P S, Khan Y. Advanced Nursing Practice.2th ed. Banglore: Emmess Medical

Publishers; 2019.pg no 358- 62.
2. Kozier B, Berman A, Snyder S, etal. Kozier and Erb’s Fundamentals of Nursing.8 th
edition. United States: Pearson Education; 2011.pg no 43
3. Also available at https:// nurseslab. Com>