Peplau’s Theory of Interpersonal Relations
Peplau’s theory defines nursing as the therapeutic relationship between both individuals;
therefore, it necessitated that the nursing interacts with the patient purposefully. Peplau
believed “through the devise of the therapeutic nurse-patient relationship, the nurse could be
most beneficial to human beings.” The nurse can collect pertinent data and facilitate a plan
of care establishing relationships with patients. The nurse uses the nurse-patient relationship
to assess the patient’s psychological, emotional, and spiritual needs with learned
communication skills, personal strengths, and an understanding of human behavior. The
result is to produce desirable goals that benefit the patient.
• Orientation: The initial phase of Peplau’s theory is orientation. It is during this time
the patient has health-seeking behaviors. The nurse is identified as someone who is
qualified to help the patient. This period sets the stage for a trusting relationship.
During this phase, the nurse collects data, makes initial assessment of the patient’s
needs, potential, interests, and the patient’s inclination to experience fear or anxiety.
• Working Phase: The second phase of Peplau’s theory is the working phase as most
of the work of the relationship occurs here. This phase includes two subphases:
identification and exploitation. As the patient progresses toward positive health
outcomes, the focus is on the patient’s reactions and the work that the patient needs
to accomplish. During the identification stage, the nurse uses professional
knowledge, education, and skill to solve a particular health problem. This is an
important period where the patient identifies the nurse as consistently helping,
providing unconditional care, and providing empathy. During the working phase, the
power shifts from the nurse to the patient as the patient becomes more independent
with personal care. During this time, the nurse starts activating the discharge plan
and acts primarily as an educator and leader.
• Termination Phase: The final phase is the termination phase which allows the
nurse and patient relationship to disengage from nurse-patient relationship
altogether. During the time, the nurse emphasizes the discharge plan and helps the
patient organize actions to progress toward new socially interdependent
relationships. This period enhances the patient’s ability to become more self-reliant
in leading a productive healthier life.
• Sepsis and Peplau’s Theory: As a future APRN, the phases of each principle
encompassed in Peplau’s theory can be applied in the clinician-patient relationship.
The process used during triage in the ED is similar to the process described in the
initial orientation phase of the theory. During the initial meeting the stage is set
during the interaction between the clinical and the patient. The type of quality of
interaction either facilitates or hinders further communication. For example, if a
patient presents with one week of persistent elevated heart rate, temperature, and
low blood pressure–the APRN responding with a judgmental attitude would set the
entire tone for the experience and the patient may have a negative perception that
leads to mistrust. Often times, the patients’ experience is based solely on the
interactions between themselves
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