The theory of interpersonal relationships in nursing, or psychoanalytic nursing|Course hero helper

Posted: March 16th, 2023

The theory of interpersonal relationships in nursing, or psychoanalytic nursing, was published in 1952 by Hildegard Peplau. In it, the author describes aspects of the nurse-patient relationship. This relationship aims to promote and maintain health. In addition, the work of the nurse is recognized as therapeutic. Due to the need to offer adequate care to the patient, Peplau raises the roles that the nurse must assume to provide quality care. (Peplau, 2002)

She described six nursing roles: Stranger, Resource, Teaching, Leadership, Counselor, and Substitute. The nurse-patient relationship must go through four stages to put these roles or responsibilities into practice. The stages through which the relationship had to pass satisfactorily are orientation, identification, exploration, and resolution. The author discusses the importance of complying with these stages to adopt one of the roles in the nurse-patient relationship. These roles still apply to modern nursing practice; sometimes, more than one applies when building a relationship with the patient. (Peplau, 1992)

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The role of the Stranger is when the patient and the nurse meet for the first time. The nurse is a Resource for the patient, and the patient uses the nurse as a source of knowledge to obtain information about their disease. Teaching is another role put into practice daily since knowledge is offered and promoted to help the patient maintain their health. In the Leadership role, the nurse is the patient’s guide, collaborating to achieve the proposed guidelines as goals in the health process. The nurse as Counselor guides the patient and helps them explore the health situation that has arisen. The last role in analyzing is the Surrogate role. In this case, the nurse advocates for the patient’s rights. (Courey et al., 2008)

The Surrogate role is rarely mentioned in modern nursing practice. Today, patients spend as little time as possible in hospitals, so it is challenging to fully develop all the stages described by Peplau in creating the nurse-patient relationship. On the other hand, there are scenarios where the Surrogate role is essential to strengthen interpersonal relationships. An example of this is nursing homes. In this environment, where the patient is almost always cared for by the same nurse, it is easier to develop trust that will make the patient see the nurse as a family member. The patient transfers to the nurse feelings that are usually linked to the family. In this role, the nurse must be able to explain to the patient dependency, interdependence, and independence. In this way, the nurse becomes the primary Defender of the patient’s rights, being able to make health decisions always for the patient’s benefit. (Peplau, 2002)



The roles of the Stranger, Resource, Teaching, Leadership, Counselor, and Substitute are all essential in establishing and maintaining a therapeutic relationship with the patient. Each role involves different responsibilities and requires the nurse to possess specific skills, such as communication, empathy, and active listening. Moreover, the four stages of the nurse-patient relationship – orientation, identification, exploration, and resolution – provide a framework for nurses to build a trusting and supportive relationship with their patients. By following these stages, nurses can establish a connection with the patient, understand their needs and concerns, and collaborate with them to achieve their health goals.

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