Knowledge for Nursing

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INTRODUCTION
This essay will explore Peplau’s concept of a nurse-patient relationship and how it narrates to the experience I had whilst on placement practice. My aim is to demonstrate my gained understanding of the nursing process, the domains of nursing, the nature of nursing models and their relationship to practice and Peplau’s model of nursing. The reason why the student has chosen this concept is because nursing is an interpersonal process which involves interaction between two or more people with a mutual goal, (George 2003). The essay will start by defining the word concept then describe the incident that I observed in placement practice. The essay will analyze how theories can be used to justify nursing interventions in practice. The conclusion summarises the main points of the essay and reflect on my learning experience. (Meleis 1991) defined concept as “a label used to describe a phenomenon or a group of phenomena” (McKenna 1997). (McKenna 1997) concludes that concepts are identified when a name is put to a phenomenon. “Therefore, a concept is a tool and not a real entity – it merely facilitates observation of a real phenomenon,” (McKenna 1997 p8). Chinn and Kramer (2008); Hage (1972); Reynolds (1971) were cited that concepts can be theoretical or tangible. Theoretical concepts are created mentally independent of a particular or interval location, whereas tangible concepts are experienced directly and relate to a specific interval or location (Alligood and Tomey, 2010). “Nursing is a significant, therapeutic, interpersonal process. It functions co-operatively with other human processes that make health possible for individuals in communities. In specific situations in which a professional health team offers health services, nurses participate in the organisation of conditions that facilitate natural on going tendencies in human organisations. Nursing is an educative instrument, a maturing force that aims to promote forward movement of personality in the direction of creative, constructive, productive, personal, and community living.” (Peplau 1988, p16) Peplau (1952) defined phases in the nurse-patient relationships that overlap and transpire during the relationship interval. George (2002) cited the three phases defined by Peplau are as follows; orientation, identification, working, and termination.

Whilst on Placement I had the prospect to put theory into practice with the supervision of my mentor when Mrs. Ahmed aged 85 was admitted into the ward after having had a fall (false name and age due to confidentiality, Nursing and Midwifery Council 2003). During handover it was reported that Mrs. Ahmed was at times unresponsive and seemed uninterested when addressed to by the nurse on duty upon admission, leaving the nurse to rely on the information obtained from the ambulance crew as she was unaccompanied. Upon arrival Mrs. Ahmed had not been able to get up from the stretcher as she was not weight bearing after the fall and appeared to be confused with the new environment. It was hoped that more information would be obtained in the morning when she awoke.

Orientation stage
My mentor gave me an opportunity to work with Mrs. Ahmed whilst under her supervision and it was obvious that the information we had was not complete. To get further information we went to her bedside which was in a mixed ward were we were introduced to the new patient. The orientation phase is initiated when a health problem occurs thus resulting in a felt “felt need, and professional assistance is sought.” Peplau (1952, p.18) Peplau (1952) further states that the nurse and patient meet as two strangers, by clarifying and defining the problem in the orienting stage the patient can direct the accumulated energy from her anxiety about unmet needs and begin working with the presenting problem. The nurse patient rapport is established and continues to be strengthened while concerns are being identified. The nurse...
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