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An Appraisal of the Article
[Senn, J.F. (2013). “Peplau’s Theory of Interpersonal Relations: Application in Emergency and Rural Nursing.” Nursing Science Quarterly, 26(1), 31-35.]
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UniversityAn Appraisal of the Article
[Senn, J.F. (2013). “Peplau’s Theory of Interpersonal Relations: Application in Emergency and Rural Nursing.” Nursing Science Quarterly, 26(1), 31-35.]
Nurse scholars have always endorsed the fact that each and every nurse implements some aspects of nursing theory in their routine practice settings. Application of such theories and analysis of the same increases the professional competency in a staff nurse (Senn, 2013). Theory in nursing practice as defined by Meleis (1985) is “an articulated and communicated conceptualization of invented or discovered reality (central phenomenon and relationships), in or pertaining to nursing for the purpose of describing, explaining, predicting or prescribing nursing care” (p.29) (Senn, 2013). One such theory that was formulated by Peplau (1952) is the ‘Person-centric or Patient –centric “care approach that was based on the theory of interpersonal relationships. She believed that outcomes in patients could be improved through appropriate therapeutic relationship.
The author Joanne F. Senn in the article reviewed “Peplau’s Theory of Interpersonal Relations: Application in Emergency and Rural Nursing” in the context of nursing care in emergency and rural nursing settings. The author reviewed Long and Weinert’s model of rural nursing too, in addition to Peplau’s concept.

Senn (2013) claimed that although there is a difference in practice standards in emergency and rural settings the theory of interpersonal relationship holds true for both the settings. The author claimed that Peplau’s Theory of Interpersonal Relations is very pertinent in emergency nursing and improves health care outcomes (Peplau, 1952).
This is because in these units critical care patients are admitted, and out of them 10% patients are admitted due to substance abuse and mental illness. Since, the nature of such diseases requires intervention through empathy, assertiveness and active listening skills, the author endorsed the need of Peplau’s theory. The assumption was interpersonal relations will help to unfold the causes of mental illness and substance much better, which might not be possible with only therapeutic interventions (Senn, 2013). Such theory in emergency settings is highly important because nurses deployed in emergency settings with multi-tasking and hence, appropriate relation with the patient will improve health care outcomes, as interventions can be planned and implemented early. However, the author also highlighted that nursing personnel in emergency departments should build trust and should not view patients as flyers, which will jeopardize health outcomes (Senn, 2013).
The supporting evidences can be extrapolated from the case studies she presented concerning emergency and rural settings. In the emergency department case studies the attending nurse exhibited adequate skills in each of the phases of orientation, working and termination as described by Peplau (1952).
The attending nurse won the trust of the patient and could unfold the reasons for her substance abuse. Further, in this situation the attending nurse facilitated patient’s independence with inculcation of positive and respectful behavior. The patient was briefed about her panic attacks and meticulously the attending nurse could make her understand the coping strategies (Senn, 2013). Although nurses in emergency settings are very busy, appropriate utilization of interpersonal skills in that limited period can impact the health care outcome in a patient, which was evident from the above case study.
Concerning nursing in rural settings, the author adapted and acknowledged the Weinert’s Rural Nursing Model. Weinert pointed out that nursing in rural context was quite different from rendering care in urban or emergency settings. The rural people are much more self –reliant concerning health care and only approach outsiders like nurses and physicians as the last resort. Nursing in rural settings requires multi-dimensional approach of care unlike nursing practice in emergency or urban departments (Winters & Lee, 2010). Even under such situations, Senn (2013) believed that Peplau’s theory of interpersonal relations will hold true.
Such claim was also complemented by a study done by Sivamalai (2008). She reported that rural patients expect that nursing personnel should be generalists and specialists and must be able to render care, without waiting for a consulting physician. Moreover, these people also believed that nurses should listen to their point of view and understand their specific health care need before initiating any intervention (Senn, 2013). This finding clearly indicated that interpersonal relations are also valued by rural people, for resolution of their health care needs. Hence, if nursing personnel exhibits more compassionate behavior in understanding the care needs of rural people, it is expected that health outcomes will improve too.
I strongly believe that the author through this review article has been successful what he or she set out to do. She wanted to convey the importance of implementation of inter personal skills in nursing practice across different settings, which she adequately conveyed. She clearly pointed out the challenges in nursing care in emergency settings and rural settings. Senn (2013) believed that in both these situations, either nurses are under time pressures or do not have the appropriate knowledge of the care settings.
She meticulously indicated the fact nurses who considers a patient as a frequent flyer, will lead to negative health care outcomes (Senn, 2013). Senn (2013) indicated that patients who visit emergency departments are often apprehensive, and hence, nurses attending them should be considerate and non-judgemental in their approach. Concerning rural settings she pointed out that nurses are considered as outsiders. She endorses the need for development of initial trust and removal of all barriers between the patient and the nurse, for successful implementation of health care interventions.
As a staff nurse I strongly believe that the review and claims made by Senn (2013), would impact and enrich my proficiency in nursing skills. Most importantly, the theoretical perspective of interpersonal relations convinced me adequately. In my practice settings too, I have observed similar situations of communication gap between nursing personnel and patients that delayed health care outcomes. The issues raised in the article are very pertinent in the process of health care delivery.
I have often noticed that in the emergency departments patients are admitted form rural settings. Under such situations the care provider needs to understand the specific care needs holistically, rather than attending the clinical problem. A patient from rural settings may require an early discharge since his or her wages depend upon manual labor. This might not be a priority for the attending physician or the staff nurse as they are guided through specific protocols. Hence, hospital administration and the health care providers must under the context and perspective of the patient before planning any health care intervention.
The article provided an evidence based approach in discussing the importance of interpersonal relations in care settings in a comprehensive manner. I also acknowledge that both qualitative and quantitative research findings are important to ensure professional competency in nursing personnel (Polit & Beck, 2012).
References
Peplau, H. E., (1952). Interpersonal relations in nursing. NewYork: G. P. Putnam’s Sons.
Polit, D., & Beck, C. (2012) Nursing research: Generating and assessing evidence for
nursing practice (9th ed.). Philadelphia:Wolters Kwuler Lippincott Williams and
Wilkins
Sivamalai, S. (2008). Desired attributes of new graduate nurses as identified by the rural
community. Rural Remote Health, 8, 938.
Senn, J.F. (2013). “Peplau’s Theory of Interpersonal Relations: Application in Emergency
and Rural Nursing.” Nursing Science Quarterly, 26(1), 31-35
Winters, C., & Lee, H. (2010). Rural nursing theory and practice (3rd ed.).New York:
Springer Publishing Company.