LET’S CALL FOR A DESTINACTION CHECK

Tasks. Using your knowledge on the Hildegard Peplau’s Psychodynamic Nursing

theory, create a short script based on the following situation. Please make sure to be guided
by Peplau’s theory.

Situation. You are to take care of an elderly patient. This is your first time to meet
your patient and based on the records, the patient does not usually entertain individuals
who are new to her.
How are you going to introduce yourself to the patient and get to have him/her
participate in your morning exercise?

Sample Conversation

Nurse: Good morning, ma’am. (With eye contact and smile)

Patient: Good morning
Nurse: I am Shekainah Jane Vildozola. I will be your nurse ma’am for this morning and for
the whole week. I am the one assigned to check your blood pressure every 9 am. Will that
be all right?
Patient: yes
Nurse: Great so how have you been feeling lately ma’am?
Patient: I’m feeling fine
Nuse: That’s good to hear. Will it be okay with you if I’ll call you by your first name ma’am?
Patient: Yes, it’s okay
Nurse: Okay ma’am Teresita. How long have you been in the ward ma’am?
Patient: 3 days
Nurse: Oh I see. So can I know have your arm ma’am so I could check your blood pressure?
Patient: Sure
Nurse: Straighten your arm ma’am with palm facing up on a level surface and just relax.
Nurse: Your blood pressure ma’am is 140/80mmHg which means high.
Patient: What are the things I need to do and avoid?
Nurse: Too much sodium raises your blood pressure ma’am, but potassium balances out the
extra salt like bananas and also you need to eat vegetables. Just try to relax each day by
performing any activity that will help you relax.
Patient: Thank you nurse!
Nurse: My pleasure ma’am. Do have any questions ma’am? Or do you need anything else?
Patient: No
Nurse: Okay ma’am. I’ll be leaving now. Thank you so much and have a great day.

How to introduce yourself?

 A Great Introduction Can Make a Patient’s Day, when you introduce yourself to
a new patient, a warm greeting, and friendly demeanor can make a big difference
for them. Whether they’re in a hospital bed or they’re seeing their GP for an annual
check-up, patients can benefit when staff members are friendly and responsive.
 Make eye contact and smile. Making eye contact and smiling helps you come
across as friendly and personable.
  Address them by an honorific. Address your patients as “Mr.,” “Mrs.,” “Miss,” and
other polite honorifics, unless they specifically ask you to address them by their first
name.
 Make sure nonverbal communication is positive. Your facial expressions, body
posture, and degree of eye contact send out social signals. Sit or stand in a position
where you’re close to being eye to eye with the patient. Lean slightly toward them,
and avoid crossing your arms or legs.
 Use the right tone of voice. Make sure your tone comes across as interested,
polite, and empathetic. Speak clearly, at a pace that is neither too fast nor too slow,
and avoid using too much jargon.
 Explain why you’re there. It’s helpful for the patient to understand why you’re
seeing them. For example, “I’ve come to measure your blood pressure today.” If
you’re performing any type of procedure, make sure the patient fully understands
what you’re doing, and that they consent to it.
 Ask the patient if they have any questions. Patients are sometimes hesitant to
actively ask questions or bring up their concerns. Inviting them to do so can
encourage them to open up, which may provide you with medically relevant
information.
 Ask if they need anything else. Before you leave, ask the patient if there’s
anything else they need from you. Again, they may be hesitant to bring it up on their
own.
 Thank them, and explain what will happen next. Saying “thank you” is only
polite. You should also explain what’s going to happen next — for example, whether
the doctor will see them momentarily, or if you’re going to come back again later.

Hildegard Peplau’s Psychodynamic Nursing theory

Orientation Phase

1. When the nurse and patient first meet is known as the orientation phase. In The situation
above this was when the nurse went to the room and first time meeting with the patient.

2. This is a time when the patient and nurse come to know each other as people and each
other’s expectations and roles are understood.

3. The patient at this time needs to recognize and understand their difficulty and the need
for help, be assisted to plan to use the professional services offered, and harness the energy
derived from felt needs.
4. It may be expected that the patient will test limits in order to establish the integrity of the
nurse.

5. The tasks of this phase are to build trust, rapport, establish a therapeutic environment,
assess the patient’s strengths and weakness and establish a mode of communication
acceptable to both patient and nurse.

6. When the patient can begin to identify problems the relationship progresses to the
working phase.

Identification Phase

1. Trust begins to develop and the patient begins to respond selectively to persons who
seem to offer help.

2. The patient begins to identify with the nurse and identify problems, which can be worked
on.

3. The meaning behind feelings and behavior of the nurse and patient are explored. Peplau
states that when a nurse permits patients to express what they feel, and still get all of the
nursing that is needed, then patients can undergo illness as an experience that reorients
feelings and strengthens positive forces in the personality.

4. The tasks of this phase are to develop clarity about the patient's preconceptions and
expectations of nurses and nursing, develop acceptance of each other, explore feelings,
identify problems and respond to people who can offer help.

5. In particular the nurse assists in the expression of needs and feelings, assists during
stress, shows acceptance and provides information.

6. The nurse and patient may make plans for the future but the implementation of the plan
signifies the beginning of the exploitation phase of the working relationship.

Exploitation Phase

1. The patient realistically exploits all of the services available to them on the basis of self-
interest and need.

2. The nurse assists the patient in their efforts to strike a balance between the needs for
dependence and independence.

3. The plan of action is implemented and evaluated. The patient may display a change in
manner of communicating, as new skills in interpersonal relationships and problem solving
are developed.

4. The nurse continues to assess and assists in meeting new needs as they emerge.

Resolution Phase

1. The resolution phase involves the gradual freeing from identification with helping persons,
and the generation and strengthening of ability to stand alone, eventually leading to the
mutual termination of the relationship.
2. The patient abandons old needs and aspires to new goals.

3. She or he continues to apply new problem solving skills and maintains changes in style of
communication and interaction.

4. Resolution includes planning for alternative sources of support, problem prevention, and
the patient’s integration of the illness experience.
REFLECTION TIME

Express your thoughts on how these theories you have learned can be used as your
inspiration in becoming a nurse in the future.

Nursing theories are the support of nursing practice today. They are significant to
nursing practice, education and scientific research because they help to determine,
what is already known, and what additional knowledge and skills are needed. Nurses
are usually first exposed to nursing theories during nursing education and further
exposure comes from hands on training. The gained knowledge, about nursing
theories, through education and training enhances better outcomes for patients and
caregivers, allows application of professional boundaries, and assists in decision
making.
There are many different nursing theories that are significant to nursing practice,
because they help nurses to examine what is already known, and what additional
knowledge and skills are required in variety of nursing situations. They provide basis
for nursing practice, as well as some additional tools, that help with delivery of
better care to patients and caregivers. Finally, nursing theories improve professional
status for nurses and provide guidance and direction for research and education.
To those who aspire to become nurse educators, like me, can build on nursing
theories for training and have an impact on the future of nursing.

Before we move on the next topic, I would gladly want to listen to your feedback to
this module. Kindly rate each area with a scale of 1-5: 1 as the lowest and 5 as the
highest.
Evaluation Rating
1.Comprehensive Content 4
2.Relevance of the Content 5
3.Clarity of the text and message 4
4.Alignment of the assessment activities to learning 5
outcomes

Comments/Suggestions:

I don’t have anything to suggest 