Running head: NURSING THEORIES DISCUSSED
Nursing Theories by Hildegard E. Peplau and Jean Watson Discussed
Jason E. Warshawky
Nursing 102
Due: October 16, 2014
Instructor: Judy Crain
College of New Caledonia
1
NURSING THEORIES DISCUSSED
2
Introduction
When comparing Hildegard E. Peplau and Jean Watson there are similarities and
differences in the framework and main concepts of their theories; however, both theories apply
to nursing, but Peplau’s theory best supports communication in nursing today. Peplau was a great
nurse and educator who will be remembered and idolized by many for her impact on the field of
nursing. Her theory of Interpersonal Relations in Nursing has helped countless nurses develop
the way they think and act when nursing. Watson created the Theory of Human Caring and she
has been instrumental in the way that nursing is viewed from the perspective of spirituality.
Nursing is the care and nurturing of living beings. Nursing is an honorable profession and it
takes a well rounded person to become a successful nurse. The women that developed these
theories have had a monumental impact on society and helped evolve the nursing practice to
what it is today. Both of their theories have practical applications and are used in nursing pratice
today.
Comparing the Theories
Peplau’s theory of Interpersonal Relations in Nursing is direct and assertive. She believes
in the fundamental nursing practice and the simplicity of the direct approach. Watson’s theory of
Transpersonal Caring is about being open minded and feeling the moment. Watson believes that
there is endless depth to human connection. She also believes that there is a unity among all
living and non living things, and she speaks of a universal consciousness. She looks at nursing
with a postmodern world view and as stated by Julia B. George (2002) she has been inspired by
quantum physics (p.411). Peplau places emphasis on nursing with the assistance of scientific
NURSING THEORIES DISCUSSED
3
method and research. Both of their theories take the patient, family and environment into
consideration when making decisions. Peplau and Watson both believe that adequate physical
and mental health is needed for the nurse to perform efficiently. Peplau’s approach is more
appealing to the current, general public. The theory of Transpersonal Caring would work better
for religious people, whereas Peplau’s theory is more suited towards an atheist. However, both
theories are built and guided towards the same destination. Nursing is about caring for one’s
personal needs, as well as caring for others.
The Framework of the Theories
Julia B. George (2002) wrote that Peplau’s original four phases were Orientation,
Identification, Exploration and Resolution which, in 1997, she changed to the three phases of:
Orientation, Working and Termination (p.63). Watson’s ten carative factors have also been
revised to ten Clinical Caritas Processes which was written by Kathleen L. Sitsman in 2007. An
obvious difference is the way the two frameworks are structured. Peplau’s structure of
Orientation, Working and Termination phases is direct, whereas Watson’s framework is not.
Watson’s ten Carative Factors include words such as: humanistic-altruistic, faith-hope,
transpersonal, existential-phenomenological, spiritual, and her Ten Caritas have the words:
Loving-kindness, helping-trusting, subtle energy, consciousness levels, spiritual-mysterious and
existential dimensions which are not direct words. These words can and may have different
definitions from various perspectives. Both of the frameworks require the nurse to care for
themselves as well as their patient. Developing and building trust between nurse and patient is
NURSING THEORIES DISCUSSED
4
another vital similarity between the two frameworks. Building trust between the nurse and client
is paramount for positive, productive nursing to take place. This similarity is a necessity for any
nursing to be accomplished.
The Main Concepts of the Theories
The main concepts stated by Julia George from Peplau’s Theory of Interpersonal
Relations in Nursing are that nursing is therapeutic, people are unique and one needs to follow
steps in a sequential pattern to obtain the goal you desire. (p. 62-63). The main concepts of
Watson’s Theory of Transpersonal Caring stated by Julia George are that authentic caring is for
the purpose of preserving the dignity and wholeness of humanity, that there are multiple truths
which leads to many constructed realities, and that there is a universal consciousness (p.405407). Watson believes in a connection that cannot yet be scientifically proven. There is a
connection between humans and our surroundings, but on the level that Watson promotes, it is
not currently scientifically sound. This is not to say that she is incorrect, but that our current
technology cannot support her fully. It was not very long ago that humans believed that the
world was flat, and current belief on human connection relates to a flat world. Many people only
believe in the information that they can gather with their five senses and would call a person
crazy for hugging a tree. Science has proven that every living thing operates on its own
frequency and that they are as unique as finger prints (www). Our modern beliefs are somewhat
contrary to Watson’s theory. This is because her theory is based on that more is felt rather then
heard. This would be a difference between the two, because Peplau believes in clear supportive
communication. If Watson’s idea of human connection was elaborating on one could
communicate without speech and their eyes closed. A great similarity between their concepts is
NURSING THEORIES DISCUSSED
5
that every person and situation is unique. The success of nursing will vary from nurse to nurse,
and patient to patient. Another similarity in the concepts between Peplau and Watson are that
both theorists believe that the nurse and patient are integral parts of an equation, however a
difference is that Watson believes the patient should eventually take the lead in the relationship.
She also believes that many nurses today are preoccupied with the scientific aspects of curing
and not paying enough attention to the spiritual connection. Both theorists believe that the nurse
must be in control of their own actions and that the betterment of all the people involved in the
process is achievable.
Practical Applications of Both Theories
Real world nursing scenarios are vastly diverse and may require many different
approaches. For example, a woman is diagnosed with breast cancer and her family relies heavily
on her for many daily tasks. The family is in the hospital waiting room and the husband begins to
have a panic attack. The children absorb the energy of the moment and begin to cry. This
problem needs to be solved before it escalates any further. Julia George wrote most importantly
is that the nurse work collaboratively with the patient and family in analyzing the situation, so
that together they can recognize, clarify, and define the existing problem (p.64). Peplau knew
that nurses needed to pay more attention to families and that every professional contact with a
patient, however brief, is an opportunity for educative input by nurses, which was stated by Julia
George (p.65). Primary importance would be to calm down the husband and preserve human
dignity during the rapidly changing situation. Watson’s belief is that the children as well as the
father need to find harmony within mind-body-soul, stated by Julia George (p.412) which will
help their mother/wife get through this difficult time. When the husband calms down and is
NURSING THEORIES DISCUSSED
6
thinking rationally is the correct time to engage in a heartfelt conversation. The nurse can
provide him with the information about his wife’s illness and reassure him that thinking in a
mature, rational manner is what will benefit his family. As stated by Watson and wrote by
Kathleen Sitzman, that effective caring relies on mindful engagement and an in the moment
connection, initiated by the nurse. (P11) When the time is right the nurse could refer the family
to another source such as a family counselor, or social worker to create a plan to aid the family
through this difficult journey.
Best Theory for Communication in Nursing Today
Clearly Peplau’s theory of Interpersonal Relations in Nursing is best suited to
communication in today’s nursing field. It is a more direct and assertive approach to nursing.
This is not saying that Watson’s approach would not develop communication, but that Peplau’s
is more suited to communication at this current point in time. Communication is needed for
teaching, counselling, leading and even being a surrogate, which are words mentioned by Peggy
Chinn (p219-220). As people evolve their consciousness, they would be more susceptible to
Watson’s ways of thinking. The vast majority of people would be sceptical when hearing about
transcending time and space. Peplau’s theory speaks to the average person directly and because
of this it is more effective. According to Peplau, mentioned in Potter and Perry, the practice of
nursing is an interactive relationship, where the nurse may be a reporter, investigator, and
interpreter, which all require communication skills (P.61). Peplau’s theory is still used today and
helps nurses of all levels improve their communication skills.
NURSING THEORIES DISCUSSED
7
Both theories have been used worldwide and their impact is immeasurable. Between the
two theories there is enough knowledge to keep one’s mind busy for a lifetime, pondering where
your own beliefs and grasp on reality are. The similarities and differences in these two theories
show that there are many ways to accomplish beneficial nursing practices. Communication can
be viewed from many levels but if it not effective, it is a waste of time. There are many ways to
get to the same destination. If your goal is to help others, you are on an honorable path. Nursing
always will have the same ideal destination, which is to help yourself to help others.
NURSING THEORIES DISCUSSED
8
References
Julia B. George, RN, PHD (2002). Nursing Theories. P.411
Julia B. George, RN, PHD (2002). Nursing Theories. P.63
Kathleen L. Sitzman, MS, RN (2007). Teaching-Learning Professional Caring Based on Jean
Watson’s Theory of Human Caring. Vol. 11, No. 4 P.9
Julia B. George, RN, PHD (2002). Nursing Theories. P. 62-63
Julia B. George, RN, PHD (2002). Nursing Theories. P. 405-407
www.doctor-cancer.org/EN/frequency.html
Julia B. George, RN, PHD (2002). Nursing Theories. P.64
Julia B. George, RN, PHD (2002). Nursing Theories. P.65
Julia B. George, RN, PHD (2002). Nursing Theories. P.412
Kathleen L. Sitzman, MS, RN (2007). Teaching-Learning Professional Caring Based on Jean
Watson’s Theory of Human Caring. Vol. 11, No. 4 P.11
Peggy L. Chinn, Maeona K. Kramer. (2004) Integrated Knowledge Development in Nursing,
Sixth Edition. P. 219-220
Potter & Perry (2014) Canadian Fundamentals of Nursing, Fifth Edition. P. 61