Use of the Psychodynamic Theory in Nursing

Use of the Psychodynamic Theory in Nursing

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Use of the Psychodynamic Theory in Nursing

Introduction

Right from the existence to well-being, theories have been created to govern the morality of man’s conduct. The grand theories are diversified means for examination and conception of the nursing phenomena. They have broadened scopes and insights into the nursing discipline and sometimes have the inclusions of other theories (Tilley, 2008).

The Psychodynamic Theory stresses the magnitude of nurses’ understanding of self and behavior to assist people point out perceived misconceptions and difficulties. In the film The Doctor (2004), Peplau Hildegard enlightens the nurse-patient relationships in four phases that she states as orientation, creation of identity, exploitation, and resolution as the last. The theorist further makes a statement that distress is always alleviated by relationships that are interpersonal, hence the magnitude for proper nurse-patient relationships. To realize the potential of such a proper relationship, the nurse should mete out the nursing roles. Among them are a leader, surrogate, counselor, teacher, stranger, and resource person (McGee, 1998).

Taking the theory into practice would improve medical care that patients are accorded and help the nurses realize their ideal meaning and purpose is highlighted by the theorist in the Jacqueline Fawcett Production. This paper probes into the relevance of the theory in the nursing profession and phenomena.

Thesis Statement: The Psychodynamic Theory is an Important Nursing Tool.

Background of the Psychodynamic Theory

Peplau built the foundations of her theory on the psychological model of behavioral science. She draws the theory from other theories and explanations of medical science. For instance, she uses Maslow’s theory of Self-actualization and Miller’s theory on personalities and social learning principles (Peplau, 2004). She also incorporates Pavlov’s model of stimuli response, Sullivan’s theory on psychiatry, and Freud’s model of interpersonal relationships.

In her elaboration of the dynamic liaison between the nurse and the patient, Peplau lays a challenge to the psychiatric nurses to lay emphasis on four key areas. The areas include the relationship between nurse and patient and participation in practices that are evidence-based. The others are mastery and competence in technology information (I.T) and leadership that aims at creating a paradigm shift to service delivery that is community-based.

Published as one of the earliest theories in nursing history, in 1952, the theory stipulates Peplau’s belief that the influences on the nurse-patient liaison are based on dynamic psychobiological experiences. She clarifies that nursing is a great opportunity to help in the completion of psychological tasks that were completed by patients as infants. The theory dignifies the nursing profession as the pillar of maturation of civilization.

Assumptions are drawn in the theory to prove its relevance and strengths. The first assumption states that the development of the nurse makes a great difference in the learning processes of a patient during medication and medical care. The other assumption recognizes fostering of the development of personality as a function of nursing education and nursing profession (Tilley, 2008).

Visitation of the female patient after surgery by the doctor in The Doctor, points a factor at the relationship developed between the patient and the medical staff for the benefit of both parties. Not only does it opportune the doctor to assess the progress of the patient and the impact of the medical surgery, but it also makes the patient feel secure. It symbolizes love and care, the very principles the institution of nursing were founded on. The scene lays credence to Peplau’s theory of Psychodynamics.

Peplau’s intellect gave rise to the first theory in nursing that played a key factor in the revolution of the nursing field. Some other theories draw their relevance and practicality from Peplau’s Nursing theory of the Psychodynamics (Basavanthappa, 2007). The theory worships nursing and also pushes it to claim a key role not just in patient recovery but also in human development. It gives an insight into the psychological impact of proper and well-defined human relations, especially in nursing. The theory also simplifies nursing by clarifying the roles and responsibilities of nurses.

Applications of the Psychodynamic Theory by Staff Nurses

Key to a patient’s recovery is his confidence that he is in the right hands and will be taken care of whole-heartedly and adequately. Not taking the right measure can make that kind of confidence an uphill task to develop in a patient. Hence, there is relevance in taking into consideration every aspect of the patient-nurse relationship as had been stipulated by Peplau. The first phase of the relationship, orientation, is usually the best time to do this. Treating a patient with care and love in a little more family-like way makes them open up and trust that the nurse is not just performing a task but also cares to perform the task. Once the trust has been built, the patient will start recovering, and this gives room for other aspects and phases of the relationship (Peterson & Bredow, 2009).

Little exhibition of emotion or general detachment from the patient’s predicaments batters their morale, ego and self confidence. Such is the scenario witnessed when Dr. McCee gets diagnosis of cancer. The dryness with which the diagnosis is delivered mutilates all the aspects of proper and well defined mutual relationship that should be the characteristic of the patient and medical staff relations. Could that have been done according to the stipulated procedurals of the psychodynamic theory, the patient would not only have felt respected, but also cared for in a manner that instills hope.

The phases of identification and exploitation that call for the two parties acceptance of each other can be used by the nurse to assess the feelings and needs of the patient. The manner of delivery of the cancer diagnosis in the 36th minute scene of The Doctor clearly shows no acceptance of the patient by the doctor. It not only makes the matter of delivery hard to bear, but in a way makes the patient feel that little is regarded by the doctor on his well-being. The two phases should hence be applied cautiously, just so to ensure that proper foundation for medical care is laid.

Proper care in the previous three phases greatly influences the way a patient conducts him or herself in the resolution phase that involves the termination of the relationship and planning for alternate support sources. That in itself shows just how importantly the nurse should handle every phase of the relationship.

The nurses should practice unconditional acceptance of every patient as psychological mothering. By using the psychological mothering, a patient’s preparation for growth and changes is achieved (Peplau, 2004).

When a nurse meets every role that is stipulated in the theory, she not only develops a mutual liaison with the patient but also serves to live the true purpose of the profession. Counseling, for instance, can be used by the nurses for reaching out and the mentally depressed patients. When the nurse plays the role of a resource person, mental peace is achieved in the patient. When a patient is mentally settled, his or her mannerisms change and embrace the treatment process and procedurals.

Preliminarily, the essence of security is created for the patient when the caregiver follows the stipulated stages of the fraternity liaison. Multiple visits by the nurse emulate deep concern and convince the patient that the environs are right.

Applications of Psychodynamic Theory by Nurse Managers

The Nurse Managers take charge of the patient’s environment virtually influencing all forces around and regarding the medical concerns of the patient. Their management ensures proper medical care and attention is accorded to every patient without discrimination.

Referring to the scene where the Dr. McCee gets the cancer diagnosis in a deflating manner, a revelation at the incompetence of the managerial staff is made. The nurse manager should play the leadership role, constantly providing the guidelines and highlighting the significance of the show of love to patients. The human nature and the need of care by all should be made clear to the medical staff by the managers just so to improve the patient’s environs.

The manager should impart into the staff the ability to elevate a patient from ordinary to important and to convince the patients that all diagnoses are ordinary. The staff should be set by the manager to have the ability to influence reception and reaction to a diagnosis.

In the process of imparting the knowledge of relations and clarifying the significance of such, the manager assumes the roles of leadership and resource person. Application of the Psychodynamic theory by the manager in that manner develops in the staff the ability to deliver heavy diagnoses in polite manners. The likelihood of an occurrence the kind witnessed in the mentioned scene becomes negligible as a result.

However, to further fit the manager into the relationship of the nurse and patients, the theory should have created provisions like Patricia Benner’s model that has the growth of a worker to expert from a novice.

Application by Advanced Registered Nurses

Authorized to perform several medical duties, a nurse practitioner’s role is somewhat different from the regular nurse. The care they provide is of a wider scope and involves actual treatment. They are charged with the role of initiating the recovery in the patient whilst the staff nurse has a duty of steering the recovery.

A Nurse Practitioner from a professional angle is encouraged by the theory to play the role of a stranger. This way, they objectively accept the patient and develop a serene atmosphere that creates trust. A reminiscence of the scenario in which Dr. McCee gets the diagnosis in a very dry manner is hence avoided. Trust and confidence in a patient helps them embrace the medical procedures intended to be performed on them. The psychological impact of the trust is a factor to a patient’s recovery (Tilley, 2008).

The Nurse Practitioner can take the teaching role and impart knowledge to a need or interest from a concerned party, either in the medical team or even the patient.

They can also play the role of the resource person in which case they inform the patient of all the medical procedures that intend to perform on them, and help them interpret. Helping the patient understand the procedure shares the burden of strain on all parties and make it a lot easier to handle increasing the success rate.

The practitioner can also request for counseling on the patient’s behalf when they realize its relevance. In the phase of resolution during the relationship, the nurse can guide the patient on how to seek alternative support and how to integrate the experiences of the illness into life and normalcy (McGee, 1998). Clarification of the domains of dependence, independence and interdependence and assumption of the role the patient’s advocate to take action on his or her behalf would give the Practitioner the surrogate duty.

The Nurse Practitioner should assume the leadership role by helping the patient bear maximum responsibility for meeting the objectives of the medical procedurals in a way that creates mutual satisfaction. Leadership is also exhibited by the Practitioner when they make contributions to a medical procedure by offering their knowledge to a doctor in the medical team.

Maintenance and rejuvenation of health in the patients can be made a lot easier through constant visitations as in the case of the visitation to surgical patient by the doctor. As such, the Advanced Registered Nurses are provided with the opportunity to assess and make adjustments on the patients.

Knowledge that is gathered by the practitioner from the nursing education and the theory is very instrumental in molding the perspectives that a practitioner bears to the field. The theory helps them understand what is required of them. It also builds a good liaison with the patients and helps cope with the challenges faced by both the patient and the nurse (Peterson & Bredow, 2009).

Discussion

Application of the theory by the nursing staff makes the process of care a lot easier and effective. Having developed a liaison with the patient, the nurse becomes privy to information, and development is affecting the patient. Hence, drastic measures can be taken in cases of failure of a performed medical procedure. Recovery that involves care is aided by the confidence that has been built by the patient on the kind of care they are receiving. If the patient develops a repulsive attitude, it will hamper the recovery and provision of feedback information that is used to make analyzes on the recovery. It is such attitude that the theory helps in eliminating.

When elements of the theory are pieced by the managers to manage the staff, efficiency is achieved in all members of the staff. Developing a mutual relationship with all staff members also gives an insight into how progress is achieved with the patients. Mistakes are avoided this way, and care is boosted (McGee, 1998).

The nurse practitioner, on the other hand, creates a serene atmosphere for both treatment and care when they embrace the theory. The wider knowledge governs their understanding and commitment they have on both the procedures. The theory is relevant in making the practitioner help the patients embrace both treatment and care in more comfortable ways.

Peplau’s Psychodynamic Theory is key in every role and serves to improve efficiency of the whole medical care and patient development. In every role, the psyche can be manipulated to adopt the required measures. It is an insight to how poor relationship within the nursing staff and with the patients can hamper medical care. That is possible when the patient is not free enough to share information or when the nurse cares less to inquire about the status and conditions of the nurse.

Though there are other theories that explain the relationships between the nurses and patients, they fall short of the link between the relationship of the two parties and their roles. The psychodynamic theory also has an edge over most because of the many models and theories it factored into place to achieve a meaning and relevance.

Conclusion

Peplau felt the deficiencies that were experienced in the nursing profession and education that could help better service delivery and patient recovery. She, hence, developed a theory to outline the roles of the nurses to better service delivery. To create a serene atmosphere for application of the roles, the theory further elaborates how a relationship should be developed with the patient. The relationship would serve to create an environment good enough for the patient adaptation and recovery. As the first nursing theory, the psychodynamic theory created the path for other theory developments and modifications.

References

Basavanthappa, B. T. (2007). Nursing theories. New Delhi: Jaypee Brothers.

McGee, P. (1998). Models of nursing in practice: A pattern for practical care. Cheltenham: S. Thornes.

Peplau, H. E. (2004). Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. New York: Springer Pub. Co.

Peterson, S. J., & Bredow, T. S. (2009). Middle range theories: Application to nursing research. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Tilley, S. (2008). Psychiatric and Mental Health Nursing: The Field of Knowledge. Chichester: John Wiley & Sons.