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Application of Middle Range Theory to Problem


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Application of Middle Range Theory To Problem

Summary of the problem

In the present times, the health of individuals plays a fundamental role as far as the economic development of a nation is concerned. When most individuals are unwell, they tend to spend most of their time seeking for quality health care services rather than attending to their daily economic activities. This is the core reason why most governments, both the developed and the developed ones allocate substantial funds to the health sector. Despite this, staffing ratios has been a major issue in the health care facilities since it influences the quality of care as well as the level of satisfaction that a patient attains after seeking health care services. It is also argued that the staffing ratio also influences the safety of patients, especially due to the fact that when the ratio is low, the individual health care professional always have a high number of patients to serve at any given time, and he or she will not manage to serve them perfectly (Negron & Cohen, 2013). Precisely, the staffing ratios influence the work load that is assigned to nurses, thus determining the quality of care they are able to impact ensuring patient safety. In addition, the staffing ratio is the major factor that influences the occurrence of medical errors in the health care facilities, especially due to the fact that when the ratio is low, nurses tend to be under pressure to serve a high number of health consumers, and this increases chances of making prescription, administration, and diagnosis errors.

Description of the middle range theory Selected: The Peplau`s theory of Interpersonal relations in Nursing

Peplau`s theory of interpersonal relations can be defined as the interpersonal and therapeutic process that occurs when health professionals (specifically those who are adequately educated to be nurses), enter in therapeutic associations with health consumers (Hagerty, 2017). According to Peplau, an effective nurse-patient relationships must meet three core phases in order to be termed as successful, and these phases are not limited to Orientation, working, and termination. During the orientation phase, the patients who have newly admitted tends to contemplate that they really require medical help and try to adjust or adapt to their new (current) experiences. At the same time, nurses tends to encounter and gain necessary information about the newly admitted patients as individuals with unique needs and priorities. At this phase, nurses tends to assume numerous roles including that of meeting a stranger. The nurses are supposed to greet the patients with the respect and positive interest that are displayed to a stranger, and they should continue displaying this level of respect and courtesy even in the other consecutive phases.

During the working phase, nurses make assessments about the patients which they (nurses) use when contributing to the interdisciplinary plan of care. Additionally, nurses become more familiar with patients and therapeutic form of communication as well as non-judgmental feedback to patients is extensively embraced by nurses. The terminal phase encompasses aspect of planning for the discharge of patients. Considering this theory focuses on the association between nurses and patients, the theory stands the most appropriate to the low safe staffing ratio of nurses.

Origin of Peplau’s theory of interpersonal relations

The theory of interpersonal relations was advocated by Hildegard E. Peplau and her core aim was to revolutionize the scholarly roles of nurses. She emphasized the importance of maintaining nurse-client relationship in the nursing practice especially in her book on Interpersonal Relations in Nursing was completed in 1948. During the 1950s, her research and support of the give and take of nurse-patient relationships was being perceived by many as revolutionary (Hagerty, 2017). Through this theory, she focused on the formation of a shared experience between the nurse and the patient as opposed to the nurses passively implementing physician`s orders and the patient passively receiving the treatment.

Ways in which the interpersonal relations Theory had been Previously Applied

The Peplau`s theory of interpersonal relations has previously been applied in various aspects. For example, this theory had been applied as a framework of helping nursing students to contemplate the holistic communication skills during their association with older adults (Snowden, Donnell & Duffy, 2014). In addition, this theory has been applied as a guide for behavior modification among nursing students, especially through the use of interpersonal collaboration and self-care techniques.

The Application of the Interpersonal Relations Theory

The Peplau`s theory of interpersonal relationship would help the health sector to contemplate the roles of nurses when it comes to the delivery of quality health care services to the increasing number of health consumers. Precisely, the theory in the determination of the workload that nurses have when it comes to the delivery of health services which would not only meet patients` expectations but also exceed them. For example, through this theory, the health care facility will contemplate that for patients to be satisfied with the health services that they receive from the nurses, the later has to embrace and implement a number of roles including stranger role, resource role, teaching role, counselling role, surrogate role, as well as the leadership role. For these roles to be achieved, effective interpersonal relationship between the nurse and the patient must be maintained. Apparently, it may take a single nurse a lot of time to implement these roles to a single patient, and considering that the number of health consumers have greatly increased, the safe staff ratio must as well be increased. In addition, this theory also sensitized the current safe staff ratio to focus on improving patients` satisfaction through embracing and implementing interpersonal relations. Moreover, this theory can also be applied by sensitizing nurses to maintain respect and courtesy to all patients’ right from the orientation phase through working phases to the terminal phase.

Ways in which my Nursing Practice will Change by Incorporating this Theory

Through the incorporation of the Peplau`s interpersonal relations theory, my nursing practice will be influenced in a number of ways. First, I have contemplated that the nursing practice is not just a matter of give-it and take-it, but there must be the creation of an interpersonal associations between the nurse and the patient. By engaging with the patients, I will manage to establish a close relationship with them, to such an extent that they can they can`t feel like they are being nuisance when inquiring anything from me as a nurse. Through this theory, I will manage to embrace and implement various nursing roles that it advocates including the stranger role, resource role, teaching role, counselling role, surrogate role, as well as the leadership role. Moreover, this theory has sensitized me concerning the various phases of the interpersonal relations, including orientation, working, and termination phases.


Hagerty T., Samuels W., Norcini-Pala A., and Gigliotti E., (2017). Peplau’s Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data? Nurs Sci Q. 2017 Apr; 30(2): 160–167. doi:  [10.1177/0894318417693286]

Negron, B., & Cohen, E. (2013). Back to the Future: A standardized approach to delivering effective Nursing Care. Nurse Leader, 11(2), 52-56.

Snowden, A., Donnell, A., & Duffy, T. (2014). Pioneering theories in nursing. London: Andrews UK.