The Theory of Joyce Travelbee

Human-to-Human Relationship Model

by

Pamela Salisbury Smith RN

Understanding Theory

Theory gave rise in nursing history, as nurses moved forward in developing nursing as a profession and an academic discipline2

Nurses began focusing on specialized knowledge to guide nursing practice2

Theory is a collection of ideas that explain that which is real in existence, and can be demonstrated3

Nursing theorists have been influenced by such disciplines as anthropology and sociology3

21st century based nursing theory practice uses models, philosophies, and theories2

Theory, if we are to continue moving forward, must be a prerequisite for the survival of our profession2

Joyce Travelbee: Nurse Theorist

1926-1973

History

Psychiatric Nurse, Educator, and Author Education and Accomplishments:

Louisiana University BSN; Yale University MSN; Nurse Educator of DePaul University, Charity Hospital School, New York University, and University of Mississippi; Author of Interpersonal Aspects of Nursing and Intervention in Psychiatric Nursing

Developed The Human-to-Human Relationship Model

Based her theory on concepts of existentialism and logotherapy by Soren Kierkegaard and Viktor Frankl

Travelbee’s theory influenced nursing, healthcare, and the hospice movement

Human-to-Human Relationship Model

The need for a “Humanistic Revolution” in nursing, with a renewed devotion on caring and compassion for patients4

Assist the person, family, or community to avert or palliate the experiences of sickness and suffering—instilling hope as a maximum goal4

Hope being a mental state with a yearning to finalize or reach a purpose, with an expectation of gaining that which is desired4

Concept of hope would evolve from psychiatric nursing to patients with chronic illnesses, requiring long-term care4

To understand the ill patient, is to recognize the person’s uniqueness4

The nurse’s spiritual values and philosophical beliefs, toward suffering, would be a driving force in helping people to find meaning in their illnesses1

Human-to-Human Relationship Model

The therapeutic use of self in communicating and establishing relationships4

Finding meaning, during interactions, is essential to the nurse and patient relationship4

Human-to-Human relationships serve to define and make proficient the practice of nursing4

Recognizing the importance of sympathy, as well as empathy, in order to develop human-to-human relationships4

A nurse exhibiting sympathy is an act of courage because the nurse is risking pain, and one should recognize the dangers involved in sympathy, such as over-identification, a distorted sense of pity, causing harm to the patient, becoming too soft hearted, or being will paralyzer to the patient4

Involves working through the phases of initial encounter, emerging identity, empathy, sympathy, and rapport4

Phases of the Nurse-Patient Relationship

Original Encounter: The need to perceive the human being in the patient, and vice versa, with the task of breaking the bond of sequence4

Emerging Identities: Patient and nurse begin to recognize the differing qualities that each possess, transcending roles by separating self and experiences from one and another—not using oneself to judge others4

Developing Feelings of Empathy: Not sharing another’s feelings, but sharing a psychological state of another—exhibiting the ability to predict the behavior of others4

Developing Feelings of Sympathy: Experiencing, sharing, and feeling what others are experiencing—emotional involvement involving the nurse transforming sympathy into concrete nursing actions4

Phases of the Nurse-Patient Relationship

Rapport: The phase of rapport is the end result of all phases. An accumulation of thoughts, experiences, feelings, and attitudes, involving both nurse and patient, that they can share, perceive, and communicate, resulting in a therapeutic relationship4

Travelbee defined her place in history as a pioneer of nursing theory, because she used a different approach, the human-to-human relationship between nurse and patient, as she synthesized her unique ideas that differentiated her work from that of other theorists4

The Relationship to My Profession

Travelbee’s Phase of the Nurse –Patient Relationship is exactly how I practice nursing on a daily basis—it is who I am, without ever thinking about it

The human-to-human relationship model of nursing, in my opinion, is a tool for gaining trust, acknowledging respect for others, and showing that empathy and sympathy are important factors for relationships to be successful and sustaining, offering a sense of foreseeable well being for the patient, family, or the community

I take pride in being able to exhibit this on a daily basis, and it is a belief of Buddhists that people can achieve compassion with such a skill that it happens without effort, being unconditional and universal in practice6

Video Empathy: The Human Connection to Patient Care5

References

1) Alligood, M., R. (2014). Nursing Theorists and Their Work. Mosby, Inc., 50.

2) Alligood, M., R. (2014). Nursing Theory: Utilization & Application. Mosby, Inc., 2-7.

3) Blais, K., K., & Hayes, J., S. (2011). Professional Nursing Practice: Concepts and

Perspectives, 6th ed., Pearson Education, Inc., 97-99.

4) Butts, J., B. & Rich, K., L. (2011). Philosophies and Theories for Advanced

Nursing Practice. Jones and Barlett Learning, LLC, 280-283.

5) Cosgrove, T. (2013, February 27). Empathy: The Human Connection to Patient Caring

[Video file]. Retrieved from https://www.youtube.com/watch?v=cDDWvj_q-o8.

6) Rich, K. (2003). Revisiting Joyce Travelbee’s Question: What’s Wrong With Sympathy?

Journal of the American Psychiatric Nurses Association, 9(6), 202-203.