Joyce Travelbee Nursing Theory: Human to Human Relationship Model

An overview of Joyce Travelbee’s nursing theory: Human to Human Relationship Model.

About the nursing theorist: Joyce Travelbee

Joyce Travelbee Nursing Theory: Human to HUman Relationship ModelJoyce Travelbee, born in 1926, was a psychiatric nurse, educator and writer. In 1956, she completed her Bachelor of Science degree in nursing education at Louisiana State University and her Master of Science Degree in Nursing from Yale University in 1959. She started a doctoral program in Florida in 1973. Unfortunately, she was not able to finish the program because she died later that year. She passed away at the prime age of 47 after a brief sickness.

In 1952, Travelbee started to be an instructor focusing in Psychiatric Nursing at Depaul Hospital Affiliate School, New Orleans, while working on her baccalaureate degree. Besides that, she also taught Psychiatric Nursing at Charity Hospital School of Nursing in Louisiana State University, New York University and University of Mississippi. In 1970,she was named Project Director at Hotel Dieu School of Nursing in New Orleans. Travelbee was the director of Graduate Education at Louisiana State University School of Nursing until her death.
In 1963, Travelbee started to publish various articles in nursing journals. Her first book entitled Interpersonal Aspects of Nursing was published in 1966 and 1971. In  1969, she had her second book published entitled Intervention in Psychiatric Nursing : Process in the One-to-One Relationship.

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Metaparadigm in Nursing according to Joyce Travelbee

Person
Person is defined as a human being. Both the nurse and patient are human beings. A human being is a unique, irreplaceable individual who is in the continuous process of becoming,evolving and changing.
Health
Travelbee stated that health is measured by subjective and objective health. “A person’s subjective health status is an individually defined state of well being in accord with self-appraisal of physical-emotional-spiritual status.” Objective health is “an absence of discernible disease, disability, or defect as measured by physical examination, laboratory tests, assessment by a spiritual director, or psychological counselor.”

Environment
Environment was not clearly defined in Travelbee’s theory. She defined human conditions and life experiences encountered by all men as sufferings, hope, pain and illness. These conditions are associated to the environment.
Nursing
- “an interpersonal process whereby the professional nurse practitioner assists an individual, family, or community to prevent or cope with the experience of illness and suffering and, if necessary, to find meaning in these experiences.”
She explained that nursing is an interpersonal process because it is an experience that occurs between the nurse and an individual or group of individuals.

Joyce Travelbee Nursing Theory: Human-to-Human Relationship Model

Travelbee’s formulation of her theory was greatly influenced by her experiences in nursing education and practice in Catholic charity institutions. She concluded that the nursing care rendered to patients in these intitutions lacked compassion. She thought that nursing care needed a “humanistic revolution”- a return to focus on the caring function towards the ill person.
Travelbee’s mentor, Ida Jean Orlando, is one of her influences in her theory.Orlando’s model has similarities to the model that Travelbee proposes. The similarities between the two models are shown in Travelbee’s statement, “the nurse and patient interrelate with each other and by her description of the purpose of Nursing”. She stated that the purpose of nursing is to “assist an individual, family, or community to prevent or cope with the experience of illness and suffering, and, if necessary, to find meaning in these experiences.”

In her human-to-human relationship model, the nurse and the patient undergoes the following series of interactional phases:

Original Encounter
This is described as the first impression by the nurse of the sick person and vice-versa. The nurse and patient see each other in stereotyped or traditional roles.
Emerging Identities
This phase is described by the nurse and patient perceiving each other as unique individuals. At this time, the link of relationship begins to form.
Empathy
Travelbee proposed that two qualities that enhance the empathy process are similarities of experience and the desire to understand another person. This phase is described as the ability to share in the person’s experience. The result of the empathic process is the ability to expect the behavior of the individual with whom he or she empathized.
Sympathy
Sympathy happens when the nurse wants to lessen the cause of the patient’s suffering. It goes beyond empathy. “When one sympathizes, one is involved but not incapacitated by the involvement.” The nurse should use a disciplined intellectual approach together with therapeutic use of self to make helpful nursing actions.
Rapport
Rapport is described as nursing interventions that lessens the patient’s suffering. The nurse and the sick person are relating as human being to human being. The sick person shows trust and confidence in the nurse. “A nurse is able to establish rapport because she possesses the necessary knowledge and skills required to assist ill persons, and because she is able to perceive, respond to, and appreciate the uniqueness of the ill human being.”
Note that the above stated interactional phases are in consecutive order and developmentally achieved by the nurse and the patient as their relationship with one another goes deeper and more therapeutic.

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