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Hildegard Peplau

Hildegard Peplau was the first published nursing theorist of the 20th century and the first since Florence Nightingale published her book, Notes on Nursing, in 1859. Even though Peplau was a psychiatric nurse, her Theory of Interpersonal Relations can be used in almost any nursing practice.

Early Life

Hildegard Elisabeth Peplau was born on September 1, 1909 in Reading, Pennsylvania. Her parents, Gustav and Oltylie Elgert Peplau, were immigrants who were born in a German territory of Poland but did not meet until they came to the United States. Her father was a fireman with the Reading Railroad and as an uneducated immigrant was very proud to have that job. Her mother was a hardworking homemaker and helped with the family finances by cleaning other houses, working at a shirt factory and selling baked goods. Hilda, as she was called, was the second of six children and was always very independent. She was still a child during the 1918 influenza epidemic, but she was influenced by the experience and saw the impact that illness and death had on families.

Hilda left high school after a disagreement with the principal and later received her high school equivalency from Reading Evening High School in 1928. In that era, there were only about four accepted paths that a girl would take after graduating high school. The preferred option was marriage, and Catholic girls might go to the convent. If they could afford the cost of tuition, some girls went to the normal school to become teachers. Hilda chose to go to nursing school because of free room and board and a monthly stipend. In 1928, she entered the Pottstown Hospital School of Nursing in Pottstown, Pennsylvania. First year students received $5.00 a month, second year students, $10.00 a month and in the third year, they were supposed to receive the huge sum of $20.00 a month. In Hilda's case, the Great Depression started in her third year of training, and she received no pay. Nevertheless, she described her nurses training as very interesting and enjoyable. While she was still a student, she assisted in surgery, delivered babies and removed tonsils, something unheard of in today's nursing education. However, her experiences as a student at Norristown State Hospital, Norristown, Pennsylvania, awakened her interest in psychiatric nursing and influenced her career path.

Education and Career

Peplau started her nursing career after graduation from the Pottstown Hospital School of Nursing in 1931. Most nurses at that time took jobs as private duty nurses, but Peplau served as a staff nurse in hospitals in Pennsylvania and New York City. After a job as a summer camp nurse for New York University, she began working at Bennington College in Vermont as a school nurse. She subsequently became head nurse of the college health service and was admitted to Bennington as a degree student. This was a very unusual achievement for a nurse at that time and paved the way for her to receive her bachelor's degree in interpersonal psychology in 1943. She studied with several well-known psychiatrists including Harry Stack Sullivan who founded the interpersonal theory of psychiatry, and her later work expanded his theory for use in nursing.

When World War II started, Peplau felt as if she needed to serve the country, so she joined the Army Nurse Corps and served as first lieutenant from 1943 until 1945. Sent to England, she worked at the 312th Field Station Hospital where the School of Military Neuropsychiatry was located. While there, she worked with leading American and English psychiatrists who she would meet again later in her career.

After her discharge from the Army in 1945, Peplau went to New York and earned a master's degree in psychiatric nursing in 1947 and a Doctor of Education (Ed.D.) degree in curriculum development in 1953 from Teachers College, Columbia University. She also studied psychoanalysis and was certified as a psychoanalyst by The William Alanson White Institute in New York City. It was during this time that Dr. Peplau developed and taught the first classes for graduate psychiatric nurses at Teachers College and also completed the manuscript for her nursing theory book, Interpersonal Relations in Nursing. Even though the manuscript was finished in 1948, she was unable to find a publisher until 1952 because she refused to change the content and did not have a physician co-author.

In 1954, she joined the faculty at the College of Nursing at Rutgers University, Newark, New Jersey, and was there until her retirement in 1974. She began as an instructor and eventually became the Director of Psychiatric Nursing. While in that position, she formed the first graduate program for psychiatric nursing clinical specialists. She also maintained a private psychotherapy practice.

She also was a visiting professor at many universities throughout the United States and internationally, an advisor to the World Health Organization and a consultant to numerous government organizations. She was president of the American Nurses Association (ANA) from 1970 to 1972 and after her retirement from Rutgers in 1974, acted as visiting professor at the University of Leuven in Belgium in 1975 and 1976.

With all of Peplau's accomplishments, her life and career were not without controversy. Barbara Callaway's 2002 book, Hildegard Peplau: Psychiatric Nurse of the Century, chronicles her life with all its strengths and imperfections. She wrote that Hilda was a visionary and was constantly pushing beyond where others wanted to go. She could be very abrasive at times. Her greatest career challenge was at Columbia Teachers College in 1953 where she met with resistance when she wanted graduate degree nurses to practice psychotherapy and contribute to research. After many confrontations with superiors, she resigned and went to Rutgers. Although she accomplished a great deal at Rutgers, her time there was marred by controversy as well, and she retired in 1974 with ill health and mental exhaustion.

Her personal life was controversial as well. In 1945, she was pregnant when she returned from England. She arranged for her brother to adopt the baby but raised her daughter alone and very few people knew the truth. Her daughter became a successful psychologist in Los Angeles.

Peplau later admitted that she was probably not as politically aware as she should have been during her career, but one cannot argue with her accomplishments, no matter how hard won. A very productive writer and a lecturer and presenter at many clinical training workshops, she fought for her beliefs and for improvement in mental health nursing education and practice. She took psychiatric nursing from custodial care to a theory-based profession.

Honors and Awards

Throughout her career, Peplau received nine honorary doctorate degrees from various universities. In 1995, she was the only nurse named as one of Fifty Great Americans in the 1996 edition of Marquis' Who's Who in America. Other awards include the American Academy of Nursing Living Legend Award in 1995 and the Christiane Reimann Prize in 1997. She was inducted into the American Nurses Association Hall of Fame in 1998.

Dr. Peplau suffered a minor stroke in 1991 and moved to California to be closer to her daughter, Dr. Leitia Peplau. She died at her home on March 17, 1999, at the age of 89. On the anniversary of her 100th birth date, her nieces posted a tribute to their "favorite aunt". They portrayed her as an independent, courageous and amazing person with a down-to-earth sense of humor. They are proud that she continues to be an "inspiration to many."

Publications related to Hildegard Peplau

Records of Dr. Peplau's work and life are archived in the Schlesinger Library at Harvard University and also at the Barbara Bates Center for the Study of the History of Nursing at the University of Pennyslvania.

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