The Theory of Joyce Travelbee

1. The Theory of Joyce Travelbee Human-to-Human Relationship Model by Pamela Salisbury Smith RN

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. Video Empathy: The Human Connection to Patient Care5

10. 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.