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As individuals, we have history, the present, and the future. Dr. Hildegard Peplau, the "mother of psychiatric nursing," developed the role of the nurse in the nurse-patient relationship. When she died in March of this year, she left a great legacy to the nursing profession. We reprint here, almost in its entirety, this article from Nursing Forum, 1966, 5(1), 60-75, in which Dr. Peplau traces the nurse-doctor relationship from the beginning of this century. Her conclusions, written more than 30 years ago, are valid today.
It is claimed that nurse-doctor relationships are deteriorating. We know that disintegration precedes reintegration, which can occur along healthier lines. In my opinion this is the process that is under way in nurse-doctor relationships. They are changing slowly, painfully, but in directions that will ensure healthier working relationships and improved patient care. This process may perhaps be accelerated by a consideration of trends in the general disintegration of previous relationships and some of the transitional tendencies by which constructive new nurse-doctor pattern integrations can occur.
1900-1930
During the first thirty years of this century the image of nurse, in the mind of the public and the nurses themselves, was of a person controlled benevolently, in a paternal way, by doctors. A parental type of doctordomination fostered dependence of nurses upon doctors for advice, education, guidance, and approval. The great depression of 1929 was a major turning point. Before that time, nurses were "handmaidens," and the majority of them were not particularly troubled by this designation.
Nursing was not yet well enough developed as a profession for its members to be clear about what nurses should do other than follow doctors' orders. Florence Nightingale and other nurses after her had ideas about what nursing should be, and some of these ideas were published. But these avant-garde leaders were still too few, and the language of the educated nurse was not really heard by enough of the "trained" nurses, who were in the majority. The focus of the average nurse was upon helping the doctor-doing what he said should be done-and she was grateful for what he helped her to learn. Several factors at work at that time combined to perpetuate this focus, which was shared by doctors and nurses.
One...