| Course | NUR-7610 Psychiatric Mental Health Nurse Practitioner Roles and Contemporary Issues |
|---|---|
| Module | Module 1 |
| Paper type | Theory application: Hildegard Peplau |
| Length | About 1,037 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | M.S. in Nursing, Psychiatric Mental Health Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NUR 7610 Module 1
Twenty Minutes Is Still a Relationship: Peplau's Phases in Medication Visits With a 48-Year-Old Man Who Distrusts Clinics
Student Name
M.S. in Nursing, Psychiatric Mental Health Nurse Practitioner, Thomas Edison State University
NUR-7610: Psychiatric Mental Health Nurse Practitioner Roles and Contemporary Issues
Mentor Name
Month Day, Year
Twenty Minutes Is Still a Relationship: Peplau's Phases in Medication Visits With a 48-Year-Old Man Who Distrusts Clinics
Introduction
I am a registered nurse at a community mental health center in Trenton, and in two years I will be a psychiatric mental health nurse practitioner. Much of my future work will be medication management in visits of 20 or 30 minutes. Colleagues sometimes say that such visits leave no time for the relationship-centered nursing that drew many of us to psychiatry. This paper argues the opposite, using the theory of Hildegard Peplau and one patient, Mr. G., a 48-year-old man with schizophrenia who has missed his last three appointments and distrusts the clinic.
Peplau's Theory
Peplau (1997) described nursing as an interpersonal process in which the relationship between nurse and patient is itself therapeutic. She identified phases through which the relationship moves. Orientation is the opening: a person asks for help, and the two of them get acquainted and agree on what is wrong. In the working phase, the patient makes use of the relationship and the help offered to work on the problem. Resolution comes last: the patient leans on the nurse less, and the relationship either ends or takes a new form. Along the way the nurse moves through roles Peplau named, from stranger to resource person, teacher, counselor and at times surrogate, as the relationship needs each one. She emphasized that the nurse must observe herself as well as the patient, since the nurse's own anxiety and assumptions shape what happens.
D'Antonio et al. (2014) argue that Peplau's work has been overshadowed by the biological turn in psychiatry, in which neurotransmitters and receptors replaced interpersonal dynamics as the main language of the field. They do not propose returning to the 1950s, but they contend that her ideas about the healing power of relationships remain relevant and can guide practice that integrates biology with relationship.
Why the Relationship Matters to Outcomes
Peplau's claim that the relationship heals is supported by modern evidence on therapeutic alliance. Flückiger et al. (2018) pooled 295 studies, over 30,000 patients in all, and found that stronger working relationships went with better results again and again, at a correlation near 0.28, whether therapy happened in a room or online. Although those studies concern psychotherapy rather than medication visits, the mechanism, agreement on goals and tasks and an emotional bond, applies whenever a patient must trust a clinician enough to follow a plan.
Orientation: The First Visit
Mr. G. arrives late, sits by the door and says he is here only because his sister insisted. In the orientation phase, my task is to help him identify what he wants, not to start with what I want. I acknowledge that he has had bad experiences, ask what made the last medication hard to take and listen. He says it made him "slow and fat" and that no one listened when he complained. I take the role of stranger, offering respect and courtesy without assuming familiarity, and then of resource person, explaining that other options exist. We agree on one goal: finding a medicine that controls the voices without the sedation he hates.
The goal matters more than its wording suggests. By naming sedation as his problem rather than adherence as mine, the visit reframes him from a noncompliant patient into a person with a reasonable complaint. Peplau warned that nurses who define problems for patients lose the chance to learn what the patient actually needs, and Mr. G.'s three missed appointments were, on his account, a rational response to a medicine that made him feel worse.
Working Phase: The Next Visits
In the second and third visits, the relationship becomes the means of change. I review his response to a lower dose of a less sedating drug, check his weight with him rather than at him and ask what he has noticed. When he reports that the voices are quieter but he feels restless, I take the counselor role, helping him describe the feeling, and the teacher role, explaining that restlessness can be a side effect that can be treated. He begins to bring questions written on a scrap of paper, a sign that he is using the relationship to work on his problem. I notice my own impatience when he repeats complaints and, following Peplau, treat it as information about the relationship rather than a fault in him.
His sister, who drives him to the clinic, joins the last few minutes of one visit at his request, and hearing her describe him as calmer at home helps him believe the change is real.
| Peplau phase | Nurse roles | What happened with Mr. G. |
|---|---|---|
| Orientation | Stranger, resource person | Shared goal: control voices without sedation |
| Working | Counselor, teacher | Side effects named and treated; he brings questions |
| Resolution | Resource person | He manages refills and calls when concerned |
Resolution
Resolution in medication management does not mean ending care, since Mr. G. will need treatment for years. It means a shift toward independence: he manages his own refills, calls when side effects change and comes to visits with his own agenda. The relationship continues, but he leads more of it.
Resolution also has a practical test. If I were to leave the clinic, would Mr. G. be able to start again with a new clinician without losing ground? Teaching him to describe his own history of medicines, side effects and what has helped is one way to make the relationship's gains portable.
Implications for My Role
Applying Peplau changes three habits I might otherwise form. I will begin each visit with the patient's concern, not my checklist. I will use the language of shared goals, so medication decisions are made with patients rather than for them. And I will observe my own reactions, especially with patients who are difficult to engage, because the relationship is where engagement is won or lost.
Conclusion
Peplau's phases fit the brief medication visit better than her critics suggest. Orientation, working and resolution can unfold across a series of 20-minute appointments, and evidence on therapeutic alliance supports her claim that the relationship affects outcomes. For a PMHNP, the theory is a guide to how prescribing should be done, not an alternative to it.
References
D'Antonio, P., Beeber, L., Sills, G., & Naegle, M. (2014). The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nursing Inquiry, 21(4), 311-317. https://doi.org/10.1111/nin.12056
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. https://doi.org/10.1037/pst0000172
Peplau, H. E. (1997). Peplau's theory of interpersonal relations. Nursing Science Quarterly, 10(4), 162-167. https://doi.org/10.1177/089431849701000407
What the NUR 7610 Module 1 instructions ask for
Theory, and Hildegard Peplau by name, opens TESU's NUR-7610 catalog paragraph; with no syllabus visible to the public, this first module puts her theory to work in a PMHNP's own visits. Expect a paper that summarizes the theory accurately, places it in the history of psychiatric nursing, connects it to current evidence and applies it to a patient or practice situation, often your own. Some classrooms ask you to compare Peplau with another theorist or to analyze a process recording. Check the directions. Apply the theory to specific moments, naming the phase and role at each, and show what the theory changes in how you will practice. Include your own reactions, as Peplau did.
How this NUR 7610 Module 1 example is built
The paper opens with the objection that brief medication visits leave no room for relationship. Peplau's phases and roles are summarized from her own account, and a historical reassessment explains why her work was overshadowed and why it matters again. A meta-analysis of 295 alliance studies supports her claim that the relationship affects outcomes. The theory is then applied across three visits with a man who distrusts clinics, naming the phase and roles in each, with a three-row table. Resolution is redefined for long-term medication care, and three changes to the writer's practice close the paper before the conclusion. The writer's own impatience appears as data, as Peplau taught.
NUR 7610 Module 1 rubric: what earns full marks
Theory papers are graded on accurate summary, meaningful application and reflection on practice. Mentors look for phases and roles applied to specific interactions rather than described in general. Connecting the theory to current evidence, such as alliance research, strengthens the argument. Awareness of critiques or historical context shows depth. The paper should end with concrete implications for the student's practice, stated as habits that could be observed. Reflection on the nurse's own reactions, a central part of Peplau's method, is often the feature that separates strong papers from adequate ones. Peplau's own writing, recent alliance evidence and APA style earn the rest of the marks. A table mapping the theory onto an example is often credited.
Common NUR 7610 Module 1 mistakes, and how to avoid them
Students often summarize Peplau's phases in a paragraph and then describe a patient without connecting the two. Name the phase and the nurse's role at each moment. Another weakness is relying only on secondary sources; cite Peplau's own writing. Avoid claiming that interpersonal theory replaces medication; show how it shapes prescribing. Include the nurse's self-observation, which Peplau emphasized. Use evidence to support the theory's claims, and redefine resolution for long-term care rather than dropping it. End with changes to your own practice. Describe a patient you have worked with and send the NUR-7610 prompt; the theory paper that comes back is free the first time.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 7610 Module 1 questions, answered
Where can I find a free NUR 7610 Module 1 sample paper?
Read it top to bottom above. It walks Peplau's three phases through four short medication visits with a man wary of clinics.
What are Peplau's phases of the nurse-patient relationship?
First they get to know each other and name the problem, then the patient uses the relationship to work on it, and finally the patient needs the nurse less.
What roles did Peplau describe for the nurse?
Stranger, resource person, teacher, counselor and surrogate, among others, each suited to different points in the relationship.
Does the therapeutic relationship affect outcomes?
Strongly, in psychotherapy at least: across 295 studies, clients who rated the relationship higher tended to improve more.
How does Peplau's theory apply to PMHNP practice?
It guides medication visits as relationships: starting with the patient's goals, making decisions together, treating side effects as shared problems and observing one's own reactions.