Unique Focus

1. Joyce Travelbee: The Story of a New Orleans Nurse TheoristbyDeborah Garbee, PhD, APRN, BC and Dianna Hutto Douglas, DNS APRN-CNS

2. Human-to-Human Relationship ModelTravelbee extended the interpersonal relationship theories of: Peplau Orlando

3. Unique Focus • With emphasis on Caring Travelbee’s theory stresses: • Empathy • Sympathy • Rapport • The Emotional Aspects of Nursing

4. Communication Communication is the Vehicle through which Nurse-Patient Relationships are established.

5. The Relationship • A “mutually significant meaningful relationship” (p. 125) through which the nursing needs of the individual (or family member) are met (Travelbee, 1966) • Phases of the Relationship • Original Encounter • Emerging Identities • Empathy • Sympathy • Rapport

6. Empathy • To Travelbee Empathy is a verb, an action word that is: • the nurses most valuable method of communicating with patients • ‘operationalzed’ by the nurse within the nurse-patient relationship • To empathize is to gain an intellectual understanding of the mental world and psychological state of another (Travelbee, 1966) • HOW: • Empathetic receivers (of communication form others): • Listen to the message • Use own experiences to feel their way into the sender’s experience • Know their own thoughts about their experience • Use their own thoughts and experiences to become sensitive to the what the sender is telling them • Know which boundaries exist between their experiences and thoughts and those of the sender • Make a conscious choice to stay with the sender and help them to bear their experience (Donna, 1979, p. 50)

7. Sympathy “…A process wherein an individual is able to comprehend the distress of another, be moved or touched by another’s distress, and desires to alleviate the cause. One ‘shares’ in the feelings of another and experiences compassion”. (Travelbee, 1966, p. 146)

8. Rapport • “The establishment of a nurse-patient relationship, and the experience that is rapport is the terminus of all nursing endeavor. Rapport is that which is experienced when nurse and patent has progressed through the four interlocking phases preceding rapport and the establishment of a nurse-patient relationship, namely: • The original encounter • Emerging identities • Empathy • Sympathy” (Travelbee, 1966, p. 155)

9. Travelbee’s View of Nursing • An interpersonal process between two individuals • One needs assistance because of an illness • The other able to give needed assistance • The Goal of the assistance is to facilitate the individual to: • Cope with the illness situation • Find meaning in the experience • Grow from the experience (Travelbee, 1966)

11. Domain Concepts of Travelbee’s TheoryDefined • Nursing • “An interpersonal process whereby the professional nurse… assists an individual… to prevent or cope with… illness and suffering and… find meaning in these experiences” (Travelbee, 1966, pp. 5-6). • Person • ...“a unique irreplaceable individual-a one-time being in the world-like yet unlike any person who has ever lived or ever will live”(Travelbee, 1966, p. 26). • Health • “…the enjoyment of the highest attainable standard… without distinction” (Travelbee, 1966, p.7). • “…an individually defined state of well-being in accord with self-appraisal of physical-emotional-spiritual status” (Travelbee, 1971, p.9). • Environment • Not defined

12. Other Major Concepts of Travelbee’s Theory • Communication • Nurse-Patient Relationship • Human-to-Human Relationship • Therapeutic Self • Perception • Suffering • Hope • Transcend Self • Self-Actualization

13. A Propositions of Travelbee’s Theory • “The Nurse’s perception of the patient is a major factor in determining the quality and quantity of nursing care… rendered to each Patient” (Travelbee, 1966, p. 34).

14. A Proposition of Travelbee’s Theory “The quality of nursing care given is determined by the nurse’s beliefs about illness, suffering, and death” (Travelbee, 1966, p. 55).

15. A Proposition of Travelbee’s Theory“The spiritual values… [and] philosophical beliefs [of nurses] about illness and suffering will determine the extent to which they will be able to help patients find meaning (or no meaning)in these situations”(Travelbee, 1966, p. 55).

16. Travelbee Life Influences • Education • Honors • Experience • Personal

17. Travelbee’s Education • Crossman School (Elementary) 1939 • Joseph Kohn High School 1943 • Charity Hospital School of Nursing 1946 • LSU (B.S.N. Ed.) 1956 • Yale University (M.S.N.) 1959 • Doctoral program enrollment (Florida, 1973)

18. Travelbee’s Honors • Kappa Delta Pi • Who’s Who in American Education Leaders in Science Edition • Teacher of the Year University of Mississippi SON 1968 • Outstanding Alumna Award Louisiana State University 1970

19. Travelbee’s Experience • LSUMC SON Director of Graduate Education 1973 • LSUMC SON 1971 – 1973 • Hotel Dieu SON Project Director 1969 – 1971 • University of Mississippi SON 1966-1969 • New York University 1965-1966 • LSU SON 1956-1965 • Charity Hospital SON 1954-1956 • De Paul Hospital Affiliate School 1952-1954

20. Travelbee Personal • Order of Diacalced Carmelites Secular • Poetry

21. Order of Diacalced Carmelites • 16th Century Reform of Carmalite Nuns • Reestablish Carmelite Objectives & Disciplines • St. Teresa of Avila • St. John of the Cross • Known as Contemplative Carmelites and later Discalced Carmelites

22. Order of Diacalced Carmelites Secular • Pervasive Ideas • 1. The Secular Rule of Life, Plan for Spiritual Growth • 2. Vocation & Mission • Evangelical Life & Contemplative Prayer • Apostolic & Contemplative Witness • 3. Contemplative Prayer

23. Poetry • Uplifting • Sounds • New Orleans • The Dreamer • Sorrow • Magnolia • The wind is White tonight • So? • Mental Health Patients • Hurry • Inspiration • Sandra • Burnt Sienna • Untitled

24. References • Catholic University of America (1967). Catholic Encyclopedia. NY: McGraw-Hill Book Company. • Donna, M.K., (1979). Intervention in psychiatric nursing (2nd ed.). Philadelphia, PA: F.A. Davis. • LSU Personnel Records (1971). Biographical Data Form. New Orleans: LSU. • Speziale, H.J. & Carpenter, D.R. (2007). Qualitative Research in Nursing Advancing the Humanistic Imperative. (4th ed.). Philadelphia: Lippincott. • Travelbee, J. (n.d.) Poetry. New Orleans. • Travelbee, J. (1966). Interpersonal aspects of nursing. Philadelphia, PA: F.A. Davis. • Travelbee, J. (1971). Interpersonal aspects of nursing (2nd ed.). Philadelphia, PA: F.A. Davis.