JOYCE TRAVELBEE (Human-to-Human Relationship Model )

JOYCE TRAVELBEE (19261973) Human-to-Human Relationship Model

A nurse does not only seek to alleviate physical pain or render physical care she ministers to the whole person. The existence of the suffering whether physical, mental or spiritual is the proper concern of the nurse. - Joyce Travelbee

Life Story A psychiatric nurse, educator and writer born in 1926. 1956, she completed her BSN degree at Louisiana State University

1959, she completed her Master of Science Degree in Nursing at Yale University Working Experiences: 1952, Psychiatric Nursing Instructor at Depaul Hospital Affilliate School, New Orleans. Also she taught at Charity Hospital School of Nursing in Louisiana State University, New York University and University of Mississippi. 1970, the Project Director of Graduate Education at Louisiana State University School of Nursing until her death. Publications:

1963, started to publish articles and journals in nursing.

1966 and 1971, publication of her first book entitled Interpersonal Aspects of Nursing. 1969, when she published her second book Intervention in Psychiatric Nursing: Process in the One-to-One Relationship.

She started Doctoral program in Florida in 1973. Unfortunately, she was not able to finish it because she died later that year. She passed away at the prime age of 47 after a brief sickness.

Theoretical Sources Catholic charity institutions

Ida Jean Orlando, her instructorThe nurse is responsible for helping the patient avoid and alleviate the distress of unmet needs. The nurse and patient interrelate with each other. Viktor Frankl, a survivor of Auschwitz and other Nazi concentration camps proposed the theory of logotherapy in which a patient is actually confronted with and reoriented toward the meaning of his life.

Nursing Metaparadigm Person - Person is defined as a human being. - Both the nurse and the patient are human beings. - A human being is a unique, irreplaceable individual who is in continuous process of becoming, evolving and changing. Health - Health is subjective and objective. - Subjective healthis an individually defined state of well being in accord with selfappraisal of physical-emotional-spiritual status. - Objective healthis an absence of discernible disease, disability of defect as measured by physical examination, laboratory tests and assessment by spiritual director or psychological counselor. Environment - Environment is not clearly defined. - She defined human conditions and life experiences encountered by all men as sufferings, hope, pain and illness.
Illness being unhealthy, but rather explored the human experience of illness

Suffering is a feeling of displeasure which ranges from simple transitory mental, physical or spiritual discomfort to extreme anguish and to those phases beyond anguishthe malignant phase of dispairful not caring and apathetic indifference

Pain is not observable. A unique experience. Pain is a lonely experience that is difficult to communicate fully to another individual.

Hope the desire to gain an end or accomplish a goal combined with some degree of expectation that what is desired or sought is attainable

Hopelessness being devoid of hope

Nursing - Nursing is an interpersonal process whereby the professional nurse practitioner assists an individual, family or community to prevent or cope with experience or illness and suffering, and if necessary to find meaning in these experiences. Human-to-Human Relationship Model - humanistic revolution Interactional Phases of Human-to-Human Relationship Model: 1. Original Encounter - First impression by the nurse of the sick person and vice-versa. - Stereotyped or traditional roles 2. Emerging Identities - the time when relationship begins - the nurse and patient perceives each others uniqueness 3. Empathy - the ability to share in the persons experience 4. Sympathy - when the nurse wants to lessen the cause of patients suffering. - it goes beyond empathyWhen one sympathizes, one is involved but not incapacitated by the involvement. - therapeutic use of self 5. Rapport - Rapport is described as nursing interventions that lessens the patients suffering. - Relation as human being to human being - A nurse is able to establish rapport because she possesses the necessary knowledge and skills required to assist ill persons and because she is able to perceive, respond to and appreciate the uniqueness of the ill human being. *phases are in consecutive and developmental process. Logical Form - An inductive theory that uses specific nursing situations to create general ideas.

Application Practice: Hospice self-actualizing life experience. Assumption of the sick role. Meaning of life and sickness and death. Education: Teaches nurses to understand the meaning of illness and suffering. Research: Applied in the theory of caring cancer patients. Analysis Clarity is not consistent in clarity and origin. 1. Definition of terms came from dictionaries and books etc. 2. Used different terms for the same definition. 3. Focus more on adult individuals who are sick and the nurses role in helping them to find meaning in their sickness and suffering. 4. Deals in families and their needs but not in the community Simplicity not simple. 1. Contains different variables. Generality has wide scope of application but applicable only to those patients in distress and life changing events. Empirical Precision low measures of empirical soundness. 1. Result of lack of simplicity. 2. Defines concepts theoretically but does not define them operationally. 3. The model has not been tested. Derivable Consequences development of quality of caring. 1. It is useful because of its ability to describe, explain, predict and control a phenomena. 2. Explains the variables that affect the establishment of a therapeutic relationship between nurses and patients. 3. Lack of empirical precision also creates lack of usefulness. References: Octaviano, E.F. & Balita, C.E. (2008). Theoretical Foundations of Nursing: The Philippine Perspective. Philippines: Ultimate Learning Series, 93-98. Tomey, A.M. & Alligood, M.R. (2002). Nursing Theorists and Their Work. 5th ed. Missouri: Mosby, 418-425.

Journal Reading
The Last Hair Strands Danela C. Oloresisimo, RN

CANCER... medically termed as CA or cellular aberration is one of the major cause of sufferings and death around the globe. It is cause by a carcinogen (cancer causing agent) and co-carcinogen (required for carcinogen to affect human cell and this was initiated by wrong and faulty lifestyle. A combined of these two produces cancer cell or oncogene which triggers cancerous characteristics by producing protein which accelerates multiplication of cells, increases its responsiveness and growth, thus cancer means any malignant growth in any part of the body which can metastasized or spread all over the body if severe or malignant... But whatever medical terms or meanings have used to refer to cancer, still cancer is a killer. Cancer is fate of hopelessness, a fate of sufferings... a fate of dying and death. It is a traitor, a disease that has been diagnosed on unexpected times when you have nothing to do but to wait for your time.
"It's cancer! The cancer cells have metastasized all over your body and its malignant. A chemotherapy can be of great help but you have nothing to do but to pray... only a miracle can save you ... You have only one short year to live." These were the words have said by my doctor six months ago and now, these are the words that keep on ringing into my ears every time I entered the chemotherapy room. A tinnitus that made me deaf and hopeless. "Miss, your chemo is finish already, how does it feel? Are you feelin' good?", my chemotherapy nurse said as I replied with a coerce smile. What a question? Everyone knows how difficult it is to undergo chemotherapy, it causes pain and weakness to my body, troubles to my mind and cries to my heart. Those questions should not been asked, the answer is obvious. As my nurse continues, "Miss, its been 6 months of chemotherapy and ... ", I distracted her with my words, "and still I have cancer. 6 months ago, meaning I have 6 more months to wait for my death. What is the purpose

of these chemotherapy anyway if still I have to die, this therapy is useless and this made me feel weak. And look at me, I'm dying. I do look like a corpse. My skin is desquamating my hairs begun to fall. Honestly, I started to count my last hair strands." Together with the fall of my hairs are the shattered of my dreams, washed-out of my youth and end of my value into this world. I am like a flamed candle that melts as the hour runs, a cigarette that little by little die and sand in the hour glass that become exhausted. I am useless! I'm just waiting for my death to be valuable. You know how? ... My body could be a great help for worms underground and soil fertilizer for plants and grasses over my tomb." My nurse replied, "Is that the only value you've considered to yourself? And that will gonna happen after your death and besides you are waiting for 6 months to be valuable for worms and plants only. Miss, you have 6 long months more to be valuable while you are living. Why don't you make the most of it? There are so many ways to be valuable, just only take all the opportunities that will knock on your door. Please think about it." I am very young to die. How cruel of life it could be made me suffered like this way at my early age. On this moment on, I should attend different night life and parties as teenagers usually do. I should go to school and finish my chosen course. Perhaps ... I should be valuable. But this cancer ruined everything, it destroys me!, it destroys my cared beauty, made meweak and useless, made me old and fearful because of my appearance. I started to have bald-headed, my hair started to fall ... how could I go out and roamed around to enjoy my last days here on earth. I don't want to die, I want to become a successful woman, I want to build a big company, to be rich and famous. I want to raise a family of my own. I want to be valuable and fulfilled. Actually, I have so much opportunities to attain all of these, I am an only child of the richest couple in town. I am young, fresh, popular, intelligent and beautiful. But all of these have nothing to do with cancer... all have faded. Before I am a very brave and courageous young lady taking up political science for I want to be a lawyer someday, a fighter fighting for one's right and now I am a useless ill lady whose coward and frightened. I want to fight for my right, my right to live... my right for my life. But fate is so cruel. If s not even, I don't have any armor to fight the battle. If s not right! It is so unfair for not giving me a chance ... a chance to prove something, to be successful, to be fulfilled... to be valuable. As my car runs along the road on my way back home while having my sensible thoughts, I have witnessed a crime, a victim of hit-and-run. With the help of my personal driver and yaya, we brought this young 20 years old man to the hospital and the surgeon's diagnosis is a simple fracture of the tibial bone of his right leg, lucky for him as a vehicular accident victim. But not 'till he woke up and complained of absence of eyesight or blindness and his opthalmologist found out that fragments of his broken eyeglasses have drawn into his eyes and his doctor suggested evisceration or removal of the contents of the eyeball only living outer sclera and muscle to prevent further spread of infections and complications and to save optical nerves from damage. Michael had underwent an emergency eye surgery and as a result he could not see ... he is totally blind. And the only way for him to see is the eye transplant. I found out that he is living in the squatter's area in Quezon City with his live-in partner Elena, 20 years old and their daughter Michaela Elleine, a 6 months old baby girl. And according to Michael he was on his way searching for a job when the accident happened. Due to early marriage and poverty, I have realized that Michael has

nothing to pay for the bills of the hospital so I've decided to have some charitable deeds. After Michael's operation on the same day, I went to his house and I found out that Elena is lying on the bed of sic kness because of her heart ailments which was worsened by her delivery to their first baby. As she discovered what happened to her husband, she experienced difficulty of breathing and chest pain that leads to heart attack and we brought her to the hospital where Michael was confined. And again, I accepted the load of their hospital bills. Michael was very weak and blind, he does not know where is his family located and Elena was still on ICU (Intensive Care Unit) waiting for a heart donor for transplant and she was totally alone for her family was a victim of fire in Tondo two years ago. And Michaela Elleine was left alone like an abandoned child. I have nothing to do but to adopt this little poor child as long as her parents recovered or someone claims her. I have realized how lucky I am despite of my condition and I am not the only unfortunate person, there are many others whose much worst and unfortunate than me ... much oppressed. With my very young age considering my condition, I started to become an instant mother to an instant baby girl. I have experienced to slept late at night because I have to read her my favorite bedtime stories and to wake in the middle of the night for her bottlefeed milk or changed her diapers. I have witnessed her first crawl, first sit, first stand and first steps which are all missed by her biological mother. And the most heart breaking experience is that when I have heard her voice as she speaks, "Mi-Mi", which I thought its mommy. Her cries serve as sirene which means she needs me and her smile and laughter told me "thank you" , both brings an innate joy to my soul. I have learned a lot from taking good care of her ... I've learned how to become a mother and how I wish to be the one. And now, I know how does my mother feels when I'll pass away and I feel so lonely and sorry for that... but it is our fate. Everyday after my therapy, together with Michaela we visited her parents and after that is her monthly check-up to her pediatrician. Days, weeks and months passed rapidly with Michaela, I really forgot about my illness... my cancer and I forgot about dying that I have only remaining 6 months to live. Not until I have noticed the passed of time one day when I woke-up very weak and tired, its hard for me to move and get-up on bed. I feel boneless. My eyes feels so heavy considering that I have a complete hours of sleep and my vision was blurred, I look at the mirror and put-off my wig, I applied some oil on my scalp and removed the sticking fallen hair and I found out that I am bald already, I have few hair strands scattered all over my head and I counted it ... its 31 all in all long hair strands which before long, silky wavy blonde hair naturally. I have remaining 31 days to go. I have realized that its getting nearer, my time is over. 5 very short months passed rapidly and I have still one month to go. Now, I am not thinking about myself anymore, my concerns are all for Michaela and what I have wished for myself is "Please LORD, let me witness Michaela's first birthday." For 3 weeks, I got busy preparing Michaela's birthday party and of signing different contracts, forms, last will and testaments inspite of my worsen condition because I have so many reasons to be strong and that are my ambitions and dreams to be fulfilled, successful and valuable. And on the first day of my last week, we celebrated Michaela Elleine's first birthday party. 6 days to go before my countdown is over, it seems that its like yesterday that I'm waiting for another 6 months to passed, feel frightened and coward to die trying to push the days ahead. And now again inside of

this four-cornered white room in front of my nurse, I put-off my wig and decided to removed it permanently as long as I am living ... for 6 days. I have combed my 6 long hair strands that are tightly attached to my scalp and it seems like me holding so tight for my life. But like my hair strands which falls everyday, I am preparing for my omega. And she asked, "How does it feel?", then I simply smiled at her down to my heart and replied, " I know my time is over ... I have accepted my fate." I can die now, I am successful and fulfilled. I have proven something to myself and I can say that I am valuable not only for worms and plants but because I have value in the real sense in this world. Considering my age and condition, I am very lucky and too successful for I have attained my dreams. I have built a big building for the needy and for 6 months I have raised a family by helping Michael's family and I become a mother with Michaela. I become an attorney by fighting for the right of Michael's family ... the right to live and the right for life. LORD is so great to me for giving me such opportunities before of my death. My nurse was right, there are so many ways to be valuable. I gave my light to Michael, the life to Elena and my love and caring to Michaela Elleine. And even when I am on my eternal life, I am sure that I'm still helping so many angels like Michaela,times the thousands of my hair strands fallen with a cause. Because my hair strand is equal to my value into this world and now I am waiting for the fall of my one last hair strand. "Okay, Miss, if s time for you to sleep and have some rest", my nurse said and then I replied as she holds my hand, "Thank you very much!", with a big smile. And as I closes my eyes, after of a deep breath my last hair strand fall on the floor.

LAST WILL AND TESTAMENT I, whose name at the undersigned was leaving my both eyes to Michael and my heart to Elena for transplant immediately after my death and I am leaving Medical Plan worth of P l, 000, 000. 00 for their hospitalization. I am also leaving them P50,000.00 for their wedding and another P50,000.00 for Michaela Elleine's baptismal plus one-fourth of myriches and properties inherited from my parents with an Educational Plan. And the three-fourth will be going to the orphanage I have signedwith contract which has to be open soon. To my parents, I am leaving all of my happiness and memories with you. To all of you, especially to my nurse, thank you very much for giving me the reason to live and making me valuable. Signed: A Lady With No Hair

Thanks To You - Collins, Tyler