Joyce Travelbee: Human-to-Human Relationship Model
Kathy Cox
South University

Joyce Travelbee: Human-to-Human Relationship Model
The work of Joyce Travelbee has influenced the nursing world since she began publishing in the early 1960’s. Her Human-to-Human Relationship Model drew upon the works of existential psychologists such as Victor Frankl, allowing their discipline’s borrowed theories to influence the growth and development of nursing practice (Butts & Rich, 2011, p. 280).
Having originated from a background in psychiatric theory, Travelbee understood the need for all entities in health care to be recognized first as human beings in order for a therapeutic patient-nurse relationship to develop; thereby, fulfilling the purpose of nursing (Butts & Rich, 2011, pp. 280-283; Nursing Theory, 2013, para. 1-2).
Background:
* Born December 14, 1926 in New Orleans, LA. * Lay Nun of the Order of Discalced Carmelites of St. Theresa * Graduated from Charity Hospital School of Nursing 1946 * Bachelor of Science in Nursing from Louisiana State University 1956 * Master of Science in Nursing from Yale in 1959 * Became an instructor at Depaul Hospital Affiliate School in New Orleans, Louisiana in 1952 * Taught Psychiatric Nursing at Charity Hospital School of Nursing at Louisiana State University, New York University and the University of Mississippi * Became Project Director at Hotel Dieu School of Nursing in New Orleans in 1970 * Published several articles in Nursing journals in 1963 * Published first book entitled Interpersonal Aspects of Nursing in which she presented her Human-to-Human Relationship Model, 1966 * Published her second book published in 1969 entitled Intervention in Psychiatric Nursing. * Director of Graduate Education at Louisiana State University School of Nursing until her death in 1973 * Avid poet * 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 * Died September 2, 1973 while enrolled in her Doctoral program in Florida
Purpose of the theory: * Developed as a means through which the purpose and experience of nursing is fulfilled (Butts & Rich, 2011, pp. 280-283). * The ultimate goal is the installation of hope. Hope for the patient and family and hope for the nurse to build a therapeutic and compassionate relationship with them (Butts & Rich, 2011, p. 280). * Original Encounter: The task of both the patient and the nurse is to move past any preconceived stereotypes and categorizations in order to perceive one another as a human being (Butts & Rich, 2011, p. 281; Travelbee, 1966, p. 133). * Emerging Identities: Both the nurse and the patient are charged with moving past their roles in order to recognize the uniqueness in the other human being without using oneself as the basis of measurement of others (Butts & Rich, 2011, p. 281; Travelbee, 1966, p. 139). * Developing Feelings of Empathy: The ability to predict the behavior of the patient or family member as a result of sharing and understanding their psychological state, without sharing their feelings (Butts & Rich, 2011, p. 281; Travelbee, 1966, p. 143). * Developing Feelings of Sympathy: We as human beings may find that while interacting with the physical and emotional pain of others we inadvertently find ourselves moving past the level of empathy and into the realm of sympathy. The emotion of sympathy involves sharing, feeling, and experiencing the emotional pain that is experienced by our patients and their families (Butts & Rich, 2011, p. 281). This stage tasks the nurse with translating this human emotion into a nursing action that will benefit their patient and/or their family (Butts & Rich, 2011, pp. 281-282; Travelbee, 1964, p. 70). * Rapport: The sum of first four phases in which the nurse and the patient are emotionally able to share their thoughts, feelings, experiences, and attitudes with one another in order to foster a therapeutic environment/relationship (Butts & Rich, 2011, p. 282; Travelbee, 1963; 1966, pp. 133-162).
Concepts in the theory: * Suffering: An emotional and/or physical experience that varies in intensity based on the person (Nursing Theory, 2013, para. 3). * Meaning: A reason that is attributed to the patient (Nurse Theory, 2013, para. 3). * Nursing: Process through which the nurse aids the patient in coping with the illness and suffering, while finding meaning in it (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: A state of well-being uniquely defined by the individual that is in line with their preconceived ideas of physical, emotional, and spiritual status; the enjoyment of the highest attainable status (Travelbee, 1966, p. 7; Travelbee, 1971, p. 9). * Hope: The patient’s faith that there will be a change for the better (Nursing Theory, 2013, para. 3). * Coping: The patient’s ability to deal with their illness and find meaning in what they are experiencing (Travelbee, 1966, pp. 5-6)
Definitions of the concepts used in the theory and of the four metaparadigms of nurse or nursing; patient; health; environment: * Person: The person is defined as a human being. Both the nurse and the patient are human beings. * Health: Health is both subjective and objective. Subjective health is defined by the individual as a state of well being in accord with self-appraisal or physical, emotional, and spiritual status. Objective health is an absence of a discernible disease, disability or defect as measured by physical exam, laboratory tests, and assessment by a spiritual director or psychological counselor. * Environment: Not clearly defined. * Nursing: An interpersonal process in which the professional nurse practitioner aids the individual person, family, or community in order to prevent an experience or illness and suffering and/or learn to cope with the event. If necessary, the nurse will aid the entity in finding meaning in these experiences
Assumptions of the theory: * How the nurse perceives the patient is a primary determinant in the care that he or she will render to the patient (Travelbee, 1966, p. 34). * The nurse’s beliefs regarding illness, suffering, and death will determine the quality of care given to the patient (Travelbee, 1966, p. 55). * The nurse’s spiritual and philosophical beliefs about illness and suffering will determine the extent to which they will aid the patient in finding meaning in their illness (Travelbee, 1966, p. 55).

References
Butts, J. & Rich, K. (2011). Philosphies and theories for advanced nursing practice. Sudbury, MA: Jones & Bartlett Learning.
Douglas, D. & Garbee, D. (2013). Joyce Travelbee: the story of a New Orleans nurse theorist. Retrieved from http://nursing.lsuhsc.edu/continuingeducation/ScholarshipDayPP/C6- 1%20Travelbee%20Presentation%20Garbee%20Douglas%202_4%2001%2008% 20revised.pptx
Nursing Theory. (2013). Travelbee’s human to human relationship model. Retrieved from http://nursing-theory.org/theories-and-models/travelbee-human-to-human- model-of- nursing.php
Speziale, H.J. & Carpenter, D.R. (2007). Qualitative Research in Nursing Advancing the Humanistic Imperative. (4th ed.). Philadelphia: Lippincott.
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.