I was asked this question several years ago when I spoke with colleagues about the idea for a textbook. The market was already comfortably occupied with a stable of psychiatric nursing textbooks that have now become standards in the field. The energy around this new book (Psychiatric-Mental Health Nursing: An Interpersonal Approach) stemmed from what I and others actively engaged in practice saw as a “drift” away from areas of psychiatric nursing that we held sacrosanct, namely the teaching of psychiatric nursing as being grounded in the art and skill of interpersonal relations. The 1980’s ushered in the decade of the brain in mental health. New knowledge was discovered about potential implications of neurotransmitters in the brain and medications were developed that purported to alleviate psychiatric symptoms. The whole discipline of mental health care, including nursing, began to shift to a more biological model. The client’s relationship with the provider (nurse, doctor, therapist or otherwise) began to be focused less on the relationship and more of the “right diagnosis and the right medication.” Now, to be sure this aspect of care is important, but many of us began to feel as though the proverbial baby had been thrown out with the bathwater.
Further evidence of erosion of the interpersonal skill sets in nursing was proposed in an alarming rate of increasing frequency of boundary violations in the nurse-patient relationship. It appeared that while we were educating nurses to pass meds and monitor side effects, we were no longer preparing them to safely navigate the interpersonal landscape. Thus, the idea for a book that intentionally shifts the focus of undergraduate nursing education back to interpersonal models of practice was born. The other editors and I felt the timing was right as relationship based care concepts were currently enjoying some positive recognition in health care organizations.
Using the conceptual theories of Hildegard Peplau and Joyce Travelbee, this book was built weaving the theme of interpersonal relations throughout the entire text rather than relegating them to one chapter as some of the other textbooks have done. Ultimately, it was felt that these concepts deserved much more exposure than they had been getting and that the time was right for the architects of relationship-based care be given their due.
New knowledge about the brain, neurotransmitters, medication, and treatments come and go. We believe that the healing power of the therapeutic relationship is timeless and still relevant.