Surrogate Role In Nursing Practice According To Peplau

Surrogate Role in Nursing Practice According to Peplau

Nurse theorist Hildegard Peplau defines the surrogate role as an essential but often overlooked element of nursing today. This role, according to Peplau, is “the temporary, interactive, psychosocial relationship between the nurse and the patient that was designed to help the patient gain insight, understanding and control of his or her feelings, attitudes and behavior.” The purpose of the surrogate role is to serve as a bridge between the patient and the nursing care team, allowing the nurse to bridge gaps in patient education and provide psychological support to patients when needed.

While this role is not frequently mentioned in nursing practice literature today, it remains relevant in contemporary nursing. Nurses continue to serve as sources of knowledge and emotional support for their patients, often becoming more vital given the increasing complexity of today’s healthcare systems. Nurses often act as surrogates by providing necessary educational resources, helping patients comprehend their diagnoses, and offering emotional support. In addition to these traditional functions, the surrogate role can now be expanded to include more contemporary and advocacy-oriented activities.

Modern nurses frequently serve as patient advocates, assisting patients in navigating intricate medical systems, securing necessary healthcare services, and supporting informed decision-making. They also connect patients with community resources, alternative medicine options, and social services that extend beyond conventional clinical care. These expanded functions align with the evolving expectations of nursing roles in today’s complex healthcare environment, emphasizing the importance of the nurse as a comprehensive support system for the patient.

The relevance of the surrogate role extends beyond mere patient education and emotional support. It also encompasses active advocacy, facilitating access to healthcare, and addressing social determinants of health that impact patient outcomes. Nurses’ ability to act as intermediaries and advocates can significantly influence a patient’s overall well-being, especially in situations where patients may be overwhelmed or lack knowledge about their healthcare options.

Furthermore, advancements in technology and the increasing importance of evidence-based practice require nurses to adapt their surrogate functions dynamically. Telehealth, electronic health records, and health informatics have transformed how nurses communicate and support patients. These tools enable nurses to maintain the surrogate role more effectively, providing real-time support, education, and decision-making aid regardless of physical distance.

Another critical aspect of the surrogate role is its impact on vulnerable populations such as older adults with neurocognitive disorders or critically ill patients. Studies have shown that surrogate decision-making in these groups requires sensitivity, clear communication, and a thorough understanding of the patient’s values and wishes (Daneau et al., 2020; Moss et al., 2019). Nurses often step into this elaborate decision-making process, ensuring that the patient's preferences are respected and that care aligns with their biological, psychological, and social needs.

In the context of end-of-life care, the surrogate role becomes especially significant. As identified in recent literature, surrogates often help make critical decisions that impact the quality and dignity of a patient’s final days. According to Daneau et al. (2020), surrogate decision-makers frequently face ethical dilemmas and emotional burdens, highlighting the need for nurses to act as informed guides and advocates in such sensitive situations. This underscores the importance of training nurses not only in clinical skills but also in communication, ethical considerations, and cultural competence.

Although the specific terminology of the “surrogate role” may be less prominent today, the fundamental aspects of Peplau’s concept continue to underpin many nursing practices. The focus on interpersonal relationships, trust-building, and advocacy remains central to nursing. As healthcare evolves, nurses are expected to redefine their roles continually, integrating technological advances while maintaining their core function as compassionate, informed, and empowered advocates for their patients.

In conclusion, the surrogate role as described by Peplau remains a vital component of modern nursing practice. Its core principles—support, advocacy, education, and bridging gaps—are more relevant than ever given the increasing complexity of healthcare systems and patient needs. Nurses must recognize the importance of their role as surrogate guides, ensuring they are equipped with the necessary knowledge, skills, and cultural competence to support their patients effectively. As healthcare landscapes shift with technological innovation and diverse patient populations, the nurse’s surrogate functions will undoubtedly expand, emphasizing the importance of continuous professional development and compassionate care.

References

• Daneau, S., Bourbonnais, A., & Legault, A. (2020). Surrogates’ end-of-life decision-making process in nursing homes for residents with a neurocognitive disorder: An integrative review. International Journal of Older People Nursing, 15(1), e12274.
• Moss, K. O., Douglas, S. L., Baum, E., & Daly, B. (2019). Family surrogate decision-making in chronic critical illness: A qualitative analysis. Critical Care Nurse, 39(3), e18-e26.
• Vogelsang, L. (2022). Peplau’s Theory of Interpersonal Relations: Application to Asynchronous Nursing Education. Canadian Journal of Nursing Informatics.
• Wasaya, F., Shah, Q., Shaheen, A., & Carroll, K. (2021). Peplau’s theory of interpersonal relations: A case study. Nursing Science Quarterly, 34(4).
• Peplau, H. (1992). A Theory of Interpersonal Relations. New York: Springer Publishing.
• Olenik-Shemesh, D., & Shulman, J. (2018). Applying Peplau’s theory in practice: an integrative review. Journal of Psychiatric and Mental Health Nursing, 25(4), 237-245.
• D’Agostino McGowan, B., & McGowan, T. M. (2019). The evolution of nursing roles: From traditional care to advocacy. Journal of Nursing Care Quality, 34(1), 88-93.
• Benner, P., et al. (2010). Educating nurses: A call for reform of nursing education. National Academies Press.
• McGillis Hall, L., et al. (2017). Advancing the practice of nursing and the importance of advocacy. Canadian Nurse Journal.
• Kelly, D., & McGowan, B. (2020). The significance of advocacy and decision-making in nursing. British Journal of Nursing, 29(16), 1014-1018.