Assumptions

Joyce Travelbee assumes that nursing is fulfilled by means of human-to-human relationship. She defined nursing as “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”. Inspired by being a psychiatric nurse, she struggles for a “Humanistic Revolution” in nursing, with devotion on caring and compassion for patients.

She expressed that achieving the goal of nursing necessitates a genuine human-to-human relationship, which can only be established by an interaction process, this process is further divided into five phases.

1. Establishing, maintaining and terminating a one-to-one relationship are activities which fall within the province of nursing practice.
The goals in nursing differ distinctly from those in other health disciplines. Members of various health disciplines share the major overall goal of relationship therapy, namely, to assist the ill person toward social recovery. However, the specific methodology used to accomplish these goals varies. It needs to be emphasized that the one-to-one relationship lies within the province of nursing and that the nurse does not require the permission of the psychiatrist to practice nursing any more than the psychiatrist needs the permission of the nurse to practice psychiatry. This is not only to deny the importance of professional collaboration, it stresses that only nurses are prepared to decide the purposes, roles, activities and functions of nurses.
Members of other health professions are qualified neither by education nor experience to direct nursing activities. This point is emphasized because the “handmaiden-to-the-physician” viewpoint still guides some nurses in the practice of their professional activities. Nurses have many independent functions but only one dependent function, namely, the execution of legal medical orders. Aside fro this one dependent function, a physician cannot “order” nursing care any more than a nurse can “order” medical care. Only professional nurses can, and should, decide and guide the destiny of nursing.

2. A relationship is established only when each participant perceives the other as a unique human being. 

Strictly speaking, a nurse and a patient cannot establish a relationship. It is only when the roles of nurse and patient are transcended, and each perceives the other as a unique human being, that relationship is possible. 

3. Only qualified psychiatric nurses are prepared to supervise nurses in the practice of psychiatric nursing.
The nurse who begins interacting with a psychiatric patient for the purpose of establishing a one-to-one relationship should have at her disposal a qualified psychiatric nurse supervisor. By supervisor we mean an individual who holds at least a master’s degree in the field of psychiatric-mental health nursing, she may be a clinical specialist in psychiatric nursing or a prepared psychiatrics nurse faculty member. The supervisor is a resource person with whom the nurse shares data relevant to the one-to-one relationship. The supervisor guides the nurse in clarifying data regarding the relationship and holds regularly scheduled conferences with the practitioner.
4. The major learning experience provided in the psychiatric nursing course in to provide students with the opportunity to establish, maintain and terminate one-to-one relationships.
It is believed that group work skills should be taught on the graduate level. Psychiatric nursing is upper-division nursing course, The concepts used to explain psychiatric nursing intervention are ambiguous and abstract. Time is required for students to understand and apply these concepts meaningfully in a nurse-patient situation. It is recommended that the psychiatric nursing course, on an undergraduate level, extend over a semester. The maturity level of students is also important in determining the extent to which they will be able to establish relatedness with mentally-ill individuals. It is recommended that psychiatric nursing be the last clinical nursing course offered in the program of study. (Behavioral concepts of course should be taught in all clinical nursing courses, not just in psychiatric nursing.)
Students enrolled in a baccalaureate program should, prior to the psychiatric nursing course, possess a basic understanding of major concepts from the natural, physical, biological, medical, behavioral, and nursing sciences. Content related to psychiatric nursing is taught concurrently with field experience. Students, through the group reconstruction process, are taught to apply theory to practice. 
5. Nurses need to know how to use library facilities and how to search the literature for needed information.
It may seem somewhat simplistic and self-evident to state that nurses need to know how to use library facilities and how to search the literature for needed information and data. It cannot be assumed, however, that nurses or faculty members know how to use library resources to find reference materials.
6. The knowledge, understanding and abilities needed to plan, structure, give and evaluate care during the one-to-one relationship are necessary prerequisites for developing competency in group work.
Some nurses object to learning skills required to establish a one-to-one relationship on the basis that most nurses in psychiatric settings are required to work with large group of patients, not with individuals. They maintain it is more “realistic” for psychiatric nurses to be prepared to work with groups of patients. However, it is believed that group work is best taught on the graduate, not the graduate, level. It is further believed that the abilities developed in learning to establish, maintain and terminate the one-to-one relationship can be readily transferred and applied to group work. It is more difficult to transfer the knowledge and abilities needed for group work to the one-to-one relationship. 

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