Allow me to take some of you back in memory and for others to, perhaps, acquaint you with the psychiatric nursing scene in the late 1940s and early 1950s. The mentally ill were, by and large, hospitalized in huge mental hospitals. It seemed then that to be bigger in size was equated with better. I was proud then that my state hospital training school was in one of the largest hospitals of its kind in the world, albeit that this was the same hospital so devastatingly documented in a veiled work of fiction, Snake Pit, but in truth was largely fact. Recall with me that these were the days before the introduction of psychotropic drugs. These were the days of the Scotch douches, the wet packs, continuous tubs, full sheet restraints, B & C mixture, paraldehyde, and leather cuffs. The preoccupation of nursing staff often seemed largely to be with the prevention of suicide and, God forgive us, what indignities were visited on patients in the name of protecting them from their suicidal impulses. No eyeglasses, no shoelaces, no belts, no dentures, no toothbrushes, no combs, no mirrors, no silverware, or, at best, a spoon--with all spoons counted before the dining room could be emptied of its weary bodies that were then to be lined up to march back to the ward, back to the section where it surely would be time to pass the paraldehyde bottle and the tin cup. Recall the sweaty smell of deep coma insulin treatment and the slightly acrid odor accompanying fifty electric shock treatments given in the same room, with no anesthesia, and all over in an hour-and-a-half or less. Recall the ice-pick leucotomies, with thirty to fifty done in a single morning, and the nursing staff left in the wake of the visiting neurosurgeons to habilitate the now vegetable-like patient. Peplau: Leader and Practitioner If I have succeeded in evoking the feeling of that era of the state mental hospital, then you will know why, when I reread Mary Jane Ward's telling portrayal of life inside those walls, I was again reminded of the large debt I owe Hildegard E. Peplau for bringing me a new perspective, a new approach, a theoretically based foundation for nursing practice, for therapeutic work with patients in those problematic settings. Imagine the excitement of making sense out of a patient's hallucinatory experience through collaborative work! Imagine the joy that came from discovering that a delusion could be dealt with and satisfactorily eliminated through effective verbal work with patients. A new day had dawned! Theory was used to guide nursing practice. Theory was tested in the real world of practice. Remember, this was twenty years before there was an NLN accreditation standard that required some conceptual framework should frame the curriculum in schools of nursing. A quote from Kaplan seems appropriate here. ...What is needed more than ever before in human history is an understanding of man and his nature, an understanding of society, an understanding of our relationship to the world around us. In a word, what is needed is knowledge. (1973, p. 35) It was precisely that which Peplau brought to the real world of the state hospital and through the use of that knowledge helped give nursing's moral aspirations a concrete basis which narrowed the gap between the ideal and the real. While Hilda Peplau taught me not to speak for others, and in general I abide by that very valuable principle, I shall violate it now for I think I can speak for other nurses, thousands of them in large and small, urban and rural mental hospitals, who, through the 50s and 60s, were the participants in Peplau's summer workshops. So, on their behalf, I express what I am certain is their gratitude for the knowledge and clinical skills which Peplau so abundantly shared. While it is likely that Peplau had peers in the field of psychiatric nursing in those decades, none, I think, shared so freely or gave so much to the ordinary, everyday practitioner in those desolate wards of the state hospitals across the country. …