Description
by Melody Crawley The Neuman’s Systems Model Betty Neuman was a nursing theorist who developed the Neuman’s Systems Model in 1970. Her model was aimed at being a teaching guide for graduate nursing students (Smith, 2020). Neuman’s theory focuses on treating an individual as a whole person that is affected by internal as well as external forces. Due to its versatility in being used in different areas of nursing, it is a model that is used globally as a guide for nursing curriculum, in clinical practice, nursing administration, and research (Smith, 2020). Betty Neuman’s Systems model is a theory that promotes the caring of individuals and or groups in a holistic manner. Neuman’s model has several concepts. One major concept of Neuman’s model is that an individual is an open system that has internal and external interactions with the environment (Smith,2020). This open system can consist of the individual, a family, community, or as a social issue (Smith, 2020). The next concept of Neuman’s model is the interacting variables. These variables are physiological, psychological, developmental, socio-cultural, and spiritual (Smith,2020). Each variable functions together in conjunction with the interactions from internal and external environmental stressor with reactions varying depending on the amount of resistance the person has to those stressors (Smith,2020). Basic structure is another concept of Neuman’s model that focuses on the basic survival factors that are common to all people and provide energy for the system to function (Smith, 2020). Each client system has several lines of defense. The flexible line of defense is used to keep the normal state of wellness from being invaded (Smith, 2020). Its flexibility allows it to be a buffer and it expands or contracts from the normal line of defense, providing the necessary amount of protection depending on the stressor (Smith, 2020). The next line of defense is the normal line of defense which the usual wellness level of the client system and reflects the different response to stressors (Smith, 2020). The expansion or contraction of this line reflects the state of wellness (Smith, 2020). Lastly, the line of resistance which are the closet line to the basic structure, uses internal factors to protect the basic structure and help the client system to return to its prior wellness state or even a higher wellness state (Smith, 2020). The environment is another concept of Neuman’s model that focuses on the internal or external forces that surround the client system (Smith, 2020). There are three environment types that include, internal, external, and created environments (Smith, 2020). The internal environment includes all factors that are internal and includes intrapersonal stressors, external includes all forces that external and includes inter and extrapersonal stressors, and created includes the unconscious use of the systems variables to create a safe functioning environment (Smith, 2020). The concept of stressors focuses on the tension producing stimuli that occur within internal and external environment of the client (Smith, 2020). There are three different stressors intrapersonal which are internal forces that occur within, interpersonal which are external forces that occur outside of the client system, and extrapersonal forces that are forces that occur outside the client system at a distal range (Smith, 2020). Next health/wellness concept is the optimal wellness state of the client system (Smith, 2020). Illness is the concept that involves being in a state of insufficiency and unmet needs not being satisfied (Smith, 2020). The next concept is reconstitution which is the process of returning to a wellness state (Smith, 2020). If reconstitution is unable to occur this will result in death due to the failure of the basic structure (Smith, 2020). Lastly, the concept of prevention as intervention focuses on the goal of maintaining stability through nursing interventions Smith,2020). This has been broken down into three preventions as interventions primary which focuses on protecting the normal line of defense, secondary which focuses on strengthening the internal lines of resistance and tertiary which focuses on helping the client system return or regain wellness following the interventions from secondary interventions (Smith, 2020). The metaparadigm for Neuman’s model in nursing the person is seen as a whole system which needs to be addressed. The goal of nursing is to assist the individual, families and or group to maintain an optimal level of wellness through nursing interventions of primary, secondary, and tertiary prevention interventions (Smith, 2020). In Neuman’s theory uses the Neuman System’s Model nursing process that uses the nursing process of nursing diagnosis, nursing goals, and nursing outcomes (Smith, 2020). The person in the metaparadigm is seen as a total individual, family, community, or society system with multiple layers that include physiological, psychological, sociocultural, spiritual, and developmental layers (Smith, 2020). The environment includes all the internal and external stressors that surrounds the client system (Smith, 2020). The stressors involved include intrapersonal, interpersonal and extrapersonal stressors that affect the client systems normal line of defense which creates instability of the system (Smith, 2020). Internal, external, and created environmental forces interact with the client system (Smith, 2020). Health is equated with overall wellness which is when all parts of the client system are in harmony with the whole client system (Smith, 2020). Neuman’s theory can be used in my clinical practice area of the PACU by maintaining an optimal level of wellness immediately after surgery. External stressors my patients’ encounter in the PACU would be the surgery itself and the side affects of surgery such as pain and nausea. When I’m forming my nursing diagnosis it would be related to pain from the surgery with a goal of achieving a pain level that is acceptable. In formulating my interventions, I also have to consider all the variables of the client for example physiological the patients’ size that may have an effect on the amount of narcotics I give or sociocultural variable of the patients’ thoughts on taking narcotics due to the social stigma tied to narcotic use. My primary intervention would include educating my patients on the importance of staying ahead of the pain and not waiting for the pain to become unbearable before asking for pain medication. This helps to reduce the stress that many people have about surgery which is pain. Secondary preventions would include giving pain medications, repositioning, using ice packs or heating pads to help with pain management. Tertiary intervention would involve giving a combination of short and long-acting pain medications to maintain the acceptable level of pain for the patient. All these things work in conjunction to achieve Neuman’s goal of nursing which is to provide stability and maintain or provide a higher level of optimal wellness (Smith, 2020). Neuman’s theory can be used in advance practice when we are treating our patient (clients) in various clinical settings. This theory can be used in our nursing process, and we diagnose, treat chronic and acute diseases, and provide preventative care. When we are developing our treatment plan, we need to remember with this theory that we are treating the whole person. The whole person includes all the major concepts of Neuman’s model that includes variables, stressors, interventions etc. For example, a study was done by Sousa et al. (2022) in which Neuman’s model was used in a case study on a woman who had cancer. The mother’s stressor was identified by the nurse taking care of the patient. Based on the client’s stressors the nurse developed a care plan that not only addressed all her needs but included the needs of her family as well (Sousa et al., 2022). That is one thing that this model helps us to incorporate is family needs and influences as well and the importance their roles are in achieving wellness for the client. Sousa et al. (2022) that it is the duty of nursing to perform an assessment of the patients’ family and including the dyad of family in the interventions. We must remember in advance practice that not only will we treat the individual, but we are also treating the family. Nursing must incorporate interventions that acknowledge the dyad and needs of the family (Sousa et., 2022). In the practice exemplar from the text, the nurse used the Neuman Systems Model to provide care for the individual client system Susan, and the family client system which was Susan and her daughter Gloria (Smith, 2020). The nurse used Neuman’s theory to conduct an assessment of Gloria that incorporated all variables that relate to each stressor. Conducting this wholistic assessment allowed the nurse to formulate a plan of care that included based on the Neuman’s Systems Model nursing process to formulate a nursing diagnosis, nursing goals, interventions, and nursing outcomes (Smith, 2020). The nurse’s care plan will be evaluated based on how effective it has been on achieving Neuman’s theory nursing goal of all interventions assisting the client systems in retaining, maintaining, or attaining optimal system stability (Smith, 2020). I believe that the nurses care plan was very effective. Not only did the interventions wholistically address the individual it also addressed the family client system. The primary, secondary, and tertiary interventions were aimed at providing Gloria with support groups suggested by the nurse who used her perceptions on how beneficial support groups were based on her research (Smith, 2020). In the end the nurses care plan strengthens Gloria’s line of defense as an individual client system and as a family client system with her mother’s defense line being strengthen as well (Smith,2020). In closing The Neuman’s Systems Model continues to be a theory/model that is widely used. Due to its versatility, it has been used in many different clinical, research and administrative areas of nursing. It has been so popular because it focuses on the person as a whole person instead of just simply a disease and or injury. Looking at the person holistically allows for optimal care to be given, thus creating better outcomes for our patients. ReferencesSmith, M. C. (2020). Nursing Theories and Nursing Practice (D. L. Gullett, Ed.; 5th ed.). F.A. Davis.Sousa, A. F. D., Santos, D., Costeira, C., Santos, M. R., & Lomba, L. (2022). EXPERIENCING PARENTAL CANCER: A CASE STUDY WITH APPLICATION OF NEUMAN’S MODEL. Texto & Contexto Enfermagem, 31. https://doi.org/10.1590/1980-265x-tce-2022-0201en
