Transcript File - Shelly M. Parker RN to BSN Portfolio

Betty M. Neuman, RN, BSN,
M.S., Ph.D, FAAN
Betty Neuman’s
System’s Model
Presented by Tina Palmer and
Shelly Parker
Neuman’s Systems Model
Nursing is more than caring for
an illness, but is about viewing
the patient as a whole (holistic
care) and assessing every
aspect of an individual that
affects health including
emotional and spiritual well
being.
History of Neuman
 Born in 1924 in Lowell, Ohio
 In 1947 she obtained her Registration Nurse Diploma
from the People’s Hospital School of Nursing in Akron
Ohio
 In 1957 she obtained a double major in psychology
and public health at the University of California at Los
Angeles (UCLA)
 In 1966 she completed a Master’s degree in mental
health and Public Health Consultation at UCLA.
History of Neuman
 In 1967, along with a co-worker she developed the first
community mental health program for graduate students in the
Los Angeles area
 She worked in a variety of nursing roles which also included
teaching. An interesting fact is that she also assisted her husband
to open and maintain a medical practice.
 In 1970, she began to develop the conceptual systems model as a
way to teach introductory nursing. This was published in 1972
after evaluation of the model. The first publication was titled, “A
model for teaching total person approach to patient problems.”
She continued to refine her publications and made further
changes in the model. The last update was made in 2010.
 In 1985 she obtained her doctorate in Clinical Psychology from
Pacific Western University
History of Neuman
 In 1988, she founded the Neuman Systems Model Trustee
group to maintain the integrity of the Neuman Model
System.
 In 1992 she was given an Honorary Doctorate of Letters at
the Neumann College in Ashton Pennsylvania
 In 1993 she was named Honorary Member Fellowship of
the American Academy of Nursing (FAAN)
 In 1998 she was given an Honorary Doctorate of Science
from the Grand Valley State University of Michigan.
Currently
 Independent Curriculum
Consultant in Nursing
 Private Practice Health
Consultant
 Author
 Lecturer
 Instructor
 Individual and Family
Counselor
 Founder and Member of the
Neuman Systems Trustee
Group, Inc
Influences
 She developed the Systems Model based on the influences
of:
 1. Gestalt theory: idea that life has ups and downs but if a
person is able to cope with the situation, balance occurs
and illness can be prevented.
 2. Seyle’s theory: stressors create tension in the body
which can be either positive or negative.
 3. deChardin and Cornu: life as a whole
 4. Von Bertalanfy, and Lazlo on general system theory.
 5. Lararus: on stress and coping
What is the Neuman Systems Model?
The model views the person as a layered,
multidimensional whole that is in constant dynamic
interaction with the environment.
Open system with a core of energy that interacts with
the environment
The goal is to achieve optimal system stability and
balance and illness has varying degrees of stability
What is the Neuman Systems Model?
Involves not only providing care to the patient, but also to the
family/caregivers and the relationships established
Key Concepts
Central Core
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System variables
Genetic features
Strengths and weaknesses of the system
The system constantly changes and evolves and the goal is
to obtain balance
 Lines of resistance is a protective mechanism that
attempts to bring the body to its usual state
Key Concepts
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Each layer is made up of five person variables
Physiological
Psychological
Sociocultural
Spiritual
Developmental
Key Concepts
 Protective mechanisms that maintain a patients stability:
 Flexible lines of defense: is referred to as “accordion like”
and flexible for example, and expands or contracts as a
response to fight off stressors. Examples include change in
eating or sleeping patterns
 Normal lines of defense: represents the normal state of
adaptation over time
 Lines of resistance: help protect, for example, leukocytosis
response to invading microorganisms
Key Concepts
 Reconstitution
Refers to the is the change in energy as a result of a reaction
to stressors and begins at any point during invasion of a
stressor
This can cause a fluctuation from the normal line of defense
and refers to the ability of the body to adapt
Key Concepts
 Stressors
 May have a positive or negative reaction and have an
impact on the stability of the system and can be
internal or external;
1. Intrapersonal-within the person
2. Interpersonal-between individuals
3. Extrapersonal-outside the individual
Key Concepts
 Prevention
 This is the primary nursing intervention which focuses
on keeping stressors and stress from creating a
detrimental outcome
Key Concepts
 Primary: occurs before the system reacts to a
stressor. Prevention includes health promotion and
wellness. Nursing interventions include identification
and reduction of risk
 Examples of nursing interventions at this state may
include: providing education and support for smoking
cessation, relaxation techniques, anger or stress
management
Key concepts
 Secondary: occurs after the system reacts to the
stressor. Nursing interventions include focus on
preventing damage to the system.
 Examples of nursing interventions may include
medications for treatment or encouragement to
verbalize feelings and emotions
Key Concepts
 Tertiary: occurs after the system has been treated
through secondary. Nursing interventions include
providing support to increase energy or conserve
energy to promote reconstitution of the body back to
normal state
 Examples of nursing interventions may include reassessing the patients ability to complete tasks or
routine consults for counseling
Key Concepts
 Nursing care under this model not only focuses on the
patient, but also focuses on the
family/caregiver/community (holistic care)
 Nursing care under this model includes achieving
goals that reduce stressors factors for patients at any
given point in their state of health
3 Stage Nursing Process
 Diagnosis
 Goals
 Outcomes
Using the model in nursing practice
 Holistic assessment obtained from patient and
family/caregiver including patient profile, stressors,
history and physical, lifestyle patterns, health
concerns, past experiences, spiritual, psychosocial
and education needs.
 Develop and implement nursing diagnosis based on
the stressors and other needs determined during the
assessment process
Using he model in nursing practice
 Set the goals for the patient that address all aspects
of well being
 Help reduce stressors and provide education to
prevent illness
 Encourage the patient to regain control over their
well being
 Review and evaluate the patients progress
Use of model in nursing practice
 The Systems Model has been accepted in academic
schools and is used in curriculums to teach new
student nurses to care for patients
 This model can be used in all aspects of nursing
 Initially this was used in Community Mental Health
Case Study
 A 48 year old Caucasian male, married with a 3 month old
and a 6 year old child.
 He is a Nursing Home Administrator and is known to his
colleagues as a hard working and dedicated.
 His wife is a stay at home mom.
 He smokes and drinks on occasion when he becomes
stressed.
Case Study
 He arrives at work daily around 7:00 am and immediately rounds
the facility to check on Residents and staff.
 He often drops in the cafeteria when staff are eating and grabs
his usual salad
 Recently his staff notice he has been arriving later after 8:00 am
and does not immediately round the facility, rather stays in his
office and there are days he does not round. Staff begin to
complain to leadership that he is not following up on concerns
or paying attention to issues in the facility.
 His wife also notices changes in that he is sleeping in later and
rushes to get to work and now skips breakfast with his family.
Case Study
 His wife notices he comes home later at night and has
difficulty falling asleep. She is also concerned because
she has noticed bills coming through the mail that
have not been paid.
 His wife calls their physician to express her concerns
because her husband seems withdrawn and no longer
spends time with the family.
Case Study
 He is eventually admitted to the hospital with chest pain
and shortness of breath and is diagnosed with pneumonia.
Question 1:
What level of prevention would the nurse apply to develop
interventions to bring the patient to a level of stability?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
Case Study
Question 2
What type of nursing interventions would you apply
during the tertiary phase?
References
Nursing Theories, (2012, January 28). Application of
Betty Neuman’s system model. Retrieved from
http://currentnursing.com/nursing_theory/applic
ation_Betty_Neuman’s_model.html
Nursing Theory, (2011). Neuman’s systems model.
Retrieved from http://nursingtheory.org/theories-and-models/neumansystems-model.php
References
Heyman, P., & Wolfe, S. (2000, April). Neuman systems
model. Retrieved from
http://www.patheyman.com/essays/neuman/ind
ex.htm
The Neuman Systems Model Trustee Group, Inc. (20012003). Neuman systems model. Retrieved from
http://neumansystemsmodel.org/NSMdocs/neu
man_systems_model_trustees.htm