Nursing Theorist

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Nursing Theorist
Betty Neuman
"Health is a condition in which all parts and
subparts are in harmonywith the whole of the
client.
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Background

• Born 1924 in Lowell, Ohio
• Received her RN Diploma in 1947
• After Graduating
• -Gained experience as a floor nurse
• -Worked as a school nurse
• -Worked as a clinical instructor

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Continuing Education

• 1957-UCLA BScN Majored in psychology and public
  health
• 1966-UCLA Completed Masters
• 1985-Pacific Western University. Received
  Doctorate in Clinical Psychology

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Metaparadigm

• Person
• Health
• Environment
• Nursing

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Person

• The Neuman model is based on the philosophy that
  each person is a layered multidimensional being
• Each layer in the model consists of 5 person
  variables or subsystems
• - Physiological
• - Psychological
• - Socio-cultural
• - Spiritual
• - Developmental

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Person Continued
Flexible Line of Defense
Normal Line of Defense
Normal Line of Defense
Normal Line of Defense
Normal Line of Defense
CORE
Lines of Resistance
CORE
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Health

• Neuman views health as wellness
• The condition in which all parts and subparts
  (variables) are in harmony with the whole of the
  client (Neumann, 1995)
• Equated with stability of normal lines of
  defense

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Health Continued
Health
Health
Health
Health
Health
Health
Flexible Line of Defense
Normal Line of Defense
Lines of Resistance
CORE
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Environment

• The mixture of the internal and external forces
  that surround a person and how they interact at
  any time
• Include intrapersonal, interpersonal and
  extra-personal stressors which can affect the
  normal line of defense and the stability of the
  system
• Internal environment- within the client system
• External environment- outside the client system

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S TRESSORS
Interpersonal
S TRESSORS
Intrapersonal
Extrapersonal
Flexible Line of Defense
Normal Line of Defense
CORE
CORE
Lines of Resistance
Interpersonal
Interpersonal
Intrapersonal
Intrapersonal
Intrapersonal
Extrapersonal
Extrapersonal
Extrapersonal
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Nursing

• The person is seen as a whole, therefore the
  nursing focus should be on the whole person
• Neumann defines nursing as an action which
  assist individuals, families and groups to
  maintain a maximum level of wellness, and the
  primary aim is stability of the patient/client
  system, through nursing interventions to reduce
  stressors.
• Which jobs the nurse does is in relation to the
  degree of reaction to the stressors as well as
  the level of prevention
• -Primary
• -Secondary
• -Tertiary

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Levels of Prevention

• Primary
• Occurs before the system reacts to a stressor
• It can strengthen a person but can also weaken
  the environment
• Ex. Health Promotion, Injury Prevention

• Secondary
• Occurs after the stressor has effected the
  environment
• Focuses on preventing damage to internal core

• Tertiary
• Occurs after the system has been treated through
  secondary prevention measure
• Focus on support

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Health
Health
Health
Health
Health
Health
Flexible Line of Defense (Primary Prevention)
Normal Line of Defense (Secondary Prevention)
Lines of Resistance (Tertiary
Prevention)
CORE
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Model

• The Neuman systems model reflects the nature of
  living organisms as open systems and interaction
  with each other and the environment
• Throughout the model, Neuman incorporates her
  own philosophical beliefs and mainly mental
  health clinical experience

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Case Study
Brittany Smith is a 20-year-old Nursing Student
at Nipissing University. Her classmates describe
her as hard working, perfectionist and very
dedicated to her schoolwork. She does very well
in school, and always keeps on top of her work
load. Brittanys day starts off very early
because she has to drive into town from Powassan
to the school. Her day at school usually consists
of intense studying, classes and preparing for
clinical. Brittany usually responds well with
school pressures and always tries to keep a
positive outlook. When Brittany gets stressed she
tends to have problems sleeping and loses the
desire to eat properly.
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Case Study Cont.
Recently, clinical and school assignments have
become overwhelming and Brittany has begun to
fall behind. Brittany started to withdraw from
social activities and her attendance in class was
dropping. Her friends and teachers were beginning
to worry about her success in the nursing
program. Because of these weird changes some of
her professors offered her small extensions on
assignments in hopes that it would relieve some
of her stress. When it became more obvious that
further measures needed to be taken Brittanys
friends contacted her parents to let them know of
her unusual behaviors. Brittanys family then
become very worried and bring her to the hospital
to seek assistance for her recent behaviors, low
self-esteem, and a serious lack of nutrition.
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Case Study Analysis
Using Neumans system model in the case study,
the identified possible stressors that
contributed to Brittanys condition were as
follows preparing for and attending clinical,
tests and assignments. Brittany is not anymore
able to handle the stressors and that had caused
the breakdown of her lines of defense. Without
seeking help from her family and friends, she was
not able to maintain her flexible line of defense
and brought instability to her system.
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Quiz
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Question 1

• Name the four metaparadigms

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Question 2

• What are the three levels of prevention

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Question 3

• Name the two lines of defense that Neuman uses in
  the model

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Question 4

• What does Neuman view health as?

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Budding Nurse Theorists Rebecca Mead Robyn
Gilpin Lindsay Raney Portia Y. Boateng Kailey
Somerville Michaela Matheson Megan Scott Kristine
Bootsma Rachel Johnson
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References

• Dewan, S. A., Ume-Nwagbo, P. N. (2006). Using
  the Neuman model for best practices. Nursing
  Science Quarterly, 19(1), 31-35.
• Tomey, A.M Alligood, M.R. Nursing theorists and
  their work. Mosby-Elsevier. 6th edition. St.
  Louis, Missouri Mosby
• Charlotte Tourville,  Karen Ingalls. (2003). The
  Living Tree of Nursing Theories. Nursing
  Forum, 38(3), 21-30, 36.  Retrieved November 12,
  2008, from ProQuest Nursing Allied Health
  Source database. (Document ID 476634011).
• Diana M L Newman (2005). A COMMUNITY NURSING
  CENTER for the HEALTH PROMOTION of Senior
  Citizens Based on the Neuman Systems
  Model. Nursing Education Perspectives, 26(4), 221-
  3.  Retrieved November 12, 2008, from ProQuest
  Nursing Allied Health Source database.
  (Document ID 869718191).
• Smith, M. (1989) Neumans model in practice.
  Nursing Science Quarterly, 2(16), 116 117.
• Ingalls, K. Tourville, C. (2003). The living
  tree of nursing theories. Nursing Forum, 38(3),
  pg 21.
• Malinski, V. (2003). Nursing research and nursing
  conceptual models Betty Neumans system model.
  Nursing Journal Quarterly, 16(3), pp 201-206.
• Betty Neumans System Model. SlideShare, 6,
  November 2008
• Http//www.slideshare.net/iversonny/betty-neumans-
  system-model/