Betty Neuman

"Health is a condition in which all parts and subparts are in harmony with the whole of the client.

Presented by: Renee Ivers Sara Towers Sheri Vandeberg

Background
Born in Ohio & lives in Watertown, Ohio Worked in many areas of nursing practice Professor at UCLA Family Therapist Founder/ Director of the NSMTG, Inc. Holds two Honorary Doctorates (1992Honorary Doctorate of Letters, Neumann College; 1998-Honorary Doctorate of Science, Grand Valley State University) Fellow, American Academy of Nursing, 1993

In 1970 she started developing the systems model as a way to teach an introductory nursing course to nursing students. The goal was to provide a Holistic overview of the physiological, psychological, sociocultural, and developmental aspects of human beings
.

Purpose

Influence
1. Pierre Tielhard deChardin : a philosopher-priest that believed human beings are continually evolving towards a state of perfection an Omega Point 2. Gestalt Theory : A theory of German origin which proposes that the dynamic interaction of the individual and the situation determines experience and behavior. 3. General Adaptation Syndrome mainly talks about an individuals reaction to stress on the 3 levels a) alarm b) resistance c) exhaustion 4. General Systems Theory postulates that the world is made up of systems that are interconnected and are influenced by each other.

Their relationship together is linked as essential concepts of the model. It takes all four global concepts to make the content of the nursing model.

Human Being

Neuman Systems Model

Nursing

Global Concepts

Environment

Health

Four Global Concepts

Human Beings
Human Beings Neuman believes that nursing is concerned with the whole person. A total person as a client system and the person is a layered multidimensional being. Each layer consist of five-person variable or subsystem

Physiological Psychological Socio-cultural Spiritual Developmental

Environment

Neuman believes that environment has an effect on the bodys response to diseases, which impacts their well-being. Neuman also identified a created environment which is an environment that is created and developed unconsciously by the patient and is symbolic of system wholeness. Neumans concept of environment is that of an internal and external environment with varying degrees of harmony and balance between the two. Changing environment affect certain stressors in the patients life. Neuman identifies three stressors that alter a persons wellness.
o Interpersonal o Extrapersonal o Intrapersonal

Health
Defined as the condition in which all parts and subparts (variables) are in harmony with the whole of the patient. Neuman Systems Model measures health holistically. Health is associated with wellness.

Nursing
Neuman defines nursing as actions which assist individuals, families and groups to maintain a maximum level of wellness, and the primary aim is stability of the patient system, through nursing interventions to reduce stressors. The roles of the nurse are seen in terms of degrees of reaction to stressors, and the use of primary, secondary and tertiary interventions.

Prevention is the primary nursing interventions.

Stressors are capable of producing either a positive or negative effect on the patient system.

Is compatible with todays health care philosophy by seeing the patient in a holistic manner. Nurses provide this care through their assessments, diagnosis, treatment and education, and evaluation

This model allows us to properly assess and treat patients holistically using 5 patient variables
Physiological Psychological Developmental Sociocultural Spiritual

Neumans Model
Is compatible with todays health care philosophy by seeing the client in a holistic manner. Nurses provide this care through their assessment, diagnosis, treatment and education, and evaluation.

The Neuman Systems Model describes nursing as it is today. This model seems to serve as a blueprint for holistic nursing. By using this holistic point of view, a single approach is used to assess the needs and concerns of the patient. In doing so the main goal is to keep the clients condition stable due to environmental stressors.

This model allows us to properly assess and treat patients holistically using 5 client variables.

The 5 client variables are Physiological, Psychological, Developmental, Sociocultural, and Spiritual. Since nurses are the primary caregivers this theory provides a blueprint and describes nursing for what it is today. This system is very versatile and is used by all levels of nurses, from associate to doctorate nurses.

Applications

Nursing Education Nursing Research Administration Direct Patient Care

Application of the Neuman Systems Model to Nursing Practice

United States- Cognitive impairment, meeting family needs of clients in critical care; to provide stable support groups for parents with infants in neonatal intensive care units; and to meet the needs of home caregivers, with emphasis on clients with cancer, HIV/AIDS, and head traumas. The model is used in psychiatric nursing, gerontological nursing, perinatal nursing, and occupational health nursing.

Internationally, the model is being used in Canada, the United Kingdom, Sweden, the Nether- lands, New Zealand, Australia, Jordan, Israel, Slovenia, and several East Asian countries (e.g., Japan, Korea, and Taiwan). Practice areas include community/ public health care.

Mrs. Smith is a 28 year old business executive. Her colleagues describe her as hard working, perfectionist, and very dedicated to work. Her day starts by leaving the house very early from Jenison to Grand Rapids and begins work by delegating various tasks with firm expectations and deadlines that are somewhat impossible to meet. She usually responds with pressure and intimidating remarks for work not perfectly done. She smokes and drinks alcohol whenever she is stressed.
Case Study

Recently, the company experienced a continuous drop in their sales and her boss started to put blame to her. Mrs. Smith began exhibiting weird mannerisms and behaviors that appear strange to her family and people around her. She misses breakfast and lunch very often and falls asleep very late at night while doing work. She has no time anymore for her family and focuses too hard on meeting deadlines and her preconceived objectives.

Because of these weird changes in her, the company decided to temporarily relieve her from her position as executive manager. A week later, she started to have periods of mania and depression. Her family becomes worried and called up the hospital to seek assistance after she locked herself in the room, refusing to eat, and most of the time quietly staring blankly at the wall. She later developed pneumonia.

Using Neumans system in the above situation identify the possible stressors that contributed to Mrs. Smiths condition.
Using primary, secondary and tertiary prevention, according to Neuman, how would you as a nurse assist this patient?
Your turn

Using Neumans system model in the above situation, the identified possible stressors that contributed to Mrs. Smiths condition were as follows: work, personality, and attitude. Mrs. Smith 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.
Answer

Tertiary Prevention

Primary Prevention
Stress management activities Relaxation techniques Anger management techniques Smoking cessation

Re-assessing patients ability to independently perform and maintain variables of health Regular consult to psychologist Maintaining clients support system.

Effects on flexible line of defense:

Sleep troubles Responds with pressure and intimidating remarks for work not perfectly done Smokes and drinks when stressed

Effects on lines of resistance

Weakened immune response Developed pneumonia

Effects on normal line of defense

Exhibiting weird mannerisms and behaviors Periods of mania and depression

Secondary Prevention
Medication (to treat symptoms) Opportunities to verbalize feelings and concerns

References
Websites:
http://currentnursing.com/nursing_theory/Neuman.html http://www.neumansystemsmodel.org http://nursingtheories.blogspot.com/2008/07/bettyneumans.html http://slsu-coam.blogspot.com/2008/09/betty-neumansystem-model-in-nursing.html
Malinski, V. (2003). Research issues. Nursing research and nursing conceptual models: Betty Neuman's Systems Model. Nursing Science Quarterly, 16(3), 201.

Articles:
Pines, E., Rauschhuber, M., Norgan, G., Cook, J., Canchola, L., Richardson, C., jones, M. (2011). Stress resiliency, psychological empowerment and conflict management styles among baccalaureate nursing students. Journal of Advanced Nursing. 1482-1493.

Toto, D., Bostian, P., Blackman, B., Hoch, C. (2009). Teaching and learning in nursing. Bridging the gap: Answering the need for nursing faculty. 4(4), 109-114.