Nursing Theory - Research Paper Example

Nursing Theory One of the most constructive theories for the advanced nursing practice in leadership and education, Myra Estrin Levine’s (1920-1996) Conservation Model was originally developed as an organizing framework for teaching the fundamental principles of nursing to the undergraduate nursing students. Several theories and models about the nursing profession have flourished ever since the time of Florence Nightingale and Levine’s Conservational Theory, which was introduced in 1973 in the book titled Introduction to Clinical Nursing, is one of the prominent theories to be applied into nursing practice. In this conceptual model of nursing theory, Levine is mainly concerned with promoting adaptation and maintaining wholeness by means of the principles of conservation. As Karen Moore Schaefer puts it, “Levine was intent on not simply teaching the skill of nursing but also providing a rationale for the behaviors. She has shown a high regard for the integration of the adjunctive sciences to develop a theoretical basis of nursing, has been a clear voice for the development of the discipline, and has called attention to the rhetoric of nursing theory.” (Schaefer, 2006, p 207). Significantly, this model has been greatly useful in the assessment and intervention on the issues related with staff nurse productivity, burnout, and satisfaction. This paper makes a reflective exploration of Levine’s Conservation Model in order to relate it with the advanced nursing practice in leadership and education. Born in Chicago in 1920, Myra Estrin Levine developed an interest in nursing from her early days and obtained her degrees in the subject. She started working as private duty nurse, but later worked also as civilian nurse in the U.S. Army, surgical nursing supervisor, and faculty in nursing administration. Her experience in the teaching of nursing at many different institutions following her M.S. in nursing in 1962 made her take interest in the development of new theories and models in nursing theory. Although she was concerned with developing any ‘nursing theory’ as such, it was essential for Levine to find an effective way to teach the major concepts in medical-surgical nursing. As she started moving away from the existing nursing education practices, Levine came up with new model of nursing education which emphasize active problem solving and individualized patient care. “The core, or central concept, of Levine’s theory is conservation. When a person is in a state of conservation, it means that individual adaptive responses confront change productively, and with the least expenditure of effort, while preserving optimal function and identity. Conservation is achieved through successful activation of adaptive pathways and behaviors that are appropriate for the wide range of responses required by functioning human beings.” (Sitzman and Eichelberger, 2010, pp 71-2). It is essential to comprehend that there are several levels at which the specific adaptive responses which make conservation possible work out and they include molecular, physiologic, emotional, psychological, and social. These specific adaptive responses are based on historicity, specificity, and redundancy. Therefore, it becomes lucid that Levine’s Conservation Model helps the nurse focus on the influences and responses at the level of organism, through the conservation of energy, structure, and personal and social integrity. Examining the major concepts of Levine’s Conservation Model, one realizes that her model comes up with some of the fundamental explanations of the nursing discipline and it, as in the case of other theories, focuses on four major concepts, i.e. person, environment, nursing and health. According to Levin, the role of the nurse in conservation is to support patient adaptation and effort in the achievement of conservation. The major principles of conservation for nurses proposed by Levin include the conservation of energy and the structural integrity of the individual, the conservation of personal integrity of the individual, and the conservation of social integrity of the individual. As Sitzman and Eichelberger maintain, “Levine expressed the view that within the nurse-patient relationship a patient’s state of health is dependent on the nurse-supported process of adaptation. Effective adaptation leads to conservation, wherein the patient achieves his or her unique optimal state of health with minimum energy expenditure. The goal of nursing care is to recognize, assist, promote, and support adaptive processes that benefit the patient.” (Sitzman and Eichelberger, 2010, pp 73). Thus, according to Levine’s Conservation Model, the role of the nurse in the adaptive processes of a patient is essential and the model provides guidelines for the nurses to improve their effectiveness in the conservation. In a detailed investigation of how Levine’s Conservation Model is applied to nursing practice, it becomes lucid that the model makes significant contribution to nursing education and practice. In nursing education, the model has been used as guidelines for curriculum development in several universities and colleges of nursing. The most fundamental concepts of the Conservation Model are wholeness (holism), adaptation, and conservation. According to Myra Estrin Levine, “nursing is human interactions.” (Levine, 1973, p.1). Levine emphasizes the role of nurses in improving the adaptation level of the patient through human interaction. “The nurse enters into a partnership of human experience where sharing moments in time – some trivial, some dramatic – leaves its mark forever on each patient.” (Levine, 1977, p. 845). Therefore, Levine’s Conservation Model maintains that major objective of nursing is to promote adaptation and maintain wholeness. According to Levine, wholeness or holism can be maintained by conserving integrity. For this, the nurses need to make use of the principles of conservation in relation to client energy, personal integrity, structural integrity, social integrity, etc. “Wholeness exists when the interactions or constant adaptations to the environment permits the assurance of integrity. Nurses promote wholeness through the use of the conservation principles. Their recognition of an open, fluid, constantly changing interaction between the individual and the environment is the basis for holistic thought, which views the individual as whole.” (Schaefer, 2006, p 209). Significantly, Levine’s Conservation Model can be realized as a conceptual model with three important nursing theories such as conservation, redundancy, and therapeutic intention. All these concepts of Levine’s Conservation Model point to the relevance of the model in the advanced nursing practice. Therefore, Levine’s Conservation Model has an essential application to nursing practice in general. In a careful analysis of the Conservation Model by Levine, it becomes clear that the concept of conservation is the central point which is surrounded by the four principles of conservation. Three important factors connected with these four principles are historicity, specificity, and redundancy. By historicity, Levine means that personal and genetic past history partially determine adaptive responses in individuals, whereas specificity refers to the unique stimulus-response pathways which determine the system of working in individuals. When one system or pathway is incapable to ensure adaptation, alternative pathway can help the system complete the job. This functioning is called redundancy. “There are four Conservation Principles, and they have implications for every nursing situation. They function as a unity, concerned with the integrity of the whole person, but nevertheless, they permit individual examination of specific nursing problems.” (Parker, 1990, p 199). Therefore, the concept of conservation, along with the four principles of conservation and the three central concepts of historicity, specificity, and redundancy, makes the focal point of Levine’s Conservation Model. To conclude, a profound exploration of Levine’s Conservation Model confirms that Levine made a central contribution to nursing theory by her nursing practice model. Levine mainly emphasizes the value of nursing for promoting adaptation and maintaining wholeness in patients, by means of the principles of conservation. Significantly, conservation is the core, or central concept, of Levine’s theory and it has four fundamental principles. Accordingly, the conservation of energy and the structural integrity of the individual, the conservation of personal integrity of the individual, and the conservation of social integrity of the individual are the central principles of conservation. The most essential contribution made by Levine’s Conservation Model to the advanced nursing practice in leadership and education is the four principles of conservation, i.e. conservation of energy, structural integrity, personal integrity and social integrity. These principles guide the nurse to focus on the patient’s process of adaptation and attainment of wholeness. Levine’s Conservation Model encourages the nurse to be valuable to the patients through the conservation of energy, structure, and personal and social integrity. References Levine, M. E. (1973). Introduction to Clinical Nursing. Philadelphia, PA: F. A. Davis Company. p 1. Levine, M. E. (1977). “Nursing Ethics and the Ethical Nurse.” American Journal of Nursing. 77 (5). pp 845-9. Schaefer, Karen Moore. (2006) “Levine’s Conservation Model in Nursing Practice.” Nursing Theory: Utilization & Application. Martha Raile Alligood, Ann Marriner-Tomey. Elsevier Health Sciences. p 207. Sitzman, Kathleen and Eichelberger, Lisa Wright. (2010). Understanding the Work of Nurse Theorists: A Creative Beginning. Jones & Bartlett Learning, pp 71-2. Parker, Marilyn E. (1990). Nursing theories in practice. Jones & Bartlett Learning. p 199. Read More