What Is Neuman's System Model?
Neuman’s system model encompasses nursing practice and relates interventions to stressors the client is experiencing. These stressors can be physiological, psychological, sociocultural, developmental, and spiritual. The overall goal of the model is to facilitate the client and family to obtain maximal level of wellness through stress reduction and interventions. This model is used to identify stressors of the client and to intervene before the stressor causes symptoms or further problems for the client. It is used in nursing practice to facilitate goal-directed, unified, wholistic approaches to patient care. The model also serves to prevent division in patient care with a multidisciplinary team.
Nursing Theory
The Neuman Systems …show more content…
Model was developed from the general systems theory. The emphasis is on the patient as a system. This might be an individual, family, group, or community and on the patient’s reactions to the stressors. The system incorporates five variables which include: physiological, psychological, sociocultural, developmental, and spiritual. The physiological variable includes body structure and function. The psychological variable includes the mental process and its interaction with the environment. The sociocultural variable includes the results of social and cultural situations. The developmental variable includes aging processes and pursuits. The spiritual variable includes religious beliefs and effects. (Alligood, 2014)
These variables are theorized as an inner core or basic energy resource bordered by concentric circles which include lines of resistance, a normal mine of defense, and a flexible line of defense. The variables are each reflected in the concentric circles. The normal line of defense or lines of resistance are considered a sequence of broken circles encompassing the basic core structure. The rings signify resource factor that aid in protecting the client from a stressor. The normal line of defense is this model’s external solid ring. This ring functions as the way in which to measure change in health. The flexible line of defense is this model’s external broken ring and functions as a safeguard from stressors going through the normal wellness state as signified by the normal line of defense. (Lawson, 2014)
Health, Wellness and Illness are also represented in this systems model. Health is defined as a continuous range of wellness to illness that is multidimensional. Wellness occurs when all system parts interrelate in coherence with the entire system and that all system needs are met. Illness occurs when the contrary of wellness happens, that is when system parts are interact unharmoniously and all system needs are not met. Illness is defined as a state of uncertainty and energy reduction. (Lawson, 2014)
Betty Neuman defined stressors as “tension-producing stimuli that have the potential to disrupt system stability, leading to an outcome that may be positive or negative.” Stressors may come from intrapersonal, interpersonal, and extra personal forces. Intrapersonal occurs inside the person, interpersonal occurs between one or more persons, and extra personal occurs outside the person. The degree of reaction signifies system insecurity that can happen when stressors occupy the normal line of defense. (Lawson, 2014, p.284)
Interventions are acts to assist the individual retain, attain, or maintain system accessibility. Intervention may be needed when a stressor is speculated or recognized. This model suggests three levels of nursing intervention, primary prevention, secondary prevention, and tertiary prevention. Primary prevention occurs when a response has not yet happened but a stressor has been identified, yet the degree of risk is still unknown. Secondary Prevention occurs after symptoms from the stressor have occurred. Tertiary prevention occurs after treatment or secondary prevention and centers on reformation concerning the maximal system constancy. The function of prevention as an intervention is to obtain the optimal possible level of system stability. (Lawson, 2014) Patient Introduction This patient is a sixty five year old male. Patient’s major health problems include: metastatic adenocarcinoma of cecum with metastases liver, hypertension, diabetes, kidney disease, atherosclerosis, cataracts, and scrotal abscess. (Ignatavicius, & Workman, 2013) The patient states the reason he is here as, “Came in for my chemo, but I couldn’t get it because of that one incident with my genitals and got sent over here.”
Patient was alert and oriented times three, appeared fatigued and continually closed eyes even when talking, when patient opened eyes, he seemed sensitive to light and agitated. The patient appears to be in ego integrity phase. He can state previous phases of his life with acceptance. (Townsend, 2012)
This patient has a learning deficit related to his medical conditions. Patient has an abscess of the scrotum and does not know the proper way to care for his wounds. The patient also has been diagnosed with Diabetes Mellitus and states that his mother died of, “sugar problems”. However patient does not follow his treatment regimen related to Diabetes and states, “I don’t have Diabetes”. The patient is using denial as a defense mechanism.
Physiologic Nursing Diagnostic Statements
The patient’s first priority nursing diagnosis is Impaired Skin Integrity R/T inflammation of dermal-epidermal junctions secondary to scrotal abscess AEB scrotal drainage of pus, abscess of scrotum, and open wound associated with scrotal abscess. Assessment finding that support this nursing diagnosis include abscess of the scrotum, yellowing of the skin, skin breakdown signs present on the coccyx, and pus drainage from the scrotal wound. Also, the wound culture and sensitivity was positive for streptococcus, and enterococci. The patient’s Lymph, Mono, and Neutrophil counts were abnormal, which indicates infection along with the positive wound culture and sensitivity. (Leeuwen, & Poelhuis-Leth, & Bladh, 2013) The second priority nursing diagnosis for this patient is Fatigue R/T biochemical changes secondary to metastatic adenocarcinoma of cecum with metastases liver AEB lethargic, reports feeling tired. The assessment findings that support this diagnosis are that the patient was lethargic, and reports feeling tired. Also the patient is on several medications that may produce fatigue such as morphine sulfate and Percocet. (Vallerand, Sanoski, & Deglin, 2014) The patient also the patient sates, “I try to sleep all day” and “I fall off to sleep”. These assessment findings support the nursing diagnosis of fatigue which is also a stressor to the patient since it affects the patient’s activities of daily living. Therefore, since this is a stressor in the patient’s life and affects the patient’s health it also intertwines with Neuman’s system model. In this model stressors affects the patient or a reaction has occurred a secondary prevention intervention should occur for this patient.
Deficient Knowledge
As previously stated the patient has deficient knowledge related to wound care and maintenance of Diabetes Mellitus. However since the patient continued to deny that he had Diabetes a teaching plan was developed for foot care and prevention related to Diabetes. The nursing diagnosis for the teaching plan was Deficient knowledge (cognitive and psychomotor) regarding diabetic foot care and maintenance and ways to prevent foot complications related to diabetes as evidenced by patient states “I don’t have diabetes” and is in denial and patient expressing need for learning diabetic foot care. The overall goal of this teaching plan was for the patient to successfully learn diabetic foot care by the end of teaching session and continue to use it at home.
Different prevention measures were taught to the client regarding diabetic foot care.
Such measures included, seeing your health care provider at least annually for a thorough foot exam, inspecting your feet daily for any changes, and informing your health care provider if any changes in your feet are noticed such as cuts or breaks in your skin. Also the patient was informed on daily measures for foot care such as, wearing well fitted comfortable shoes, washing your feet every day, keeping skin soft and moisturized, and protecting feet and skin from hot or cold. (Ignatavicius, & Workman, 2013) The patient was also given a handout with this information included on …show more content…
it.
After the teaching session the patient was able to verbalize state 2 reasons he is at increased risk for foot complications due to diabetes, which were “diabetes and neuropathy”. The patient was also able to verbalize 3 general measures to prevent diabetic foot complications, which were, “getting annual exam, looking at feet every day, and telling doctor of changes with feet”. The patient was also able to verbalize 3 the ways to care for diabetic feet, which were, “wearing fitted shoes, washing feet every day, and protecting feet from hot or cold”.
This teaching plan relates to Neuman’s system model because it is a Primary prevention intervention.
The stressor of this medical condition has not yet caused any symptoms but this intervention will reduce the possibility of any symptoms happening from this stressor. This teaching plan increases the patient’s knowledge of diabetic foot care and will help increase the client’s awareness of diabetic maintenance. The defense mechanism of denial and fatigue that the patient is experiencing are barriers to teaching the patient and are also other stressors the patient is encountering which also relate to the systems
model.
Conclusion
This system’s model is useful for patient care when stressors are present. Such as the above patient mention with stressors of diabetes, impaired skin integrity and wound care, and fatigue. The system allows for intervention to occur to help relieve these stressors on the patient through a wholistic approach by treating the entire patient instead of one stressor at a time. Neuman’s system model encompasses nursing practice and relates interventions to stressors the client is experiencing. These stressors can be physiological, psychological, sociocultural, developmental, and spiritual. The overall goal of the model is to facilitate the client and family to obtain maximal level of wellness through stress reduction and interventions. (Lawson, 2014)
Nursing Theory
The Neuman Systems …show more content…
Model was developed from the general systems theory. The emphasis is on the patient as a system. This might be an individual, family, group, or community and on the patient’s reactions to the stressors. The system incorporates five variables which include: physiological, psychological, sociocultural, developmental, and spiritual. The physiological variable includes body structure and function. The psychological variable includes the mental process and its interaction with the environment. The sociocultural variable includes the results of social and cultural situations. The developmental variable includes aging processes and pursuits. The spiritual variable includes religious beliefs and effects. (Alligood, 2014)
These variables are theorized as an inner core or basic energy resource bordered by concentric circles which include lines of resistance, a normal mine of defense, and a flexible line of defense. The variables are each reflected in the concentric circles. The normal line of defense or lines of resistance are considered a sequence of broken circles encompassing the basic core structure. The rings signify resource factor that aid in protecting the client from a stressor. The normal line of defense is this model’s external solid ring. This ring functions as the way in which to measure change in health. The flexible line of defense is this model’s external broken ring and functions as a safeguard from stressors going through the normal wellness state as signified by the normal line of defense. (Lawson, 2014)
Health, Wellness and Illness are also represented in this systems model. Health is defined as a continuous range of wellness to illness that is multidimensional. Wellness occurs when all system parts interrelate in coherence with the entire system and that all system needs are met. Illness occurs when the contrary of wellness happens, that is when system parts are interact unharmoniously and all system needs are not met. Illness is defined as a state of uncertainty and energy reduction. (Lawson, 2014)
Betty Neuman defined stressors as “tension-producing stimuli that have the potential to disrupt system stability, leading to an outcome that may be positive or negative.” Stressors may come from intrapersonal, interpersonal, and extra personal forces. Intrapersonal occurs inside the person, interpersonal occurs between one or more persons, and extra personal occurs outside the person. The degree of reaction signifies system insecurity that can happen when stressors occupy the normal line of defense. (Lawson, 2014, p.284)
Interventions are acts to assist the individual retain, attain, or maintain system accessibility. Intervention may be needed when a stressor is speculated or recognized. This model suggests three levels of nursing intervention, primary prevention, secondary prevention, and tertiary prevention. Primary prevention occurs when a response has not yet happened but a stressor has been identified, yet the degree of risk is still unknown. Secondary Prevention occurs after symptoms from the stressor have occurred. Tertiary prevention occurs after treatment or secondary prevention and centers on reformation concerning the maximal system constancy. The function of prevention as an intervention is to obtain the optimal possible level of system stability. (Lawson, 2014) Patient Introduction This patient is a sixty five year old male. Patient’s major health problems include: metastatic adenocarcinoma of cecum with metastases liver, hypertension, diabetes, kidney disease, atherosclerosis, cataracts, and scrotal abscess. (Ignatavicius, & Workman, 2013) The patient states the reason he is here as, “Came in for my chemo, but I couldn’t get it because of that one incident with my genitals and got sent over here.”
Patient was alert and oriented times three, appeared fatigued and continually closed eyes even when talking, when patient opened eyes, he seemed sensitive to light and agitated. The patient appears to be in ego integrity phase. He can state previous phases of his life with acceptance. (Townsend, 2012)
This patient has a learning deficit related to his medical conditions. Patient has an abscess of the scrotum and does not know the proper way to care for his wounds. The patient also has been diagnosed with Diabetes Mellitus and states that his mother died of, “sugar problems”. However patient does not follow his treatment regimen related to Diabetes and states, “I don’t have Diabetes”. The patient is using denial as a defense mechanism.
Physiologic Nursing Diagnostic Statements
The patient’s first priority nursing diagnosis is Impaired Skin Integrity R/T inflammation of dermal-epidermal junctions secondary to scrotal abscess AEB scrotal drainage of pus, abscess of scrotum, and open wound associated with scrotal abscess. Assessment finding that support this nursing diagnosis include abscess of the scrotum, yellowing of the skin, skin breakdown signs present on the coccyx, and pus drainage from the scrotal wound. Also, the wound culture and sensitivity was positive for streptococcus, and enterococci. The patient’s Lymph, Mono, and Neutrophil counts were abnormal, which indicates infection along with the positive wound culture and sensitivity. (Leeuwen, & Poelhuis-Leth, & Bladh, 2013) The second priority nursing diagnosis for this patient is Fatigue R/T biochemical changes secondary to metastatic adenocarcinoma of cecum with metastases liver AEB lethargic, reports feeling tired. The assessment findings that support this diagnosis are that the patient was lethargic, and reports feeling tired. Also the patient is on several medications that may produce fatigue such as morphine sulfate and Percocet. (Vallerand, Sanoski, & Deglin, 2014) The patient also the patient sates, “I try to sleep all day” and “I fall off to sleep”. These assessment findings support the nursing diagnosis of fatigue which is also a stressor to the patient since it affects the patient’s activities of daily living. Therefore, since this is a stressor in the patient’s life and affects the patient’s health it also intertwines with Neuman’s system model. In this model stressors affects the patient or a reaction has occurred a secondary prevention intervention should occur for this patient.
Deficient Knowledge
As previously stated the patient has deficient knowledge related to wound care and maintenance of Diabetes Mellitus. However since the patient continued to deny that he had Diabetes a teaching plan was developed for foot care and prevention related to Diabetes. The nursing diagnosis for the teaching plan was Deficient knowledge (cognitive and psychomotor) regarding diabetic foot care and maintenance and ways to prevent foot complications related to diabetes as evidenced by patient states “I don’t have diabetes” and is in denial and patient expressing need for learning diabetic foot care. The overall goal of this teaching plan was for the patient to successfully learn diabetic foot care by the end of teaching session and continue to use it at home.
Different prevention measures were taught to the client regarding diabetic foot care.
Such measures included, seeing your health care provider at least annually for a thorough foot exam, inspecting your feet daily for any changes, and informing your health care provider if any changes in your feet are noticed such as cuts or breaks in your skin. Also the patient was informed on daily measures for foot care such as, wearing well fitted comfortable shoes, washing your feet every day, keeping skin soft and moisturized, and protecting feet and skin from hot or cold. (Ignatavicius, & Workman, 2013) The patient was also given a handout with this information included on …show more content…
it.
After the teaching session the patient was able to verbalize state 2 reasons he is at increased risk for foot complications due to diabetes, which were “diabetes and neuropathy”. The patient was also able to verbalize 3 general measures to prevent diabetic foot complications, which were, “getting annual exam, looking at feet every day, and telling doctor of changes with feet”. The patient was also able to verbalize 3 the ways to care for diabetic feet, which were, “wearing fitted shoes, washing feet every day, and protecting feet from hot or cold”.
This teaching plan relates to Neuman’s system model because it is a Primary prevention intervention.
The stressor of this medical condition has not yet caused any symptoms but this intervention will reduce the possibility of any symptoms happening from this stressor. This teaching plan increases the patient’s knowledge of diabetic foot care and will help increase the client’s awareness of diabetic maintenance. The defense mechanism of denial and fatigue that the patient is experiencing are barriers to teaching the patient and are also other stressors the patient is encountering which also relate to the systems
model.
Conclusion
This system’s model is useful for patient care when stressors are present. Such as the above patient mention with stressors of diabetes, impaired skin integrity and wound care, and fatigue. The system allows for intervention to occur to help relieve these stressors on the patient through a wholistic approach by treating the entire patient instead of one stressor at a time. Neuman’s system model encompasses nursing practice and relates interventions to stressors the client is experiencing. These stressors can be physiological, psychological, sociocultural, developmental, and spiritual. The overall goal of the model is to facilitate the client and family to obtain maximal level of wellness through stress reduction and interventions. (Lawson, 2014)