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Biography
Ateneo de Davao University • Myra Estrin Levine (1921–1996) is a nursing
theorist known for her esoteric model of nursing—
the Conservation Model.
• In this model, the goal of nursing is to promote
Myra Estrin Levine adaptation and maintain wholeness using the four
principles of conservation.
The Conservation Model of Nursing
• Aside from being a major influence in the nursing
profession, Levine was also a family woman, friend,
educator, administrator, student of humanities,
Lectured by: scholar, enabler, and confidante.
JENNY-ANN B. SORIANO, RN MAN
Clinical Instructor, Ateneo de Davao • She was creative and knowledgeable, opinionated, and
University
Davao City, Philippines
global in her concept of nursing.

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Biography
• Myra Estrin Levine was born in Chicago in 1920, the
first child in a family of three siblings. Her
involvement throughout her father’s persistent
gastrointestinal illness contributed to her interest in
and devotedness to nursing.
• In 1944, Myra Estrin Levine received her diploma in
nursing from the Cook County School of Nursing, then
continued on to finish her Bachelor of Science in
Nursing from the University of Chicago in 1949. Her
Master’s of Science in Nursing was granted to her
from Wayne State University in Detroit in 1962.
Biography
• Myra Estrin Levine had experienced several careers.
She was a private duty nurse in 1944, a civilian nurse
in the U.S. Army in 1945, a preclinical instructor in the
physical sciences at Cook County from 1947 to 1950,
director of nursing at Drexel Home in Chicago from
1950 to 1951, and surgical supervisor at both the
University of Chicago Clinics from 1951 to 1952, and
the Henry Ford Hospital in Detroit from 1956 to 1962.
• In 1951, Levine also became a clinical instructor at
Bryan Memorial Hospital in Lincoln, Nebraska and
administrative supervisor at the University of Chicago.

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Biography Four Conservative Principles of Nursing

• As a charismatic speaker, Myra Estrin Levine was a • “The Four Conservation Principles of
regular presenter of programs, classes, courses, and Nursing” was the first statement of the
councils, and a prolific writer concerning nursing conservation principles.
and education. • Other preliminary works included are:
• She also worked as a consultant to different 1. Adaptation and Assessment: A Rationale for
hospitals and schools of nursing. Nursing Intervention
2. For Lack of Love Alone
• In spite of the fact that she never planned to 3. The Pursuit of Wholeness
develop a nursing theory, she presented an
Levine is known for her publication, Introduction to Clinical
organizational structure for teaching medical- Nursing, which was first published in 1969, with additional
surgical nursing and a stimulus for theory editions printed in 1973 and 1989 when she elaborated on
development. how redundancy characterizes the availability of adaptive
responses when stability is threatened.

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Conservation Model Conservation Model

• Levine’s conservation model believes nursing intervention
is a conservation activity, with conservation of energy as a • The fundamental concept of Myra Estrin Levine’s
fundamental concern, four conservation principles of theory is conservation.
nursing. • When an individual is in a phase of conservation, it
• It guides nurses to concentrate on the importance and means that the person has been able to adapt to
responses at the level of the person. the health challenges, with the slightest amount of
• Nurses fulfill the theory’s purpose through the effort.
conservation of energy, structure, and personal and social • The core of Levine’s Conservation Model is to
integrity.
improve the physical and emotional wellbeing of a
• Every patient has a different array of adaptive responses, person, by considering the four domains of
which vary based on personal factors including age, conservation she set out.
gender, and illness.
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Conservation Model Conservation Model

Levine (1989) proposed the following
• By proposing to address the conservation of energy, structure, and
four principles of conservation:
personal and social integrity, this nursing theory helps guide nurses in
the provision of care that will help maintain and promote the health of 1.The conservation of energy of the
individual.
the patient.
2.The conservation of the structural
• The core of the conservation model is to improve the physical and integrity of the individual.
emotional wellbeing of a person by considering the four domains of 3.The conservation of the personal
conservation she set out. integrity of the individual.
• Nursing’s role in conservation is to help the person with the process of 4.The conservation of the social integrity
“keeping together” the total person through the least amount of effort. of the individual.

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Conservation Model Conservation Model

1. Conservation of energy refers to balancing energy input 3. Conservation of personal integrity recognizes the
and output to avoid excessive fatigue. It includes adequate individual as one who strives for recognition, respect,
rest, nutrition and exercise. self-awareness, selfhood, and self-determination.
Examples: Availability of adequate rest; Sustenance of Example: Acknowledge and preserve patient’s space needs
adequate nutrition

2. Conservation of structural integrity refers to maintaining 4. Conservation of social integrity exists when a patient
or restoring the structure of body preventing physical is recognized as someone who resides within a family,
breakdown and promoting healing. a community, a religious group, an ethnic group, a
political system, and a nation.
Examples: Assist patient in ROM exercise; Preservation of
patient’s personal hygiene Example: Help the individual to preserve his or her place in
a family, community, and society.
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Conservation Model The Environment

Environment includes both the internal and external Internal
environment. Three Aspects of Environment Drawn • Homeostasis
upon Bates’ (1967) Classification:
• Homeorrhesis
• The operational environment consists of the
undetected natural forces and that impinge on
the individual. External
• The perceptual environment consists of • Preconceptual
information that is recorded by the sensory • Operational
organs.
• Conceptual
• The conceptual environment is influenced by
language, culture, ideas, and cognition.
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The Person and Environment Person and the Environment

• Adaptation Adaptation
• Historicity: Adaptations are grounded
• Organismic response in history and await the challenges to
• Conservation which they respond
• Specificity: Individual responses and
their adaptive pattern varies on the
base of specific genetic structure
• Redundancy: Safe and fail options
available to the individual to ensure
continued adaptation
Organismic response
• A change in behavior of an individual
during an attempt to adapt to the
environment
• Help individual to protect and
maintain their integrity
• They co-exist

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Orgasmic Response Nine models of guided assessment

They are four types:
1. Flight or fight: An instantaneous
response to real or imagined threat,
most primitive response
2. Inflammatory: response intended
to provide for structural integrity and
the promotion of healing
3. Stress: Response developed over 1. Vital’s signs 6. Pressure gradient system in nursing
time and influenced by each stressful 2. Body movement and positioning 7. Local application of heat and cold
experience encountered by person
3. Ministration of personal hygiene 8. Administration of medicine
needs 9. Establishing an aseptic environment
4. Perceptual: Involves gathering 4. Pressure gradient system in nursing
information from the environment interventions
and converting it in to a meaning
5. Nursing determination in provision
experience of nutritional needs

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Conservation Model Conservational Models

Conservational model provides the basis for Theory of redundancy
• Untested, speculative theory that
development of two theories: redefined aging and everything
1. Theory of redundancy else that has to do with human life
2. Theory of therapeutic intention • Aging is diminished availability of
redundant system necessary for
effective maintenance of physical
and social well being
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
Theory of therapeutic intention
• Goal: To seek a way of organizing
nursing interventions out of the
biological realities which the nurse
has to confront
• Therapeutic regimens should support
the following goals:
• Facilitate healing through natural
response to disease
• Provide support for a failing auto
regulatory portion of the integrated
system
• Restore individual integrity and well
being
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Major Concepts of the Conservation Theory Major Concepts of the Conservation Theory

1. Person is the unique individual in unity and integrity, feeling, 5. Conservation includes joining together and is the product of adaptation
believing, thinking, and whole. including nursing intervention and patient participation to maintain a safe
balance.
2. Health is the pattern of adaptive change of the whole being.
6. Personal integrity is a person’s sense of identity and self-definition.
3. Nursing is the human interaction relying on communication, Nursing intervention is based on the conservation of the individual’s
rooted in the organic dependency of the individual human being personal integrity.
in his relationships with other human beings. 7. Social integrity is life’s meaning gained through interactions with others.
4. Adaptation is the process of change and integration of the Nurses intervene to maintain relationships.
organism in which the individual retains integrity or wholeness. It 8. Structural integrity: Healing is the process of restoring structural integrity
is possible to have degrees of adaptation. through nursing interventions that promote healing and maintain
structural integrity.
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Sub-concepts Sub-concepts
1. Historicity
4. Energy Conservation
Adaptation is a historical process, responses are based on past
experiences, both personal and genetic Nursing interventions based on the conservation of
2. Specificity the patient’s energy.
Adaptation is also specific. Each system has very specific responses. The 5. Holism
physiologic responses that “defend oxygen supply to the brain are
distinct from those that maintain the appropriate blood glucose levels.” The singular, yet integrated response of the individual
(Levine, 1989) to forces in the environment.
3. Redundancy 6. Homeostasis
Although the changes that occur are sequential, they should not be Stable state normal alterations in physiologic
viewed as linear. Rather, Levine describes them as occurring in parameters in response to environmental changes; an
“cascades” in which there is an interacting and evolving effect in which
one sequence is not yet completed when the next begins. energy sparing state, a state of conservation.
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Sub-concepts Assumptions

7. Modes of Communication Assumptions About Individuals

The many ways in which information, needs, • Each individual “is an active participant in interactions with the
and feelings are transmitted among the environment… constantly seeking information from it.” (Levine,
patient, family, nurses, and other health care 1969)
workers. • The individual “is a sentient being and the ability to interact with
8. Therapeutic Interventions the environment seems ineluctably tied to his sensory organs.”
Interventions that influence adaptation in a • “Change is the essence of life and it is unceasing as long as life
favorable way, enhancing the adaptive goes on. Change is characteristic of life.” (Levine, 1973)
responses available to the person.

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Assumptions
Assumptions About Nursing
• “Ultimately the decisions for nursing intervention must be based
on the unique behavior of the individual patient.”
• “Patient-centered nursing care means individualized nursing care.
It is predicated on the reality of common experience: every man is
a unique individual, and as such he requires a unique constellation
of skills, techniques and ideas designed specifically for him.”
(Levine, 1973)
Theoretical Foundations of Nursing | Jenny-Ann B. Soriano, RN MAN
Assumptions
Relationships
• Conservation of energy is based on nursing interventions to conserve through a
deliberate decision as to the balance between activity and the person’s available
energy.
• Conservation of structural integrity is the basis for nursing interventions to limit
the amount of tissue involvement.
• Conservation of personal integrity is based on nursing interventions that permit
the individual to make decisions for himself or participate in the decisions.
• Conservation of social integrity is based on nursing interventions to preserve the
client’s interactions with the family and the social system to which they belong.
• All nursing interventions are based on careful and continued observation over
time.
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Summary of Assumptions Characteristics of theory

• The nurse creates an environment in which healing could occur • The concept of illness adaptation, using interventions, and the evaluation of nursing
interventions are interrelated.
• A human being is more than the sum of the part
• Concepts are sequential and logical and can be used to explain the consequences of
• Human being respond in a predictable way nursing action.
• Human being are unique in their responses • Levine’s theory is easy to use and elements are easily comprehensible.
• Human being know and appraise objects ,condition and situation • Levine’s idea can be tested and hypothesis can be derived from them.
• Human being sense, reflects, reason and understand • The principle of conservation are specific enough to be testable
• human being action are self determined even when emotional • Levine’s idea have not yet been widely researched.
• Human being are capable of prolonging reflection through such strategists • Levine's theory has been applied in surgical settings.
raising questions • Levine’s ideas are consistent with other theories, laws and principles particularly
those from the humanities and sciences
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Analysis of the Conservation Theory Analysis of the Conservation Theory

• Although there are many concepts similar • The concept of conservation, adaptation, and
to that of other nursing theories, Levine’s integrity can be applied to any age group since
concept of energy conservation makes it every individual has the need to expand and
unique in guiding nursing actions. reserve bodily energy.
• Borrowed concepts from Bates regarding • The operational definition of homeostasis by Levine
Levine’s view with the environment were is in question since to achieve homeostasis, energy
not translated into how it affects the is continuously being used by the body thus her
individual. statement that homeostasis is an energy sparing
• The necessity of connecting incorporated state is quite vague in nature.
concepts is crucial when trying to develop a • Rewording might be helpful in this part of her
model for nursing so as to be applied to model.
human care.
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Strengths Weaknesses
• Levine has interrelated the concepts • There are many concepts with comparatively
of adaptation, conservation, and unspecified relationships and unstated
integrity in a way that provides a assumptions.
nursing view different from that of the • Nurse has the responsibility for determining
adjunctive disciplines with which the patient ability to participate in the care,
and if the perception of nurse and patient
nursing shares these concepts. about the patient ability to participate in care
• Levine’s work is logical. One thought don’t match, this mismatch will be an area of
or idea flows from the previous one conflict.
and into the next. • The major limitation is the focus on individual
in an illness state and on the dependency of
patient.
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References
1. Alligood, M. R. (2013). Nursing Theory-E-Book: Utilization & Application. Elsevier Health Sciences.
2. Levine, M. E. (1969). Introduction to clinical nursing. In McEwen, M. and Wills, E. (Ed.). Theoretical basis for nursing. USA: Lippincott Williams & Wilkins.
3. Levine, M. E. (1973). Introduction to clinical nursing(2nd ed.). In McEwen, M. and Wills, E. (Ed.). Theoretical basis for nursing. USA: Lippincott Williams &
Wilkins.
4. Levine, M.E. (1989). The conservation principles of nursing: Twenty years later. In George, J. (Ed.). Nursing theories: the base for professional nursing
practice. Norwalk, Connecticut: Appleton & Lange.
5. Timber BK. Fundamental skills and concepts in Patient Care, 7th edition, LWW.
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8. Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott.
9. Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott.
10. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.
11. Vandemark L.M. Awareness of self & expanding consciousness: using Nursing theories to prepare nurse –therapists Ment Health Nurs. 2006 Jul; 27(6) :
605-15
12. Reed PG, The force of nursing theory guided- practice. Nurs Sci Q. 2006 Jul;19(3):225
13. Cheng MY. Using King's Goal Attainment Theory to facilitate drug compliance in a psychiatric patient. Hu Li Za Zhi. 2006 Jun;53(3):90-7.
14. Delaune SC,. Ladner PK, Fundamental of nursing, standard and practice, 2nd edition, Thomson, NY, 2002.

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