MYRA LEVINE

The Conservation Model

• NOCES, Gian Angelo Soriano
• OBERES, Aleiah Josa Naces
• PADALLA, Precious Hillary Tacio
• PANADEN, Esthermae Palaguitang

CREDENTIALS AND BACKGROUND

Who is Myra Levine as a person?
• Has been called a Renaissance woman
• was a daughter, sister, wife, mother, and friend.
• intelligent… trustworthy, and global in her vision of nursing.
Early Life
• born: December 12, 1921
• Her involvement throughout her father’s persistent gastrointestinal
illness resulted to her interest in nursing
Education
• 1944: graduated with a nursing diploma (Cook County School of
Nursing)
• 1949: Bachelor’s Degree in Nursing (University of Chicago)
• 1962: Master of Science in Nursing (Wayne State University in
Detroit)
Career and Appointments
• Myra Estrin Levine enjoyed a varied career
Works
• was a regular presenter… and a prolific writer concerning nursing
and education.
• worked as a consultant to different hospitals and schools of
nursing
• Levine never intended to develop a theory, but she developed a
conceptual organizational structure for teaching medical-surgical
nursing that stimulated theory development
• Introduction to Clinical Nursing (1st edition) (1969)
• Holistic Nursing (1971): addressed the goal of the conservation
principles
• Introduction to Clinical Nursing (2nd edition) (1973)
• 1984: presented the conservation principles at nurse theory
conferences and at the (now DeSales University) conference.
• The Four Conservation Principles: Twenty Years Later (1989):
substantial enhancement and clarification
Death
• died: March 20, 1996 (75 years old)
• legacy as an administrator, educator, friend, mother, nurse,
scholar, student of humanities, and wife.
• 1992: Dr. Baumhart, President of Loyola University, said the
following about Levine:
"Mrs. Levine is a renaissance woman… who uses knowledge from several disciplines to expand the
vision of health needs of persons that can be met by modern nursing. In the Talmudic tradition of her
ancestors, [she] has been a forthright spokesperson for social justice and the inherent dignity of [the]
human person as a child of God."

THE CONSERVATION MODEL

• focused in: promoting adaptation and maintaining wholeness
using the principles of conservation.
• improve the physical and emotional wellbeing of a person by
considering the four principles of conservation
• Conservation and two other important concepts: adaptation and
wholeness

THREE MAJOR CONCEPTS OF CONSERVATION MODEL

• Wholeness, Adaptation, Conservation
Wholeness (Holism)
• As an open system
• “Wholeness emphasizes a sound, organic, progressive mutuality
between diversified functions and parts within an entirety, the
boundaries of which are open and fluid.“
• Integrity
o The oneness of the individuals emphasizing that they respond
in an integrated, singular fashion to environmental
challenges.
Adaptation
• the process of change and integration… in which the individual
retains integrity or wholeness
• Organismic Response – a change during an attempt to adapt to
the environment
o Response to fear
o Inflammatory-immune response
o Response to stress
o Sensory response
Conservation
• Joining together
• Product of adaptation
The Four Conservation Principles
1. Conservation of Energy
2. Conservation of Structural Integrity
3. Conservation of Personal Integrity
4. Conservation of Social Integrity

MAJOR ASSUMPTIONS
• Not stated specifically, but Levine valued “a holistic approach to
care of all people, well or sick” and respect for the individuality

NURSING METAPARADIGM
Nursing
• A profession and scientific discipline
• Nursing practice is based on nursing’s unique knowledge and the
scientific knowledge of other disciplines adjunctive to nursing
knowledge.
• “Nursing is a human interaction.”
Person
• People continuously defend their completeness and adopt the
most cost-effective, thrifty, and energy-efficient solutions.
• a holistic being; sentient, thinking, future-oriented, and past-aware
• A unique individual in unity and integrity, feeling, believing,
thinking, and whole system of system
Health
• Health and disease are patterns of adaptive change
• an individual response that may change over time in response to
new situations, new life challenges, and aging, or in response to
social, political, economic, and spiritual factors.
• Health is implied to mean unity and integrity.
Environment
• Internal environment: physiological and pathophysiological
aspects of the patient
• External environment: Levine uses Bates’ definition of the external
environment and suggests the following three levels:
o Perceptual – able to intercept and interpret with their sense
organs
o Operational – things that affect individuals physically,
although they cannot directly perceive them
o Conceptual – cultural patterns

APPLICATION INTO NURSING PRACTICE

Scenario 1
A 75-year-old man currently staying in a long-term care facility. He
has a history of congestive heart failure (CHF) and generalized
weakness. Currently, he states that he has been feeling “depressed”
due to his inability to do his personal care. He also states that he
misses his old friends in the community.
• Conservation of Energy
Ensure the patient has enough rest periods to provide the energy
needed for activities of daily living.
• Conservation of Structural Integrity
The patient is at high risk for immobility due to CHF and weakness,
so the nurse will need to put interventions in place for prevention of
pressure ulcers.
• Conservation of Personal Integrity
The nurse must recognize that the patient wants to maintain a
sense of independence, so she will take steps to have the patient
achieve as high a level of independence as possible with personal
care (i.e. working together with a physiotherapist/occupational
therapist).
• Conservation of Social Integrity
The nurse can facilitate the maintenance of old friendships by
contacting the family and asking if they would be able to take him
out on social leave. Also, the nurse can discuss with the
interdisciplinary team (activity/recreation aides) ways of having
the patient form new connections with other patient within the
long-term care facility.

Scenario 2
Yolanda is a 55-year-old married African American mother of two
adult children who has a history of breast cancer. She was
diagnosed with fibromyalgia 2 years ago, afteryears of
unexplained muscle aches and what she thought was arthritis. The
diagnosis was a relief for her; she was able to read about it and
learn how to care for herself. Over the past 2 months, Yolanda
stopped taking all of her medicine, because she was seeing a new
primary care provider and wanted to start her care at "ground
zero." In addition to her family responsibilities, she is completing her
degree as an English major. At the time of her clinic appointment,
she told the nurse practitioner that she was having the worst pain
possible.
• Conservation of Energy
Focuses on the balance of energy input and output to prevent
excessive fatigue.
1. Discuss strategies to balance rest and activity;
2. Discuss strategies to help her achieve restful sleep;
3. Discuss both nonpharmacological and pharmacological
approaches to manage pain;
4. And assess her nutritional intake to make sure adequate
energy stores.
• Conservation of Structural Integrity
Involves maintaining the structure of the body to promote normal
functioning.
1. Discuss any needed modifications of activities to prevent
injury;
2. Assess diet to identify whether any foods exacerbate
gastrointestinal symptoms;
3. Discuss the normal physiological process of menopause,
including associated symptoms;
4. And consider additional laboratory work or referrals to
evaluate hormone levels and assess whether additional
treatment is indicated to relieve menopause symptoms.
• Conservation of Personal Integrity
Involves the maintenance of one’s sense of personal worth and
self-esteem.
1. Validate the illness experience;
2. Encourage continued use of prayer, Bible reading, and
humor to help her feel better;
3. Discuss strategies to help her manage her anxiety related
to the irritable bowel syndrome, including both
nonpharmacological and pharmacological approaches.
• Conservation of Social Integrity
Acknowledges that the patient is a social being.
1. Praise Yolanda for the strong family relationships that she
has built and encourage her to continue to work together
with her family to optimize her health;
2. With Yolanda’s permission, talk with her husband to answer
his questions about her condition and discuss how they can
continue to work together to improve her health;
3. And praise Yolanda for continuing to seek achievement of
her goal of completing her English degree and discuss
strategies to manage the irritable bowel syndrome and
manage problems to help her feel more confident about
going to school.
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