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FOUR CONSERVATION PRINCIPLES OF NURSING Theorist: MYRA ESTRIN LEVINE
• Born: Chicago, Illinois in 1920 • Died: Hospice of the North Shore at Evanston Hospital in 1996.
Nursing Education History
• Diploma in nursing: Cook County School of Nursing in 1944 • Bachelor of Science in Nursing: University of Chicago in 1949 • Master of Science in Nursing:Wayne State University in 1962
Career Milestones in Nursing Profession and Science
• Enjoyed a varied career. • Her nursing experience: staff nursing, administrative and teaching supervision, clinical instruction, and direction of nursing services.
" .Published Article • "Trophicognosis: An Alternative to Nursing Diagnosis.
. A big factor in the development of this theory was her strong physical science background. promoting “wholeness”. With this background she influenced the practice of nursing through the attainment of the nursing goal.LEVINE’S CONSERVATION THEORY and ITS CONCEPTS • Levine’s Conservation Theory was developed because she believed that nursing revolves around controlling and preserving the energy resources of the patient.
An example is a patient’s anxiety is still present despite the alleviation of pain. He is a whole being who is conserved and integral. cultural and spiritual aspects—who constantly strives to preserve wholeness and integrity • One who is sentient. • A holistic being who has open and fluid boundaries that coexist with the environment. feeling. and pastaware • A unique individual in unity and integrity. thinking. future-oriented. thinking and whole system of system. but also the psychosocial. believing.MAJOR CONCEPTS PERSON • A holistic being—not only in the physical needs. .
and conceptual environments: . • Where the individual lives her life.Environment ENVIRONMENT • Plays an important role in completing the individual’s wholeness. internal environment combines the physiological and pathophysiological aspects of the individual and is constantly challenged by the external environment. b. • The individual has both an internal and external environment: a. operational. external environment is divided into the perceptual.
symbols. these elements may physically affect individuals but are not perceived by the latter. touch.individuals respond to with their sense organs and includes light. sound. the ability to think and experience emotion. • conceptual environment . microorganisms. and position sense and balance. religious beliefs.interacts with living tissue even though the individual does not possess sensory organs that can record the presence of these factors and includes all forms of radiation. temperature. and individual psychological patterns that come from life experiences. and pollutants. • operational environment . and concepts and inventions and encompasses the exchange of language. .Environment • perceptual environment . ethnic and cultural traditions. In other words.consists of language. chemical change that is smelled or tasted. value systems. ideas.
• Stress response.according to Selye. and taste-smell systems. • Perceptual awareness—information seeking response used by the individual to seek and maintain safety for himself. a defense mechanism to protect self from insult in a hostile environment. An individual may turn away "flight" or face his condition "fight" to assure his safety and well-being. synaptic. Includes the basic orienting. auditory. Environmental control is important. .Environment Individuals respond to the environmental challenges by means of four integrated processes: • Fight-or-flight mechanism .a way of healing. • Inflammatory-immune response . stress response syndrome is a predictable non-specifically induced organismic changes. Uses available energy to remove or keep out unwanted irritants or pathogens. visual.most primitive response. Characterized by irreversibility and influences the way patients respond to nursing care. Hospitalization. illness and new experiences triggers a response .
• The goal of nursing is to promote wholeness. 1977. . 845). p. • “Wholeness” can be achieved through the use of supportive and therapeutic aspect of caring.rooted on the organic dependency of an individual as well as communications with other human beings. some dramatic—leaves its mark forever on each patient (Levine. The nurse enters into a partnership of human experience where sharing moments in time—some trivial.NURSING • Involves engaging in “human interactions” .
Involve the whole individual Nurses should also use the nursing process in giving care to their patients.• A profession as well as an academic discipline that always should be studied and practiced along with other health sciences. condition and situation 5. Be aware and able to contemplate objects. .A nurse should have the following goals: 1. Make decision through prioritizing course of action 4. Assist the person (his sole concern) to defend and to seek its realization 3. Realize that every individual requires a unique and separate cluster of activities 2. Human interaction is the focus of nursing.
and ability to pursue one's interest without constraints. .HEALTH • A state of wholeness and not just an absence of disease and successful adaptation and not merely healing of an affected part. self-hood. • Ability to function normally and able to return to daily activities.
structural integrity. . personal integrity and social integrity of the client.KEY CONCEPTS The Four Conservation Principles • The nurse has to promote conservation of energy.
Conservation of Energy • It refers to balance between energy expenditure and conservation. Patient activity is dependent on energy balance. inhaling of clean air. • Illness increases energy demand. adequate hydration. pulse. proper nutrition and exercising. • The balance is brought by proper rest. • Energy is measured in everyday nursing practice via body temperature.I. and that increased energy demand can be measured by the level of fatigue. . and blood pressure. blood gases. fluctuations determine either energy expenditure or conservation.
Regular turning of patient side to side every 2 hours to patients who are bedridden.II. c. Examples include: a. Perform ROM exercise d. Maintenance of clean. and that healing restores.structural integrity. dry. to regain structure and function. the body needs to restore structural integrity through repair and healing • Nursing Intervention aims in helping the individual to prevent skin breakdown and limiting the amount of tissue involvement in infectious disease. Conservation of Structural Integrity • Focused on preserving the anatomical structure of the body and preserving healing • Refers to maintaining or restoring the structure of body preventing physical breakdown and promoting healing • Changes in structure ultimately affect function. Maintenance of patient’s personal hygiene . b. that structural integrity may be compromised by pathophysiological processes. Therefore. wrinkle free linen.
self awareness. • Illness and hospitalization compromise personal integrity. and defense mechanisms and supporting personal choice. • Nursing interventions include protecting and respecting patient privacy. selfidentity. respect. sense of identity and self-worth. • Individual strives for recognition. and self-respect • Person’s integrity is compromised when the individual becomes dependent. Conservation of Personal Integrity • A client is a person with dignity.III. possessions. • Individuals require privacy and are responsible for their own decisions. selfhood and self-determination. .
Reinforce positive traits e. Involvement of patient in plan of care. f. c. Recognize and protect patient’s space needs . Promote socialization in such a way he can developed positive self-esteem. Expression of patient’s feelings b. Focus on self aspect by not comparing to others d.Examples include: a.
• Individual behavior is influenced by the ability to relate to various social groups. families often are affected by an individual’s illness.IV. and hospitalization results in social isolation. • Nursing Intervention: Helping the individual to preserve his or her place in the family. a religious group. . an ethnic group. a community. a political system and a nation • Individuals recognize social responsibilities. traditional customs and spiritual group. community and society. academe. Conservation of Social Integrity • An individual is recognized as someone who resides and interacts with in a family.
b. Provide support and assistance to family • “The Goal of the individual is conservation or preserving an integrated and balance whole”(Levine. 1973) . TV e. Avoid sensory deprivation d. Position patient in bed to foster social interaction with other patients c.Examples include: a. radio. Promote patient’s use of news paper. In the case of a pregnant women scheduled for caesarean operation.her support system is very important both before and after the operation. magazines.
cervical cancer. from critical care. patients with burns. chronic pain. and epilepsy. intensive care nursery. acute care. emergency room. . congestive heart failure. pediatrics. community care. 2008). 2008) and geriatric nursing where majority of the elderly patients will have some problems in at least two of the conservation models (Bautista. long-term care. Education & Research) • Nursing Practice Used in variety of settings. homeless. smoking cessation (as cited by George.(Application in Nursing Practice. perioperative nursing.
so she will take steps to have the patient achieve as high a level of independence as possible with personal care (i. working together with a physiotherapist / occupational therapist). Conservation of structural integrity: The patient is at high risk for immobility due to CHF and weakness. activity / recreation aides) ways of having the patient form new connections with other patient within the long term care facility.Scenario: A 75 year old man currently staying in a long term care facility. Also. 4. The nurse could use the four principles of conservation to address his needs as follows: 1. the nurse can discuss with the interdisciplinary team (i. . Conservation of personal integrity: The nurse recognizes that the patient wants to maintain a sense of independence. 3. so the nurse will need to put interventions in place for prevention of pressure ulcers.e. 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 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. Currently he states that he has been feeling “depressed” due to his inability to do his own personal care. He has a history of congestive heart failure and generalized weakness.e. 2.
Francis de Sales. 2007).Nursing Education • Provides a student friendly nursing theory. This reflects simple yet complete and concise nursing theory. • Provided an organizational structure for teaching Medical-Surgical Nursing and stimulus for theory development. (Basavanthappa. Pennsylvania and KapatHolim in Israel. . • Used as a curriculum model and is a part of both undergraduate and graduate curricula (Marriner-Tomey & Alligood. She aimed to move away from a procedurally oriented educational process and instead sought to teach the major concepts of medical surgical nursing as generalized content. 2006). • Used to develop nursing undergraduate program at Allentown college of St.
2008). Hypotheses have been developed from Levine’s theory.Nursing Research • Enhances the foundation of nursing practice and nursing education. and research has been conducted to test these hypotheses (George. .
MARTHA ROGERS The Science of Unitary Human Beings .
• She grew up in a family.Brief History • Martha Elizabeth Rogers was born in Dallas. Texas May 12. . sharing her birthday with Florence Nightingale. • She completed her BSN in Public Health Nursing in 1937 from George Peabody College Nashville in 1937 and worked as a public health nurse. • Received Nursing diploma from Knoxville General Hospital in 1936. where learning was fostered and reading was a favorite pastime. 1914. • Earned her master's degree in public health nursing from Teacher's College Columbia University.
(The human being and the environment cannot be understood in isolation of each other).Essence of Theory: • The energy field of the human being interacts with the energy field environment. Nursing therapeutics: “Repatterning of man and environment for more effective fulfillment of life’s capabilities” . Nursing Client: Human beings-environment energy fields relationship.
there is no temporal ordering of lives. "Pattern is an abstraction and it gives identity to the field". Pattern • Pattern is defined as the distinguishing characteristic of an energy field.CONCEPTS Energy field • The energy field is the fundamental unit of both the living and nonliving. . There are no boundaries or barriers that inhibit energy flow between the fields. The parameters that humans use in language to describe events is arbitrary. Openness • The human field and the environmental field are constantly exchanging their energy back and forth. Pan-dimensionality • Pan-dimensionality is defined as "non linear domain without spatial or temporal attributes". The present is relative. density. This energy field "provides a way to perceive people and environment as irreducible wholes". and extent. The energy fields continuously varies in intensity.
The multiple events taking place along life's axis denote the extent to which man is achieving his maximum health potential and vary in their expressions from greatest health to those conditions which are incompatible with maintaining life processes. pan-dimensional energy field identified by pattern and integral with the human field". The person has the capacity to participate knowingly and probabilistically in the process of change. indivisible. describing. or summarizing the parts". Environment • The environment is an "irreducible. . they are the "characteristics and behavior emerging out of the mutual. The two fields coexist and are integral. Manifestations emerge from this field and are perceived by the person.CONCEPTS Unitary Human Being (person) • A unitary human being is an "irreducible. simultaneous interaction of the human and environmental fields". pan-dimensional (four-dimensional) energy field identified by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts" and "a unified whole having its own distinctive characteristics which cannot be perceived by looking at. Health and illness are the part of the same continuum. Health • Rogers defined health as an expression of the life process.
. • Nursing as an art .Rogers claimed that the creative use of science for the betterment of humans and the creative use of its knowledge is the art of its nursing.The theory asserts the independent science of nursing because an organized body of knowledge which is specific to nursing is arrived at by scientific research and logical analysis.Nursing • Nursing as a science .
Assumptions about people and nursing: • Nursing exists to serve people. • It is the direct and overriding responsibility to the society. • People need knowledgeable nursing. • The safe practice of nursing depends on the nature and amount of scientific nursing knowledge the individual brings to practice. .
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