Introduction
This research paper explores and compares the metaparadigm concepts of nursing (nursing, person, environment and health) from a personal perspective and that of Myra Levine – a nursing theorist. For this writer, nursing as a philosophy is centered around four concepts: nursing as a service to society, the benefits that can be afforded to the patient in terms of restoration of health, the environment (the basis of society), and the positive interaction between the individual, society and the environment. Nursing is a vital service that requires the nurse to be instinctively attracted to the care of others; a caring nurse connects naturally with the patient. However, today’s nurses also need to be educated – to understand human anatomy and physiology, and to understand and be competent in the use of the technology that is an integral element in nursing today. Nursing patients back to full health is rewarding in itself, as is doing a good job which obviously is also important. The environment can be considered as a physical thing (such as where one lives or one’s home and/or workplace), but can also be considered to include one’s mental attitudes, emotions, and awareness of situations. The environment in that sense encompasses everyone the nurse encounters, who can as a consequence be affected in either a positive or negative way. A good nurse can make the most of those situations.
The Research
Personal Philosophies. As regards the nursing aspect of my personal philosophies, it seems evident that the required caring characteristics of a good nurse are paramount if the trust of patients is to be gained in the nurse-patient relationship. However, technical knowledge is also vital. Understanding the technical side of nursing including pharmacological matters is equally important, and requires ongoing education to keep pace with new developments.
These philosophies that are important to me are embodied in my daily routine and actions as a nurse – in most instances without conscious thought. For example, ensuring that the patient’s mental and emotional state is considered and responded to appropriately, whilst dealing with their physical and medical needs. In my view, a nurse’s job to restore a patient’s health cannot be performed properly unless that approach is taken with each and every patient.
The Myra Levine Philosophies. Schaefer discusses the Myra Levine Conservation Model Theory of Nursing in Chapter 9 of Parker’s book “Nursing Theories and Nursing Practice” (2005). She explains (p. 97) that the “Conservation” in the name of the theory refers to the principles that a nurse should follow in the interests of “conservation of energy, structure, and personal and social integrity.” She also suggests that the purpose of interventions should be to help to improve the condition of the patient (“therapeutic”) or to make the patient comfortable (“supportive”), in instances and situations when improvement cannot be achieved.
Schaefer describes the components of the Levine model as Adaptation, Conservation, and Wholeness (p. 97-98), stating that “The goal of the Conservation Model is to promote adaptation and maintain wholeness using the principles of conservation.” Quoting Levine, she defines nursing as “human interaction” and its goal as being to promote the principle of adaptation and to maintain health (wholeness). Further, that the goal is accomplished through the conservation principles of “energy, structure, personal, and social.”
Levine’s Conservation Model theory of nursing is also discussed extensively by Fawcett & DeSanto-Madeya (2013). The authors note that the conservation of wholeness (health) is the “unique focus” of the Conservation Model, which specifically focuses on the concept of adaptation as the means humans use to maintain their health as well as their integrity. It also concentrates on a nurse’s interaction with other humans and the inherent complexity not just of their relationships with the environment (internal and external) but also on the responsibility that the nurse should have for conserving the patient’s energy as well as the nurse’s own integrity (“structural, personal and social”) (p. 115).
“Four Conservation Principles” (2011) is the title of an article about Levine’s theory of nursing, published by Nursing Theory, which states that the theory assumes that a nurse creates the environment in which the process of healing can take place, and that humans: are more than the sum of their individual parts; respond predictably and uniquely; are able to appraise objects, situations and conditions; can sense, reflect, use reason and understanding; act in a self-determined manner, even when emotionally affected; are capable of posing questions.
That Nursing Theory article describes the four conservation principles as conserving energy, structural integrity, and both personal and social integrity. The first relates to balancing energy needs and useage to minimize fatigue by getting sufficient rest, nutrition and physical exercise. Structural energy conservation refers to maintaining and/or restoring the body, either to promote healing or to avoid breakdown. Conserving personal integrity refers to recognizing the patient as an individual who requires not just recognition but also respect. Social integrity is conserved when the patient is recognized within his/her environment of a family and community and in the wider context of religious or racial groupings, and a political system and the nation.
Levine’s theories are also covered by Daniels (2004) in Nursing Fundamentals: Caring & Clinical Decision Making. Chapter 3 “Framework of Nursing Practice” by Ellen Poole, which discusses Myra Levine’s Conservation Model (p. 57). Poole notes that the “person” is who the individual sees himself or herself as; the “environment” is interpreted as the context within which a person lives their life; “health” is defined socially, and the goal of nursing is based upon the four principles of conservation mentioned previously.
Personal and Levine Philosophies Compared. Reviewing my personal philosophies as set out earlier in this paper, and comparing them with those expressed in Levine’s Conservation Model, whilst there are detail differences in the way they are expressed, the philosophies are essentially the same, at least in intent and in terms of overall objectives. Reiterating:
- Nursing: As stated, my philosophy of nursing is essentially to be a thoughtful, caring and educated provider of patient care, recognizing the mental and emotional needs of the patient as well as his/her physical needs. Whilst those ideals are not expressed in the same way as Levine’s conservation theories, the objectives as far as the patient is concerned are the same, or at least very similar.
- Person: My philosophy of recognizing each patient as an individual with own needs is not far removed from Myra Levine’s Conservation Model.
- Environment: Both my interpretation of “environment” and that offered by Myra Levine are similar, though mine may not be expressed in quite the same terms.
- Health: Restoring a patient to full health is a common goal in both my personal philosophy and that of Myra Levine (and doubtless every conscientious nurse).
Conclusions
Having put my personal philosophies in writing and then compared them with the concepts expressed in Myra Levine’s Conservation Model of nursing theory, it seems that although there may be detailed differences of expression, essentially my own philosophies and those expressed in detail by Myra Levine are not poles apart – certainly there is no conflict, nor disagreement. Levine’s concepts of nursing, person, environment and health are just about the same as my own. It is my opinion that because Myra Levine’s theories are generally considered valid, then those of any conscientious nurse should be as little removed from them as possible.
References
Daniels, R. (2004). Nursing Fundamentals: Caring & Clinical Decision Making. Delmar Learning, New York, NY.
Fawcett, J., & DeSanto-Madeya, S. (2013). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories (3rd. Ed.), Part Two Chapter 6: “Levine’s Conservation Model” (pp. 111-137). Philadelphia, PA. F.A. Davis Company.
“Four Conservation Principles.” (2011). Nursing Theory. Retrieved from http://nursing-theory.org/theories-and-models/levine-four-conservation-principles.php
Schaefer, K., M. (2005). “Myra Levine’s Conservation Model and Its Applications.” Nursing Theories and Nursing Practice (Parker, 2005)(pp 94-112). Retrieved from http://ehis.ebscohost.com/ehost/ebookviewer/ebook/nlebk_145559_AN?sid=9ec1243b-95f0-45c4-a66d-06a4bcbef313@sessionmgr114&vid=1&format=EB&lpid=lp_xxiii&rid=0
