Levine's conservation model for nursing

Levine's conservation model for nursing is a method used by nurses in caring for patients. It uses four principles of conservation to help the patient achieve adaptation, or acting in his or her own best interest, and maintain wholeness. Conservation in this use refers to the patient's ability to balance his or her need for energy with the available supply. The model defines for the nurse various factors in the patient's environment that affect the patient's ability to achieve adaptation. It also defines possible patient responses to his or her condition, and how these factors affect the patient's recovery. According to Levine's model, knowing how to assess and respond to these factors helps a nurse to assist the patient in achieving the ultimate goal of promoting the patient's adaptation and the ability to maintain wholeness.

Background

The woman behind the theory of the conservation model of nursing was Myra Estrin Levine. She was born in Chicago in 1920 and developed an interest in nursing after caring for her ailing father. After training at Cook County School of Nursing, she became a private duty nurse and then served as a civilian nurse attached to the army during World War II (1939–1945). Following that, she held a number of supervisory and administrative positions with medical facilities in Illinois and in Israel. The loss of her son at the age of just three days old and time spent in Israel during the Yom Kippur War in October of 1973 awakened a deep interest in and appreciation for her Jewish faith; this would influence Levine's approach to nursing by causing her to see patient care as a loving act.

Levine wrote extensively about her thoughts and theories about nursing, completing at least two dozen books and articles on the subject. She also lectured to several generations of nursing students as well as to the public. Levine passed away in 1996.

The theory that bears her name was originally developed as a new way to teach student nurses the basics of medical-surgical nursing. Levine wanted an approach that emphasized problem solving and attentiveness to the individual patient. She did not favor the strict adherence to a set of rules and procedures that provided a one-size-fits-all guide to tending to patients. Instead, Levine wanted nurses to tune in to the patient's needs and his or her individual responses, and then to assess those responses and find ways to guide the patient to act in his or her own best interest. Levine saw this as the most beneficial, efficient, and effective way to help the patient achieve maximum health outcomes.

Overview

Levine's model was built on the idea of conservation. Conservation, from the Latin word conservatio, means "to keep or hold together." In this usage, Levine referred to the human being's ability to hold himself or herself together emotionally, mentally, and physically even when facing significant challenges to mind or body. Levine's model emphasized the need to see the patient as an entire and holistic being, with more to tend to than just the specific illness or injury for which he or she was being treated. The theory proposed that the nurse use conservation of energy, structure, and personal and social integrity to help the patient adapt and maintain wholeness during treatment.

Conservation of energy refers to the human need for energy as fuel to power the body's functions. Tending to the patient's need for food and oxygen addresses conservation of energy concerns. Conservation of structure refers to the structural integrity of the human body; the skin and other membranes must be maintained to prevent loss of bodily fluids and the entrance of infections. Conservation of personal integrity refers to the mental and emotional well-being of the individual; the nurse should help the patient restore and/or maintain a sense of self-worth and self-esteem during treatment. Conservation of social integrity refers to the patient as a member of a family and other entities in society; restoring the patient to health means helping one maintain his or her place in the family or other social entity.

Maintaining the patient's personal and social integrity means recognizing that the patient exists in both an internal and an external environment. The patient's internal environment operates in a state of homeostasis, or expending the minimum energy needed for function, and homeorhesis, or a stable flow of energy. Homeostasis and homeorhesis operate in conjunction with each other to help the patient's body adapt to the demands placed on it by an illness or injury.

The patient's external environment has three factors that affect the patient's adaptation. Preconceptual aspects of the environment are those that are within the patient's control. The operational environment includes things that are outside the patient's control and of which he or she may not be aware of such as pollution and germs that can affect the patient's health. The patient's conceptual environment includes non-material factors such as spiritual beliefs, values, and traditions that can play a role in one's health.

In addition to the principles of conservation that guide a patient's response to illness or injury, Levine's theory teaches that the patient also responds with adaptation and organismic responses. Adaptation has three characteristics: historicity, or responses that have been developed over time and repeat when a similar health challenge appears; specificity, or responses that are an inherent part of the patient's genetic coding; and redundancy, or the human ability to examine and determine responses based on experiences.

Organismic responses are those that are part of the human constitution. The oldest and most basic of these is the fight-or-flight response, during which a person responds to a real or perceived threat by either becoming aggressive or attempting to flee. An inflammatory response is a self-protective response by the body as fluids containing white blood cells and other substances the body thinks might be needed move to an injured or infected area of the body. The stress response results in an abundance of biological chemicals such as adrenaline and cortisol flooding the body in response to the injury or illness. A perceptual response is the mind's way of working through the body's situation through information gathering and assessment.

Nurses using Levine's model assess the patient's vital signs and body position, take steps to ensure personal hygiene and an appropriate environment for the patient's care, assess and address the patient's nutritional needs, and use treatments and the administration of medications to help the patient in conservation and adaptation. In this way, the nurse is treating the whole patient, not just the patient's illness or injury.

Bibliography

"Four Conservation Principles." Nursing Theory, www.nursing-theory.org/theories-and-models/levine-four-conservation-principles.php. Accessed 2 May 2017.

Leach, Matthew J. "Wound Management: Using Levine's Conservation Model to Guide Practice." Ostomy Wound Management, Aug. 2006, www.o-wm.com/content/wound-management-using-levine's-conservation-model-guide-practice. Accessed 2 May 2017.

"Levine's Four Conservation Principles." Current Nursing: Nursing Theories, 26 Jan. 2012, currentnursing.com/nursing‗theory/Levin‗four‗conservation‗principles.html. Accessed 2 May 2017.

"Myra Estrin Levine: Conservation Model." Cardinal Stritch University, www.stritch.edu/Library/Doing-Research/Research-by-Subject/Health-Sciences-Nursing-Theorists/Myra-Estrin-Levine---Conservation-Model/. Accessed 2 May 2017.

"Myra Levine's Conservation Theory." Nursing Theories, 18 July 2009, nursingtheories.blogspot.com/2009/07/myra-levines-conservation-theory.html. Accessed 2 May 2017.

"Nursing Theorist: Levine." Texas Women's University, libguides.twu.edu/c.php?g=270174&p=1803331. Accessed 2 May 2017.

Schaefer, Karen Moore. "Levine's Conservation Model in Nursing Practice." Nurse Key, nursekey.com/levines-conservation-model-in-nursing-practice/. Accessed 2 May 2017.

Snowden, Austyn, et al. Pioneering Theories in Nursing.Andrews UK Limited, 2014.