Neuman’s Systems Model: what is it and what does it explain about patients?

Summary of Neuman's Systems Model, Betty M. Neuman's contribution to the world of nursing.

A nurse is defined as a person whose occupation is to assist or care for the sick, wounded or injured under the prescriptions of a physician, or to assist a physician or surgeon in the proper performance of his or her practice.

The World Health Organization (WHO) reveals that there are some 28 million nursing professionals worldwide. Their ranks have increased by 4.7 million between 2013 and 2018 but, nevertheless, the current figure still leaves a shortfall of 5.9 million healthcare professionals globally.

Nursing models and theories aim to describe, establish and examine the phenomena that shape general nursing practice. This set of currents and techniques encompasses philosophical, scientific, theoretical, modeling and knowledge fronts, in turn formed by the perception of reality that we perceive through learning and research.

Conceptual models in nursing allow the organization of information into logical systems, develop an organized way of studying nursing (and its strengths and weaknesses), uncover knowledge gaps in postulated mechanisms and theories, provide measures to assess the degree of care in a patient in a healthcare setting, and much more. Taken together, they attempt to apply the discipline of nursing as effectively and respectfully as possible to the sick.

One of these important theories in the field of nursing is Neuman's systems model, proposed by Betty M. Neuman (1924-present). (1924-present), a graduate in Mental Health and Public Health. If you want to learn all about this premise, read on.

What is Neuman's systems model?

Neuman's systems model is a postulation of nursing based on the individual's relationship to stress, their response to this emotion and the dynamic restorative factors in nature.. This model can be broken down into the 4 meta-paradigms of nursing, which are the environment, the patient, the nurse's action and health.

Within this conceptual framework, the patient is seen as a client (or client system) composed of innate traits in a particular environment. A person, a family, a community and even a social problem are conceived as "a set of physiological, psychological, sociological, developmental and spiritual variables" linked to a central core based on individual survival, which is surrounded by "concentric rings of defense".

We know all this terminology may sound confusing, but stick with us, you'll understand better. The client develops a series of defenses that are used to protect him or herself when interacting with the environment, the outermost lines being the flexible and the line of defense (normal line) being the limit of well-being in a moment of rest. When the innermost lines of defense break down (lines of resistance), the client/patient feels more or less severe stress, which can become a lethal threat to the whole system.

In other words, we conceive of the patient as a core of survival and a series of concentric rings that go from greater to lesser severity, with the line that limits the state of health being the situation of normality. Neuman's systems model attempts to keep the client's system intact, protecting the outermost lines and promoting greater flexibility of the rest. Thus, the patient is prevented from worsening faster than normal due to disease progression and environmental stress.

As a summary of this theory, we can distinguish several elements that make up the patient when describing the "outside-in" model.. These are the following:

• Flexible lines of defense: these are the outermost layer of the client, the ones that protect the normal line.
• Normal line of defense: the level of sanitary normality in the client. In other words, the boundary between being well and not well.
• Resistance lines: protect the system from imbalance and try to preserve the patient's well-being once the normal line is broken.
• Core: is composed of the vital factors that define the species.

If you prefer, we can look at the individual as an onion, which goes through layers.. The outermost are the casing, which, if broken, do not affect the structure. When you go deeper, you find the normal and resistance lines, until you reach the nucleus, which contains the vegetable primordium. If the core is destroyed, the whole system falls under its own weight.

The foundations of Neuman's systems model

There are 11 bases on which Neuman's systems model rests.. Here are some of the ones we have found most interesting:

• The patient is a dynamic source of energy that is in constant exchange with the surrounding environment.
• There are many known, unknown and universal stressors. They all differ in their potential to unbalance the patient in question.
• Each patient is a unique system composed of its own factors and characteristics that have a common survival core.
• The normal line of defense serves to calculate the individual welfare deviation.
• The particularities of the patient may, at any time, cause his or her lines of resistance to fail to protect the patient from a stressor.

Based on these premises, in nursing, primary prevention is applied to protect the normal line of defense and to harden the more "flexible" layers of the system (flexible lines of defense). (flexible lines of defense). Secondary prevention focuses on strengthening the lines of resistance, thus reducing the reaction to a stressor and increasing the patient's tools. Finally, tertiary prevention aims to readapt and stabilize the patient (return to wellness) while he or she is undergoing treatment.

In addition to all this, Neuman's model Neuman's model places special emphasis on the patient's environment, which is essential for the maintenance of the balance of the system.. There are 3 types of "environments" according to the model, being internal, external and created.

The internal environment grows within the patient's own system. All the interacting forces and influences that characterize the client form this concept. On the other hand, the external environment is the physical space in which the person finds himself, while the created environment is the subconscious mechanism that he himself generates to cope with the current situation.

Practical applications

This may all sound very ethereal, but hopefully it has become clearer to you with the nuanced explanations. At the clinical level, Neuman's model can help nurses manage potential stressors for patients in the facilities in which they work..

This stream of thought helps professionals understand the idea of adversity by delineating the boundaries of the factors that make up a whole, the effects of circumstances, and a patient's relationship to his or her situation and environment. If the patient's core and lines are known, it is theoretically possible to act accordingly and get the patient to present a better overall state throughout the process.

You may have already noticed, but this model is not without its critics. According to pharmacological portals, the biggest flaw in this postulation is undoubtedly the lack of clarification of terms, the lack of clarification of terms. On the other hand, it fails somewhat to differentiate between interpersonal and extrapersonal stressors.

Summary

As you have been able to see, we have moved at all times in abstract terms, between lines, rings and wellness cores. If we want you to keep a general idea in mind, this is the following: as clients or patients we are composed of layers, some external and flexible and others internal and more delicate. When a stressor reaches our core, the system fails and our health can be seriously compromised. The job of nurses is to make sure this never happens.

This is why Neuman's system pays special attention to the limits of each client, their particularities and the relationships they develop with the environment. The more each specific situation is compartmentalized and described, the easier it will be to avoid stressors that can put the entire individual system in check.

Bibliographical references:

• Bourbonnais, F. F., & Ross, M. M. (1985). The Neuman systems model in nursing education: Course development and implementation. Journal of advanced nursing, 10(2), 117-123.
• Günüşen, N. P., Üstün, B., & Gigliotti, E. (2009). Conceptualization of burnout from the perspective of the Neuman systems model. Nursing Science Quarterly, 22(3), 200-204.
• Haggart, M. (1993). A critical analysis of Neuman's systems model in relation to public health nursing. Journal of advanced nursing, 18(12), 1917-1922.
• Neuman, B. M., & Fawcett, J. (1989). The Neuman systems model (2nd ed.). Norwalk, CT: Appleton & Lange.
• Reed, K. S. (1993). Adapting the Neuman systems model for family nursing. Nursing science quarterly, 6(2), 93-97.
• Reed, K. S. (1993). Betty Neuman: The Neuman Systems Model (Vol. 11). Sage.
• Ume-Nwagbo, P. N., DeWan, S. A., & Lowry, L. W. (2006). Using the Neuman systems model for best practices. Nursing Science Quarterly, 19(1), 31-35.