Betty Neuman

1. Betty Neuman By: Tracy Gregory Katy Lucas Wendy Webster

2. Introduction • The focus of Betty Neuman’s theory was unique as it viewed each patient as whole. She believed the focus of care should be directed around each patient’s response gauged by the physiological, psychological, sociocultural, spiritual, and developmental effects. In 1972, her first model was published entitled “Model for teaching total person approach to Patient Problems (Neuman, B. & Young, R., 1972).

3. 1947-graduated as a Register Nurse. After graduating, she worked as a floor nurse and became a clinical instructor.1957-Betty received her Bachelor’s degree1966- received Master’s degree1972-”The Systems Model” was published in Nursing Research1985-received Doctorate degree1988-Betty founded The Neuman Model Trustee Group, Inc.1998-received an honorary doctorate

4. Philosophical Views • Betty Neuman believed that “Health is a condition in which all parts and supports are in harmony with the whole of the client.” • Neuman thought that in order for a person to achieve health, all variables of internal and external stressors must be assessed to determine appropriate interventions-intrapersonal stressors, interpersonal stressors, and extrapersonal stressors.

5. In the above model, the core represents the intrapersonwith each ring representing a line of defense.The flexible line of defense is in place to respond to the external stressors it may encounter. The flexible line expands and decreases in accordance to the severity of the stressor. When the stress becomes too great, the normal line of defense is then affected. When this happens, there is a reaction with “instability or sickness.” The normal line of defense is affected by both internal and external factors and frequently changes based on stressors. The line of defense starts working as soon as the flexible line of defense is broken. The line of defense is designed to promote homeostasis, and get the person back to whole again.

6. Influences • Betty Neuman was influenced by the following people/theories. • Gestault Theory-this theory is based on the person and situation that determines the behavior/outcome. • General Systems Theory-this theory is states that all systems are connected and related to one another. • General Adaptation Model-persons reaction to stress-alarm, resistance, and distraction.

7. HUMAN BEINGS “Human beings who have unmet needs related to their health or illness status are the central focus. The goal of meeting human needs is to promote health and well-being” (Ume-Nwagbo, DeWan & Lowry, 2006. pg. 31).

8. ENVIRONMENT Environment is further broken down to internal and external factors. Neuman's theory describes how stressors in both the internal and external environment can move the person from wellness to illness. Environment is important to this model all stressors come from the environment which can leave the person vulnerable to illness. (Ume-Nwagbo, DeWan & Lowry, 2006. pg. 31-32).

9. HEALTH “The NLD, protected by the FLD, represents the usual wellness level of the client system. The NLD develops over time and is influenced by system variable such as coping patterns, lifestyle factors, developmental spiritual, and cultural influences. Neuman’s theory notes that nurses provided “accurate assessment of the possible effects of internal and environmental stressors, and then, to assist the client…to readjust so that an optimal wellness state can be obtained. (Ume-Nwagbo, DeWan & Lowry, 2006. pg. 32).

10. NURSING According to the Neuman Model “The goal of nursing is bringing back balance and stability and preserving energy, focus on interventions that will attain, maintain, and retain client system stability The nurse approaches the patient by the way of three preventions as intervention: Primary, secondary, and tertiary”. ” (Ume-Nwagbo, DeWan & Lowry, 2006. pg. 31-32).

11. Origins • Betty Neuman’s model is not unique specifically to nursing. The origins came from several different theories and concepts that relate to biological function, environment, and behaviors. • Betty Neuman shared her models and theories while teaching, through books, and in her practice (although much of her life was dedicated to education).

12. Content • Model for teaching total person approach to Patient Problems (Neuman, & Young,1972) encompasses the four global concepts. The model takes into account the intra- extra- and inner person which includes their surrounding environment and behavior.

13. Abstract or specific • The views in Betty Neuman’s model can be seen as both abstract and specific. • It is specific in the sense that the measures are assessed on every patient. The model looks at all possible stressors to that patient in the environment: Intra, Inter, and External. • It is abstract in the sense that every patient behaves different, responds to stress differently, and the responses can not be predicted. • This model is holistic and pertains to each and every person, the model can be used in any area or department of nursing.

14. Application of Betty Neuman’s Model/Theory • This model can be used in case studies as well as at tool to assess patients and create care plans. The model teaches how to look at all aspects surrounding the patient and how they respond. The model allows for three types of prevention as intervention to move the patient toward wellness. • In teaching, students can assess the patient and their environment and learn what encompasses the assessment process that continues over into the developing a plan of care and interventions.

15. Case Study “During final exams, Eugenia, a 17-year-old high school junior, reported to the school health office complaining of a headache, nausea, and feeling “shaky” and “dizzy”. The school nurse notices that she is pale with dark circles under her eyes. Eugenia’ s temperature is normal but her heart rate is 110 bpm and her BP is slightly elevated. She tells the nurse “I am so tired I don’t think I can stand up anymore.” When the school nurse asks her if she has eaten today, Eugenia re[plies, “I was so anxious about my exams this morning I couldn’t eat. If I don’t do well on my chemistry exam I wont get into college and my parents will take my car for the summer.” In reviewing her chart, the nurse notes that Eugenia takes Ritalin for attention-deficit/hyperactivity disorder (ADHD), inattentive type. The nurse asks her when was the last time she had a good night’s sleep and how often she had been taking her Ritalin. Eugenia tells the nurse that though she knows she should take her Ritalin only in the morning, she has been using the Ritalin to stay awake at night and study for the past 3 days. Eugenia attends a Christian high school and worries that her misuse of a prescription drug is a violation of the school and her personal anti-drug values.” Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice. (3 ed.). Philadelphia, PA: F.A. Davis Co. Retrieved from http://resources.fadavis.com/parker/Interactive_Exercises/interactive_exercises.cfm?exercise=Chapter12&title=Chapter 12: Case Study

16. Questions…. • What are the effects of short-term lose of sleep and misuse of Ritalin on Eugenia’s normal state of wellness? • What are the internal and external environmental stressors that have an influencing effect on Eugenia’s behavior and wellness? • Use Neuman’s concepts of primary, secondary, and tertiary prevention as intervention in developing a plan of care for Eugenia. Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice. (3 ed.). Philadelphia, PA: F.A. Davis Co. Retrieved from http://resources.fadavis.com/parker/Interactive_Exercises/interactive_exercises.cfm?exercise=Chapter12&title=Chapter 12: Case Study

17. References Neuman, B., & Young, R. J., (1972). A model for teaching total person approach to patient problems. Nursing Research, 21(2), 264-269. Neuman, B. (1974). The Betty Neuman health care systems model: A total person approach to patient problems. In J. Riehl & C. Roy (Eds.), Conceptual models for nursing practice. New York: Appleton-Century-Crofts. Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice. (3 ed.). Philadelphia, PA: F.A. Davis Co. Retrieved from http://resources.fadavis.com/parker/Interactive_Exercises/interactive_exercises.cfm?exercise=Chapter12&title=Chapter 12: Case Study Ume-Nwagbo, P. N., DeWan, S. A., & Lowry, L. W. (2006). Using the neuman systems model for best practices. Nursing Science Quarterly, 19, 31-35. doi: 10.1177/0894318405284125

18. Websites • http://www.neumansystemsmodel.org/NSMdocs/neuman_systems_model_trustees.htm#Betty M. Neuman, R.N., B.S.N. • •Blueprint for Use of Nursing Models: Education, Research, Practice, and Administration • http://currentnursing.com/nursing_theory/application_Betty_Neuman's_model.html