Conservation Model Myra estrin Levine. April Beresford, RN Heidi Ertman , RN Latrice Garner, RN Mary Jacobs, RN Maureen Koval, RN. Myra E. Levine.
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April Beresford, RN
Heidi Ertman, RN
Latrice Garner, RN
Mary Jacobs, RN
Maureen Koval, RN
"Ethical behavior is not the display of one's moral rectitude in times of crisis," says nurse Myra Levine.“It is the day-to-day expression of one's commitment to other persons and the ways in which human beings relate to one another in their daily interactions.”
- Levine (1977)
The purpose of this project is to describe the use of a conceptual nursing model, Levine’s Conservation Model.
Myra Estrin Levine proposed four principles of conservation. The process by which conservation is achieved is adaptation and the desired outcome is integrity or wholeness. Adaptation includes responses based on past experiences (historicity), specific to the need (specificity), and with a variety of levels of possible response (redundancy). The principles of conservation relate to the conservation of energy, structural integrity, personal integrity, and social integrity of the individual.
Myra Estrin Levine (1920-1996) was born in Chicago, Illinois. Levine
developed an interest in nursing because her father was frequently ill and required nursing care on many occasions. Levine did not desire to make a nursing model or theory. Her model developed from the organizational structure she developed for teaching medical surgical nursing students (Stafford,1996). According to Tomey and Alligood (2006, p. 288). “The Four Conservation Principles of Nursing” was the first statement of the conservation principles. The theory was completed in 1973.
Academic Education Bryan Memorial Hospital in Lincoln, Nebraska (1951), Cook County School of Nursing (1963 to 1973), Rush University (1974-1977), and University of Illinois (1962, 1963, 1977 to 1987).
Mrs. Levine’s study of theory started with Badland’s: specific causation and multiple factors, and gives credit to Florence Nightingale, according to Alligood and Tomey (Alligood and Tomey, 2006, p. 229 [as cited in Levine, 1992, p.42]), “guardian activity” of observation used by nurses to “save lives and increase health and comfort", it was a large contribution in to the thinking aspect of the Conservation model.
She continued to modify her Conceptual Model throughout her career based on her continued education, work experience and advances in scientific principles.
Levine told others that she did not set out to develop a nursing theory but had wanted to find a way to teach the major concepts in medical-surgical nursing and attempt to teach associate degree students a new approach for daily nursing activities. Levine also wished to move away from nursing education practices that were strongly procedurally oriented and refocus on active problem solving and individualized patient care (George, 2002), as quoted from nursingtheories, [blog,2009,(03)].
“Adaptation is the process of change whereby the individual retains his integrity within the realities of his internal and external environment” (Levine, 1973).
“Conservation describes the way complex systems are able to continue to function even when severely challenged (Levine, 1973).
“The goal of nursing is to promote adaptation and maintain wholeness” (Levine 1971).
Each one of the global concepts of nursing has the ability to add to wholeness or to detract from it.
Levine’s Conservation Model is clearly influenced by other disciplines. It is not unique to nursing. It has elements of the physical sciences as evidenced by the principle of energy conservation. The social sciences are represented in the concept of the perseveration of personal integrity. The influence of humanities is reflected by the concept of how a person’s social system is part of their environment and all forms of environment have an influence on the person.
Levine’s Conservation model was developed as an organizational framework for teaching medical surgical nursing. It was not intended to be a nursing theory (Schaefer, 2006, p.228).
This model adequately describes the four global concepts:
All of these concepts represent the factors that influence individuals and their ideas about their own health and how they view healthcare in general which can influence the individual’s treatment goals and outcome.
This model has been used in varied areas of nursing. “Conservation principles have been used as frameworks for numerous practice settings in cardiology, obstetrics, gerontology, acute care (neurology), pediatrics, long-term care, emergency care, primary care, neonatology, critical care areas, and in the homeless community” (Savage & Culbert, 1989; Schaefer & Pond, 1991).
“Use of an appropriate conceptual model facilitates the design and testing of theory-based interventions and the development of science to support nursing practice”(Mock et al, 2007, p. 512).
You are a labor and delivery nurse working for a local hospital. You are caring for a teenager who is about to deliver her first child. In the room are her boyfriend, her mother, and her best friend. She is quiet and is not making eye contact with care staff, and her family members are watching television. You sit down next to the bed and ask the patient if there is anything she needs and she replies “no” but your gut instinct tells you there’s more to the picture. Your assessment skills tell you there is a great potential here for problems.
You ask the patient how she feels about becoming a mother. She tells you she is scared. In further conversation, she tells you she is not planning to go back to school because she is embarrassed and afraid of social rejection. She did not take any birthing classes or childcare education. She is afraid of pain during active labor, and has questions about pain control options. She says her mother and her boyfriend have been supportive, but also voices concern about taking care of her mother, who has a physical disability.
Wow. This patient has issues, right? Let’s look at the pieces here. Levine states we have to look at all of the little pieces to see the whole person. In order to understand our patient, we have to assess her lifestyle, social integration, spirituality, self-image, family dynamic, environment, cultural identity, and anything else she feels may contribute to her identity. We get a few hints of that in our initial conversation.
How well is your patient adapting? Before you say “poorly” look at what you can build on. Adaptation is not a “pass or fail” but can vary in degree. Consider environment, organismic response, and trophicognosis in your response. This is a new situation for your patient. How is she relating this to past experiences? What does she perceive as a challenge? What does she not perceive as a challenge or a goal?
Levine describes conservation as “… the way complex systems are able to continue to function even when severely challenged” (1990). Is your patient conserving energy? Is she conserving structural (physical) integrity? Is she conserving her personal integrity? Is she preserving social integrity? How could you, as a nurse, promote these principles?
Using Levine’s Conservation Model to guide our nursing practice takes conscious effort, but has the potential to help our patients reach a higher state of health, which is the ultimate goal of nursing practice.
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Levine, M. E. (1992). Nightingale redux. In B.S. Barnum (Ed.), Nightingale’s notes on nursing (pp. 39-43). Philadelphia: J.B. Lippincott.
Schaefer, K.M. (2006). Nursing Theorists and Their Work. In Y.Alexopaoulos (Ed. “Et al”), Myra Estrin Levine: The Conservation Model (pp. 227-243). St. Louis, Missouri: Mosby Elsevier.
Schaefer, K.M. & Pond, J.B. (1994). Levine’s Conservation Model as a Guide to Nursing Practice. Nursing Science Quarterly, 7, 53-54. doi: 10.1177/089431849400700204