The Neuman Systems Model PDF

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The Neuman Systems Model (NSM) developed by Betty Neuman is a holistic systembased viewpoint. The NSM demonstrates an active relationship between an individual, stressors, and their environment. This model will be used in our study to explore the impact of long working hours on nurses’ performance and patient care. The definition of client, within the NSM, can range from an individual patient to a group or community. The NSM incorporates physiology, psychology, sociocultural, developmental, and spiritual variables to enable a holistic understanding of the client. Both the client system and each individual variable has an influence on each other. Hence, the system should be viewed holistically. Ideally, a harmonious state should exist in which all components are in congruence with each other (Fawcett, 2005).

The NSM includes four key components; the central core is the basic structure which is surrounded by three lines of defense. These lines are demarcated as a flexible line of defense, a normal line of defense, and a line of resistance that protects the central core. The basic survival aspect and the baseline features that combat stress, form the central core. Any disturbance to the central core can endanger the whole system, causing the organism to seek balance and acquire equilibrium. The central core in this study will be adequate rest between shifts to address stress and fatigue.

The outermost line of defense is the flexible line of defense, which protects the core from external stressors and maintains equilibrium (Bademli & Duman, 2017). This defense line is prone to alterations by factors such as sleep deprivation, inadequate nutrition, and dehydration. This defense contains a person’s age, gender, state, cognitive skills, developmental level, and beliefs which determine a person’s response to the stressors. The next line of defense is the normal line of defense and it represents an individual’s normal stable state and their adaptive responses to stressors. The normal line of defense can be affected by stressors such as long shift hours and associated fatigue. When these two defense lines are impacted a disequilibrium of the central core occurs. This can lead to poor patient care, medication errors, and poor performance at work (Neuman & Fawcett, 2011). The line of resistance is the innermost defense that

encircles the core. This line contains information about basic needs and protects the core integrity (Neuman & Fawcett, 2011). The NSM describes the stressor and the body’s reaction to these stressors. According to Neuman, an environment is composed of all the internal and external stressors that influence and become influenced by the organism. The three stressors defined by Neuman include: intrapersonal (from within the person), interpersonal (between persons), and extra-personal (outside the person, i.e. from the external environment) (Gonzalo, 2011). Stressors can produce system disturbances by breaching the defense lines. The systems model is also composed of the following concepts: primary prevention, secondary prevention, and tertiary prevention. Primary prevention keeps stressors and its effect from having detrimental effects on the body and the individual. Secondary prevention is seen when the normal lines of defense have been invaded by stressors. Interventions would need to be implemented to repair the defense for optimal system stability. Tertiary prevention restores a person’s level of function and finds a way to prevent future invasion by stressors. Basically, tertiary prevention restores balance and equilibrium to the person as they recuperate from ill effects (Alligood & Marriner-Tomey, 2014) The ideas and associations of the NSM agrees with the variables of our study specifically, the effects of long shift hours on the nurses’ performance. Both the stressor (shift length [independent variables]) and the reactions (fatigue, medication errors, and patient outcomes [dependent variables]) can be explained using NSM. A line of defense prevents the stressors (shift length) from creating disequilibrium to the central core (fatigue, negative patient outcome etc.). However, stressors can pressure these defenses to result in discord to the central core. In

our study, the stressor (shift length) can disrupt the line of defense leading to reactions, such as fatigue, which can lead to medical errors and negative patient outcomes.

References Alligood, M. R., & Marriner-Tomey, A. (2014). Nursing theorists and their work: Utilization & application. St. Louis: Mosby. Bademli, K. & Duman, Z. C. (2017). Conceptual framework for nurses in the use of the Neuman Systems Model on caregivers of people suffering by schizophrenia. International Archives of Nursing and Health Care 3:079. doi.org/10.23937/2469-5823/1510079 Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2nd ed.). Philadelphia: F.A. Davis Gonzalo, A. G. (2011). Betty Neuman – theoretical foundations of nursing. Retrieved from https://nursingtheories.weebly.com/betty-neuman.html Neuman, B. & Fawcett, J. (2011). The Neuman systems model (5th ed.). Boston, MA: Pearson...