Running head: EXPLORING NURSING THEORIES
Exploring Nursing Theories
Courtney Humphrey
Stenberg College
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Exploring Nursing Theories
The implementation of theoretical approaches bridges the gap between psychiatric
nursing theory and practice. When psychiatric nurses explore these theoretical ideas they become
consciously aware of their values and beliefs and thus begin to practice more safely and
effectively. Theoretical models act as guidelines for psychiatric nurses to follow when they
administer care to others. Similarly, it facilitates the opportunity for nurses to view themselves
from a different angle, one that they may have over-looked beforehand. In turn, this supports the
strength of the nurse’s practice and therefore provides consistency throughout it. Psychiatric
nurses must take it upon themselves to figure out what theories work best for their practice.
However, this is not to say that their decision of what model to use has to be definitive.
Psychiatric nurses must recognize that theories, like themselves are continuously changing and
developing. As nurses grow and become more experienced in their craft their theories must mold
with them. On the other hand, if these theories no longer match the psychiatric nurse’s values
and beliefs they must seek out new theories that do. Traditionally, psychiatric nurses have relied
solely on the biomedical model approach which focuses on the scientific methods of treatment.
Conversely, they do not take into account the variety of differences found amongst individuals.
However, when we focus on a theoretical approach to health care we can implement better
patient care. It is imperative then that different types of models are discussed so that it opens up
dialogue between psychiatric nurses. As we explore the Neuman Systems Model – developed by
Dr. Betty Neuman – we begin to understand the model in terms of how it can be used, where
psychiatric nurses can use it, and what validity, if any, does it hold.
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The Neuman System Model is used as a conceptual framework to guide psychiatric
nursing care. It provides a holistic approach to health care while also being both flexible and
practical in its use. It is a universal and open-based perspective that allows psychiatric nurses to
focus in on an array of health concerns. It is believed that the Neuman Systems Model “has the
necessary characteristics to guide nursing care with particular focus” (Moore & Munro, 1990, p.
293). More specifically, the Neuman Systems Model’s main emphasis is directed on the
patient’s response to environmental stressors. When a patient is exposed to stress their normal
line of defense is triggered in an attempt to maintain homeostasis. However, if the patient is
unable to deal with these stressors their internal structure may crumble. If the patient’s internal
balance is compromised, this then gives illness the opportunity to develop. What factors could
possibly affect a patient’s homeostasis? There are certainly many factors both internally and
externally that can contribute to the disturbance of a patient’s over-all health. However,
psychiatric nurse can use the Neuman Systems Model as a tool to help identify these stressors.
Psychiatric nurses have a responsibility to reduce illness while maintaining patient’s optimal
level of health. It is imperative then that psychiatric nurses implement the Neuman Systems
Model so that they can carry out this obligation. The Neuman Systems Model is also used to
assist psychiatric nurses in the intervention process for patient care. The Neuman Systems Model
uses a primary, secondary and tertiary system to deal with patient care. The primary level of
prevention is used by psychiatric nurses to help them recognize “positive ways to cope with
changes and potential crises” (Moore & Munro, 1990, p. 297). The secondary level of prevention
identifies patient symptoms and offers interventions that are related to their symptoms. The
tertiary level focuses on re-education to prevent future occurrences and maintain patient’s
stability. For example, if a patient is unable to handle a stressor it may cause an internal
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breakdown in their bodies’ first line of defense. Therefore, the patient’s body system would
begin to become extremely unbalanced. It is imperative that, to deal with this situation properly,
the psychiatric nurse must go through each of the three systems. Firstly, with the primary
prevention process, the psychiatric nurse may focus on incorporating relaxation techniques into
their patients care plan. In turn, this would begin to decrease the patient’s over-all stress levels
while restoring their internal balance. Secondly, the psychiatric nurse may use medication to
treat any symptoms that have been caused by the patient’s illness. During the secondary
prevention system the patient is also given the opportunity to voice any concerns they may have.
Lastly, after re-education the psychiatric nurse would re-assess the patients for signs that
homeostasis had been restored. It is important that the patient continues to maintain their support
system to avoid recurrence. It is clear that the Neuman Systems Model can act as an imperative
tool to guide the maintenance and restoration of patient’s health.
The Neuman Systems Model is used by psychiatric nurses in various health care settings.
Due to the model’s flexibility it can be found in community practice, educational institutions and
at numerous clinical capacities. The Neuman Systems Model can be used not only by psychiatric
nurses but by other members found on the medical team. Moreover, this is why the Neuman
Systems Model is found not only in practice, but in teaching in a multitude of places. The
Neuman Systems Model focuses on a patient as a whole which is why it is applicable across
heath care disciplines. The model has the potential for addressing the needs of these disciplines,
which would explain why it is so widely used (Moore & Munro, 1990, p. 298). The model can
also be used to tackle the nursing process when it comes to dealing with patient care. It is used in
the patient’s assessment process and can assist psychiatric nurses in making a diagnosis.
Psychiatric nurses may also use the Neuman Systems Model to identify stressors that affect
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patients. From here, psychiatric nurses can begin to implement care plans for their patient.
Although the Neuman Systems Model is used in numerous health care settings it can also be
used by nursing students. A correlational study was conducted by Eula et al. (2012) that showed
how the Neuman Systems Model can be used amongst nursing students to reduce their stress.
The study looked at 166 baccalaureate nursing students who used the model to empower
themselves which subsequently helped reduce their stress levels. Authors Eula et al. (2012) in
Stress resiliency, psychological empowerment and conflict management styles among
baccalaureate nursing students concluded that the Neuman Systems Model can be used by
educators as a guide to strengthen nursing student’s management of stressors in the workplace
(Pines et al., 2012, p. 1482). Clearly, this proves the versatility of the Neuman Systems Model
and shows how it can be used in various settings.
Over the years, much research has been conducted which proves the validity of the
Neuman Systems Model. It was said to have “proven its validity as a wholistic global perspective
for interdisciplinary health care concerns” (Neuman, 2011, para. 1). The fact that the model is
used throughout many medical institutions proves its importance and usefulness in the medical
community. How can the Neuman Systems Model prove its validity? By implementing the
model into medical research we can therefore test and measure what the researchers intends to
prove and see how the model facilitates this process. In 2003 the Neuman Systems Model
Research Institute (NSMRI) was created specifically to test the Neuman Systems Model theory
(Skalski, DiGerolamo, & Gigliott, 2006, p. 70). The NSMRI identified key concepts and existing
research based on the Neuman Systems Model. Much of the NSMRS focus was on patient’s
response to environmental stressors. Out of all the studies conducted, ‘stressors’ was the
conceptual category most frequently studied within the Neuman Systems Model. On the other
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hand, research has also focused on how the Neuman Systems Model can be applied to practice
which further proves its validity in the workforce. It is the responsibility of psychiatric nurses to
“maintain, regain or attain [a patient’s] stability” (Knight, 1990, p. 450), and the implementation
of the Neuman Systems Theory assists the nurse in carrying out this duty. Furthermore, the
flexibility of the model allows its use in dealing with various types of patients. What this also
does is permit psychiatric nurses to prove – in different ways – the validity of the model. For
example, author Janet Knight in The Betty Neuman Systems Model applied to practice: a client
with multiple sclerosis (1990) investigated the validity of the Neuman Systems Model when
applied to the patient care of those suffering with multiple sclerosis (MS). The model was
applied to a case study of a young women suffering from the disease. The author felt that the
“Betty Neuman Systems Model [was] ideally suited for guided nursing practice” (Knight, 1990,
p. 448). More specifically, the model – because of its versatility – was a perfect fit in relations to
patients suffering from MS. The author goes on to suggest that the Neuman Systems Theory is
“extremely helpful in dealing with various clients’ feelings, attitudes, and belief that may affect
the course of [their] disease” (Knight, 1990, p. 448). Furthermore, it was felt that the model is an
extremely useful framework used to prevent, treat and rehabilitate the patient. Therefore the
Neuman Systems Model should be implemented into the psychiatric nurse’s practice to further
assist in patient care. The author noted that when the Neuman System Theory was implemented
it allowed nurses to understand the various stressors that were affecting the patient and they were
able to formulate interventions. Interventions were made following the primary, secondary and
tertiary levels of prevention. It was concluded by the author that the Neuman System model
“demonstrated to be useful and effective in the implantation of the nursing process” (Knight,
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1990, p. 447). Likewise, it is apparent that the Neuman Systems Theory is a vital tool in patient
care and its validity is continually proven in the application of it.
Nursing theories are used by psychiatric nurses as a framework to deliver quality patient
care. Without the application of nursing theories it would be difficult for psychiatric nurses to
focus their care to mirror their values and beliefs. The Neuman Systems Model provides a
holistic approach to patient intervention. It is used in an array of various health care setting and
has proven to hold its validity in the psychiatric nursing practice.
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References
Knight, J. (1990). The Betty Neuman Systems Model applied to practice: a client with multiple
sclerosis. Journal Of Advanced Nursing, 15(4), 447-455.
http://dx.doi.org/doi:10.1111/1365-2648.ep8530016
Moore, S., & Munro, M. (1990). The Neuman System Model applied to mental health nursing of
older adults. Journal Of Advanced Nursing , 15(3), 293-299.
http://dx.doi.org/doi:10.1111/j.1365-2648.1990.tb01816.x
Neuman, B. (2011). Neuman systems model. Retrieved from
http://www.neumansystemsmodel.org/
Pines, E., Rauschhuber, M., Jones, M., Norgan, G., Cook, J., Canchola, L., & Richardson, C.
(2012). Stress resiliency, psychological empowerment and conflict management styles
among baccalaureate nursing students. Journal Of Advanced Nursing, 68(7), 1482-1493.
http://dx.doi.org/doi:10.1111/j.1365-2648.2011.05875.x
Skalski, C., DiGerolamo, L., & Gigliott, E. (2006). Stressors in five client populations: Neuman
systems model-based literature review. Journal Of Advanced Nursing, 56(1), 69-78.
http://dx.doi.org/doi:10.1111/j.1365-2648.2006.03981.x