The Neuman Systems Model: What It Is And What It Explains About Patients
A nurse is defined as a person whose job is to assist or care for the sick, wounded or injured under the prescriptions of a doctor, or to help the doctor or surgeon to carry out their practices appropriately.
The World Health Organization (WHO) reveals that there are about 28 million nursing professionals around the world. Their ranks have increased by 4.7 million between 2013 and 2018 but, however, the current figure still leaves a deficit of 5.9 million health professionals globally.
Nursing models and theories aim to describe, establish and examine the phenomena that make up the practice of general nursing.. 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 the field of nursing allow the organization of information in logical systems, develop an organized way of studying nursing (and its strengths and shortcomings), discover knowledge gaps in the postulated mechanisms and theories, provide measures to evaluate the degree of care for a patient in a healthcare environment and many other things. Together, they try to apply the discipline of nursing in the most effective and respectful way possible with the sick.
One of these important theories in the field of nursing is the Neuman systems model, proposed by Betty M. Neuman. (1924-present), graduate in Mental Health and Public Health. If you want to know everything about this premise, she continues reading.
Neuman’s systems model is a nursing postulation based on the individual’s relationship with stress, his response to this emotion and the dynamic restorative factors in nature. This model can be divided 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 system of clients) 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 that all this terminology may sound confusing, but stick with us, you will understand it better. The client develops a series of defenses that are used to protect themselves when interacting with the environment, the outermost lines being the flexible ones and the line of defense (normal line) the limit of well-being at a moment of rest. When the most internal lines of defense are broken (lines of resistance), the client/patient feels more or less serious stress, which can become a lethal threat to the entire system.
In other words, we conceive the patient as a survival nucleus 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 tries to keep the client’s system intact, protecting the outermost lines and promoting greater flexibility of the rest. Thus, the patient is prevented from getting worse faster than normal due to the progress of their disease and environmental stress.
As a summary of this theory, We can distinguish several elements that make up the patient when describing the model, from “outside to inside.”. These are the following:
If you prefer, we can see the individual as an onion, which is layered. The most external ones are the casing which, if broken, does not affect the structure. When you delve deeper into them, you will find the normal and resistance lines, until you reach the core, which contains the plant primordium. If the core is destroyed, the entire system falls under its own weight.
There are 11 bases on which Neuman’s systems model rests.. We present some of the ones that we found most interesting:
Based on these premises, In the nursing field, primary prevention is applied to protect the normal line of defense and harden the most “flexible” layers of the system. (flexible defense lines). Secondary prevention focuses on strengthening the lines of resistance, thus reducing the reaction to a stressor and increasing the patient’s tools. Lastly, tertiary prevention tries to readapt and stabilize the patient (return to wellness) while he or she continues treatment.
Besides all this, Neuman’s model places special emphasis on the environment in which the patient is located, as it is essential for maintaining the balance of the system.. There are 3 types of “environments” depending on the model, these being internal, external and created.
The internal environment grows within the patient’s own system. All the interactive 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
All this may sound very ethereal, but we hope it has become clearer to you with the nuanced explanations. At a clinical level, Neuman’s model can help nurses manage potential stressors for patients in the facilities where they work.
This school of thought helps professionals understand the idea of adversity by delineating the limits of the factors that make up a whole, the effects of circumstances and the relationship of a patient with their situation and environment. If the core and lines of the patient are known, it is theoretically possible to act accordingly and ensure that the patient is in a better general condition throughout the process.
You may have already noticed, but this model is not without criticism. According to pharmacological portals, the biggest flaw in this postulation is, without a doubt, lack of clarification of terms. On the other hand, it fails a bit when it comes to differentiating interpersonal and extrapersonal stressors.
Summary
As you have seen, we have moved at all times in abstract terms, between lines, rings and nuclei of well-being. If we want you to leave with a general idea, this is the following: clients or patients are made up of layers, some external and flexible and others internal, more delicate. When a stressor reaches our core, the system fails and our health can be seriously compromised. The nurses’ job is to ensure that this never happens.
For this reason, 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.
