a neuman approach -

7/27/2019 A Neuman Approach -

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A Neuman Approach

Kaitlyn Kelley

3102Introduction to Nursing Science


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A Neuman Approach

Betty Neumans nursing approach focuses on the person as a system. This system

focused nursing is based on the idea that a person is a combination of intrapersonal

characteristics as well as external forces. The person is a combination of psychological,

physiological, sociocultural, developmental and spiritual components (Pearson, 2005). A

person has lines of defense that are specific to each individual. These include ones immune

system, coping mechanisms, immunization, environment, and amount of rest at a given moment.

A person has stressors that influence the individuals equilibrium and people are forced to adapt

when they put tension on the system. Therefore a person is not only made of themselves, but

also their reaction to their environment. Environmental stressors can be intrapersonal,

interpersonal, and extrapersonal (Peason, 2005).

Neuman defines health as a position on a scale between order and disorder and it reflects

a systems stability (Pearson, 2005). Because of this, it is the responsibility of the nurse to assist

a patient to be able to cope with the stressors that occur in their lives. When caring for a patient,

it is important to understand that the stressor can be a result of something outside of the

individual. For this reason, it is important not to limit the patient to the individual and to open

the care to the family and community. This opens care to increase coping strategies and altering

ones interaction with harmful stressors of the environment such as wearing sunscreen when

going outside. When providing nursing care, a person who ascribes to Neumans theory would

focus a patients assessment on how they react to things and the affects that are evident in the

body as a result. The interventions focus on creating stability of their system by reducing or

stopping the interaction with the stressor through education and illness prevention. They also

focus on reconstitution of the system by teaching adaptation and management. Finally, the nurse


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encourages strengthening of the system through education to prevent the recurrence of the

reaction. A nurse is part of a larger health care team that is needed when a patient can no longer

cope with their environment and needs assistance. The role of a nurse is to bring stability to the

person as a whole (Pearson, 2005).

I worked in a pediatric clinic in which the care was centered not only on the child, but

also the family because of the influence of the parents and health conditions surrounding the

child. The clinic had a diverse patient base; only ten percent of the families spoke English well.

Due to a diverse office staff, the clinic is prepared to provide care to people who speak Spanish,

English, Polish, French, Mandarin, and Vietnamese. When faced with a situation of an

international clinic, Neuman would focus on decreasing stressors that would inhibit ones ability

to obtain and maintain their health. The language barrier not only interferes with building a

relationship with a patient; but also, it can impede a patient from fully expressing their symptoms

and concerns. By increasing the communication between nurses and patient, it allows for

individualized care that help a person reach their optimal health. Language barriers can increase

stress. A nurse would also want to educate themselves on the traditions of the patients culture

so that they can teach and encourage the traditions that form a positive line of defense for their

system. In thepediatricians clinic, we educated the patient and families on the importance of

wearing seat belts, washing hands, and other protective measures to maintain ones equilibrium.

The immunizations that we provided for the children protected them from future stressors and

strengthened the lines of defense that add protection to the open system of a person. The

medications that the doctor prescribed aided in helping to reconstitute a persons defenses after a

negative interaction with a stressors and restore ones adaptation to threats.


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I had a conversation with a nurse who accepted the opportunity to go above the Arctic

Circle in northern Canada for a few years and work as a nurse for a native tribe. For four years,

she was responsible for the health of this tribe by herself. She had to be aware of the practices

and daily living of the culture because this directly influences their view of health. She

implemented nursing efforts that were directed by viewing a patient as an open system.

Integrating the native health beliefs, she presented community health education in order to

promote health and respect the culture. Her ability to respect and incorporate the native traditions

was imperative because it allowed the people to adhere to her advice and teachings. The natives

in turn respected her teaching and could follow treatment plans because it did not interfere with

their traditions and beliefs. The support structures for the natives were extremely important to

them and helped to define who the individual is. Also, the environment often played a large role

in effecting the open system of a person by providing environmental stressors that affected their

health, accessibility to medicine, and in some cases, availability of nutritional requirements. It

was important for the nurse to follow Neumans example by considering the environment and

its affect on her patients when providing nursing care.

By applying Neumans model to nursing, it focuses on the person as a product of many

factors; both internal and external stressors and defenses. When I worked in the clinic, I was

more focused on the treatment and the diseases forward progression; however, it is equally

important to discover the reason for the bodys decrease defense that lead to the presenting

illness. Perhaps then education on the process that an illness occurred could be used to prevent it

in the future or prevent it from being spread to another person in their system. According to

Neuman, the act of adapting to new conditions and accepting the locals as a new support system

is an important part of preventing mal-adaptation to stressors. As a nurse there are many


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proactive things one can do to promote good communication, identify systems that a patient is a

part of, and increase apatients ability to defend against stressors. Adhering to these actions

supports Neumans theory of nursing practice and increases a nurses effectiveness and care to

the person as a system.


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References

Pearson, A., Vaughan, B., & FitzGerald, M. (2005).Nursing models for practice (3rd ed.,

pp. 143-149). Philadelphia, PA: Butterworth Heinemann.

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