Betty Neumanns Systems Model
Lisa is a ten-year-old girl who came to the hospital in which I was working as a volunteer during the last summer. She was shy and did not want to disclose the problem that made her come to the hospital. She was brought by her mother, who informed the nurses of what preceded the visit to the facility. Lisa had visible bruises on the arms. Her mother reported that the child had been sexually assaulted by her stepfather, who takes liquor, in the neighboring village. Lisa’s mother separated with her daughter’s biological father when Lisa was four years old because of domestic violence. When Lisa was asked by a female nurse, she explained that she felt some pain in her genitalia and that her stepfather hit her whenever she resisted taking part in sexual intercourse. Her mother came after the culprit had left the home and saw the child crying helplessly in the house. The mother reported having had a hard time in getting the information from her daughter since she had never talked about sexual issues with the child. On further interrogation, Lisa’s mother reported that many children are sexually abused in her village, and most cases go unnoticed.
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The focus of the paper and the theory applicable to the above-mentioned scenario is the Betty Neumanns Systems model that has four paradigms, some concepts, and the model’s nursing process. The paradigms are the human, environment, health, and nursing (Smith and Parker, 2015). The human is multidimensional and layered total individual as a client system (Neuman & Fawcett, 2012). Each layer of the person comprises subsystems. In this case, the subsystems are psychological, which refers both to the emotional and mental processes, and the physiological one. The socio cultural subsystem concerns individuals social and cultural activities and expectations while the developmental one is connected to the processes associated with development (Smith & Parker, 2015). Finally, the influence of spiritual beliefs forms the theorys spiritual subsystem. This guides the nursing practice because nurses can view a person as a whole but not just the sum of parts or systems, yet the person requires optimal functioning of all the systems (Neuman & Fawcett, 2012). Such is the applicability of the theory that humans are systems with various subsystems.
Furthermore, the systems model describes the environment in which all the forces, both internal and external, not only interact but also surround a person at any given moment. According to Neumann, extra personal, interpersonal, and intrapersonal stressors constitute the forces affecting an individuals normal line of defense and the overall stability of the system (Neuman & Fawcett, 2012). The internal environmental component exists within the system of the client while the external component is outside the system. However, the symbolic system of wholeness is the environment that is created and developed unconsciously by the person.
Additionally, Neumann describes the two models of health and nursing. Health refers to wellness, in which all the systems and subsystems are in harmony with the clients whole. The movement of the system towards either disease or death occurs when the required resources exceed the available (Smith and Parker, 2015). Moreover, the client systems movement towards wellness is feasible when the required energy is available. Nursing as a profession concerns variables that affect the patients response to stressors (Neuman & Fawcett, 2012). The nurses role is to focus on an individual as a whole: the concept that gives rise to the theory of holistic perspective. In this model, Neumann defines nursing as all the actions to help people, families as well as groups, so as to sustain maximum levels of wellness (Smith and Parker, 2015). The core aim is the patient-client systems stability through the intervention of the nursing profession to mitigate stressors. Both the nurses and patients perception need to be examined because the former substantially affects the care plan (Bourdeanu & Dee, 2013). Conclusively, the degree of response to current stressors and the application of primary, secondary and tertiary interventions constitute the nurses’ role.
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Furthermore, the concept of prevention as primary intervention is one of the major aspects of the Systems Model. The focus of this theory is on keeping the stressors as well as the patient`s response to them from detrimentally affecting the body (Smith and Parker, 2015). It involves primary prevention before a stressful situation occurs, maintenance and promotion of wellness. In secondary prevention, when the patient has already experienced stress, the aim is to prevent damage (Bourdeanu & Dee, 2013). It entails strengthening of internal lines of defense as well as removing the stressing factors. Finally, tertiary prevention comes after the application of the first two strategies. Other than offering support to the affected patient, tertiary intervention adds the required energy.
This theory can be utilized in the primary prevention of health issues in the society such as sexual abuse. For instance, Ogunfowokan and Fajemilehin (2012) found sexual assault to be a societal stressor among high school girls. Their aim was to identify a strategy to enforce primary prevention measures through the provision of education to the girls. The abuse was a public health issue because it resulted in adverse health or disease’ in the community. Ogunfowokan and Fajemilehin (2012) then adopted a quasi-experimental design, through which they developed a sexual abuse prevention education package and utilized it in educating the girls. The prevention concept of the Newmans Systems model worked well. The girls knowledge on sexual abuse significantly increased, which was accompanied by reduced rates of sexual assault. Therefore, the models concept of prevention is utilizable in enhancing the nursing practice of health promotion and prevention of disease or damage to a community as a patient system.
The Systems Model applies to Lisa’s scenario. The stressor has already occurred and the secondary prevention strategies are relevant. First, it is necessary to alleviate the impacts of sexual abuse to the child by stopping the pain and preventing further damage to her body (system). Regarding the patient (person), the physiological subsystem has been impacted because she experiences pain and theres substantial injury to the tissues. Nurses can view the visible bruises on her arms. Psychosocially, Lisa is shy to talk and interact with both the mother and nurses. Also, her mother has never talked with her about sexual life. Psychologically, she has low self-esteem, which makes her shy. Most importantly, sexual abuse cases need to be prevented using the model since they have become frequent in the community.
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Solutions to Lisa scenario lie in the implementation of prevention strategies. Treating her by alleviating pain will help the patient move towards wellness in the disease health continuum. Also, nurses should provide her with psychological care as well as other medical therapies to heal her condition and restore her status. That notwithstanding, the community should be a target of primary intervention strategies. Children and parents should be taught how to prevent sexual abuse and what to do if such cases occur. Nurses should encourage parents to inform their children that there are no secrets on sexuality and children should feel free to discuss the topic with their parents (American Academy of Pediatrics, 2016). Furthermore, parents should report and bring their abused children to health care workers for care.
In conclusion, the model is useful not only in this particular scenario but in many other nursing situations. For instance, patients with respiratory failure can receive continuous positive airway pressure (CPAP) to restore their respiratory physiological subsystem function as an intervention concept. Stevens et al. (2014) found that CPAP treatment promotes low respiratory morbidity. Also, nurses can use this theory in assessing patients while on duty by trying to find the internal and external stressors that impact health. This theory makes nurses aware of their role when working with their patients since the model has outlined what they should do as professionals. Therefore, the model is applicable in many areas of nursing practice.