The Neuman Systems Model applies a comprehensive and holistic approach to the care of patients based on the five variables. According to Parker and Smith (2010), the Neuman System Model is described as, “wellness orientation, client perception and motivation, and a dynamic systems perspective of energy and variable interaction with the environment to mitigate possible harm from internal and external stressors” (p. 183). The patient/ family are the client system and interrelate with the five variables namely; the physiological, psychological, sociocultural, developmental, and spiritual beliefs. The Neuman System Model has been used in diverse settings such as, in critical nursing, psychiatric nursing, gerontological nursing, and for teaching purposes. In the United States, “the model is used to guide practice with clients with acute and chronic health problems” (Parker & Smith, 2010, p. 192).
As further explained by Parker and Smith (2010), the client system is the core: a person, individual, or community and the core interact with the flexible lines of defense, the normal lines of defense, and the lines of resistance. The client system is constantly affected by internal and external stressors. The goal of nurses in applying the Neuman System Model is, “to maximizing the quality of life lived, maintaining the highest level of independence possible, and preventing exacerbations of the on-going illness” (Ebersole, Hess, Touhy, Jett, and Luggen, 2008, p. 258).
Mrs. J is a 79-year-old African-American female client, who lives with her husband in a wheelchair accessible home. She has always been a home maker, enjoys cooking the family meals, and raising the grandchildren. Mrs. J is a mother of three children with great family support and loves the outdoors. She has multiple medical conditions: adult onset diabetes, moderate obesity, indigestion, hypertension, chronic heart failure, depression, and currently, still smoking. She uses the wheelchair frequently due to painful swollen knee. She also has a walker to aid with ambulation. She has lost about 20 pounds in the last three months. Her husband’s health is declining, but her children and family members are very supportive. She takes a lot of medication and uses inhalers. She has the government medical health insurance and social security income. She used to go to church, and was an active member until her worsening respiratory status. Some church members do visit occasionally.
She was able to accomplish most of her tasks and activities of daily living until she was admitted to the Medical Intensive Care Unit with Chronic Obstructive Pulmonary Disease (COPD) exacerbation. During the course of this admission, she has developed new onset of confusion, oxygen dependency, and fatigue. Mrs. J has recovered significantly; her vital signs are within normal ranges; her mental status and respiratory has improved, and overall assessment indicates that Mrs. J is ready for discharge home. ...