Think back to the last time someone close to you became sick. Using Myra Estrin Levine’s conservation model: what would have been the focus of your assessment? How did the illness affect you and the rest of your family? Levine’s Conservation Model is focused in promoting adaptation and maintaining wholeness using the principles of conservation. The model guides the nurse to focus on the influences and responses at the organismic level. The nurse accomplishes the goals of the model through the conservation of energy, structure, and personal and social integrity (Levine, 1967).
Although conservation is fundamental to the outcomes expected when the model is used, Levine also discussed two other important concepts critical to the use of her model – adaptation and wholeness. (http://nursingtheories. blogspot. com, retrieved April 16, 2012) Now recalling the recent hospitalization of patient RG (my girlfriend) due to vaso-vagal syncope, I unknowingly applied all of the four conservation principles, as well as the major concepts that revolve around the model. A few days prior to admission, patient RG reported to began having episodes of constipation.
Two hours prior to admission, she stated that she woke up due to severe abdominal pain and directly went to the bathroom. A few moments later she was found by her mom on the floor, just regaining her consciousness and with a deep, moderately bleeding, 2-cm laceration on the right cheek bone area. She was rushed to the emergency room and was eventually brought to the OR for repair of facial laceration by a plastic surgeon. I happened to be on duty at that time and, as expected, was the one to attend to her during her stay in the ER.
Standard ER protocols would lead me to primarily assess for changes her level of consciousness (should the origin would be neurological in nature), followed by a brief review of systems – any variation from the normal vital signs would deem significant for a patient who’s chief complaint is loss of consciousness (should the origin would be cardiac in nature). Immediately, the theory of conservation would imply that the patient should temporarily be placed on bed rest while we still determine the possible cause of the problem (conservation of energy). Simultaneously, measures were done to revent infection from and further bleeding of the laceration (conservation of structural integrity). When the bleeding has been controlled and tests and other basic interventions have already been done, I tried on keeping her mind as far away as possible from worrying about the probable effects of the cheek injury and the development of a facial scar with her self-image perception (conservation of personal integrity). Lastly, as I was already on the outgoing shift, I made sure that I stayed with her even after my duty for additional support until she was brought up to the OR (conservation of social integrity).
Once she was out of the OR, it was advised that she still be confined for the next 24 hours for observation and to make sure that the episode of loss of consciousness would not recur again. After being discharged, she was advised by her attending physician to rest for a additional week prior to going back to work. Apparently the facial damage has also exposed her facial nerves which also had to be repaired. In addition, her parotid gland has also been injured, causing facial swelling whenever she eats.
For the next week she had to adapt with the condition and I was there for her helping her adjust with the challenges and though out the whole ordeal. To make matters worse, the injury on her facial nerves caused weakness on her facial muscles leaving her central incisors to become unstable, resulting into even more pain and discomfort when eating and chewing. This caused strain in our relationship as she was highly irritable most of the time. It was as hard for me and for the rest of her family as it was for her as we are all clearly affected by her disability/limitations.
Still, that did not deter us from being all there to support her. In two weeks, the swelling improved and the pain went away. She started eating normally again and the scar on her face became barely noticeable. Without realizing it, I have put into good use Myra Levine’s conservation theory. B. Using Roy’s model of adaptation, what were her adaptive needs in the following modes: physiologic, interdependence, role function, and self-concept In the physiologic mode, adaptation is concerned about the preservation of physical integrity (Fawcett, 1984).
Basic human needs such as oxygenation, nutrition, elimination, activity and rest, protection, and temperature regulation are identified with this mode. In addition, the body’s complex processes in the form of fluid, electrolyte, and acid-base balances as well as the neurologic and endocrine functions are also taken into consideration (Manriquez, 2009). In the interdependence mode, emphasis is on the need for social integrity. Interdependence entails maintaining balance between dependence and independence of an individual’s relationship with others.
Dependent behaviors can be observed as affection-seeking, help-seeking, and attention-seeking. Independent behaviors include mastery of obstacles and initiative taking. Manriquez (2009) describes this as “the need is to achieve relational integrity using the process of affectional adequacy”, i. e. the giving and receiving of love, respect and value through effective relations and communication. In the role function mode, the need for social integrity is also emphasized. When human beings adapt to various role changes that occur throughout a lifetime, they are adapting in this mode.
Knowing who one is, in relation to others, so one can act is the primary essence of this mode. “Role set” is the complex of positions that an individual holds which involve role development, instrumental and expressive behaviors as well as the role-taking process (Manriquez, 2009). In a group setup such as a family, the role can be assessed by observing the communication patterns. The need is role clarity, understanding and committing to fulfill expected tasks so the group can achieve common goals.
For example, when a couple adjusts their lifestyle appropriately following retirement from full-time employment, they are adapting in this mode (Wikipedia retrieved April 24, 2012). In self-concept mode, the need for maintenance of psychic and spiritual integrity is its main function. Perceptions of one’s physical and personal self are included in this mode. (Wikipedia retrieved April 24, 2012). The goal is to exist with a sense of unity, meaning, and purposefulness in the universe (Manriquez, 2009).