Betty Neuman was born near Lowell, Ohio in 1924. She received a Registered Nurse Diploma from Peoples Hospital School of Nursing in Akron, Ohio in 1947. She moved to California, where she gained experience as a staff, head nurse, school nurse, industrial nurse, clinical instructor, critical care, and communicable disease nurse. In 1957, Betty attended the University of California at Los Angeles with a double major in psychology and public health.
Betty Newman originally developed the Neuman Systems Model in 1970 at the University of California, Los Angeles. Dr. Neuman developed the model as a way to teach an introductory course to nursing students. The goal of the model was to provide a holistic overview of the socio-cultural, psychological, physiological, and developmental aspects of human beings (Neuman & Young, 1972). This model does not represent a full theory; it is only a model. It is a conceptual framework, a visual representation for thinking about the interactions between nurses and humans. The model views the person as a layered, multidimensional whole that is in constant dynamic interaction with the environment.
The layers represent various levels of defense protecting the core being. The two major components in the model are stress reactions and systemic feedback loops. Clients react to stress with lines of defense and resistance so as to achieve a maximal level of stability. The client is in continuous and dynamic interaction with the environment. The exchanges between the environment and the client are reciprocal. The goal is to achieve optimal system stability and balance. Prevention is the main nursing intervention to achieve this balance. Primary, secondary, and tertiary prevention activities are used to attain, retain, and maintain system balance (Reed, 1993).
Neuman sees nursing as a unique profession that is concerned with all of the variables that influence the response an individual may have to a stressor. The person is seen as a whole, and it is the task of nursing to address the whole person. Neuman defines nursing as actions that assist individuals, families, and groups to maintain a maximum level of wellness, and the primary aim is the stability of the client system, through nursing interventions to reduce stressors. Neuman states that because the nurse’s perception will influence the care given, not only must the client’s perceptions be assessed, but so must those of the caregiver. The role of the nurse is seen in terms of degrees of reaction to stressors, and the use of primary, secondary, and tertiary interventions (Reed, 1993).
The main use of the Neuman Model in practice and in research is that its concentric layers allow for a simple classification of how severe a problem is. For example, since the line of normal defense represents dynamic balance, it represents homeostasis, and thus a lack of stress. If a stress response is perceived by the patient or assessed by the nurse, then there has been an invasion of the normal line of defense and a major contraction of the flexible line of defense. Infection or other invasions of the lines of resistance indicates failure of both lines of defense. The level of insult can be quantified allowing for graduated interventions. Furthermore, each person variable can be prepared and the relationship to the normal line of defense or stress response can be analyzed. The drawback of this is that there is no way to know whether our preparation of the person variables is a good representation of the underlying theoretical structures (Neuman & Young, 1972).
- Neuman, B. & Young, R. (1972). A model for teaching total person approach to patient problems. Nursing Research, 21, 264-269
- Reed, K. (1993). Betty Neuman: The Neuman Systems Model. London: Sage Publication.
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