Myra Estrin Levine
50
Audio Transcript Auto-generated
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Hey everyone.
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My name is Troy Car and today's focus will be
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in Meira Estrin.
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Levine's conservation model model, Some background about Meira.
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She was born in 1920 in Chicago Illinois and was
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the oldest of three Children.
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Kind of during her growing up stage became very interested
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in nursing because her father was frequently sick.
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It could be anything too specific other than it was
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something to do with Gi related.
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But he was constantly sick and uh with frequently needing
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nursing care at home.
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And so that kind of inspired her passion and be
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a nurse.
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Um in regards to her mother, she was just kind
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of described as a strong and loving woman and she
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was very supportive Meira in this pursuit to the nursing
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profession. Eventually, Myra went to Cook County School nursing and
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graduated 1944 and follow this up with getting her bachelor's
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degree And nursing from the University of Chicago in 1949.
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During her early nursing career, she worked kind of many
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different professions.
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She which is a private duty nurse.
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I just see when she graduated her nursing programs right
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during World War two.
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So she also worked as a civilian nurse for the
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United States Army.
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She was a surgical nurse supervisor and she also worked
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in the Nursing administration 1962.
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She earned her master's of science and nursing at Wayne
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State University and began teaching at many different institutions.
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Uh 1967.
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She began working her way through the academic ranks at
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Loyola University where during this time she made her first
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publication in 1969 known as an introduction to clinical nursing.
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So some additional influences and foundations to her kind of,
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her model which has presented um like many other theorists
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at the time.
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Or they kind of say that they did not plan
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on developing a nursing theory theory, but strive to find
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for her specifically to find a successful way to educate
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undergraduate nursing students about the major concepts of medical, surgical
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nursing at the time.
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There's only three college quarter.
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So she was trying to cram all that information.
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They need to know the most efficient and effective way
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to teach the undergraduate students.
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And like I mentioned earlier, this desire this what really
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um influence her to make her first publication mentioned earlier,
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the introduction of clinical nursing kind of whatever topics in
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this is focusing on establishing nursing as an implied applied
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science, really focus on organization, holistic holistic approach and bringing
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together practice and research for that nursing as an applied
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science. She also was inspired to enact change of teaching
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from the educational practices which were procedurally oriented and that
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was the norm for the time to a more active
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problem solving approach and a focus on individualized patient care.
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So, she really wanted to be a transition point for
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the nursing at that time.
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So, her conservation model in general.
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Um as you can tell, the conservation is the core
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concept of this model.
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The belief is behind that the individual is in a
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state of conservation and is able to confront change productively
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and within the least amount of effort while preserving optimal
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function and identity.
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The specific adaptive responses making conservation obtainable are based on
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molecular, physiological, emotional and social levels.
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These five levels are further defined Under really fee or
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FAT four key principles that develop her model and then
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under each key principle.
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There's three factors that is the kind of the basis
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of our model and these are uh known as historicity
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specificity and redundancy.
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So going to our four principles us developed for meta
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paradigm. They are the conservation of energy for the individual,
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the conservation of structural integrity, the conservation of personal and
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then as well as the conservation of social integrity for
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the individual regarding the conservation of energy.
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This promotes encouraging rest rest in the patient to allow
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required energy needed for baseline and health functioning.
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So pretty much having a good balance between rest, um
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Rehydrating, eating nutrition um and kind of emphasizing a balanced
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not over exerting too much energy.
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I should mention too much of a good thing.
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Can be a bad thing.
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Example is um working too hard, straining too much and
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I have enough energy for appropriate recovery.
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Say after an injury regarding the conservation of the structural
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integrity of the individual.
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This refers to um promoting healing with doing as little
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damage or scarring to the patient.
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The idea of this is restoring the body structure.
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Examples are doing things like active range of motion or
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operations. Personal hygiene regarding personal integrity and the conservation of
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it. This is encouraging the patient to retain their sense
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of self and place in society.
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Example is kind of acknowledging the patient's needs and recognition
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finally, for the social integrity of the individual is preserving
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old and creating new connections if needed between patients.
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Social entities outside of yourself, for example, would be basically
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the patient returning from their illness or injury um to
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return to their normal function in the community or the
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family. So following this will be the three sub components
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components that we mentioned earlier.
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This was regarding to historicity.
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It's described as the determining factor of adaptive responses that
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are partially influenced by the person's past history and genetics
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for taking an account for, you know, the importance of
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past medical history, for example, for a patient.
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Um and this relates to nursing care because it explains
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that healthcare workers need to take the consideration of patients
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personal genetic factors when planning for care and hence why
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the importance as uh nurse practitioner for them to do
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a history and physical exam to take a whole history,
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including there's any illnesses or anything like that with the
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patient's family specificity.
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And it's a little different than what we talk about
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two days.
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But in terms of my iras model, this refers to
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the fact that each system, an individual has a unique
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stimulus response pathway.
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Refine further elaborates that responses are stimulated by specific stressors
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and are task oriented.
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For example, a person touching a hot stove will have
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an enlisted pain response, inflammatory response to the injury site
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and emotional response all occurring at the same time.
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The body's adaptive response would consist of a swift withdrawal
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from the hot stove inflammatory response to ultimately heal the
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affected area.
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An emotional response, are remembering not to touch the stove.
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Then the third component is redundancy.
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The basis of this is that one system or pathway.
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If one of those fails, then another pathway may be
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able to override this or take over and complete the
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adaptive response.
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Well, one example if corrective responses diminishing the sensitivity to
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severe allergies through gradual desensitization.
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However, on the detrimental side of redundancy, this is when
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a previously failed responses are established, such as autoimmune conditions
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causing immune system to attack previously healthy tissue.
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So it's finding that um balance within the body.
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Moving on to the next topic.
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Is talking about some of the assumptions of her model.
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Ah you kind of can read through this but really
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the big things are focusing on the patient and patient
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centered care, Really viewing the holistic approach that has become
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such the key thing in the nursing and why so
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many people pursue the nursing route uh talks about how
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humans respond in a singular integrated fashion or that the
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assumption that we do.
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Yeah. Um And then that's really the main key things
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and then talking about how nursing is a unique contributor
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to patient care.
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Um and that really nurses are responsible for recognizing the
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state of altered health.
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And we're now seeing how the patient responds to their
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altered health.
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So that's really the basis that did know um regarding
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my role Levine's model, just kind of want to tie
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it into how it compares to the christian Worldview.
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Uh So her model, like some of the readings we've
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already read for the first week of class, that's maintaining
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that personal and social integrity for the patient.
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Uh and really listening to the patient and working with
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the patient to just discover a community plan of care.
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Like the christian Worldview.
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It does focus on the empirical science, um evidence based
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practice, on promoting health for the patient, and also focus
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on caring for the whole person, not just the biological
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or the pathological issue going on.
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Um And that's just I think that's a pretty good
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way too tight and how it compares to the christian
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Worldview. Um next for her now, she's actually won many
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awards because of her progress and everything she's done.
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So she won the Charter Fellow of American Academy of
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Nursing in 1973, She's an honorary member, a member of
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the American Mental Health Aid to Israel 1976.
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She was even elected fellow of the Institute of Medicine
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of Chicago, and from 1987 to 1991, uh remembering in
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Chicago, that's where she spent a lot of her nursing
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education. Um And that's where also where she was born,
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she was the first recipient of the Elizabeth Russell Belford,
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a word for the excellence in teaching from sigma theta
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tau in 17 1977.
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And finally her introduction of clinical nursing, her first publication
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received the american Journal of Nursing Book of the Year
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award. So quite successful career.
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Um where everything she's done, so kind of why I
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chose my ira Levine.
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Um because it's constantly conservation model really exemplifies the nursing
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model of focusing on both evidence based practice and nursing
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and using as an implied science and also integrating the
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holistic and patients that an approach.
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I think that's probably why a lot of us got
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into nursing.
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I know that's why I really enjoy as you have
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that both sides of the aspect you're treating the whole
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patient. And I really like her four principles, they really
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and at the end of day to me, I take
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it as it focuses on balance too much of a
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good thing is a bad thing.
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For example, too much potassium could have cardiac arrest, things
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like that.
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Or not enough of a good thing is also a
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bad thing, but she really focuses on finding that perfect
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balance for the patient working for the patient.
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Um Let's see, she also talks about kind of which
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I like that shared decision making, you know, as we
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have a lot of experience in our rotations if a
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patient if they have to come with a great plan
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for a patient but they don't have the means to
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fulfill the plan such as financials to pay for the
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medication. And that plan is not a good plan.
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So kind of focusing on being that listening ear for
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the patient, listening, see what they need and how you
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can best fit that need to work for a plan
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that fits for the patients kind of individualized patient centered
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plan which I really like that focus.
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And another reason chose our model.
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As I mentioned, there is a balance, I think that's
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just a good thing to really focusing on finding, playing
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with that fine line and then basically in summary, you
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know, she believes in the nurse patient leadership to improve
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patient centered outcomes.
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Um She really thinks that each patient can achieve their
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own unique optimal state of health through balance and conservation.
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That works best for the patient treating the whole patient.
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And then the goal for nursing care is to recognize
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that patients need to benefit that patient, you know to
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assist, promote and support the adaptive process to encourage health
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and returning back to their baseline function or improving.
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So is that a little case study at the end
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to try to tie into one for four key principles.
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So every now and then I'll post it to the
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LP this seven year old male patient who recently had
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a left knee replacement for significant osteoarthritis that's causing him
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pain and difficulty amputating since that surgery two days ago.
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The picture I've been working with physical therapy and has
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only been slowly progressing.
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He has moderate additional pain but feel steady on his
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feet, however, is concerned with the slow progress.
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I was hoping to watch his grandkids in the next
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two weeks.
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Unfortunately not sure if you'll be able to do that
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because of the surgery.
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So, my focus is, you know, you don't have to
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answer to many things to think about is how each
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one of the four key principles of my religion is
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conservation model could be tied into this case study.
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Yeah. And then finally, I have my references in case
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you want to look anything up.
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All right, thank you.