Conservation Model

Conservation Model
✓ First child of three siblings
✓ Her father's gastrointestinal illness contributed to her
interest in nursing

✓ Cook county School of Nursing- diploma in nursing 1944

✓ Bachelor of Science in Nursing from University of
Chicago 1949
✓ Masters in Nursing from Wayne State University in
Detroit 1962
✓ Introduction to Clinical Nursing 1969
✓ Renewal for Nursing 1971
✓ Levine's conservation model : a framework for nursing
practice 1991

✓ First recipient of the Elizabeth Russel Belford Award for

excellence in teaching Sigma Theta Tau in 1977
✓ Introduction to Clinical Nursing received an American
Journal of Nursing Book of the Year award
Levine’s Conservation Model is based on
three major concepts and assumptions:

1. Conservation
2. Adaptation
3. Wholeness

Promoting adaptation and maintaining

wholeness using the principles of
conservation
✓ Is about achieving a balance of energy supply and
demand that is within the unique biological realities of
the individual.
✓ Through conservation, individuals are able to confront
obstacles, adapt accordingly, and maintain their
uniqueness.
✓ The goal of conservation is health and the strength to
confront disability
✓ The primary focus of conservation is keeping together of
the wholeness of the individual
 Conservation of energy

Conservation of structural integrity

Conservation of personal integrity

Conservation of social integrity

✓ Individuals choose the most economical, frugal, energy-sparing options available

to safeguard their integrity.
✓ On the whole, conservation is about achieving a balance of energy supply and
demand that is within the unique biological realities of the individual.
— Refers to balancing energy input
and output to avoid excessive
fatigue. It includes adequate
rest, nutrition, and exercise.

Regular pattern of exercise

Maintenance of adequate nutrition

Availability of adequate rest and sleep

 EXAMPLES
Provide range of motion (ROM) exercise to a bedridden
patient to prevent deformities

Turn the unconscious patient at regular intervals to prevent

pressure sores

Change of diaper and good perianal care for an infant to

prevent perianal rashes.

✓ Refers to maintaining Maintenance of patient’s personal hygiene to prevent

or restoring the infection.
structure of the body
preventing physical
breakdown and
promoting healing.
— Recognizes the individual as one who strives for recognition,
respect, self awareness, selfhood and self determination.

Recognizes and protect patient’s privacy and space needs

Assisting the patient to maintain good body image after breast surgery

Providing the patient adequate information about procedures to be done to him

 An individual is recognized as one who has
family and friends, community, workplace and
school, religion, personal choices, political
system, cultural and ethnic heritage and a nation.

Helping the individual to preserve his or her place in a

family, community and society

Allowing visits from family members in times of

hospitalization
✓ Is whereby individuals retain their integrity within the realities of
their environment
✓ Change is the life process, and adaptation is the method of change.
✓ Every individual possesses a range of adaptive responses that is
unique to that individual. These ranges may vary as one ages or is
challenged by illness.

Chronic low blood level of oxygen in patients with anemia will

stimulate the kidneys to secrete erythropoietin. And in turn
erythropoietin stimulates the bone marrow to produce more red blood
cells (polycythemia). This is the body’s attempt to improve the
oxygen-carrying capacity of the blood.
✓ Is whereby individuals retain their integrity within the realities of
their environment
✓ Change is the life process, and adaptation is the method of change.
✓ Every individual possesses a range of adaptive responses that is
unique to that individual. These ranges may vary as one ages or is
challenged by illness.

During cold climate, there is decreased fluid loss via the skin
because of decreased respiration. The kidneys will help the body
maintain fluid balance by producing more urine. So, the person
urinates more.
✓ Is achieved through the “frugal, economic, contained, and
controlled use of environmental resources by the individual in
his or her best interest
✓ Exists when the interactions or constant adaptations
to the environment permit the assurance of integrity.
✓ Levine stated that “the unceasing interaction of the
individua organism with its environment does
represent an “open field” system, and a condition of
health, wholeness, exists when there is interaction or
constant adaptations to the environment and
integrity. In all dimensions of life.
1. You are a labor and delivery nurse working for a local hospital.
You are caring for a teenager who is about to deliver her first child.
In the room are her boyfriend, her mother, and her best friend. She
is quiet and is not making eye contact with care staff, and her
family members are watching television. You sit down next to the
bed and ask the patient if there is anything she needs and she
replies “no” but your gut instinct tells you there’s more to the
picture. Your assessment skills tell you there is a great potential
here for problems.
1. You ask the patient how she feels about becoming a mother. She
tells you she is scared. In further conversation, she tells you she is
not planning to go back to school because she is embarrassed and
afraid of social rejection. She did not take any birthing classes or
childcare education. She is afraid of pain during active labor, and
has questions about pain control options. She says her mother and
her boyfriend have been supportive, but also voices concern about
taking care of her mother, who has a physical disability.
 Assessing the situation

Is this patient demonstrating wholeness?

Is this patient demonstrating adaptation?

Is this patient demonstrating conservation?

✓ This patient has issues, right? Let’s look at the pieces here.
Levine states we have to look at all of the little pieces to see the
whole person. In order to understand our patient, we have to
assess her lifestyle, social integration, spirituality, self- image,
family dynamic, environment, cultural identity, and anything
else she feels may contribute to her identity. We get a few hints
of that in our initial conversation.

PROMOTING WHOLENESS:
✓ Talk with your patient about what roles for her are
important, discuss what parts of her identity have been
fragmented. What is she proud of? What is she missing?
What are her goals?
✓ How well is your patient adapting? Before you say “poorly” look at what
you can build on. Adaptation is not a “pass or fail” but can vary in degree.
Consider environment, organismic response, and trophicognosis in your
response. This is a new situation for your patient. How is she relating this
to past experiences? What does she perceive as a challenge? What does
she not perceive as a challenge or a goal?
PROMOTING ADAPTATION:
✓ Although your patient has not been to prenatal education and has
dropped out of school, she has spent time gathering baby supplies
and has stopped hanging out with unsupportive friends. Build on this.
Encourage her and tell her about other community resources
available to her. Help her explore all of her options and consider her
preferences.
✓ Levine describes conservation as “… the way complex systems are able
to continue to function even when severely challenged” (1990). Is your
patient conserving energy? Is she conserving structural (physical)
integrity? Is she conserving her personal integrity? Is she preserving
social integrity? How could you, as a nurse, promote these principles?
PROMOTING CONSERVATION:
✓ Provide her with pain control options, encourage physical rest.
Encourage her to advocate for her needs and allow her to carry out
her social roles during her hospital stay by involving friends and
family there to support her, if that is what she desires.
Person

Environment

Health & Disease

Nursing
— is a holistic being who constantly
strives to preserve wholeness
and integrity and one “who is
sentient, thinking, future
oriented, and past-aware.” - a
unique individual in unity and
integrity, feeling, believing,
thinking and whole system of
system.
 — Completes the wholeness of the
individual. The individual has
both an internal and external
environment.

Internal Environment
Operational Environment
External Environment
Conceptual Environment
Perceptual Environment
— Are patterns of adaptive change. Health is implied to mean unity and
integrity and “is wholeness and successful adaptation.” The goal of
nursing is to promote health.
✓ It is not only the insult of the injury that is repaired but the person
himself or herself.
✓ It is not merely the healing of an afflicted part. It is rather the return to
selfhood, where the encroachment of the disability can be set aside
entirely, and the individual is free to pursue once more his or her own
interests without constraint.
✓ Disease is unregulated and undisciplined change and must be
stopped or death will ensue.
— Involves engaging in “human interactions”
— The nurse enters into a partnership of human experience where sharing
moments in time--- some trivial, some dramatic--- leaves its mark forever
on each patient. The goal of nursing is to promote adaptation and
maintain wholeness (health).
✓ The goal of nursing is to promote wholeness, realizing that every
individual requires a unique and separate cluster of activities.
✓ The individual’s integrity is his/her abiding concern and it is the
nurse’s responsibility to assist the patient to defend and to seek its
realization.
 The specific adaptive responses make
conservation possible occur on many levels:
Molecular

Physiologic

Emotional

Psychologic

Social

These responses are based on three

✓ discussed the way in factors:
which the person and Historicity
the environment Specificity
become congruent
Redundancy
over time.
✓ refers to the notion that adaptive responses are partially
based on personal and genetic past history. each
individual is made up of combination of personal and
genetic history, and adaptive responses are the result of
both.
✓ refers to the fact that each system that makes up a
human being has unique stimulus-response pathways.
Responses are stimulated by specific stressors and are
task oriented.
✓ responses that are stimulated in multiple pathways tend
to be synchronized and occur in a cascade of
complimentary reactions.
✓ describes the notion that if one system of pathway, is
unable to ensure adaptation, then another pathway may
be able to take over and complete the job.
✓ Levine expressed the view that within the nurse-
patient relationship a patient's state of health is
dependent on the nurse- supported process of
adaptation.
✓ This guides nurses to focus on the influences and
responses of a client to promote wholeness
through the Conservation Principles.
✓ The goal of this model is to accomplish this
through the conservation of energy, structural,
personal and social integrity.
✓ The goal of nursing is to recognize, assist,
promote, and support adaptive processes that
would benefit the patient.