Welcome to the Nursing Theories blog! This part of the blog introduces you to the theory of the Four Conservation Principles of Nursing. The full version of this theory was formulated by Myra Estrin Levine in 1973, and continues to influence nursing practice, education, and research until today.

This part of the blog will briefly introduce the theorist and her background in order to understand her thought processes in developing the theory. Next, the theory, its characteristics, and its concepts will be presented, along with its strengths and limitations. The paradigm will then be presented in a series of diagrams, followed by a discussion of the theory’s application in nursing practice, education, and research. Finally, a registered nurse will share his experience in using Levine’s theory in his nursing practice.

We hope that you will find this helpful, and we eagerly wait for your comments!

July 06, 2011

The Link (Experience & References)


Personal Experience
by Magtalas,JP

I have cared for a 21 year old female patient diagnosed to have dengue hemorrhagic fever stage II when I was an ER nurse in a tertiary hospital. The patient was acutely ill and presented with signs of high grade fever, (+) tourniquet test, and epigastric pain. The relative of the patient verbalized that the patient had on and off fever for five days, and no previous consultation was made. The patient sought consultation due to persistent fever, epigastric pain, and passage of black stool. Diagnostic testing was done that revealed low platelet count and low hematocrit count that further supported the admission diagnosis. The physician informed the patient and her relatives about the current health condition of the patient. Admission was advised. Being a nurse advocate, I supported the physician’s order on diagnostic and treatment regimen such as intravenous fluid and electrolytes replacement and prescribed diet which was full diet with no dark-colored foods. I explained the procedure and prescribed treatment regimen to patient and her relatives including the need for bed rest, adequate rehydration, loosening and removing extra clothing, and importance of hematocrit and absolute platelet count monitoring. With this thorough explanation, the patient’s anxiety was relieved as manifested by further asking questions to me regarding the management of her case (i.e. if she can drink orange juice, when will the rashes disappear, how long would be the hospitalization, and if she is allowed to take a bath etc.). Rapport was evident. I also provided room choices if she wanted to be in a private room, semi-private room, or service ward. In this sense, I can say that I already applied the conservation of personal integrity. I carried out the above interventions (i.e. intravenous fluid replacement, IV medications, bed rest etc.) after that I transferred the patient using a wheelchair to a semi private room. With that, energy is conserved. The patient asked when the visiting hours were and how many visitors were allowed in the room. By answering that question, conservation of social integrity was evident, since I equated sense of security with support system, just like the motherly role for an infant. Conservation of structural integrity was facilitated through evaluation if the patient’s temperature normalized, if the degree of epigastric pain lessened, and if the color of stool is not black tarry anymore after the interventions were carried out respective of time-frame set by the nurse for the evaluation.





by Molina, I.


As part of the health care unit in one of the military hospital in the Philippines, most of our patients are in active service men of Philippine Air Force. It is our responsibility to provide holistic care to those who are in distress of ill. A 27- year- old male complaining of pain on the surgical site after his hemorrhoidectomy. It is expressed by pain scale of 8 out of 10, resulted in limited physical activities. Pertaining to Conservation of Energy, it applies in assisting the patient such as, supporting in getting up from bed, hot sitz bath, even ambulation and also providing adequate rest and comfort. So if possible I make sure to render complete and proper nursing care in all at a given time to conserve patient’s energy. While Conserving Structural Integrity, thorough assessment on the site and continues hot sitz bath as ordered to help out from discomfort and teaching proper care of the existing wound to prevent complications. Encouragement of verbalization of feelings and giving information is one way to present Conservation of Personality Integrity.  The patient stated “I’m worried with this pain it wakes me at night when the effect of painkiller is gone already”. As a nurse, sitting and listening to the patient’s concern and address it is indeed an intervention of giving importance to them as an individual in need of care. We understand that being confined in the hospital deprives social aspect.  Given the fact that he’s away to friends and family, encourage them to visit the patient during visiting hours. Support system could play an important role in promoting healing process and one of the means in Conserving Social Integrity. Above all, it depicts the totality of an individual. It is essential to conserve the wholeness to meet and satisfy one’s needs.





References

Anonuevo, C.A.,  et. al. (2000).Theoretical Foundations of Nursing. Philippines.UP Open University Office of Academic Support and Instructional Services
Bautista, J.N. (2008). Theoretical Foundation of Nursing: A Beginner's Journey Into Professional Practice .Philippines Educational Publishing House.
Basavanthappa, B. T. (2007). Nursing Theories. New Delhi: Jaypee Brothers
Kozier, B. (2004) "Fundamentals of Nursing 7th edition.
George, Julia B. (2008). Nursing Theories: The Base of Professional Nursing Practice.5th edition.Pearson Education South Asia. Philippines.
George, J.B.(2003).Nursing Theories the Base for Professional Practice.5th Ed. New Jersey: Prentice Hall International Inc.
George, J.B. (1990). Nursing Theories the Base for Professional Nursing Practice, 3rd Ed. New Jersey.Prentice Hall International Inc.
George, J.B.(1980).Nursing  Theories the Base for Professional  Nursing  Practice. New Jersey: Prentice Hall International Inc.
Marriner, A. (1986). Nursing Theorists and Their Works.The CV Mosby Co.
Parker, M.E.(2007).Nursing Theories and Nursing Practice. Philadelphia: F.A. Davis Company.

Parker, M. E. (2001). Nursing Theories and Nursing Practice. Philadelphia, PA: F.A. Davis Company.
Sitzman, K., &Eichelberger, L. W. (2004). Understanding the work of nurse theorists: A creative beginning. Sudbury, Mass: Jones and Bartlett Publishers.
Tomey, A.M. and Alligood, M.R.(2006).Nursing Theorists and their Work. 6th ed. Elsevier Health Sciences.

Udan,Jose.(2004) "Mastering Fundamentals of Nursing."2nd Ed. Philippines.

Journal(s)

Gagner-Tjellesen D, Yurkovich EE, Gragert M. Use of music therapy and other ITNIs in acute care. J PsychosocNursMent Health Serv. 2001 Oct;39(10):26-37.
Leach MJ. Wound management: using Levine's conservation model to guide practice. Ostomy Wound Manage. 2006 Aug;52(8):74-80.
Mefford, L.C. (2004). A Theory of Health Promotion for Preterm Infants Based on Levine's Conservation Model of Nursing.Nursing Science Quarterly, 17(3), 260-266.
Schaefer KM, ShoberPotylycki MJ. Fatigue associated with congestive heart failure: use of Levine's conservation model. J AdvNurs. 1993;18(2):260–268

Online Sources

Current Nursing.(n.d.). Nursing theories: Levine’s four conservation principles.
Retrieved June 28,2011, from http://currentnursing.com/nursing_theory/Levin_four_conservation_principles.htm Scribd.com.(n.d.).Nursing Theories.Retrieved June 28,2011, fromhttp://www.scribd.com/doc/9693090






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