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OVERVIEW The Neuman systems model, first published in 1972, is a complete guide in nursing practice, research, education, and administration. The model has the potential to unite health related theories through the examination of the relationship between a nursing intervention and patient response to stressors. Since 1970, Neuman’s model has been through many changes, and today this model is comprehensive, flexible, wholistic, and a systems-based guide that focuses on potential environmental stressors. Neuman’s model uses primary, secondary and tertiary nursing prevention interventions designed for retention, attainment, and maintenance of optimal client wellness. This model has evolved to approach the process in a wholistic way that includes the person, environment, health and nursing. The open structure of the model provides nursing a unifying focus. This model expands the perspective of the nurse by considering the five variables that allow a person to be approached in a wholistic manner: physiological, psychological, socio-cultural, developmental and spiritual. Neuman’s perception of nursing includes :
 * Nursing Diagnosis: obtained by assessment and consists of the five stressor variables.
 * Nursing Goals: negotiated with the patient and includes the perceptions of both the nurse and patient.
 * Nursing Outcomes: achieved by primary, secondary, and tertiary interventions, as well as five variables.

HEALTH Neuman’s systems model nursing process was designed specifically for implementation into clinical practice, predicated upon diagnosis and assessment, goals of clients and nurses, and outcomes. The perception of health is defined as the condition or degree of system stability and is viewed as a continuum from wellness to illness. When system needs are met, optimal wellness exists. When requirements are not satisfied, illness exists. When the energy needed to support life is not available, death occurs. The nurse focuses his or her practice on promoting system stability through attainment, retention, and maintenance of optimal wellness and wholeness. If nurses are to keep a system stable, they must create a connection between the client, the environment, health, and nursing. Nursing interventions are aimed at helping the system adapt or adjust and to retain, restore, or maintain some degree of stability between and among the client system variables and environmental stressors with a focus on conserving energy.

NURSING The nucleus of nursing is the patient, the nurse helps the patient attain optimal wellness. Proper planning of outcomes involves negotiation between the caregiver and the client or recipient. Neuman’s goals for nursing are based on the synthesis of a comprehensive database about the client and the theory appropriate to the client’s and caregiver’s perceptions and possibilities for functional competence in the environment (Whetsell et al., 2015). This system guides nursing practice through broad perspective, research, education, and administration. Wellness is attributed to setting goals and identifying prevention.

The Model Supports:
 * The use of clinical tools that are practical and that guide holistic assessment and prevention for individuals, families, communities, and organizations.
 * Practice includes actual and potential reactions to stressors.
 * Practice takes place in any healthcare setting.
 * Persons, families, communities who face stressors.
 * Diagnosis, goals, and outcomes.
 * Focus on the client system
 * Primary, Secondary, and Tertiary prevention interventions need to be delivered.
 * GOAL = optimal client health and stability.

Patient Each person is a unique individual that is composed of various characteristics and factors. According to the 2013 article in Essays, it mentions how Neuman viewed the human as an open system and the open system is comprised of the individual, family, and community. A human being is described as a layered, multidimensional being that interacts with other individuals as well as the surrounding environment forces and stressors. The human is continuously changing and evolving as time progresses. The human either is moving towards a state of stability or towards a state of illness. There are five layers to the human being: Physiological, psychological, socio-cultural, spiritual and developmental. The physiological layer refers to the functionality of the human's body. The psychological layer refers to the mental processes that occur within the human brain and any emotions or thoughts that may come up. The social-cultural layer refers to the spiritual needs and beliefs of a person. The developmental layer relates to the human evolvement and maturation over their lifespan.

Environment The environment is described as the surrounding area in which the patient is exposed to at any given time; it encircles the person. The environment can be broken down into two parts: internal environment and external environment. The internal environment exists within the person, and the external environment exists outside of the person. The environment can include but are not limited to the arrangement of the bed, the lighting in the room, the color of paint on the walls, decoration of the rooms and halls, cleanliness of the surrounding, and the temperature.

Figure 1. The Neuman Systems Model conceptual framework. Copyright 1970 by Betty Neuman. Reprinted with permission.

Betty Neuman established and published her model, helping to define nursing, describe beliefs, and provide a framework for practice, research, and education. The NSM is a comprehensive, dynamic, and multidimensional with individuals, groups, and communities in constant interaction with environmental stressors. The NSM basic structure consists of factors common to all individuals such as genetic features, strengths, and weaknesses of the system parts, ability to maintain body temperature, and respond to stimuli, and the five client variables. The NSM is a nursing conceptual framework that focuses on the wellness of the patient related to environmental stress and reaction to stress. The NSM serves as a theoretical framework based on thinking perspective, as well as on a methodical approach to investigate nursing problems. Applying the NSM can help nurses to bridge theory and practice by organizing their practice and assisting the client in the maintenance of homeostasis among all five variables. This wellness-oriented model provides the nurse with a comprehensive and holistic system and is flexible enough to promote individual interpretation and explore nursing goals and interventions.

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