Myra Levine

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Biography
• Born in Chicago, Illinois in 1920, the first child in a family of three siblings. Her father
had a persistent gastrointestinal illness which contributed to her interest in and
devotedness to nursing.
• She graduated from the Cook County School of Nursing in 1944 and obtained her BS in
nursing from the University of Chicago in 1949.
• Worked as a private nurse, as a civilian nurse for the US army, as surgical nursing
supervisor, and in nursing administration. • She was the first recipient of the “Elizabeth
Russel Belford Award”.
• Both the first and second edition of her book received “American Journal of Nursing
Book of the Year Award”.
• Died on March 20,1996.

Major Concept and Definitions

Wholeness/Health/Integrity (holism)
• The word health comes from the Anglo-Saxon word hal. The translation of hal is whole.
Human life must be described in the language of “wholes”.
• Integrity encompasses the wholeness of the individual. Conserving the integrity of the
individual is the hallmark of nursing intervention.
• Healing is the defense of wholeness. Healing is the avenue of return to the daily activities
compromised by ill health. Environment
The environment consists of an internal environment and an external environment.
• The internal includes the physiological and pathophysiological processes.
• The external environment includes having three components:
1. Perceptual: aspects of the world that individuals intercept and interpret with their sense
organs.
2. Operational: environmental components that physically affect individuals, although they
cannot directly perceive them, such as microorganisms.
 3. Conceptual: characterized by cultural patterns, spirituality, and aspects mediated through
the symbols of language, thought and history.

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Adaptation
• Adaptation is the process of change where the individual retains his integrity within the
realities of their environments.
• The measure of effective adaptation is compatibility with life. A poor adaptation may
threaten life itself, but at the same time the degree of adaptive potential available to the
individual may be sufficient to maintain life at a different level of effectiveness.
• Adaptation is not all or none.
• The goal of adaptive change is the conservation of wholeness (health) and integrity.

Conservation
• Conservation is from the Latin word conservation, which means “to keep together”.
• “Describes the way complex systems are able to continue to function even when severely
challenged”.
• Through conservation, individuals are able to confront challenges, adapt accordingly, and
maintain their uniqueness.

Levine’s 4 Conservation Principles 1. Conservation of Energy

• Refers to balancing energy input and output to avoid excessive fatigue. It includes
adequate rest, nutrition, and exercise.
• The individual requires a balance of energy and a constant renewal of energy to
maintain life activities. Conservation of energy is typical of the natural defense
against disease processes.
• Conservation of energy is based on nursing interventions to conserve through a
deliberate decision as to the balance between activity and the person’s available
energy.
 2. Conservation of Structural Integrity
• Refers to maintaining or restoring the structure of body preventing physical
breakdown and promoting healing.
• Structure and function are strongly interrelated complementary aspects of human
organism. Therefore, nursing interventions to ensure adequate energy to support
life processes (function) must be balanced by interventions to conserve the normal
structure of the body.
• Conservation of structural integrity is the basis for nursing interventions to limit
the amount of tissue involvement.

3. Conservation of Personal Integrity

• Recognizes the individual as one who strives for recognition, respect,
selfawareness, selfhood, and self-determination.
• Based in a valuing of self-identity, self-worth, and self-respect, also reflecting the
understanding that “the body does not exist separately from the mind, emotions,
and soul”.
• Nursing interventions to conserve integrity include interventions to teach patients,
promote patient participation in decision making and consent to treatment.
• Conservation of personal integrity is based on nursing interventions that permit
the individual to make decisions for himself or participate in the decisions.

4. Conservation of Social Integrity

• Exists when a patient is recognized as someone who resides within a family, a
community, a religious group, an ethnic group, a political system, and a nation.
• Conservation of social integrity is based on nursing interventions to preserve the
client’s interactions with the family and the social system to which they belong.

Nursing Paradigm
Nursing is the human interaction. The nurse enters into a partnership of human experience where
sharing moments leaves its mark forever on each patient. The goal of nursing is to promote
adaptation and maintain wholeness (health).

Person is the unique individual in unity and integrity, feeling, believing, thinking, and whole.

Health is the pattern of adaptive change of the whole being.

Environment includes both the internal and external environment. Three Aspects of
Environment
Drawn upon Bates’ (1967) Classification:
1. The operational environment consists of the undetected natural forces and that impinge
on the individual.
2. The perceptual environment consists of information that is recorded by the sensory
organs.
3. The conceptual environment is influenced by language, culture, ideas, and cognition.