Myra Estrin Levine

The Conservation Model

Nursing’s role in conservation is to help the person with the process of “keeping together” the total
person through the least expense of effort. Levine (1989) proposed the following four principles of
conservation:

The conservation of energy of the individual

The conservation of the structural integrity of the individual.

The conservation of the personal integrity of the individual.

The conservation of the social integrity of the individual.

“The conservation principles do not, of course, operate singly and in isolation from each other. They are
joined within the individual as a cascade of life events, churning and changing as the environmental
challenge is confronted and resolved in each individual’s unique way. The nurse as caregiver becomes
part of that environment, bringing to every nursing opportunity his or her own cascading repertoire of
skill, knowledge, and compassion. It is shared enterprise and each participant is rewarded.” (Levine,
1989)

Major Concepts

Environment includes both the internal and external environment.

Three Aspects of Environment Drawn upon Bates’ (1967) Classification:

The operational environment consists of the undetected natural forces and that impinge on the
individual.

The perceptual environment consists of information that is recorded by the sensory organs.

The conceptual environment is influenced by language, culture, ideas, and cognition.

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.

Nursing is the human interaction relying on communication, rooted in the organic dependency of the
individual human being in his relationships with other human beings.

Adaptation is the process of change and integration of the organism in which the individual retains
integrity or wholeness. It is possible to have degrees of adaptation.

Conservation includes joining together and is the product of adaptation including nursing intervention
and patient participation to maintain a safe balance.

Personal integrity is the person’s sense of identity and self-definition. Nursing intervention is based on
the conservation of the individual’s personal integrity.

Social integrity is life’s meaning gained through interactions with others. Nurses intervene to maintain
relationships.

Structural integrity: Healing is the process of restoring structural integrity through nursing interventions
that promote healing and maintain structural integrity.

Subconcepts

Three Concepts of Adaptation

(a) Historicity

Adaptation is a historical process, responses are based on past experiences, both personal and genetic
(b) Specificity

Adaptation is also specific. Each system has very specific responses. The physiologic responses that
“defend oxygen supply to the brain are distinct from those that maintain the appropriate blood glucose
levels.” (Levine, 1989)

(c) Redundancy

Although the changes that occur are sequential, they should not be viewed as linear. Rather, Levine
describes them as occurring in “cascades” in which there is an interacting and evolving effect in which
one sequence is not yet completed when the next begins.

Energy conservation

Nursing interventions based on the conservation of the patient’s energy.

Holism

The singular, yet integrated response of the individual to forces in the environment.

Homeostasis

Stable state normal alterations in physiologic parameters in response to environmental changes; an

energy sparing state, a state of conservation.

Modes of communication
The many ways in which information, needs, and feelings are transmitted among the patient, family,
nurses, and other health care workers.

Therapeutic interventions

Interventions that influence adaptation in a favorable way, enhancing the adaptive responses available to
the person.

Assumptions

Assumptions About Individuals

Each individual “is an active participant in interactions with the environment… constantly seeking
information from it.” (Levine, 1969)

The individual “is a sentient being and the ability to interact with the environment seems ineluctably tied
to his sensory organs.”

“Change is the essence of life and it is unceasing as long as life goes on. Change is characteristic of life.”
(Levine, 1973)

Assumptions About Nursing

“Ultimately the decisions for nursing intervention must be based on the unique behavior of the
individual patient.”

“Patient centered nursing care means individualized nursing care. It is predicated on the reality of
common experience: every man is a unique individual, and as such he requires a unique constellation of
skills, techniques and ideas designed specifically for him.” (Levine, 1973)
Relationships

1. 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 is the basis for nursing interventions to limit the amount of tissue
involvement.

3. 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 is based on nursing interventions to preserve the client’s interactions
with family and the social system to which they belong.

5. All nursing interventions are based on careful and continued observation over time.

Strengths/Weaknesses

The four principles of conservation were briefly stated.

Strengths:

Levine has interrelated the concepts of adaptation, conservation and integrity in a way that provides a
nursing view different from that of the adjunctive disciplines with which nursing shares these concepts.

Levine’s work is logical. One thought or idea flows from the previous one and into the next.

Weakness:
There are many concepts with comparatively unspecified relationships and unstated assumptions.

Analysis

Although there are many concepts similar to that of other nursing theories, Levine’s concept of energy
conservation makes it unique in guiding nursing actions.

Borrowed concepts from Bates regarding Levine’s view with the environment were not translated into
how it affects the individual. The necessity of connecting incorporated concepts is crucial when trying to
develop a model for nursing so as to be applied to human care.

The concept of conservation, adaptation and integrity can be applied to any age group since every
individual has the need to expend and reserve bodily energy.

The operational definition of homeostasis by Levine is in question since to achieve homeostasis, energy
is continuously being used by the body thus her statement that homeostasis is an energy sparing state is
quite vague in nature. Rewording might be helpful in this part of her model.