MYRA ESTRIN LEVINE

(December 20, 1920 - March 20, 1996)

Early life
-Born in Chicago
-- She was a registered nurse, an educator, an innovative thinker.
- best known for her Conservative Model of Nursing, which she first introduced
in 1967
CREDENTIALS, CAREER, AND BACKGROUND OF THE THEORIST
1944- She was a private duty nurse
1945- She was a civilian nurse in the U.S Army
1947-1950 – She became a preclinical instructor in the physical sciences at Cook
County School of Nursing.
1950-1951 – She became a director of nursing at Drexel Home in Chicago
1951-1952 – She became a surgical supervisor at the University of Chicago Clinics
1956-1962 – She became a surgical supervisor t the Henry Ford Hospital in Detroit.
1963-1967 - She chaired the Department of Clinical Nursing at Cook County School
of Nursing
1974-1977 – She coordinated the graduate nursing program in oncology in Rush
University.
1974- She was a director of the Department of Continuing Education at Evanston
Hospital
1987- She became a professor Emerita, Medical Surgical Nursing, at the University
of Illinois at Chicago
1973- Received an honor as charter fellow of the American Academy of Nursing
1976- Became an honorary member of the American Mental Health Aid to Israel.

CONSERVATION MODEL OF NURSING

- This model was developed from her belief that nursing should focus not just
on disease but on how patients can maintain or recover their health by
conserving resources within their body and their environment.
- It emphasizes the conservation of an individual’s resources to promote
healing and health.
- Levine believed that all nursing interventions should aim to conserve a
patient’s energy, structural integrity, personal integrity, and social integrity.
 - These principles align closely with the holistic approach to patient care,
focusing on the whole person rather than just treating symptoms of disease.

MAJOR CONCEPTS AND DEFINITIONS:

Adaptation
- Adaptation is the process by which individuals ‘fit’ the environments in which they live.”

Environment
- Consists of an internal environment (the physiological and pathophysiological
processes) and an external environment; both are in constant interaction.

Organismic Response
- “The human being responds to forces in his environment in a singular yet integrated
fashion . . . in a way which is peculiar to him and to him alone." The term “organismic”
reflects the language of the biology of living organisms, with multiple components
working together to generate a whole, integrated organismic response.

Nursing
- Nursing has a conservative function, seeking to actively support the patient’s adaptive
efforts to achieve the best available environmental fit, thus conserving wholeness and
integrity. Both the nurse and the patient have active roles in this conservation of
wholeness.

Conservation
- “Conservation” is from the Latin word conservatio, which means “to keep together."
Conservation is a natural law that “describes the way complex systems can continue to
function even when severely challenged." Through conservation, individuals can
confront challenges, adapt accordingly, and maintain their uniqueness.

The Four Conservation Principles:

“Nursing principles are fundamental assumptions that provide a unifying structure for
understanding a wide variety of nursing activities." Levine proposed four “conservation
principles” to guide nursing care, which “have as a postulate the unity and integrity of
the individual.”
1. Conservation of Energy
“All of life’s processes are fundamentally dependent upon the production and
expenditure of energy." This fundamental concept of energy balance is drawn from the first law
of thermodynamics (from the adjunctive discipline of physics), which applies to everything in the
universe, including people

2. Conservation of Structural Integrity

Structure and function are strongly interrelated complementary aspects of the 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.

3. Conservation of Personal Integrity

 Conservation of personal integrity is based on a valuing of self-identity, self-worth, and
self-respect, also reflecting the understanding that “the body does not exist separate from the
mind, emotions, and soul.”

4. Conservation of Social Integrity

Social integrity is reflected in dynamic relationships among human beings. Family is a
critical social unit, and the life of each individual is “woven in the fabric" of family, with the
constitution of the social group that is “family” defined by each patient.

USE OF EMPIRICAL EVIDENCE

Levine based much of her work on accepted, well-researched scientific principles. She
believed that specific nursing activities could be deduced from scientific principles.

MAJOR ASSUMPTIONS:

Nursing
Levine viewed nursing as both a profession and a scientific discipline. Nursing practice is
based on nursing’s unique knowledge and the scientific knowledge of other disciplines
adjunctive to nursing knowledge

Person
Described as a holistic being, wholeness is integrity. Integrity means the person has
freedom of choice and movement. The person has a sense of identity and self-worth. Levine
also described the person as a “system of systems, and in its wholeness expresses the
organization of all the contributing parts.”

Health
Health is socially determined by the ability to function in a reasonably normal manner.
Health is not just the absence of pathological conditions. Health is the return to self; individuals
are free and able to pursue their interests within the context of their resources.

Environment
Environment is the context in which individuals live their lives. It is not a passive
backdrop. “The individual actively participates in his environment." “All adaptations represent the
accommodation that is possible between the internal and external environment.”

APPLICATIONS TO THE NURSING COMMUNITY

Practice
Conservation principles and other concepts within the model can be used in numerous
contexts. Levine’s model has been applied to nursing practice with many patient types

Education
Levine wrote her textbook Introduction to Clinical Nursing as an organizational structure
for teaching medical-surgical nursing to beginning students. It introduced new material into the
curricula and presented an early discussion of death and dying.
Research
Many research questions can be generated from Levine’s model. Researchers have
used the conservation principles as a framework to guide research in wide-ranging clinical
situations.

FURTHER DEVELOPMENT
Levine and colleagues developed a nursing diagnosis taxonomy based on conservation
principles. The Conservation Model is gaining global interest, with studies published in various
languages and discussions on its future potential in nursing.

CRITIQUE

Clarity
Levine’s model possesses clarity. Fawcett (2000) states that Levine’s Conservation Model
provides nursing with a logically consistent, holistic view of the person” (p. 189). George (2002)
affirms, “This theory directs nursing actions that lead to favorable outcomes” (p. 237). The
model has numerous terms; however, Levine adequately defines them for clarity.
Simplicity
Although the four conservation principles appear simple initially, they contain
subconcepts and multiple variables. Nevertheless, this model is still one of the simpler ones to
understand.

Generality
The four conservation principles can be used in all nursing contexts.

Accessibility
Levine used deductive logic to develop her model, which has been used to generate
research questions. As she lived her conservation model, she verified the use of inductive
reasoning to further develop and inform her model.

Importance
Levine’s conservation model is recognized as one of the earliest nursing models to
organize and clarify elements of patient care for nursing practice. Furthermore, the model
continues to demonstrate powerful evidence of its utility for nursing practice and research and is
receiving increased recognition in the 21st century.