Using NANDA, NIC, and NOC With Levine's Conservation Principles in a Nursing Home

Abstract

BACKGROUND In the 1960s, 1970s, and 1980s, several nurses proposed theories to guide professional nursing practice. These theories ranged from conceptual frameworks to grand theories. Nursing diagnoses were introduced during that same time; NIC and NOC were developed in the 1990s. With the emphasis today on standardized language, NANDA, NIC, and NOC are coming to the forefront. It is important, however, that professional nurses remember and use the nursing theories developed by our predecessors. MAIN CONTENT POINTS Myra Levine, one of the early major nursing theorists, proposed the use of four Conservation Principles to guide practice. She believed that nursing activities were conservation activities — a keeping-together function that promotes wholeness in the patient. The four Conservation Principles (with major nursing goals) are ▪ Conservation of Energy: All physiologic and psychological processes that sustain life depend on the body's energy balance (adjusting to life in the nursing home; improving nutritional status, balancing resident activity, controlling resident anxiety and pain). ▪ Conservation of Structural Integrity: All body systems decline with aging. Chronic illness also produces bodily structural changes (maintaining or promoting mobility, preventing injury, preventing infection, maintaining skin integrity). ▪ Conservation of Personal Integrity: Self-identity is intrinsically bound to wholeness and all individuals cherish the sense of self (respecting one's privacy and property; enhancing self-esteem through good personal hygiene, grooming, and dress; fostering independence through choice and rehabilitation; promoting self-identity for those who are cognitively impaired; obtaining advance directives for treatment). ▪ Conservation of Social Integrity: Individual life has meaning only in the context of social life (providing meaningful social activities for residents and staff, considering the family and resident as a unit). Appropriate nursing diagnoses, interventions, and outcomes can be identified for all these nursing problems. CONCLUSIONS Nurses can use standardized nursing languages and a nursing theory simultaneously. One way to do this is to identify the nursing problems that relate to each aspect of a theory, and then select the appropriate nursing diagnoses, interventions, and outcomes. A second method of uniting the two involves identifying a major patient category in the practice setting and then using standardized language.