untitled

defense protects the normal line of defense. The
client has more protection from stressors when the
flexible line expands away from the normal line of
defense. The opposite is true when the flexible line
moves closer to the normal line of defense. The ef-
fectiveness of the buffer system can be reduced by
single or multiple stressors. The flexible line of de-
fense can be rapidly altered over a relatively short
time period. States of emergency, or short-term
conditions, such as loss of sleep, poor nutrition, or
dehydration, are examples of what the client is like
in the temporary state that is represented by the
flexible line of defense (Neuman, 1995). Consider

the latter examples. What are the effects of short-

term loss of sleep, poor nutrition, or dehydration

on a client’s normal state of wellness? Will these sit-

uations increase the possibility for stressor penetra-

tion? The answer is that the possibility for stressor

penetration may be increased. The actual response

depends upon the accordion-like mechanism pre-

viously described, along with the other compo-

nents of the client system.

Normal Line of Defense

The normal line of defense represents what the

client has become over time, or the usual state of

The normal line of defense represents

what the client has become over time,

or the usual state of wellness.

wellness. The nurse should determine the client’s

usual level of wellness in order to recognize a

change in the level of wellness. The normal line of

defense is considered dynamic by Neuman, because

it can expand or contract over time. She demon-

strated this dynamic state by giving an example in

which the usual wellness level or system stability

decreases, remains the same, or improves following

treatment of a stressor reaction. Neuman also con-

siders the normal line of defense dynamic because

of its ability to become and remain stabilized with

life stresses over time. The basic structure and

system integrity are protected (Neuman, 1995).

Lines of Resistance

Neuman identified the series of concentric circles

that surround the basic structure as lines of resist-

ance for the client. When the normal line of defense

is penetrated by stressors, a degree of reaction, or

signs and/or symptoms, will occur. Lines of resist-

ance are activated following invasion of the normal

line of defense by environmental stressors. Each

line of resistance contains known and unknown in-

ternal and external resource factors. These factors

support the client’s basic structure and the normal

line of defense, resulting in protection of system in-

tegrity. Examples of the factors that support the

basic structure and normal line of defense include

the body’s mobilization of white blood cells and ac-

tivation of the immune system mechanisms. There

CHAPTER 18 Betty Neuman:The Neuman Systems Model and Global Applications 285

Line

sofResistan

ce

Nor

malLineofDefens

e

Flexi

bleLineofDefens

e

Basic structure

Basic factors common to

all organisms, i.e,

Normal temperature

range

Genetic structure

Response pattern

Organ strength or

weakness

Ego structure

Knowns or commonalities

Physiological, psychological, sociocultural,

developmental, and spiritual variables occur

and are considered simultaneously in each

client concentric circle.

NOTE:

BASIC

STRUCTURE

ENERGY

RESOURCES

FIGURE 18–2 Client-client system. The structure of the client-
client system, including the five variables that are occurring simul-
taneously in each client concentric circle. From Neuman, 1995,
p. 26, with permission.