and female created He them....Sanctity of life is
manifested in everyone. The holiness of life itself
[testifies] to its spiritual reality” (p. 40). “Person”
can be an individual, a family, or a community.
Levine’s (1968a, 1968b, 1973) discussion of the
person includes recognition that the person is de-
fined to a certain degree based on the boundaries
defined by Hall (1966) as “personal space.” Levine
rejected the notion that energy can be manipulated
and transferred from one human to another as in
therapeutic touch. Yet a person is affected by the
presence of another relative to his or her personal
space boundaries. Admittedly, some of this is de-
fined based on cultural ethos, yet what is it about
the “bubble” that results in a specific organismic re-
sponse? It may be that the energy involved in the
interaction is not clearly defined. Scientists are
challenged to examine this. Levine encouraged cre-
ativity such as therapeutic touch but rejected activ-
ities that are not scientifically sound.
The environmentcompletes the wholeness of the
individual. The individual has both an internal and
external environment. The internal environment
combines the physiological and pathophysiological
aspects of the individual and is constantly chal-
lenged by the external environment.
The external environment includes those factors
that impinge on and challenge the individual. The
environment as described by Levine (1973) was
adapted from the following three levels of environ-
ment identified by Bates (1967).
The perceptualenvironment includes aspects of
the world that individuals are able to seize or inter-
pret through the senses. The individual “seeks, se-
lects, and tests information from the environment
in the context of his [her] definition of himself
[herself], and so defends his [her] safety, his [her]
identity, and in a larger sense, his [her] purpose”
(Levine, 1971, p. 262).
The operationalenvironment includes factors
that may physically affect individuals but are not
directly perceived by them, such as radiation, mi-
croorganisms, and pollution.
The conceptualenvironment includes the cultural
patterns characterized by spiritual existence and me-
diated by language, thought, and history. Factors
that affect behavior—such as norms, values, and be-
liefs—are also part of the conceptual environment.
Nursingis “human interaction” (Levine, 1973,
p. 1). “The nurse enters into a partnership of human
experience where sharing moments in time—some
trivial, some dramatic—leaves its mark forever on
each patient” (Levine, 1977, p. 845). The goal of
nursing is to promote adaptation and maintain
wholeness (health). The goal is accomplished
through the use of the conservation principles: en-
ergy, structure, personal, and social.The Model
Energy conservation is dependent on the free ex-
change of energy with the internal and external en-
vironment to maintain the balance of energy supply
and demand. Conservation of structural integrity is
dependent on an intact defense system (immune
system) that supports healing and repair to preserve
the structure and function of the whole being.
The conservation of personal integrity acknowl-
edges the individual as one who strives for recogni-
tion, respect, self-awareness, humanness, self-hood,
and self-determination. The conservation of social
integrity recognizes the individual as a social being
who functions in a society that helps to establish
boundaries of the self. The value of the individual
is recognized, but it is also recognized that the indi-
vidual resides within a family, a community, a reli-
gious group, an ethnic group, a political system,
and a nation (Levine, 1973).
The outcome of nursing involves the assessment
of organismic responses. The nurse is responsible
for responding to a request for health care and for
recognizing altered health and the patient’s organ-
ismic response to altered health. An organismic
response is a change in behavior or change in the
level of functioning during an attempt to adapt to
the environment. The organismic responses are
intended to maintain the patient’s integrity.
According to Levine (1973), the levels of organis-
mic response include:1.Response to fear (flight/fight response).This is the
most primitive response. It is the physiological
and behavioral readiness to respond to a sudden
and unexpected environmental change; it is an in-
stantaneous response to real or imagined threat.
2.Inflammatory response.This is the second level
of response intended to provide for structural
integrity and the promotion of healing. Both are
defenses against noxious stimuli and the initia-
tion of healing.
3.Response to stress.This is the third level of
response, which is developed over time and
influenced by each stressful experience encoun-CHAPTER 9 Myra Levine’s Conservation Model and Its Applications 99