California in 1970. She is an author, lecturer, and
independent nursing curriculum consultant.
Neuman has published numerous books and jour-
nal articles in response to requests for support in
applying the model to education, practice, research,
and administration. Dr. Neuman received honorary
doctorates from Grand Valley State University in
Allendale, Michigan, in 1998, and from Neuman
College in Aston, Pennsylvania, in 1992. Dr.
Neuman is an honorary fellow in the American
Academy of Nursing.
The Neuman Systems Model
The Neuman Systems Model provides a comprehen-
sive, flexible, holistic, and systems-based perspective
for nursing. This conceptual model of nursing focuses
attention on the response of the client system to actual
or potential environmental stressors, and the use of
primary, secondary, and tertiary nursing prevention
interventions for retention, attainment, and mainte-
nance of optimal client system wellness.
—Betty Neuman (1996)As its name suggests, the Neuman Systems
Model is classified as a systems model or a systems
category of knowledge. Neuman (1995) defined
Neuman (1995) defined system as a perva-
sive order that holds together its parts.systemas a pervasive order that holds together its
parts. With this definition in mind, she writes that
nursing can be readily conceptualized as a complete
whole, with identifiable smaller wholes or parts.
The complete whole structure is maintained by in-
terrelationships among identifiable smaller wholes
or parts through regulations that evolve out of the
dynamics of the open system. In the system there
is dynamic energy exchange, moving either toward
or away from stability. Energy moves toward ne-
gentropy or evolution as a system absorbs energy
to increase its organization, complexity, and devel-
opment when it moves toward a steady or wellness
state. An open system of energy exchange is never
at rest. The open system tends to move cyclically
toward differentiation and elaboration for further
growth and survival of the organism. With the
dynamic energy exchange, the system also can
move away from stability. Energy can move toward
extinction (entropy) by gradual disorganization,
increasing randomness, and energy dissipation.
The Neuman Systems Model illustrates a client-
client system and presents nursing as a field prima-
rily concerned with defining appropriate nursing
actions in stressor-related situations or in possible
reactions of the client-client system. The client and
environment may be positively or negatively af-
fected by each other. There is a tendency within any
system to maintain a steady state or balance among
the various disruptive forces operating within or
upon it. Neuman has identified these forces as
stressors and suggests that possible reactions and
actual reactions with identifiable signs or symp-
toms may be mitigated through appropriate early
interventions (Neuman, 1995).PROPOSITIONS
Neuman has identified 10 propositions inherent
within her model. Fawcett (1995a, p. 2) defined
propositions as “statements that describe or link
concepts.” She provided additional clarity to the
term “proposition” by adding that some proposi-
tions are general descriptions or definitions of the
conceptual model concepts, whereas other proposi-
tions state the relationships among conceptual
model concepts in a general manner. In Fawcett’s
(1995a) analysis of the Neuman Systems Model,
she acknowledged that Neuman’s propositions that
link person, environment, health, and nursing
leave no gaps between these concepts. Fawcett
believes that Neuman’s primary, secondary, and
tertiary preventions provide the required linkages
among the concepts of the model (1995a). The fol-
lowing propositions describe, define, and connect
concepts essential to understanding the conceptual
model that is presented in the next section of this
chapter.- Although each individual client or group as a
client system is unique, each system is a com-
posite of common known factors or innate
characteristics within a normal, given range of
response contained within a basic structure. - Many known, unknown, and universal envi-
ronmental stressors exist. Each differs in its
potential for disturbing a client’s usual stability
282 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration