The Neuman Systems Model:
An Examination of Essential Concepts and Implications for Nursing Practice
Winston Salem State University

Abstract
This article examines Betty Neuman’s nursing theory, The Neuman Systems Model. The four concepts of nursing’s metaparadigm - person, environment, health, and nursing are evaluated as well as the interrelationships between these concepts as they apply to the Neuman Systems Model. Implications of the theory for clinical nursing practice are also discussed and compared with empirical results when possible. Keywords: Betty Neuman, Neuman Systems Model, Nursing, Theory
The Neuman System Model:
An Examination of Essential Concepts and Implications for Nursing Practice
Introduction
Betty Neuman is a holistic nursing theorist who initially received her Registered Nurse (RN) credentials through a diploma cadet program in 1947 (“NSM History” n.d). She went on to receive her Bachelors and then Masters degrees in nursing from the University of California, Los Angeles (UCLA), where she was then employed as faculty from 1967 – 1973 (“NSM History” n.d). She published her first description of what would become the Neuman Systems Model in a 1972 paper entitled “A model for teaching total person approach to patient problems.” In 1985, she received her Doctoral degree from Pacific Western University in clinical psychology. Further development led to a theory that is broad, comprehensive, and therefore complementary to other nursing models. This article will discuss the major concepts of the Neuman theory, how they are interrelated, and the implications of her theory for the clinical practice setting.
Major Concepts of the Theory The Neuman Systems Model is broken down into four distinct concepts. These concepts are the person/client, environment, health, and nursing. Each distinct concept of the systems model is considered a system unto itself, all interacting to form the systems model theory. The four major concepts of the theory are discussed as follows.
Client System:
According to Neuman a client can be “an individual, a family, a group, a community, or a social issue” (Neuman & Fawcett, 2002, p. 15). It is this broadness in defining a system that makes the Neuman Systems Model versatile in dealing with clients of all types.
There are five variables that influence the client system. The physiological variable takes into account the structure of the body and its internal function. Psychological refers to the mental processes, how the client deals with the environment both external and internal. Sociocultural deals with how the social cultural conditions and influences produce a combined effect on the client. Developmental is the age-related development activities and processes related to the client. Spiritual “refers to the spiritual beliefs and influences”(Neuman & Fawcett, 2002, p. 17). Each client is considered to have a basic structure which is innate to the client. Each client has unique baseline characteristics among the five system variables.
In a pictograph each client has a series of circles around them, viewed as lines of defense and lines of resistance. The outermost line is the flexible line of defense. The line is dynamic, moving in and out from the client as needed for protection. The closer the line comes to the client, the more danger for an insult. It is applicable to the five variables, buffering them to keep the client protected and stable. When the line is broken and the buffering system fails the client develops an insult and starts developing symptoms related to the failure. The normal line of defense is a dynamic one that the client develops over the course of a lifetime. This line does not fluctuate to each potential threat as the flexible line does but rather is more at the core. The lines of resistance are reactionary and are only activated when a stressor makes it past the lines of defense. The client may know when the lines of