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Loyola University Chicago Loyola eCommons Dissertations Theses and Dissertations 1987 Toward a General Understanding of Nursing Education: A Critical Analysis of the Work of Myra Estrin Levine Marie Blasage Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_diss Part of the Education Commons Recommended Citation Blasage, Marie, "Toward a General Understanding of Nursing Education: A Critical Analysis of the Work of Myra Estrin Levine" (1987). Dissertations. 2530. https://ecommons.luc.edu/luc_diss/2530 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Dissertations by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 1987 Marie Blasage TOWARD A GENERAL UNDERSTANDING OF NURSING EDUCATION: A CRITICAL ANALYSIS OF THE WORK OF MYRA ESTRIN LEVINE by Marie Carol Blasage A Dissertation Submitted to the Faculty of the School of c' . ,/: .. , ,"·, Education of Loyola University of Chicago in Partial Fulfillment of the Requirements for the Degree of Doctor of Philos~phy January 1987 ACKNOWLEDGMENTS I am especially indebted to my major professor, Dr. Steven I. Miller, professor of education at Loyola University of Chicago, who, through his assistance and guidance has helped to make this research project a reality. My gratitude is also extended to the other members of my committee: Professor Marcel Fredericks, Professor Joan K. Smith and Professor John M. Wozniak. As the subject of this dissertation, Myra Estrin Levine, Professor of Nursing at the University of Illinois College of Nursing, was most cooperative in providing me with a better understanding and appreciation of her work and her philosophy of nursing. Mention must also be made of the interviewees who took time out of their otherwise busy schedules to offer their thoughts and opinions con­ cerning nursing education. They were especially helpful in providing information which was not available anywhere else. I am also grateful to the Loyola University library staff who .assisted me in obtaining the volumes of material needed to complete this research. The interlibrary loan policy was especially useful. The much needed assistance I received from the Loyola Data Center staff is greatly appreciated. Their patience and dedication helped me through the many long and frustrating hours I spent there. It has been my "home away from home." ii To my friend Mrs. Linda Sarcu R.N., M.S., who has offered many helpful suggestions from a nurse's point of view, I extend my warm appreciation. Finally, I am truly indebted to my family and friends whose patience and support has encouraged me from beginning to end. Most importantly, to my husband, Richard, without whose help and encourage­ ment this dissertation would not have been possible. iii DEDICATED TO MY HUSBAND RICHARD iv VITA The author, Marie Carol Blasage, is the daughter of Frank Gagliano and the late Olga (Fenili) Gagliano, and was born July 25, 1948, Chi­ cago, Illinois. Her elementary education was obtained at Prescott School and St. Bonaventure SchOQl, Chicago, Illinois. Her secondary education was com­ pleted at Waller High School, Chicago, Illinois, from which she was graduated in 1966. She received a diploma in nursing (1969) from St. Mary of Nazareth School of Nursing, Chicago, Illinois. She received her B.S.N. (1978) and M.S.N. (1980) from De Paul University, Chicago, Illinois. She is also a member of Sigma Theta Tau. Her experience includes nursing at Children's Memorial Hospital, Grant Hospital, Ravenswood Hospital, all in Chicago, Illinois. She has also taught nursing at North Park College, Chicago, Illinois. V TABLE OF CONTENTS Page ACKNOWLEDGMENTS ii VITA .....• V LIST OF TABLES viii LIST OF FIGURES. ix CONTENTS OF APPENDICES . X Chapter I. AN OVERVIEW OF NURSING HISTORY., . 1 Introduction ......•. 1 Early History of Nursing 2 Nursing During The Nineteenth Century 5 Nursing During The Twentieth Century 15 Summary 37 II. MYRA ESTRIN LEVINE 38 Family History 39 High School and College 40 Early Married Life 42 An Awakening ...... 46 Establishing Her Reputation . ' . 48 Beginning of the Conservation Principles 52 The Conservation Principles 54 An Era of Professional Freedom 57 Extending Her Beliefs 60 A Lesson In Compassion 61 Physiological Determinates 67 Human Responses •.. 68 Ethics In Nursing 71 The Future Of Nursing 73 Summary .......• 74 III. REVIEW OF THE WRITINGS OF MYRA LEVINE '75 Introduction •..... 75 Holistic Patient-Centered Care 75 Nursing Education 84 Communications 90 Ethics ..... 93 vi Summary 96 IV. AN OVERVIEW, ANALYSIS, AND COMPARISON OF NURSING MODELS. 98 Overview of Nursing Models 98 Myra Levine's Conservation Model 104 Internal Analysis .. 108 External ·Analysis. 115 Summary of Analyses . 119 Model Comparisons ..•.. 121 Evaluation of Models •• 134 Summary . .. 136 V. FROM THEORY TO PRACTICE . 137 Professionalism and Nursing. 137 Nursing Science and Theory 139 Practice and Research •.. 141 Levine's Model-Nursing Process 149 Problems and Issues .... 153 Curriculum and Policy Making 160 Strengths and Limitations 163 Recommendations 165 BIBLIOGRAPHY . 167 APPENDIX A 177 APPENDIX B. 181 APPENDIX C . 185 APPENDIX D 187 APPENDIX E 193 vii LIST OF TABLES Table Page 1. Earned Degrees Below Bachelor's, by Curriculum: 1971 To 1979 23 2. Number and Percent Distribution of Registered Nurses Employed in Nursing by Highest Educational Preparation According to Year of Inventory: United States, 1972 and 19 77-78 • • . • • . • . 25 3. Bachelor's, Masters, and Doctor's Degrees Conferred by Institutions of Higher Education, by Sex of Student and by Field of Study: United States, 1980-81-Continued. 27 4. Number and Percent Distribution of Nursing Student Admissions by Type of Program, According to Academic Year: United States, 1972-73 and 1979-80 . • . • . 28 5. Number and Percent Distribution of Registered Nurses Employed in Nursing by Age, According to Year of Inventory, and Median Age by Year Inventory: United States, 1972 and 1977-78 . 30 6. Number and Percent Distribution of Registered Nurses Employed in Nursing By Sex, According To Year of Inventory: United States, 1972 and 1977-78 . ~ . • • . • . 31 7. Number and Percent Distribution of Registered Nurses by Race or Hispanic origin: United States, 1977-78 . 32 8. Number and Percent Distribution of Male Registered Nurses Employed in Nursing by Type of Position, According to Year of Inventory: United States, 1972 and 1977-78 • . • . • . 34 9. Number of Registered Nurses Employed in Nursing and Percent Distribution by Type of Position, According To Year of Inventory and Sex: United States, 1972 and 1977-78 . • . 35 vi-ii LIST OF FIGURES Figure Page 1. Representation of Person, Health and Environment and Nursing in Levine's Model ..... 109 2. Dynamic Interacting Systems in King's Model 122 3. A Conceptual Structure For Nursing in Orem.'s Model .•••... 125 41,. Nursing Agency and Nursing Systems in Orem' s Model 129 5. A Process of Human Interaction in King's Model 131 ix CONTENTS OF APPENDICES Page APPENDIX A ..... 177 A Chronology of General History. APPENDIX B ..... 181 A Chronology of Nursing History. APPENDIX C . 185 Consent Form APPENDIX D. 187 Nursing Care Plan Utilizing Levine's Model APPENDIX E . ,. ; . i • • ,, • ·• .' . 193 Nursing Course Outline Utilizing Levine's Model. X CHAPTER I AN OVERVIEW OF NlJRSING HISTORY Introduction Down through the ages each ensuing century brought about changes in medicine, environment, politics and the sciences which directly influenced nursing. These changes were not, however, always for the better, as will be seen. Chapter I addresses some of the more predomi­ nant events of nursing which are of significant importance such as; how and why nursing has almost always been female dominated; how nursing achieved great heights as an art and also how it reached levels of shame; how discoveries in the sciences and changes in legislation have improved nursing; changes in the environment which in turn have enhanced our lives; how and why nursing came to be taught at the college level; and the struggle of nurses to gain respect, credibility and recognition. It is not the writer's intent to repeat all of nursing's history. 1 Rather, primary emphasis will be placed on the nineteenth and twentieth centuries where events of significant importance have had the greatest impact on nursing. However, to understand the evolution of nursing some preliminary history will be mentioned. 1 For a more detailed account of the history of nursing, see Bonnie Bullough and Vern L. Bullough, The Care of the Sick. (New York: G.P. Putnam's Sons, Company, 1978). For a review of the early history see Lavinia L. Dock,~ History of Nursing. (New York: G.P. Putnam's Sons, 1972). See also Lavinia L. Dock and M. Adelaide Nutting,~ History of Nursing. (New York: G.P. Putnam's Sons, 1907). 1 2 The Early History of Nursing The Crusades were great religious and military enterprises as well as important stimulants to hospital work in that there were problems of communicable disease, fatigue, and malnutrition which further increased the demand for hospitals, doctors, and nurses. 2 This in tum brought about one of the major results of nursing during the Crusades: the for­ mation of military nursing orders. The strict dis'cipline of the mili­ tary had an effect on nursing because the military established rank, strict obedience and the institution of penalties when obedience was not met. Since human li_fe was being dealt with, these rules appeared entirely logical, and are still felt in nursing today. 3 A current exam­ ple of this obedience would be the doctor/nurse relationship. The nurse is expected to carry out the doctor's orders, exactly, and without ques­ tion. During Medieval times, as countries became more populated and vil­ lages grew into towns and cities, the need for places to care for the sick gradually evolved into what are now known as hospitals.

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