An Open Mind to an Open System AN OPEN MIND TO AN OPEN SYSTEM The Open System Theory was initially developed by Ludwig von Bertanlanffy (1956), a biologist, but it was immediately applicable across all disciplines. It defines the concept of a system, where “all systems are characterized by an assemblage or combination of parts whose relations make them interdependent”. As one moves from mechanical to organic and social systems, the interactions between parts in the system become more complex and variable. Bellinger, 2008) Open systems like organizations are “multi-cephalous: many heads are present to receive information, make decisions, direct action” (Bellinger, 2008). Individual and subgroups form and leave coalitions. Boundaries are amorphous, permeable, and ever changing. But the system must exchange resources with the environment to survive. Nurses today are enmeshed in many systems; health care system, a family system, body systems, information systems, banking systems, political systems, etc.
Therefore, it is beneficial for nurses to gain some basic understanding of how systems work. Through understanding of the Open Systems theory, nurses can more effectively care for patients, families and communities, and can more effectively bring about desired results of patient care efforts. If one only focused on fixing the steering wheel of a car that is not running; without also checking the engine, lights, and transmission, the car would never function again.
The open systems approach allows for a primary focus of a disease process while also concentrating on the many systems that can be affected as a result of the illness or disease. In the patient with Chronic Obstructive Pulmonary Disease (COPD), the care of the patient offers challenges in management, and is greatly improved by an open systems approach to patient care. In order to analyze the origin, pathophysiology, and effects of the disease, an open system allowing many components to contribute would be best utilized.
Ideally many disciplines; such as, physicians, nurses, respiratory therapist, exercise specialists, social workers, and dieticians would all collaborate to provide the patient with the most optimal and effective treatment plan of care. The team’s focus is on providing education and reinforcement the medical plan. For example, the medical plan needs to include not only the prescription of medications but also an assessment of the patient’s ability to use the devices and understanding of how and when to use the medications and should include written instructions if needed.
An assessment of the patient’s coping skills and the presence of depression and or anxiety should be included. A nutritional assessment focusing on dietary habits should be completed on all patients with COPD. Preventing weight loss has been shown to decrease morbidity and mortality in the low- and normal-weight patient with COPD. A weight loss in the overweight patient may decrease breathlessness symptoms. The patient should be prescribed pulmonary rehabilitation.
Providing the patient with information about advanced directives, traveling, smoking cessation and support groups, and community resources should not be overlooked in the plan. Regular assessment of the patient and communication between team members is vital to the management of the patient with COPD. This open systems approach offers the patient the greatest opportunity to maximize their respiratory potential and quality of life.
REFERENCES Bellinger, Gene (2008). System Thinking. Retrieved November 1, 2012 from http://www. ystems-thinking. org/systems/systems. htm Barnum, B. J. S. (1994). Nursing Theory: Analysis, application, and evaluation. 4th edition. Philadelphia, PA: J. B. Lippincott. Bertalanffy, L. von. (1968). General systems theory: Foundations, development application, rev’d ed. New York: George Braziller. Chinn, P. L. (1979). Practice oriented theory: Part 1. Advances in Nursing Science, pp 41-52. Hazzard, M. E. (1971). An overview of systems theory. Nursing Clinics of North America, pp. 385-393.