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CHAPTER 18 Dorothy E. Johnson 349

fluids to prevent constipation will be needed. The socialization with friends and family. The patient
nurse should advocate for inpatient physical and and his wife will need support and teaching to
speech therapy to stimulate functional abilities identify methods of adapting to and managing
and reinforce the patient’s achievement behaviors system imbalance and instability and to identify
and to decrease dependency requirements. It actions that will enhance behaviors to create sys-
will be equally important to encourage ongoing tem balance and stability.

CRITICAL THINKING ACTIVITIES

1. Select a patient from your clinical practice and one e. What were the sources of nurturance, protec-
or two of Johnson’s subsystems where there is evi- tion, and stimulation for the actual or desired
dence of behavioral system imbalance or the threat behavior(s)? Was the source consistent and
of loss of order. Then answer the following questions: sufficient?
a. What observation indicates there is a behav- f. What diagnoses did you make? Describe your
ioral system imbalance or the threat of the loss intervention(s).
of order for the subsystem(s)? 2. After completing activity number one, reflect on
b. Consider the patient’s set. What did the patient the ways the model influenced your assessment,
focus on in the situation? the description of the problem, and your diagno-
c. Consider the patient’s choices. Did the patient sis. What insights did using the theory provide
consider a range of behaviors for the situation? for you about the patient?
What role did the patient’s set play in his choice 3. Consider the use of Johnson’s model for preven-
of behavior? tive care in a community setting. What strengths
d. What behaviors (actions) did you see and how and limitations might you encounter?
often? What level of intensity?

POINTS FOR FURTHER STUDY
n Cardinal Stritch University Library at: http:// n Holaday, B. (2010). Johnson’s behavioral system
library.stritch.edu/research/subjects/health/ model in nursing practice. In M.R. Alligood,
nursingtheorists/nursingtheoristsIndex.htm (Ed.), Nursing theory: Utilization & application.
n Clayton State University at: http://nursing.clayton. Philadelphia; Mosby Elsevier.
edu/health/nursing/nursingtheory n Vanderbilt Medical Center at: http://www.
n Dorothy Johnson’s Theory at: http://dorothyjohnson. mc.vanderbilt/edu/biolib/hc/biopages/djohnson.
wetpaint.com html
n Dorothy Johnson at: http://www.youtube.com/ n Vanderbilt University, Eskind Biomedical Library
watch?v5DMG3HIArc20 Historical Collections has a complete set of
n Dorothy Johnson, (1988) Portraits of Excellence: Dorothy Johnson’s published and unpublished
The Nurse Theorists. Video/DVD. Available from papers, personal correspondence and photographs.
Athens, (OH): Fitne, Inc. (http://www.fitne.net/
nurse_theorists1.jsp).

REFERENCES
Alexander, M. (2006). Compassion fatigue experienced by Auger, J. A. & Dee, V. (1983). A patient classification
emergency department nurses who provided care during system based on the Johnson Behavioral System Model
and after the hurricane season of 2005. College of of Nursing: Part 1. Journal of Nursing Administration,
Nursing Master’s Thesis, Florida State University. 13(4), 38–43.