Changes in theory and focus related to patient care were changing dynamically. Theorists worked to define nursing in a distinct way that separated the medical structure from the nursing one. This period presented new ideas, “this change offered the potential to move nursing from a context-dependent reactive position to a context-interactive proactive position” (Chinn & Kramer, 2011, p. 44-45). Roy's Adaptation Model indicates that “nurses direct care in helping the client adapt” (Potter & Perry, 2009, p. 50). Additionally, the nurse must interact with each patient to assess the patient's feelings about his or her current health status, environment, and goals in order to anticipate what interventions may be needed to encourage adaptation. Callista Roy worked for over three decades to further detail her model. Over the years, modifications improved the initial model. Previous versions of the RAM include three “…essential elements: the person, the goal, and the nursing intervention” (Roy & Roberts, 1981, p. 42). However, a more recent publication includes five concepts in the definition of the model: adaptation, person, environment, health, and goal of nursing care (Roy, 2009). It also defines four adaptive modes that describe how a person reacts to stimulation from the environment (Roy,