INTRODUCTION OF THE THEORIST:
Florence Nightingale was born on May 12, 1820, in Florence, Italy. From an early age, she felt she had a calling to be a nurse. She "trained" to be a nurse at a hospital in Kaiserworth, Germany, and returned to London. She led nurses during the Crimean War at Scutari, Turkey; gathered extensive statistics about the health of the soldiers she and her nurses served; and began a life-long effort to improve health by improving the environment. She was a statistician, using bar and pie charts, highlighting key points. International Nurses Day, May 12 is observed in respect to her contribution to Nursing. She died - 13 August 1910.
Florence Nightingale considered the founder of educated and scientific nursing and widely known as "The Lady with the Lamp", wrote the first nursing notes that became the basis of nursing practice and research. The notes, entitled Notes on Nursing: What it is, what is not (1860), listed some of her theories that have served as foundations of nursing practice in various settings. Nightingale is considered the first nursing theorist. One of her theories was the Environmental Theory, which incorporated the restoration of the usual health status of the nurse's clients into the delivery of health care—it is still practised today.
PURPOSE:
- To facilitate & encourage the process of healing by manipulating the environment.
- The environment is critical to health, & the nurse’s role in caring for the sick is to provide a clean, quiet, peaceful environment to promote healing.
ASSUMPTIONS OF NIGHTINGALE'S THEORY:
- Nursing is separate from medicine
- Nurse should be trained
- The environment is important to the health of the patient
- The disease process is not important to nursing
- Nursing should support the environment to assist the patient in healing
- Research should be utilized through observation and empirics to define the nursing discipline.
- Nursing is both an empirical science and an art.
- Nursing’s concern is with the person in the environment.
- The person is interacting with the environment
- Sick and well are governed by the same laws of health.
- The nurse should be observant and confidential.
5 MAJOR COMPONENTS OF A HEALTHFUL ENVIRONMENTAL
- CLEAN AIR
- PURE WATER
- EFFICIENT DRAINAGE
- CLEANLINESS
- LIGHT
NIGHTINGALE’S CANONS: MAJOR CONCEPTS
- Ventilation and warming
- Light, noise
- Cleanliness of rooms/walls
- Health of houses
- Bed and bedding
- Personal cleanliness
- Variety
- Chattering hopes and advices
- Taking food. What food?
- Petty management/observation
ORIGIN OF NIGHTINGALE’S ENVIRONMENTAL CONCEPTS:
- Nightingale believed that the environment could be altered to improve conditions so that the natural laws would allow healing to occur.
- This grew from empirical observation that poor or difficult environments led to poor health and disease.
- In her Crimean experience, filth, inadequate nutrition, dirty water, and inappropriate sewage disposal led to a situation in which more British soldiers died in the hospital than of battlefield wounds.
- Florence nightingale conceptualized disease as a reparative process.
- Nurses role as manipulating the environment.
- Persons are in relation with the environment
- Stresses the healing properties of the physical environment (fresh air, light, warmth,diet,noise and cleanliness)
- Nursing puts patients in the “best conditions” for nature to act upon them
- Health is “the positive of which the pathology is the negative”
- “Nature alone cures”
THREE TYPES OF ENVIRONMENTS
- Physical
- Psychological
- Social
PHYSICAL ENVIRONMENT
- Consists of physical elements where the patient is being treated
- Affects all other aspects of the environment
- Cleanliness of environment relates directly to disease prevention and patient mortality
- Aspects of the physical environment influence the social and psychological environments of the person
PSYCHOLOGICAL ENVIRONMENT
- Can be affected by a negative physical environment which then causes STRESS
- Requires various activities to keep the mind active (i.e, manual work, appealing food, a pleasing environment)
- Involves communication with the person, about the person, and about other people.
- Communication should be therapeutic, soothing, & unhurried!
SOCIAL ENVIRONMENT
- Involves collecting data about illness and disease prevention
- Includes components of the physical environment - clean air, clean water, proper drainage
- Consists of a person’s home or hospital room, as well as the total community that affects the patient’s specific environment.
NURSING PARADIGM:
Nightingale's documents contain her philosophical assumptions and beliefs regarding all elements found in the metaparadigm of nursing. These can be formed into a conceptual model that has great utility in the practice setting and offers a framework for research conceptualization. (Selanders LC, 2010).
Nursing
- Nursing is different from medicine and the goal of nursing is to place the patient in the best possible condition for nature to act.
- Nursing is the "activities that promote health (as outlined in canons) which occur in any caregiving situation. They can be done by anyone."
Person
- People are multidimensional, composed of biological, psychological, social and spiritual components.
Health
- Health is “not only to be well, but to be able to use well every power we have”.
- Disease is considered as dys-ease or the absence of comfort.
Environment
- "Poor or difficult environments led to poor health and disease".
- "Environment could be altered to improve conditions so that the natural laws would allow healing to occur.
NIGHTINGALE'S THEORY AND NURSING PRACTICE:
Application of Nightingale's theory in practice:
- "Patients are to be put in the best condition for nature to act on them, it is the responsibility of nurses to reduce noise, to relieve patients’ anxieties, and to help them sleep."
- As per most of the nursing theories, environmental adaptation remains the basis of holistic nursing care.
CRITICISMS
- She emphasized subservience to doctors.
- She focused more on physical factors than on psychological needs of patient.
CONCLUSION:
Florence nightingale’s legacy of caring & activism it implies is carried on in nursing today. Nightingale for inspiration, for she remains a role model for excellence on the transformation of values of caring into an activism that could potentially transform our current health care system into a more humanistic & just one. Florence Nightingale provided a professional model for nursing organization. She was the first to use a theoretical foundation to nursing Her thoughts have influenced nursing significantly
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