FUR PALMA SERQUINIA , RN,R M,MAN© [FLORENCE NIGHTINGALE: ENVIRONMENTAL THEORY
FLORENCE NIGHTINGALE  She believes that nurses needed to be excellent at
Environmental Theory
MAJOR ASSUMPTIONS
NURISNG
 She believed that every woman, at one time in their
life, would be a nurse in the sense that nursing is
having the responsibility for someone else’s health
PERSON
 She referred to the person as the patient. Nurses
performed tasks to an for the patient and controlled
the patient’s environment to enhance recovery.
HEALTH
 She defined health as being well and using power
that the person has to the fullest extent
 She envisioned the maintenance of health thru the
prevention of the disease via environmental control
 Disease was a reparative process that nature
instituted from a want of attention.
ENVIRONMENT
 She defined it “as those elements external to and
which affects of the sick and healthy person”
 It included everything from the patient’s food and
flowers to the patient’s verbal and non-verbal
interactions with the patient.” Little if anything from
the patient’s world is excluded from her definition of
environment.
 She believed that the sick, poor people would
benefit from environmental improvements that
addressed both their bodies and minds.
 She believed that nurses could be instrumental in
changing the social status of the poor by improving
their living conditions.
THEORETICAL ASSERTIONS
 Disease is a reparative process; its nature’s effort to
remedy a process of poisoning or decay reactions to
conditions in which a person is placed.
 She believes that the nurse’s role is prevent an
interruption of the reparative process and to provide
optimal conditions for its enhancement.
 Nightingale believes in the formal training of nurses
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the observation of their patients and the
environment and use common sense in their
practice coupled with observation, perseverance and
ingenuity.
 Persons desired good health and that they would
cooperate with the nurse and nature to allow the
reparative process to occur or alter their
environment to prevent disease.
 Appropriate manipulations of the environment
would prevent disease.
 She believed that nurses should be moral agents.
 She addressed their professional relationship with
their patients, she instructed them on the principle
of confidentiality and advocated for care to the poor
improve their health and social situation
NIGHTINGALE’S 13 CANONS
VENTILLATION AND WARMTH
 Check the patient’s body temperature, room
temperature, ventilation and foul odors
 Create a plan to keep the room well-ventilated and
free of odor while maintaining the patient’s body
temperature
LIGHT
 Check room for adequate light. Sunlight is beneficial
to the patient
 Create and implement adequate light in room
without placing the patient in direct
CLEANLINESS OF ROOMS AND WALLS
 Check room for dust, dampness and dirt
 Keep room free from dust, dirt, and dampness
HEALTH OF HOUSES
 Check surrounding environment for fresh air, pure
water, drainage, cleanliness and light
 Remove garbage, stagnant water and ensure clean
water and fresh air.
NOISE
 Check noise level in the room and surroundings
 Attempt to keep noise level in minimum
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 FUR PALMA SERQUINIA , RN,R M,MAN© [FLORENCE NIGHTINGALE: ENVIRONMENTAL THEORY

BED AND BEDDING APPLICATION OF NIGHTINGALE’S THEORY TO NURSING

 Check bed and bedding for dampness, wrinkles and
soiling
 Keep the bed dry, wrinkle free and lowest height to
ensure comfort
PRACTICE
 The environmental aspects of her theory
(ventilation, warmth, quiet, diet, and cleanliness)
remain integral components of the nursing practice

PERSONAL CLEANLINESS  Modern sanitation and treatment have controlled

 Attempt to keep the patient dry and clean at all
times
 Frequent assessment of the patient’s skin is essential
to maintain good skin integrity
traditional sources of disease fairly well but
contaminated water has become a health issue again
for many communities as global traveler has
dramatically altered the actual and potential spread
of diseases more rapidly

VARIETY  New environmental concerns are created by modern

 Attempt to accomplish variety in the room and with
the client
 This is done with cards, flowers, pictures and books
also encourage friends or relatives to engage in
stimulating activities
CHATTERINNG HOPES AND ADVICES
architecture nurses need to ask whether modern
buildings meet Nightingale’s principle of good
ventilation
 Disposal of waste, including toxic wastes and the use
of chemicals in modern society also challenge health
care professionals to reassess the concept of a
healthy environment.

 Avoid talking without giving advice that is without a  In healthcare facilities, the ability to control room
fact temperature for an individual patient is increasingly
 Respect the patient as a person and avoid personal difficult. That same environment may create great
talk noise through multiple activities and technology
(equipment) used to assist the patients reparative
TAKING FOOD process.

 Check the diet of the patient note that the amount
of food and fluid ingested by the patient at every
meal
PETTY MANAGEMENT
 This ensures continuity of care
 Document the plan of care and evaluate the
outcomes to ensure continuity
OBSERVATION OF SICK
 Observe and record anything about the patient
 Continue observation in the patient’s environment
and make changes in the plan of care if needed.
APPLICATION OF NIGHTINGALE’S THEORY TO NURSING
EDUCATION
 Nightingale’s principles of nursing training
instruction (instruction in scientific principle and
practical experiences for the mastery of skills)
provided a universal template for early nurse
training schools
 She advocated the independence of the school from
the hospital to ensure that students would not be
involved in the hospital’s labor pool as part of their
training
 She believes that good practice can result only from
good education

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 FUR PALMA SERQUINIA , RN,R M,MAN© [FLORENCE NIGHTINGALE: ENVIRONMENTAL THEORY

APPLICATION OF NIGHTINGALE’S THEORY TO NURSING

RESEARCH REFERENCES:

 Her interest in scientific inquiry and statistics
continues to define scientific inquiry used in nursing
research
 She is considered the first nurse researcher
CRITIQUE OF NIGHTINGALE’S THEORY
SIMPLICITY
 The theory contains 3 major relationships:
environment to patient; nurse to environment and
least nurse to patient (the least defined)
George, J. (1995). Nursing Theories: The Basis for Professional
th
Nursing Practice. 4 edition. Norwalk, Connecticut: Appleton-
Century Crofts.
rd
Marriner-Tommey, A. (1994). Nursing Theorists and their Works. 3
edition. St. Louis: Mosby Year Book, Inc.
University of the Philippines Open University (2005). N207:
Theoretical Foundations of Nursing. UPOU: National Computer
Center, Diliman, Quezon City.
- MANUS CAPUT COR

 The environment was the main factor creating illness

in a patient and good environment in preventing
illness

 Nursing practice includes manipulation of the

environment in a number of ways to enhance
patient recovery: elimination of contamination and
contagion; exposure to fresh of air, light, warmth
and quiet; cleanliness

 Her conditions for the nurse and patient-relationship

suggest cooperation and collaboration between the
nurse and the patient.

GENERALITY

 Provide general guidelines for all nurse practitioner’s

for number of years
 Universality of her concepts still remain relevant
except for some specific activities
 The concept of nurse, patient and environment are
still capable and relevant in all nursing settings today
– meets the criterion of generality.

EMPIRICAL PRECISION

 Her concepts in her theory are stated completely

and presented as truths rather than tentative,
testable statements.
 In contrast to her quantitative research on mortality
in the Crimea, she proposed that nurses should base
their practice base on observations and experiences
rather than systematic, empirical research.

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FUR PALMA SERQUINIA , RN,R M,MAN© [FLORENCE NIGHTINGALE: ENVIRONMENTAL THEORY

THEORETICAL FOUNDATIONS OF NURSING: MANILA DOCTORS COLLEGE 1ST SEMESTER AY 2010-2011

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