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Florence Nightingale
Nursing: Notes on Nursing
Client and environment in balance
Note that the client, the nurse, and the major environment concepts are in
balance; that is; the nurse can manipulate the environment to compensate for the
clients response to it.
The goal of the nurse is to assist the patient in staying in balance.
If the environment of a client is out of balance, the client epends unnecessary
The net !gure depicts a client eperiencing stress because of noise in the
Nursing observations focus on the clients response to noise; nursing interventions
focus on reducing the noise and decreasing the clients unnecessary energy
The nurses role is to place the client in the best position for nature to act upon
him, thus encouraging healing.
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Client expending unnecessary energy by being stressed by the environment (noise)
Major Concepts
01hat nursing has to do2 is to put the patient in the best condition for nature to
act upon him3 4Nightingale, 56789588:;
Nightingale stated that nursing 0ought to signify the proper use of fresh air, light,
<armth, cleanliness, =uiet, and the proper selection and administration of diet > all
at the least epense of vital po<er to the patient.3
-he re?ected the art of nursing in her statement that, 0the art of nursing, as no<
practised , seems to be epressly constituted to unma@e <hat /od had made
disease to be, viA., a reparative process.3
Human eings
#uman beings are not de!ned by Nightingale speci!cally.
They are de!ned in relationship to their environment and the impact of the
environment upon them.
The physical environment is stressed by Nightingale in her <riting.
Nightingales <ritings re?ect a community health model in <hich all that surrounds
human beings is considered in relation to their state of health.
Nightingale 456789588:; did not de!ne health speci!cally.
-he stated, 01e @no< nothing of health, the positive of <hich pathology is the
negative, ecept from the observation and eperience.
/iven her de!nition that of the art of nursing is to 0unma@e <hat /od had made
disease,3 then the goal of all nursing activities should be client health.
She believed that nursing should provide care to the healthy as well as the ill
and discussed health promotion as an activity in which nurses should engage.
#ubconcepts$ Nightingales 456789588:; statements:
Healt" of Houses
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0Badly constructed houses do for the healthy <hat badly constructed hospitals do
for the sic@. &nce insure that the air is stagnant and sic@ness is certain to follo<.3
&entilation and 'arming
0Ceep the air he breathes as pure as the eternal air, <ithout chilling him.3
Nightingale believed that the person <ho repeatedly breathed his or her o<n air
<ould become sic@ or remain sic@.
Nightingale <as very concerned about 0noious air3 or 0eDuvia3 or foul odors that
came from ecrement
-he also criticiAed 0fumigations,3 for she believed that the oEensive source, not
the smell, must be removed.
The importance of room temperature <as stressed by Nightingale. The patient
should not be too <arm or too cold.
The temperature could be controlled by appropriate balance bet<een burning !res
and ventilation from <indo<s.
Nightingale believed that second to fresh air the sic@ needed light. -he noted that
direct sunlight <as <hat patients <anted.
-he stated that patients should never be <a@ed intentionally or accidentally during
the !rst part of sleep.
-he asserted that <hispered or long conversations about patients are thoughtless
and cruel.
-he vie<ed unnecessary noise, including noise from female dress, as cruel and
irritating to the patient.
-he discussed the need for changes in color and form, including bringing the
patient brightly colored ?o<ers or plants.
-he also advocated rotating 5F or 5: paintings and engravings each day, <ee@, or
month to provide variety for the patient.
Nightingale also advocated reading, needle<or@, <riting, and cleaning as activities
to relieve the sic@ of boredom.
ed and edding
-he noted that an adult in health ehales about three pints of moisture through the
lungs and s@in in a :GHhour period.
This organic matter enters the sheets and stays there unless the bedding is
changed and aired fre=uently.
-he believed that the bed should be placed in the lightest part of the room and
placed so the patient could see out of a <indo<. -he reminded the caregiver never
to lean against, sit upon, or unnecessarily sha@e the bed of the patient.
)ersonal Cleanliness
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0Iust as it is necessary to rene< the air round a sic@ person fre=uently to carry oE
morbid eDuvia from the lungs and s@in, by maintaining free ventilation, so it is
necessary to @eep pores of the s@in free from all obstructing ecretions.3
0*very nurse ought to <ash her hands very fre=uently during the day.3
Nutrition and +a,ing -ood
-he noted that individuals desire diEerent foods at diEerent times of the day and
that fre=uent small servings may be more bene!cial to the patient than a large
brea@fast or dinner.
-he urged that no business be done <ith patients <hile they are eating because
this <as distraction.
C"attering Hopes and .dvices
-he <rote that to falsely cheer the sic@ by ma@ing light of their illness and its
danger is not helpful.
Nightingale encouraged the nurse to heed <hat is being said by visitors, believing
that sic@ persons should hear good ne<s that <ould assist them in becoming
#ocial Considerations
Nightingale supported the importance of loo@ing beyond the individual to the social
environment in <hich he or she lived.
Nightingale 456JF9587K958J8; believed that !ve points <ere essential in achieving
a healthful house: 0pure air, pure <ater, eLcient drainage, cleanliness and light.3
$ healthy environment is essential for healing. -he stated that 0nature alone
Nurses must ma@e accurate observations of their patients and be able to report
the state of the patient to the physician in an orderly manner.
Nursing is an art, <hereas medicine is a science. Nurses are to be loyal to the
medical plan, but not servile.
The language she used to <rite her boo@s <as cultured and ?o<ing, logical in
format, and elegant in style.
Nightingales theory has broad applicability to the practitioner. #er model can be
applied in most comple hospital intensive care environment, the home, a <or@
site, or the community at large.
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)eading her <or@ raises a consciousness in the nurse about ho< the environment
in?uences client outcomes.
There is scant information on the psychosocial environment <hen compared to the
physical environment.
The application of her concepts in the t<entieth century is in =uestion.
In the era that <e are in today, <e are faced <ith environmental conditions beyond
<hat <as ought to be natural and nurturing.
-ome of the global environmental issues that <e have no< are the global <arming,
nuclear radiation threats, manHmade environmental calamities and pollution.
From these occurrences, Nightingales model seemed to be very ideal. #er
concept of providing fresh air to patients is in =uestion <ith todays
industrialiAation eEects.
In addition to the analysis of the concept of ventilation, it is not al<ays bene!cial
for all clients to have fresh air. Natural air has its impurities <hich in turn may
infect open <ounds and drainages such as in burns.
1ith the idea of providing light, the light emitted by the sun today is proven to be
harmful already because of the destruction of the oAone layer of the *arth.
*posing the patient constantly to direct sunlight may then be more destructive to
patients betterment than being bene!cial.
It is true that a health environment heals as <hat Nightingale stated but the
=uestion no< is ho< our environment <ould remain health amidst the negative
eEects of the progress of technology and industrialiAation.
-ince the applicability of some of the concepts to speci!c situations today are nonH
feasible, development of this theory is utterly needed to accommodate the
changes of the environment that <e currently have.
-till, above all this, it is very much clear the Nightingales theory is superb as a
starting point of the progression of our profession and served as a catalyst for
nursings improvement.
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