Rea C.

Tubat
BSN1-A

Nursing Theorist: Florence Nightingale

Title of the Theory: Environmental Theory
Nursing Background
 Education
Florence was provided with a classical education. She was
tutored in mathematics, languages, religion, and philosophy.
Nightingale eventually enrolled as a nursing student in 1850 at
the Institution of Protestant Deaconesses in Kaisersworth,
Germany, a Protestant religious community with a hospital facility. She stayed there for
approximately three months and at the end, her teacher declared her to be trained as a
nurse.

 Nursing Experience
From a young age, Nightingale was active in philanthropy, ministering to the ill and poor
people in the village neighboring her family’s estate. Nightingale eventually came to the
conclusion that nursing was her calling; she believed the vocation to be her divine
purpose. Determined to pursue her true calling.
In the early 1850s, Nightingale returned to London, where she took a nursing job in a
Harley Street hospital for ailing governesses. Her performance there so impressed her
employer that Nightingale was promoted to superintendent. Nightingale also
volunteered at a Middlesex hospital around this time, grappling with a cholera outbreak
and unsanitary conditions conducive to the rapid spread of the disease. Nightingale made
it her mission to improve hygiene practices, significantly lowering the death rate at the
hospital in the process. In October of 1853, the Crimean War broke out. Allied British and
French forces were at war against the Russian Empire for control of Ottoman territory.
Thousands of British soldiers were sent to the Black Sea, where supplies quickly dwindled.
By 1854, no fewer than 18,000 soldiers had been admitted into military hospitals. At the
time, there were no female nurses stationed at hospitals in the Crimea. After the Battle
of Alma, England was in an uproar about the neglect of their ill and injured soldiers, who
not only lacked sufficient medical attention due to hospitals being horribly understaffed
but also languished in appallingly unsanitary conditions.

Nursing Philosophy
Based on Nightingale's observations during the Crimean War, she wrote Notes on Matters
Affecting the Health, Efficiency and Hospital Administration of the British Army, a massive report
published in 1858 analyzing her experience and proposing reforms for other military hospitals.
Her research would spark a total restructuring of the War Office's administrative department,
including the establishment of a Royal Commission for the Health of the Army in 1857. She
Nightingale also believed that the environment of the patient should be altered to allow nature
to act on the patient . Her work focuses mostly on the patient and the environment but also
includes the nurse and health. For instance, it was the nurse’s duty to alter the patient’s
environment so that nature could act on the patient and repair health. Nightingale was also noted
for her statistician skills, creating coxcomb pie charts on patient mortality in Scutari that would
influence the direction of medical epidemiology.

Metaparadigm
 Person
Nightingale referred to the person as a patient. Nurses performed tasks to and foe the
patient and controlled the patient’s environment to enhance recovery. For the most part,
Nightingale described a passive patient in this relationship. However, there are specific
references to the patient performing self-care when possible and being involved in the
timing and substance of meals. The nurse was specifically instructed to ask the patient
about his or her preferences; however, Nightingale emphasized that the nurse was in
control of the patient’s environment.

 Nursing
Nightingale believed that every woman at one time in her life, would be a nurse in the
sense that nursing is having the responsibility for someone else’s health.

 Health
Nightingale defined health as being well and using every power that the person has to the
fullest extent. Additionally, she saw disease as a reparative process that nature instituted
from a want to intention. Nightingale envisioned the maintenance of health through the
prevention of disease via environmental control; what she described is modern public
health nursing and the more modern concept of health promotion. She distinguished
these concepts of nursing as different from nursing a sick patient to enhance recovery or
from living better until death.

 Environment
Nightingale described environment as the elements external to and which affect the
health of the sick and healthy person. It includes everything from the patient’s food and
flowers to the patient’s verbal and nonverbal interactions with the patient.
Diagram of Nightingale’s Environmental Theory

Reflection on how the theory can be use in Life