• After 1 hour of lecture

discussion, the BSN 1 students

will be able to gain knowledge,
acquire beginning skills and
develop positive attitude on the
concept environmental theory
of Florence Nightingale.
• Discuss the early life of Florence Nightingale
• Trace her educational background
• Identify her contributions in nursing
• Explain her nursing theory
• Discuss the four paradigms in nursing
Religious inspiration called her to
focus on the health of the masses
q Florence Nightingale
was born into a rich,
upper-class, well-
connected British family
q Was born in Florence,
Italy, and was named
after the city of her birth.
q Florence's older sister
Parthenope had similarly
been named after her
place of birth
q As she grew up, her father
provided her with a reputable
education
q she was a linguist; had a
vast knowledge of science,
mathematics, literature and
arts.
q well read in philosophy,
history, politics, and
economics
q well-informed about the
workings of government and
political science
 Inspired by what she took as a call
from God in February 1837 while at
Embley Park, Florence announced
her decision to enter nursing in
1844, despite the intense anger and
distress of her mother and sister. In
this, she rebelled against the
expected role for a woman of her
status, which was to become a wife
and mother. Nightingale worked
hard to educate herself in the art
and science of nursing, in spite of
opposition from her family and the
restrictive societal code for affluent
young English women.
• Germany was the place of the first
nursing school
• Pastor Theodor Fleidner, a protestant
pastor in Kaiserswerth, Germany, opened
the hospital
• Nightingale went to Germany and stayed
for 14 days
• She then applied for admission to the
school with a 12-page curriculum
• Entered the nursing program July 6, 1851
• The 134th nursing student to attend the
Fleidner School of Nursing
• Left Keiserswerth on October 7, 1851
• Was considered to be educated as a
nurse
• She developed skills in both nursing care
and management
Embley Park, now a school, was the
family home of Florence Nightingale
• Went back to England
• Used her knowledge to prove her cause
as a reformer for the well-being of the
citizen
With her lamp, Nightingale
traverse the night during
the Crimean War.
Nightingale became a
heroine in Great Britain as
a result of her work in the
war.
• Used her statistical and
managerial skills
• Mortality rate at the
hospital was 42.7% (was
higher from diseases
than from war injuries)
• 6 months later: mortality
rate went down to 2.2%
(achieved by attending to
the environment of the
soldiers)
During the Crimean campaign,
Florence Nightingale gained the
nickname "The Lady with the
Lamp", deriving from a phrase in a
report in The Times:
“She is a ‘ministering angel’ without any
exaggeration in these hospitals, and
as her slender form glides quietly
along each corridor, every poor
fellow's face softens with gratitude at
the sight of her. When all the medical
officers have retired for the night and
silence and darkness have settled
down upon those miles of prostrate
sick, she may be observed alone, with
a little lamp in her hand, making her
solitary rounds.”
The phrase was further popularized by
Henry Wadsworth Longfellow's 1857 poem
"Santa Filomena“

Lo! in that house of misery

A lady with a lamp I see
Pass through the glimmering gloom,
And flit from room to room.
•Pioneered the concept of formal nursing education

•Her experience in treating sick/injured soldiers in

the Crimean War strongly influenced her philosophy
of nursing

•First to use statistics to guide care delivery

• Based her ideas on individual, societal,
and professional values
• Her strongest influence was
education, observation, and
hands-on experience
• She formulated her values
through years of working
with charities, hospitals,
& the military
• In 1860 Nightingale published Notes
on Nursing
• Considered the first “nursing theorist”
• Information on her theory has been
obtained through interpretation of her
writings
• Her theory significantly influenced 3
other groups of theories - Adaptation
Theory, Need Theory, & Stress Theory
• Was not written as a nursing text
• Was a guide to help organize &
manipulate the environment for persons
requiring nursing care
• Nightingale originally wanted women to
teach themselves to nurse and viewed
Notes on Nursing as “hints” to enable
them to do so
• Order of Merit (OM)
• Royal Red Cross (by Queen Victoria of
Great Britain)
• Second most famous British person
• Birthday marks the International Nurses
Day
 Environmental Theory
• Florence
Nightingale’s
Environmental
Theory defined
Nursing as “the act
of utilizing the
environment of the
patient to assist
him in his recovery.”
• The first published nursing theory (1860)
• Persons are in relation with the
environment
• Stresses the healing properties of the
physical environment (fresh air, light,
warmth, 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”
• When aspects of the environment are out of
balance, the client must use energy to
counter these environmental stresses
• Stresses drain the client of the energy
needed for healing
• Viewed disease as a reparative process
• The health of the home/community are
critical components in an individual’s health
• Theory basis: the inter-relationship
• of a healthful environment with nursing
– External influences and conditions can
prevent, suppress, or contribute to disease
or death
• Theory goal: Nurses help patients retain
their own vitality by meeting their basic
needs through control of the environment
• Nursing’s Focus: control of the environment
for individuals, families & the community
• Physical
• Psychological
• Social
• 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
• 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!
 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
1. Proper ventilation
2. Adequate light
3. Sufficient warmth
4. Control of noise
5. Control of effluvia (noxious odors)
• Referred to by Nightingale as
“the patient”
• A human being acted upon by
a nurse, or affected by the
environment
• Has reparative powers to deal
with disease
• Recovery is in the patient’s
power as long as a safe
environment exists
• The foundational component of
Nightingale’s theory
• The external conditions & forces
that affect one’s life and
development
• Includes everything from a
person’s food to a nurse’s verbal
& nonverbal interactions with the
patient
• Maintained by using a person’s healing
powers to their fullest extent
• Maintained by controlling the
environmental factors so as to prevent
disease
• Disease is viewed as a reparative
process instituted by nature
• Health & disease are the focus of the
nurse
• Nurses help patients through their
healing process
 Provides fresh air, light, warmth,
cleanliness, quiet, and a proper
diet
 Facilitates a patient’s reparative
process by ensuring the best
possible environment
 Influences the environment to
affect health
 Supports the nursing process
(even though it was not even
developed yet!)
• Nursing education belongs in the
hands of nurses!
• Nursing is a discipline distinct
from medicine focusing on the
patient’s reparative process rather
than on their disease!!
Using Nightingale’s model, compare and
contract the practice of nursing in the late 1800’s
with nursing in present times.