FLORENCE NITHINGALE

Biography:

     Was born in Florence Italy

     May 12, 1820
     was provided with very broad education
     fought the bureaucracy for bandages, food, fresh bedding, & cleaning supplies for the soldiers
during the Crimean War
     great concern for the well-being of the English soldiers
     she provided comfort for the critically ill & dying
     after the war, she established schools of nursing
     She died on August 13, 1910
     MOTHER OF  MODERN NURSING ---She used the information gathered through life experiences
in the development of nursing
     GERMANY
 -      was the first site of organized nursing school in1836
 -      Pastor Theodor Fliedner; opened a hospital in Kaiserswerth Germany
 -      one patient, one nurse & one cook
 -      lack of work force led to the development of a school in nursing
 -      the physician spent time to teach nursing students
o     GERTRUDE REICHARDT
 -      1ST Matron of the Deaconess School of Nursing
 -      no textbooks available until 1837
 -      Nightingale visited Kaiserswerth for 14 days
 -      she entered the nursing program July 6, 1851, the 134 th nursing student
 -      she developed both nursing care & management skills

Approach to Nursing:

o     Used her knowledge, understanding & prevalence of disease & her observation to
develop an approach to nursing
o     CONTROL OF ENVIRONMENT---Individuals & family both healthy & ill
  Ventilation & light
 Proper disposal of sewage
 Appropriate nutrition

o    NOTES ON NURSING:
 thought to women who have personal charge of health of others
 everyday sanitary knowledge
 she wanted women to teach themselves to nurse
 In her writings, she provided much information on the influence of the environment

THEORY: Environmental Model

 Manipulation of the physical environment as a component of nursing care

Major Areas Of Environment

1.    Health Of Houses
-    Badly constructed houses do for the healthy what badly constructed hospitals do for the sick. Once
insure that air is stagnant & sickness is certain to follow”
-    Cleanliness outside the house affects the inside
2.    Ventilation & Warming
-    “keep the air he breathes as pure as the external air w/o chilling him”
3.    Light
       -     patient’s need direct sunlight
-     sick people rarely lie with their face toward the wall but are much more likely to face the window
4.    Noise
-     patient’s should never be waked intentionally or accidentally
-     noise affects the healing
5.    Variety
-     Variety of environment was a critical aspect affecting the patient’s recovery
-     effect of the body & the mind
-     reading, needlework, writing, cleaning activities to relieve boredom
6.    Bed And Bedding
-          Keep bedding clean, neat, & dry & position the patient for maximum comfort
7.    Cleanliness Of Rooms And Walls
-          “the greater part of nursing consists in preserving cleanliness”
-          she urges removal of dust instead of relocating
-          a clean room is a healthy room
8.    Personal Cleanliness
-          Skin is important
-          excretion must be washed
-          unwashed skin can poison, drying & bathing can provide great relief
-          ”it is necessary to keep the pores of the skin free from all obstructing excretions”
-          “every nurse ought to wash her hands very frequently during the day
9.    Nutrition And Taking Food
10. Chattering Hopes And Pieces Of Advice
11. Observation Of The Sick
12. Social Considerations
               

Metaparadigm In Nursing

Nursing

-       “what nursing has to do...is to put the patient in the best condition for nature to act upon him”
-         signifies the proper use of the major areas in environment

Person
-         Not defined by Nightingale specifically, but are defined in relationship to their environment & the
impact on them

Environment

-         She focused on ventilation, warmth, noise, light, & cleanliness

-         All that surrounds human beings is considered in relation to his state of health

Health

-         No definition of health specifically

-         pathology teaches the harm disease has done
-         “nature alone cures”
-          Nursing should provide care to the healthy & ill & discussed health promotion as an activity in
which nurses should engage

VIRGINIA HENDERSON
Biography:

 She was the “First Lady of Nursing” and “First Truly International Nurse”.

 She began her career in Public health nursing in the Henry Street Settlement and visiting nurse
service in Washington, D.C.
 She was First  Full-time Instructor in nursing in Virginia when she was at Norfolk Protestant
Hospital.
 During her years at Teacher College, Columbia University, she was an outstanding teacher and
student.
 She was Selected to the American Nurse Association Hall of Fame and had the sigma Theta Tau
international Library named in her honored.
 She introduced Textbook of the Principles and practice.
 She also directed twelve-years project entitled Nursing Study Index.
 In Nature of Nursing – she expressed her belief about the essence of nursing and influenced the
hearts and mind of those who read it.
 In 1921 – Virginia Henderson was an early advocate for introduction of psychiatric nursing in
curriculum and serve on committee to develop such a course at Eastern State Hospital in
Williamsbrug.
 Age of 75 – Henderson directed her career to international teaching and speaking.
 1988 – she was honored by the Virginia Nurse association and when the Virginia Historical Nurse
Leadership Award was presented to her.
 In 2000 – the Virginia nurse association recognize Henderson as one of fifty-one Pioneer Nurse in
Virginia
"The unique function of the nurse is to assist the individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he
had the necessary strength, will or knowledge.  And to do this in such a way as to help him gain
independence as rapidly as possible”.

THEORY: 14    Basic Needs

Physiological

1.    Breath normally
2.    Eat and drink adequately
3.    Eliminate body wastes
4.   Move and maintain desirable postures
5.   Sleep and rest
6.   Select suitable clothes - dress and undress
7. Maintain body temperature within normal range by adjusting clothing    and modifying the
environment.
8.  Keep the body clean and well groomed and protect the integument.
9.  Avoid dangers in the environment and avoid injuring others.
10.Communicate with others in expressing emotions, needs, fears, or opinions.
11. Learn, discover, or satisfy the curiosity that leads to normal developmentand health and use the
available health facilities.

Sociological

12. Work in such a way that there is a sense of   accomplishment.

13. Play or participate in various forms of recreation

Spiritual

14.Worship according to one’s faith

The Three Level Compromising The Nurse-Patient Relationship: 

1.   “The nurse as a substitute for the patient”

-          In times of illness, when the patient cannot function fully, the nurse serve as then substitute as to
what the patient lack such, as knowledge, will and strength in order to make him completed, whole
independence once again.

2.   “The nurse as a helper to the patient”

-          In situation where the patient cannot meet his basic needs, the nurse serve as a helper to
accomplish them.

3.   “The nurse as a partner with the patient”

-          As a partners, the nurse and the patient formulate the plan together. Both as an advocate and as a
resource-person , the nurse  can empower the patient to make effective decisions regarding his care plan.
 Metaparadigm In Nursing

    Nursing

-      Henderson asserted that nurse function independently from the physician, but they must promote
the treatment plan prescribe by the physician.
-      Although part of the health team, the nurse must act independently but in coordination with with the
therapeutic plan developed by the team

    Person

-      Is an individual who requires assistance to achieve health and independence or in some case, a
peaceful death.

    Environment

-      Individuals in relation to families

-      Supports tasks of private and public agencies
-      Society expects nurses to act for individuals who are unable to function independently
-      Basic nursing care involves providing conditions under which the patient can perform the 14 activities
unaided

    Health

-      Definition based on individual’s ability to function independently as outlined in the 14 components.

-      Nurses need to stress promotion of health and prevention and cure of disease.
-      Good health is a challenge.
-      Affected by age, cultural background, physical, and intellectual capacities, and emotional balance
-      Impact on health by working of various social issues.

FAYE GLENN ABDELLAH

Biography:

 Born on March 13, 1919 in New York to a father of Algerian heritage and Scottish mother
 Abdellah went on to earn three degrees from Columbia University: a bachelor of science degree in
nursing in 1945, a master of arts degree in physiology in 1947 and a doctor of education degree in
1955.
 During her 40-year career as a Commissioned Officer in the U.S. Public Health Service from 1949 to
1989, Abdellah was assigned to work with the Korean people during the Korean War.
  She served as Chief Nurse Officer from 1970 to 1987 and was the first nurse to achieve the rank of
a two-star Flag Officer and was named by U.S. Surgeon General C. Everett Koop as the first woman
and nurse Deputy Surgeon General from 1982 to 1989.
 Identified 21 nursing problems.
 Defined nursing as a service to individuals and families therefore to society.
 Conceptualized nursing as an Art and science.

THEORY: 21 Nursing Problems 

1.    To maintain good hygiene

2.    To promote optimal activity; exercise rest and sleep
3.    To promote safety
4.    To maintain good body mechanics
5.    To facilitate the maintenance of a supply of oxygen
6.    To facilitate maintenance of nutrition
7.    To facilitate maintenance of elimination
8.    To facilitate the maintenance of F&E balance
9.    To recognize the physiologic responses of the body to disease condition
10. To facilitate the maintenance of regulatory mechanisms and functions
11. To facilitate the maintenance of sensory function
12. To identify and accept the positive and negative expressions, feelings and reactions
13. To identify and accept the interrelatedness of emotions and illness
14. To facilitate the maintenance of effective verbal and non-verbal communication
15. To promote the development of productive interpersonal relationship
16. To facilitate the progress towards achievement of personal spiritual goals
17. To create and maintain a therapeutic environment
18. To facilitate awareness of self as an individual with varying needs
19. To accept the optimum possible goals
20. To use community resources as an aid in resolving problems arising from illness
21. To understand the role of social problems as influencing factors

Metaparadigm In Nursing

Person

-   She describes the recipients of nursing as individuals (and families), although she does not delineate
her beliefs or assumptions about the nature of human beings.

Health

-   Health, or the achieving of it, is the purpose of nursing services. Although Abdellah does not give a
definition of health, she speaks to “total health needs” and “a healthy state of mind and body.”
-   Health may be defined as the dynamic pattern of functioning whereby there is a continued interaction
with internal and external forces that results in the optimal use of necessary resources to minimize
vulnerabilities.

Environment
-   Society is included in “planning for optimum health on local, state, and international levels.” However,
as Abdellah further delineates her ideas, the focus of nursing service is clearly the individual.

Nursing

 -   The client’s health needs can be viewed as problems, which may be overt as an apparent condition, or
covert as a hidden or concealed one.
-   Because covert problems can be emotional, sociological, and interpersonal in nature, they are often
missed or perceived incorrectly. Yet, in many instances, solving the covert problems may solve the overt
problems as well.