Florence Nightingale

Nursing Theory
Florence Nightingale
-Born: May 12, 1820
-Nursing Education: trained in Germany at a Protestant religious community
with a hospital and after 3 months she was declared trained as a nurse
Nickname: The Lady with the Lamp
• One day she visited a hospital
• THIS CHANGED HER LIFE
Hospitals in 1830’s
Often people who went
into hospital died • They were Dirty

• Badly run

• Nurses didn’t know what to

do
Florence Nightingale
Harry Nicholson

Turned down several offers

of marriage to pursue her
 Richard Monckton Milnes  career.

Harry Verney
 Crimean War
• Broke out when Florence
34 was years old

• War Russia v Turkey(Britain

and France)

• Reports were coming

through about terrible
conditions in hospitals
Florence left London

• With 38 nurses
• Scutari Barrack
Hospital
• Mortality rate at the
hospital was 42.7% of
those treated
• mortality rate dropped
to 2.2%
She got to work
• Scrubbed the floors

• Cleaned the wards

• Washed the bedclothes

• Made the men comfortable

•In the night she carried a
lamp so she was called
“The Lady with the Lamp”
•Soldiers kissed her
shadow
They began to get better
Sitting up, cheerful and happier!
Letter from Queen Victoria
• Thanking “Miss Nightingale and
her ladies” for all their hard
work
Notes on Nursing: What it is and What it is Not was a book first
published by Florence Nightingale in 1859
Quotations:
• On the purpose of nursing.”…the proper
use of fresh air, light, warmth,
cleanliness, quiet, and the proper
selection and administration of diet- all
at the least expense of vital power to the
patient”
• On the empowering partnership with
clients in the community.” We must not
talk to them or at them but with them”
Origins of Nightingale’s Theory for
Nursing Practice:
• Prolific writer.

• Her ideas, values, and beliefs on a wide range of topics can

be identified in her documents.

• In 1859, she was the first to conceptualize nursing

work into a theoretical framework.
Assumptions of Florence
Nightingale’s Theory:
• Law –”thoughts of God”
• Natural laws
• Mankind can achieve
perfection
• Nursing is a calling
• Nursing is an art and a science
• Nursing is achieved through
environmental alteration
• Nursing requires a specific
educational base
• Nursing is distinct and separate
from medicine
Nightingale’s Canons: (10)
Ventilation and warming
Light, Noise
Cleanliness of rooms/walls
Health of houses
05 - Scrubbing, Gowning & Gloving Part 2.mp4
Bed and bedding
Personal cleanliness
Variety
Chattering hopes and advices
Taking food. What food?
Petty management/observation
Environmental Theory

- Philosophy or Metatheory
 Environmental Theory:
Major Concepts and Definitions
1.Environment - concepts of ventilation, warmth, light, diet,
cleanliness and noise. She focused on the physical aspects of the
environment.

• She believed that "Healthy surroundings were necessary for

proper nursing care."
“Nursing is an act of utilizing the
environment of the patient to
assist him in his recovery”
 Configure
environmental
settings
appropriate for


NURSE PATIENT

gradual
INITIATIVE restoration
of health
Configure external factors associated with the patient's surroundings
that affect life or biologic and physiologic processes, and his
development.
 5 Essential Components of
A Healthy Environment:

1. pure air
2. pure water
3. efficient drainage
4. cleanliness
5. light
1. Pure fresh air - "to keep the air he breathes as
pure as the external air without chilling him.“

2. Pure water - "well water of a very impure kind is

used for domestic purposes. And when epidemic
disease shows itself, persons using such water are
almost sure to suffer.“

3. Effective drainage - "all the while the sewer

maybe nothing but a laboratory from which
epidemic disease and ill health is being installed
into the house."
4. Cleanliness - "the greater part of nursing consists in
preserving cleanliness.“

5. Light (especially direct sunlight) - "the usefulness of

light in treating disease is very important.“

• Any deficiency in one or more of these factors could

lead to impaired functioning of life processes or
diminished health status.
• The, factors posed great significance during
Nightingale's time, when health institutions had
poor sanitation, and health workers had little
education and training and were frequently
incompetent and unreliable in attending to the needs
of the patients.
How are the issues public hospitals
now?

Pure Water?
Pure fresh air?
Effective drainage
Light?
Control of noise?
FIVE MAJOR COMPONENTS OF A
HEALING ENVIRONMENT

VENTILATION LIGHT WARMTH

CONTROL NOISE CONTROL ODOR

27
• Also emphasized in her environmental theory is the provision of a
quiet or noise-free and warm environment, attending to patient's
dietary needs by assessment, documentation of time of food
intake, and evaluating its effects on the patient.
Concerns of Environmental Theory
1. Proper ventilation focus on the architectural aspect
of the hospital.

2. Light has quite as real and tangible effects to the

body.

.
3. Cleanliness and sanitation. She assumes that dirty
environment was the source of infection and rejected
the "germ theory". Her nursing interventions focus on
proper handling and disposal of bodily secretions and
sewage, frequent bathing for patients and nurses,
clean clothing and handwashing.
4. Warmth, diet and quiet environment. She introduced the
manipulation of the environment for patient's adaptation
such as fire, opening the windows and repositioning the
room seasonally, etc.

5. Unnecessary noise is not healthy for recuperating

patients.

6. Dietary intake.

7. Petty management proposed the avoidance of

psychological harm, no upsetting news. Strictly war issues
and concerns should not be discussed inside the hospital.
She includes the use of small pets of psychological therapy.
Nursing Metaparadigm
Nursing
• Nursing is different from
medicine and the goal of
nursing is to place the
patient in the best possible
condition for nature to act.
• Nursing is the "activities
that promote health (as
outlined in canons) which
occur in any caregiving
situation. They can be
done by anyone."
Person
• People are
multidimensional,
composed of biological,
psychological, social and
spiritual components.

• The patient is the focus of the

environmental theory. The
nurse should perform the task
for the patient and control the
environment for easy recovery.
She practices nurse-patient
passive relationship.
Health
• Health is “not only to be
well, but to be able to
use well every power we
have”.

• A healthy body can recuperate and

undergo reparative process.
Environmental control uplifts
maintenance of health.
Six D’s of Dys-ease:
• Disease is considered as dys-ease Dirt
or the absence of comfort. Drink
Diet
Damp
Draughts
Drains
Environment
• Poor or difficult
environments led to
poor health and disease.
• Environment could
be altered to
improve conditions
so that the natural
laws would allow
healing to occur.
 Logical Form
• She used inductive reasoning from her experiences and
observation which is addressed with logical thinking and philosophy.
 Importance of
Environmental Theory
 Practice
1. Disease control
2. Sanitation and water treatment
3. Utilized modern architecture in the prevention of "sick building
syndrome" applying the principles of ventilation and good lighting.
4. Waste disposal
5. Control of room temperature.
6. Noise management.
 Education
1. Principles of nursing training. Better practice result from better
education.

2. Skills measurement through licensing by the use of testing

methods, the case studies.
 Research
1. Use of graphical representations like the polar
diagrams.

2. Notes on nursing.
 Critique

• Simplicity – simple and logical; tends toward

description and explanation rather than prediction

• Generality – provides general guidelines for all

nurses
 Critique

• Empirical Precision – Little or no provision is made for empirical

examination; individual observation rather than systematic research

• Derivable Consequences – to extraordinary degree, direct the

nurse to action on behalf of patient and herself; These directives
encompass the areas of practice, research and education