Original Nursing

Theories of Florence
Nightingale
Origins of Nightingale’s Theory
for Nursing Practice:
Florence Nightingale was a prolific writer. She lived
from 1820 to 1910 in Victorian England.
Her ideas, values, and beliefs on a wide range of
topics can be identified in her documents.
They contain philosophical assumptions and beliefs
regarding all elements found in the metaparadigm of
nursing.
In 1859, she was the first to conceptualize nursing’s
work into a theoretical framework.
She was credited with founding the practice of
nursing.
Relevance to Nursing Today
Florence Nightingale developed a body of nursing
knowledge clearly expressed in the 79 pages of
Notes on Nursing: What It Is and What It Is Not
(Nightingale, 1969).
A 221 page second edition (Nightingale, 1992)
was intended for the professional nurse, and is
relevant to nurses today who are searching for
wisdom on her perspectives on illness, the person,
their environment, and holistic nursing.
Relevant to Nursing Knowledge:
The body of Regardless of
knowledge left whether the
by Florence environment is
Nightingale high tech, the
includes an “nurse remains
environmental responsible for
adaptation altering the
theory, which is environment to
entirely relevant improve it for
to the modern the benefit of the
setting. client”
Assumptions of Florence
Nightingale’s Theory:

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
Major Premises of
Environmental Adaptation
Theory:
People are multidimensional, composed of
biological, psychological, social and spiritual
components.
Disease is more accurately portrayed as dys-ease or
the absence of comfort.
Symptoms alert nurses to the presence of illness,
which allows for appropriate interventions.
Breaking the natural laws will cause disease.
Improvement in the health of individuals and
families lead to the improved health of society.
The Environmental
Adaptation Concepts:
Florence Nightingale’s original Six D’s of Dys-ease:
theory for nursing practice was
Dirt
holistic.
Drink (need clean
Her concepts included drinking water)
human/individual, Diet
society/environment, health/disease Damp
and nursing. Draughts (Drafts)
She focused more on physical Drains (need proper
factors than on psychological needs drainage and sewer
systems)
of patients because of the nature of
nursing practice during her time.
Origin of Nightingale’s
Environmental Concepts:
Nightingale believed that the environment could be
altered to improve conditions so that the natural
laws would allow healing to occur.
This grew from empirical observation that poor or
difficult environments led to poor health and
disease.
In her Crimean experience, filth, inadequate
nutrition, dirty water, and inappropriate sewage
disposal led to a situation in which more British
soldiers died in the hospital than of battlefield
wounds.
NIGHTINGALE’S 13 CANONS
Nightingale defined 13 canons of
environment and she gave a detailed
description of each aspect.
According to Nightingale, if nurses modify
patients environment according to her 13
canons, she can help patient to restore his
usual health or bring patient in recovery.
Ventilation and warming
Light, Noise
Cleanliness of rooms/walls
Health of houses
Bed and bedding
Personal cleanliness
Variety
Chattering hopes and advices
Taking food.
What food?
Petty management
Observation of the sick
The Metaparadigms
Nursing – “..is to put the patient in the best
condition for nature to act upon him”
“ought to signify the proper use of fresh air,
warmth, light, cleanliness, quiet and the
proper selection and administration of diet”
Person – not specifically defined

Environment- stressed out the importance of

the environment to healing (physical envi)

Health- “nature alone cures”

“Unmake what God had made disease”
In Nursing Today:
Nurses old and young have
been influenced by
Florence Nightingale’s
Theories.
Environmental Adaptation
remains the basis of our
holistic nursing care.
I am proud to follow in the
important work of of “The
Lady with the Lamp.”
Reference List:
Attewell, A. (1998) Florence Nightingale’s relevance to nurses.
Journal of Holistic Nursing, 16 (2), 281-291

McDonald, L. (2001). Florence Nightingale and the early origins of

evidence-based nursing, EBN Notebook 4(3), 68-9
McCarthy D, Ouimen M, Daun J. (1991) Shades of Florence
Nightingale: Potential impact of noise stress on wound healing.
Holistic Nursing Practice. 5(4) 39-48
Nightingale, F. (19690. Notes on nursing: What it is and what it is
not. New York: Dover. (original work published 1860)
Selanders, L. (1998) The power of environmental adaptation. Journal
of Holistic Nursing, 16,(2) 247-263
Watson J. (1998), Florence Nightingale and the enduring legacy of
Transpersonal Human Caring. Journal of Holistic Nursing, 16(2), 292-294