Nightingale Theory
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Florence Nightingale
Madeline N. Gerzon, RN, MM BSN 11C TFN, Davao Doctors College
***** Religious inspiration called her to focus on the health of the masses
Florence Nightingale
Began her nursing training in 1851 in Germany 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
Florence Nightingale… “All sciences of observation depend upon statistical methods —without these, are blind empiricism. Make your facts comparable before deducing causes. Incomplete, pell-mell observations arranged so as to support theory; insufficient number of observations; this is what one sees.”
Florence Nightingale
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
Florence Nightingale
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
Nightingale’s Notes on Nursing:
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
Nightingale on Notes on Nursing… “I thank you sincerely & kindly for what you have to say about my Notes on Nursing —you do not know how, in the midst of much disappointment, such words cheer & strengthen us. The only possible merit of my little book is that there is not a word in it written for the sake of writing, but only forced out of me by much experience in human suffering.”
Nightingale’s Nursing Theory
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”
Nightingale’s Nursing Theory
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
Nightingale’s Nursing Theory
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
Three Types of Environments Physical Psychological Social
Physical Environment
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
Psychological Environment
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!
Social Environment
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
5 Major Components of a Healthful Environmental 1. 2. 3. 4. 5.
Proper ventilation Adequate light Sufficient warmth Control of noise Control of effluvia (noxious odors)
Components of Nightingale’s Environmental Theory:
Health of Houses Ventilation and Warming Light Noise Variety Bed and Bedding Cleanliness of Rooms and Walls
Personal Cleanliness Nutrition and Taking Food Chattering Hopes and Advices Observation of the Sick Social Considerations
Nightingale’s Theory & Nursing’s Metaparadigm - PERSON
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
Nightingale’s Theory & Nursing’s Metaparadigm - ENVIRONMENT
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
Nightingale’s Theory & Nursing’s Metaparadigm - HEALTH
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
Nightingale’s Theory & Nursing’s Metaparadigm - NURSING
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!)
Nightingale’s Theory & Nursing’s Metaparadigm - NURSING 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!!
Critical Thinking Exercise
Complete an environmental assessment of this learning environment. Develop a plan for repair or maintenance. Consider a patient you have recently cared for. Identify areas of the environment that Nightingale’s theory guides you to assess. Did you consider these before in your own model of practice?
*****
Using Nightingale’s model, compare and contract the practice of nursing in the late 1800’s with nursing in present times.
Madeline N. Gerzon, RN, MM BSN 11C TFN, Davao Doctors College
***** Religious inspiration called her to focus on the health of the masses
Florence Nightingale
Began her nursing training in 1851 in Germany 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
Florence Nightingale… “All sciences of observation depend upon statistical methods —without these, are blind empiricism. Make your facts comparable before deducing causes. Incomplete, pell-mell observations arranged so as to support theory; insufficient number of observations; this is what one sees.”
Florence Nightingale
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
Florence Nightingale
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
Nightingale’s Notes on Nursing:
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
Nightingale on Notes on Nursing… “I thank you sincerely & kindly for what you have to say about my Notes on Nursing —you do not know how, in the midst of much disappointment, such words cheer & strengthen us. The only possible merit of my little book is that there is not a word in it written for the sake of writing, but only forced out of me by much experience in human suffering.”
Nightingale’s Nursing Theory
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”
Nightingale’s Nursing Theory
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
Nightingale’s Nursing Theory
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
Three Types of Environments Physical Psychological Social
Physical Environment
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
Psychological Environment
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!
Social Environment
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
5 Major Components of a Healthful Environmental 1. 2. 3. 4. 5.
Proper ventilation Adequate light Sufficient warmth Control of noise Control of effluvia (noxious odors)
Components of Nightingale’s Environmental Theory:
Health of Houses Ventilation and Warming Light Noise Variety Bed and Bedding Cleanliness of Rooms and Walls
Personal Cleanliness Nutrition and Taking Food Chattering Hopes and Advices Observation of the Sick Social Considerations
Nightingale’s Theory & Nursing’s Metaparadigm - PERSON
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
Nightingale’s Theory & Nursing’s Metaparadigm - ENVIRONMENT
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
Nightingale’s Theory & Nursing’s Metaparadigm - HEALTH
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
Nightingale’s Theory & Nursing’s Metaparadigm - NURSING
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!)
Nightingale’s Theory & Nursing’s Metaparadigm - NURSING 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!!
Critical Thinking Exercise
Complete an environmental assessment of this learning environment. Develop a plan for repair or maintenance. Consider a patient you have recently cared for. Identify areas of the environment that Nightingale’s theory guides you to assess. Did you consider these before in your own model of practice?
*****
Using Nightingale’s model, compare and contract the practice of nursing in the late 1800’s with nursing in present times.
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