Nightingale Theory

Florence Nightingale NUR 3006

***** 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.” Source: Florence Nightingale: Mystic, Visionary, Healer (B.M. Dossey), p. 230.

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.” Source: Florence Nightingale: Mystic, Visionary, Healer (B.M. Dossey), p. 231.

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.

Nightingale Resources  On-line Florence Connection  Florence Nightingale Museum  Her Gravesite, Website  Interesting Stories  Collection of Her Letters  Her Impact on Rural Hygiene