Florence NightingaleFlorence Nightingale

Madeline N. Gerzon, RN, MMBSN 11CTFN, Davao Doctors College

**********

Religious inspiration Religious inspiration called her to focus called her to focus on the health of on the health of the massesthe masses

Florence NightingaleFlorence Nightingale

Began her nursing training in 1851 in Began her nursing training in 1851 in GermanyGermany

Pioneered the concept of Pioneered the concept of formalformal nursing educationnursing education

Her experience in treating sick/injured Her experience in treating sick/injured soldiers in the Crimean War strongly soldiers in the Crimean War strongly influenced her philosophy of nursinginfluenced her philosophy of nursing

First to use statistics to guide care First to use statistics to guide care deliverydelivery

Florence Nightingale… Florence Nightingale…

““All sciences of observation depend All sciences of observation depend upon statistical methods—without upon statistical methods—without these, are blind empiricism. Make these, are blind empiricism. Make your facts comparable before your facts comparable before deducing causes. Incomplete, pell-deducing causes. Incomplete, pell-mell observations arranged so as to mell observations arranged so as to support theory; insufficient number support theory; insufficient number of observations; this is what one of observations; this is what one sees.” sees.”

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

Florence NightingaleFlorence Nightingale

Based her ideas on individual, Based her ideas on individual, societal, and professional valuessocietal, and professional values

Her strongest influence was Her strongest influence was education, observation, and education, observation, and hands-on experiencehands-on experience She formulated her values She formulated her values through years of working through years of working with charities, hospitals, with charities, hospitals, & the military & the military

Florence NightingaleFlorence Nightingale

In 1860 Nightingale published In 1860 Nightingale published Notes Notes on Nursingon Nursing

Considered the first “nursing theorist”Considered the first “nursing theorist” Information on her theory has been Information on her theory has been

obtained through interpretation of her obtained through interpretation of her writings writings

Her theory significantly influenced 3 Her theory significantly influenced 3 other groups of theories - Adaptation other groups of theories - Adaptation Theory, Need Theory, & Stress TheoryTheory, Need Theory, & Stress Theory

Nightingale’s Nightingale’s Notes on NursingNotes on Nursing::

Was Was notnot written as a nursing text written as a nursing text Was a guide to help organize & Was a guide to help organize &

manipulate the environment for manipulate the environment for persons requiring nursing carepersons requiring nursing care

Nightingale originally wanted women Nightingale originally wanted women to teach themselves to nurse and to teach themselves to nurse and viewed viewed Notes on NursingNotes on Nursing as “hints” as “hints” to enable them to do soto enable them to do so

Nightingale on Nightingale on Notes on NursingNotes on Nursing……

“ “I thank you sincerely & kindly for what I thank you sincerely & kindly for what you have to say about my you have to say about my Notes on Notes on NursingNursing —you do not know how, in the —you do not know how, in the midst of much disappointment, such midst of much disappointment, such words cheer & strengthen us. The only words cheer & strengthen us. The only possible merit of my little book is that possible merit of my little book is that there is not a word in it written for the there is not a word in it written for the sake of writing, but only forced out of me sake of writing, but only forced out of me by much experience in human suffering.”by much experience in human suffering.”

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

Nightingale’s Nursing TheoryNightingale’s Nursing Theory The The firstfirst published nursing theory (1860) published nursing theory (1860) Persons are in relation with the environmentPersons are in relation with the environment Stresses the healing properties of the Stresses the healing properties of the

physical environment (fresh air, light, physical environment (fresh air, light, warmth, and cleanliness)warmth, and cleanliness)

Nursing puts patients in the “best Nursing puts patients in the “best conditions” for nature to act upon themconditions” for nature to act upon them

Health is “the positive of which the Health is “the positive of which the pathology is the negative”pathology is the negative”

““Nature alone cures”Nature alone cures”

Nightingale’s Nursing TheoryNightingale’s Nursing Theory

When aspects of the environment are When aspects of the environment are out out of balanceof balance, the client must use energy to , the client must use energy to counter these environmental stressescounter these environmental stresses

Stresses drain the client of the energy Stresses drain the client of the energy needed for healingneeded for healing

Viewed disease as a reparative processViewed disease as a reparative process The health of the home/community are The health of the home/community are

critical components in an individual’s healthcritical components in an individual’s health

Nightingale’s Nursing TheoryNightingale’s Nursing Theory Theory basisTheory basis: the inter-relationship of a : the inter-relationship of a

healthful environment with nursing healthful environment with nursing • External influences and conditions can prevent, External influences and conditions can prevent,

suppress, or contribute to disease or deathsuppress, or contribute to disease or death Theory goalTheory goal:: Nurses help patients retain Nurses help patients retain

their own vitality by meeting their their own vitality by meeting their basic basic needsneeds through control of the environmentthrough control of the environment

Nursing’s FocusNursing’s Focus: : control of the control of the environment for individuals, families & the environment for individuals, families & the community community

Three Types of EnvironmentsThree Types of Environments

PhysicalPhysical PsychologicalPsychological SocialSocial

Physical EnvironmentPhysical Environment

Consists of physical elements where the Consists of physical elements where the patient is being treatedpatient is being treated

Affects all other aspects of the environmentAffects all other aspects of the environment Cleanliness of environment relates directly Cleanliness of environment relates directly

to disease prevention and patient mortalityto disease prevention and patient mortality Aspects of the physical environment Aspects of the physical environment

influence the social and psychological influence the social and psychological environments of the personenvironments of the person

Psychological EnvironmentPsychological Environment

Can be affected by a negative physical Can be affected by a negative physical environment which then causes STRESSenvironment which then causes STRESS

Requires various activities to keep the mind Requires various activities to keep the mind active (i.e, manual work, appealing food, a active (i.e, manual work, appealing food, a pleasing environment)pleasing environment)

Involves communication with the person, Involves communication with the person, about the person, and about other people about the person, and about other people • communication should be therapeutic, soothing, communication should be therapeutic, soothing,

& unhurried!& unhurried!

Social EnvironmentSocial Environment

Involves collecting data about illness Involves collecting data about illness and disease preventionand disease prevention

Includes components of the physical Includes components of the physical environment - clean air, clean water, environment - clean air, clean water, proper drainageproper drainage

Consists of a person’s home or Consists of a person’s home or hospital room, as well as the total hospital room, as well as the total community that affects the patient’s community that affects the patient’s specific environmentspecific environment

5 Major Components of a 5 Major Components of a Healthful EnvironmentalHealthful Environmental

1.1. Proper ventilationProper ventilation

2.2. Adequate lightAdequate light

3.3. Sufficient warmthSufficient warmth

4.4. Control of noiseControl of noise

5.5. Control of effluvia (noxious Control of effluvia (noxious odors)odors)

Components of Nightingale’s Components of Nightingale’s Environmental Theory:Environmental Theory:

Health of HousesHealth of Houses Ventilation and Ventilation and

WarmingWarming LightLight NoiseNoise VarietyVariety Bed and BeddingBed and Bedding Cleanliness of Cleanliness of

Rooms and WallsRooms and Walls

Personal Personal CleanlinessCleanliness

Nutrition and Nutrition and Taking FoodTaking Food

Chattering Hopes Chattering Hopes and Advicesand Advices

Observation of the Observation of the SickSick

Social Social ConsiderationsConsiderations

Nightingale’s Theory & Nursing’s Nightingale’s Theory & Nursing’s Metaparadigm - Metaparadigm - PERSONPERSON

Referred to by Nightingale as “the Referred to by Nightingale as “the patient”patient”

A human being acted upon by a A human being acted upon by a nurse, or affected by the environmentnurse, or affected by the environment

Has reparative powers to deal with Has reparative powers to deal with diseasedisease

Recovery is in the patient’s power as Recovery is in the patient’s power as long as a safe environment existslong as a safe environment exists

Nightingale’s Theory & Nursing’s Nightingale’s Theory & Nursing’s Metaparadigm - Metaparadigm - ENVIRONMENTENVIRONMENT

The foundational component of The foundational component of Nightingale’s theoryNightingale’s theory

The external conditions & forces that The external conditions & forces that affect one’s life and developmentaffect one’s life and development

Includes everything from a person’s Includes everything from a person’s food to a nurse’s verbal & nonverbal food to a nurse’s verbal & nonverbal interactions with the patientinteractions with the patient

Nightingale’s Theory & Nursing’s Nightingale’s Theory & Nursing’s Metaparadigm - Metaparadigm - HEALTHHEALTH

Maintained by using a person’s healing Maintained by using a person’s healing powers to their fullest extentpowers to their fullest extent

Maintained by controlling the environmental Maintained by controlling the environmental factors so as to prevent diseasefactors so as to prevent disease

Disease is viewed as a reparative process Disease is viewed as a reparative process instituted by natureinstituted by nature

Health & disease are the focus of the nurseHealth & disease are the focus of the nurse Nurses help patients through their Nurses help patients through their

healing processhealing process

Nightingale’s Theory & Nursing’s Nightingale’s Theory & Nursing’s Metaparadigm - Metaparadigm - NURSINGNURSING

Provides fresh air, light, warmth, Provides fresh air, light, warmth, cleanliness, quiet, and a proper dietcleanliness, quiet, and a proper diet

Facilitates a patient’s reparative process by Facilitates a patient’s reparative process by ensuring the best possible environmentensuring the best possible environment

Influences the environment to affect healthInfluences the environment to affect health Supports the nursing process (even though Supports the nursing process (even though

it was not even developed yet!)it was not even developed yet!)

Nightingale’s Theory & Nursing’s Nightingale’s Theory & Nursing’s Metaparadigm - Metaparadigm - NURSINGNURSING

Nursing education belongs in Nursing education belongs in the hands of nurses!the hands of nurses!

Nursing is a disciplineNursing is a discipline distinct from medicine distinct from medicine focusing on the patient’s focusing on the patient’s reparative process rather reparative process rather than on their disease!!than on their disease!!

Critical Thinking ExerciseCritical Thinking Exercise

Complete an environmental assessment of Complete an environmental assessment of this learning environment. Develop a plan this learning environment. Develop a plan for repair or maintenance.for repair or maintenance.

Consider a patient you have recently cared Consider a patient you have recently cared for. Identify areas of the environment that for. Identify areas of the environment that Nightingale’s theory guides you to assess. Nightingale’s theory guides you to assess. Did you consider these before in your own Did you consider these before in your own model of practice?model of practice?

**********

Using Nightingale’s model, compare and Using Nightingale’s model, compare and contract the practice of nursing in the late contract the practice of nursing in the late 1800’s with nursing in present times.1800’s with nursing in present times.