nightingale theory

Florence NightingaleFlorence Nightingale

NUR 3006 NUR 3006

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Religious inspiration Religious inspiration called her to focus on called her to focus on the health of the the health of the massesmasses


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 nursing educationeducation

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 deliveryFirst to use statistics to guide care delivery

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 your these, are blind empiricism. Make your facts comparable before deducing facts comparable before deducing causes. Incomplete, pell-mell causes. Incomplete, pell-mell observations arranged so as to support observations arranged so as to support theory; insufficient number of theory; insufficient number of observations; this is what one sees.” observations; this is what one sees.”

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


Based her ideas on individual, societal, Based her ideas on individual, societal, and professional valuesand 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


In 1860 Nightingale published In 1860 Nightingale published Notes on Notes on NursingNursing

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 other Her theory significantly influenced 3 other groups of theories - Adaptation Theory, groups of theories - Adaptation Theory, Need Theory, & Stress TheoryNeed 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 & manipulate Was a guide to help organize & manipulate

the environment for persons requiring the environment for persons requiring nursing carenursing care

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

Nightingale on Nightingale on Notes on NursingNotes on Nursing……

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

Health is “the positive of which the pathology Health is “the positive of which the pathology is the negative”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 External influences and conditions can

prevent, suppress, or contribute to disease or prevent, suppress, or contribute to disease or deathdeath

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, communication should be therapeutic,

soothing, & unhurried!soothing, & unhurried!

Social EnvironmentSocial Environment

Involves collecting data about illness and Involves collecting data about illness and disease preventiondisease 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 hospital Consists of a person’s home or hospital room, as well as the total community that room, as well as the total community that affects the patient’s specific environmentaffects the patient’s specific 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 odors)Control of effluvia (noxious 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 Rooms Cleanliness of Rooms

and Wallsand Walls

Personal CleanlinessPersonal Cleanliness Nutrition and Taking Nutrition and Taking

FoodFood Chattering Hopes and Chattering Hopes and

AdvicesAdvices Observation of the Observation of the

SickSick Social ConsiderationsSocial Considerations

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

Referred to by Nightingale as “the patient”Referred to by Nightingale as “the patient” A human being acted upon by a nurse, or A human being acted upon by a nurse, or

affected by the environmentaffected by the environment Has reparative powers to deal with diseaseHas reparative powers to deal with disease Recovery is in the patient’s power as long Recovery is in the patient’s power as long

as a safe environment existsas 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 affect The external conditions & forces that affect one’s life and developmentone’s life and development

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

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

Maintained by using a person’s healing powers Maintained by using a person’s healing powers to their fullest extentto 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 healing Nurses help patients through their healing

processprocess

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

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

Critical Thinking ExerciseCritical Thinking Exercise

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

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

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

Nightingale ResourcesNightingale Resources

On-line Florence ConnectionOn-line Florence Connection Florence Nightingale MuseumFlorence Nightingale Museum Her Gravesite, WebsiteHer Gravesite, Website Interesting StoriesInteresting Stories Collection of Her LettersCollection of Her Letters Her Impact on Rural HygieneHer Impact on Rural Hygiene

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