A Review of Florence Nightingale’s Environmental Philosophy in Advanced Care Nursing The mother of modern nursing, Florence Nightingale, originally published her Environmental Theory in 1860 in a book entitled Notes on Nursing: What It Is and What It Is Not. This book became the foundation for formal education of nurses throughout Britain and the United States (McEwan & Wills, 2011). She was one of the first to document and understand the impact of the physical environment on the patient and thus their outcomes. According to Nightingale (1860) nursing is it’s own art, separate but not inferior to medicine. This paper will look at a brief overview of Florence Nightingale’s Environmental Philosophy and discuss how this is applicable to nursing …show more content…
Nightingale had seven basic assumptions as follows: there are natural laws, mankind can achieve perfection, nursing is a calling, nursing is an art science, nursing is achieved through environmental alteration, nursing requires a special education base, and nursing is distinct and separate form medicine (Nightingale, 1860). There are also specific concepts listed within the Environmental Theory that are referred to as canons which include ventilation and warming, health and houses, petty management, noise, variety, taking food, what food, bed and bedding, light, cleanliness of rooms and walls, personal cleanliness, chattering hopes and advices, and observation of the sick (Nightingale, 1860). Selanders (2010, p.86) explains that environment is the “umbrella concept” for this philosophy. As such, Nightingale believed the environment could be altered to allow for the natural state of healing to …show more content…
This becomes increasingly important when the nurse takes on an advanced practitioner role. Traditionally physicians have been responsible for diagnosing and prescribing and nurses have been the ones to carry out the bedside care. When combining both of these roles, there is an even greater influence on the care patients receive. With this kind of influence it is critical that the advanced care practitioner bring their knowledge of the designed environment, creative implementation, as well as the art of nursing, to the table when treating each
One of the many theorists that followed the founder of modern nursing, Florence Nightingale, was Merle Mishel (Alligood, 2014). However, Florence Nightingale’s theory is different
The second concept, the environment, is the setting that can be controlled by the nurse or an individual to augment comfort. (Masters, 2017). In a hospital setting this could include dimming the lights, providing a low stimulation environment, or limiting visitors. Another example may be removing an individual from a situation that is not conducive to healing. Health is the third concept and refers to the orchestration and collaboration of those involved in assisting the patient to a state of well-being. Lastly, the concept of nursing describes the utilization of the nursing process of assessment, planning, intervention to meet the comfort needs of the individual and evaluating the effectiveness of those
According to Nightingale, external influences and conditions can prevent, suppress, or contribute to disease or death. Her first theory in her journal titled “Notes on Nursing: What It Is and What It Is Not” is ventilation and warming in which Nightingale states “ to keep the air he breathes as pure as the external air, without chilling him” (Nightingale, 2005). Toronto Public Health, in accordance with The City of Toronto’s TB program developed guidelines to reduce TB transmission in homeless shelters and drop- in centers using environmental controls (Environmental Control Best Practices, 2007), the basis of Nightingales theories. In this document they discuss that environmental control measures act to dilute infectious particles by mixing fresh air into a space and one can interrupt TB transmission by introducing fresh outside air to replace room air (Environmental Control Best Practices, 2007). Additionally, it discusses ventilation, in terms of natural ventilation, which refers to fresh dilution air that enters and leaves a building through openings such as windows, when weather permits (Environmental Control Best Practices, 2007). Nightingale stressed the importance of always having proper ventilation, as she believed that the air an individual breathes could be a source of disease
Nightingale, F. (1898). Notes on nursing: what it is and what it is not. New York, NY:
One of which is person “the recipient of nursing care” (Finkleman & Kenner, 2013, p. 28). I feel two of Nightingale’s canons are based on the patient petty management and personal cleanliness. Environment is the second concept which Nightingale explains “the external and internal environment” of the patient (Finkleman & Kenner, 2013, p. 29). I believe nine of Nightingales canons are aimed towards this concept ventilation and warmth, health of the house, noise, variety, food intake, food, bed and bedding, light, and cleanliness of room and walls. Nursing is the third concept which Nightingale believes they “alter or manage the environment to implement the natural laws of health” (Finkleman & Kenner, 2013, p. 28). I feel the two canons chattering hopes and advice, and observation of the sick best explains this concept. Lastly, the concept of Health, Nightingale believed that health is not only the absence of disease but being able to utilize everything that we are. I believe that the previous three concepts must be fulfilled to achieve the last and final concept because the patient is effected by the environment and the
Philosophy of Nursing When one thinks of the evolution of nursing, several noteworthy women come to mind, yet one stands out, Florence Nightingale. In Notes on Nursing, Nightingale says “.put the patient in the best conditions for nature to act upon him.” (1859, p.75) She established standards that reformed the industry.
A nurse is able to achieve this great balance, with the patient and self, by being conscious of the environment that surrounds them and through self awareness. For example, in the scene of an emergency, first and foremost, a nurse must check the environment before started emergent care. Both the patient and nurse must be safe for treatment to be effective. The environment is what surrounds us; our workplace, home, communities, issues we think about, the people we interact with, and the emotions associated with these interactions. The nurse knows that all of these components play an integral role in maintaining stability in a person’s life and health. The nurse assumes care of not just a disease process but of a human being as a whole; a family, a livelihood, a spirit, a person. A nurse knows that in order for holistic care to be effective, the care taker themselves should be at a point of stability as well. A true nurse knows that in order to excel you must know your limits and understand that while your main goal is to help the patient regain their strength, identity, and independence, that goal does not have to be achieved by compromising your own self, identity, and
She believed that nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet and proper selection and administration of diet – all at least expense of vital power to the patient” (Steele, 2017, p.58). These interventions helped reduce death rates significantly. Soldiers admired Florence for her patience and passion of care. They named her “lady of the lamp” because during the night she would make rounds to make sure the wounded soldiers needs were met. Today, Florence Nightingale is recognized as the first nursing theorist (Cooper & Gosnell, p.2)
In 2005 Fawcett stated “the metaparadigm of professional nursing incorporates four concepts: human beings, environment, health, and nursing” (as sited in Kearney, 2012, p. 4). This paper discusses my philosophy of nursing by stating my own personal definitions, values, and assumptions regarding each of the above mentioned concepts. My paper concludes with an exemplar from my own nursing practice and how I integrated my nursing philosophy into that particular clinical situation.
When Nightingale was 16 years of age, she cared for the sick villagers near her family’s home. At this point in her life she knew nursing was what she wanted to pursue. In 1854 she was asked to put together a team of nurses who could care for sick and injured soldiers. She gathered thirty-eight other nurses together to staff a hospital overseas for the British army during the Crimean War. Nightingale trained herself for this great profession we call nursing, as she approached the hospital she knew what steps she needed to take to get her patients well. The first step was cleaning up the environment, the hospital was not what she expected at all! Towels contained dry blood and sewage discharge. She was not very big on the concept of bacterial infection; she did not accept the crowding and unsanitary environment. Although Florence was a very successful woman and due to her desire to help others nursing has
Nursing is a growing and constantly changing profession, making a bigger impact in healthcare with every turn. In fact, it was not so long ago that nursing was not even thought of as a profession and we have come a long way since the pioneer days of Florence Nightingale. Nursing is steadily evolving in terms of opportunities, educational requirements, professional recognition, and the advancement of nursing theories. These theories influence the environment, the patient, health, and overall nursing. Nursing theories will continue to evolve and guide as we continue to explore and learn new ways to improve overall nursing practice not only for the sake of the patients, but also for the future of nursing as a whole. However, when one looks to the future of nursing, they must also remember where it started; the basics of Florence Nightingale and that “Were there none who were discontented with what they have, the world would never reach anything better” (Nightingale, 1859).
I believe people are connected beings with fundamental pride and values. To appropriately care for a person, the patient must be considered as a whole package. In order to do this, the person’s physical, social, psychological, cultural, spiritual, and aspects of their life must be considered when creating a plan of care. Environment can be defined as “the aggregate of surrounding things, conditions, or influences; surrounding and the social and cultural forces that shape the life of a person or a population,” (n.d.). A person’s environment is such a large part of their life and such an influencing factor on their day-to-day decisions. Their environment includes their socio-economic status (can they afford their prescriptions? Is the test that’s being run really necessary or an undue burden on them financially?), demographics (what is their understanding of health? What are their religious beliefs? what are their race/are they more susceptible to certain conditions?), access of to health care (do they drive/have transportation? Do they have health insurance?), and social support (are they alone? Do they have too much support with too many opinions?). As a nurse, one must always know a person is in continuous contact with their environment and the stress that come along with it. An appropriate and relaxing environment can impact a patient’s adherence to their medications and treatments and reduce their recovery time. The third concept on which I based my philosophy is health, which is the absence of illness. As a nurse and/or practitioner, it is important to focus on the patient’s main health complaint as well as any associated symptoms, needs, and overall wellness of the patient. Nursing is the promotion, deterrence of sickness and harm, protection, optimization of wellbeing and abilities; and advocacy in the care of individuals, populations, communities,
ANA describes “The Scope of Nursing Practice (as) the “who,” “what,” “where,” “when,” “why,” and “how’ (8).’ In other words, it is the responsibility of the nurse to know who their patient is, what the patient’s diagnosis and treatment are, where it is they will be delivering treatment, the rationale behind their actions, and how they will deliver the care. By following the scope of practice, nurses reduce avoidable errors and are aware of the liability their actions entail. The ANA also puts forth a nursing process to guide nurses in treatment. The constantly evolving process is currently assessment, diagnosis, identification of outcomes, planning, implementation, and evaluation (ANA 9). Though this method has dramatically improved nursing care, it may be necessary to repeat steps to adapt to a patient’s changing needs and pathologies. By following guidelines set by the ANA, nurses are able to better connect with their patients and instill the image of professionalism to the public while also optimizing safety
Sometimes in war a person can learn new things that can befit the world. Nightingale saw that most soldiers were dying from illness and not from there injures that they had received. ("Florence nightingale," 2011) She observed the environment that the patients were in, and notice that most of them did not have adequate nutrition, and their environment was not clean. ("Florence nightingale," 2011) The changes she made in the ward included a better nutrition and a sanitary environment these changes greatly decreased the mortality rate which was at a 42% then drop to 2% ("Florence nightingale," 2011) Nightingale believed that a patient environment affected the healing process for the patient. Nightingale states, “Nursing out to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and then proper selection and administration of diet.” (Alligod & Tomey, 2006) Nightingale created 13 canons, which revolves around nurse to critical think and how the nurse can change the environment. An example of one of her Canons is noise, states “asses the noise level in the client room and surrounding area. Attempt to keep noise level to a minimum.”(Alligod & Tomey, 2006)
According to Kristen Swanson’s theory of caring, caring consists of Knowing, Being with, Doing for, Enabling, and maintaining belief. She believes that the environment and what is in the environment can affect people, either positively or negatively. As a nursing student, I possess the qualities of enabling, doing for, and being with. These qualities are implanted in me via my upbringing, culture, religious belief, and life experience/encounters(my environment). “Enabling” is the nurses’ responsibility to help the make a transition into the unknown.