Throughout the 18th and 19th century, the stigmas of nursing practice began to change. Florence Nightingale, a prominent nursing theorist, began to alter the perspective individuals had on nursing. One of Florence Nightingale’s impacting theories stemmed from her novel Florence Nightingale: Notes on Nursing, known as the environmental theory. This theory is chaptered “Noise” in the novel, and while Nightingale identified noise as a disturbance in healthcare over a century ago, this issue is increasingly present in today’s healthcare. This paper examines the modern day theory of “Noise,” current research on the topic in hospital settings and will discuss another historical nursing figures thoughts on the subject and how I plan to incorporate …show more content…
The underlying meaning of this theory focuses on the relationship of a healthy environment with nursing. In the chapter “Noise,” Nightingale addresses several types of environments where external conditions influence or suppress the disease process (Selanders & Crane, 2012, p. 1). The first environmental factor is the physical environment, including the elements such as linens, squeaky floors, and plumbing. Nightingale (1859/1969) remarks on this “noise” when stating, “The fidget of silk and of crinoline, the rattling of keys, the creaking of stays and of shoes, will do a patient more harm than all the medicines in the world will do him good” (p. 47). In order to address this issue, Nightingale focused on controlling the physical environment. This is still addressed today, as the Basset Healthcare Network employee Gary S. Madaras (2012) proves in their initiative to train housekeeping. This network also created the Noise Project, including a questionnaire where 71% participants agreed noise needs to be reduced inside patient rooms …show more content…
In the future I aspire to become a neuro ICU nurse. In this setting, patients are recovering from traumatic brain injuries or other nervous system injuries. Because this body system is so vital to human survival, an appropriate setting of peace and quiet is essential to a full recovery for these patients. Specifically, these patients need sleep. Nightingale (1859/1969) remarks in the beginning of “Noise,” “If he is roused out of his sleep, he is almost certain to have no more sleep” (p. 43). Although I will need to do continuous neurological assessments on these patients, the patient and I will need to come to an agreement on how they wish to be awoken and what aids them in falling asleep. My practice will include not only the idea of reducing noxious stimuli of technology, but regarding myself as a noise-maker as well, and limiting the amount of times a healthcare professional or family member enters the room. Each subtopic in this chapter such as music, unnecessary noise, just outside the door, and effects of over-exertion on the sick, all contribute to the ideal characteristics I wish to obtain as a neurological ICU
...s, physicians, and family members on the importance of prevention, detection, and treatment of ICU delirium. When successful, the ICU staff can promote a healthy environment to support physical and physiological well-being.
“Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion. Remember he is face to face with his enemy all the time, internally wrestling with him” (Nightingale, 1992, p. 22). Fortunately, in the nineteenth century, Florence Nightingale recognized uncertainty could cause harm to her patients (Nightingale, 1992). Equally important to the nursing profession are the nursing theorists, their work, and the evolution of the theories that followed Florence Nightingale, the founder of modern nursing (Alligood, 2014). One of the many theorists that followed the founder of modern nursing, Florence Nightingale, was Merle Mishel (Alligood, 2014).
Registered nurses work to contribute good health and prevent illness. They also treat patients and help go through there rehabilitation and also give support and advice to patients family. Registered nurses are general-duty nurses who focus in the achievement of caring for their patients. They are under the supervision of a doctor. As I researched this career It brought more questions to my life. It became a big interest that soon I would have an opportunity to answer my own questions obviously with the help of others.
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 charge nurse working the night shift overhears loud talking coming from a nearby room within the unit. Upon locating the room where the noise is coming from, she recognizes that it is a patient with dementia who is becoming increasingly confused, agitated, and combative. The family member at bedside who is also the primary caregiver is trying to keep the patient in bed, and also appears quite frustrated. The primary nurse is in the room, but seems to be struggling with what to do. The charge nurse instructs the primary nurse to review the patient’s medications, and obtain the one used for agitation. The charge nurse then explains to the family member about using the medication, and suggests they take a break while other alternative methods are attempted. The charge nurse then dims some of the lighting within the room, begins to play relaxing music, and purposefully speaks in a very soft tone to the patient. The charge nurse continues to try to redirect the patient, but also understands that you must not argue the reality with dementia patients. The charge nurse proceeds with light massage to the hands, and feet of the patient, all while ensuring the patient that they are safe. The patient is showing less agitation, and the nurse soon arrives with the proper medication. The patient is calm and resting by the time the family member returns. Both the primary nurse and the family
After being in the ICU for a couple of weeks the patients started to show signs of ICU psychosis. The patient would be afraid to sleep, would think machines, tubes, and monitors is keeping him/her alive. Alarms in the hospital would sound off, the patient assumes that they were going to die. As days pass the patient sign and symptoms worsen. The patient finally moved to a different unit. Nurses explained to the patient family that the patient is experiencing ICU psychosis and its unhealthy for patient mental status. To treat the ICU psychosis for this patient the nurses would try to increase patient self-esteem and independence. The patient would exercise in the physical therapy department, for 15 minutes every shift. After a few days of treatment patient symptoms start to decrease. Having the patient get out the room for a few minutes a day help patient break through ICU psychosis(1982).
...managing the environment for the benefit of the patient to help reduce risk factors. Supportive measures by the nurse such as attention to noise reduction and lighting should be implemented to all patient care settings. The nurse should be proficient in their assessment method. The bedside nurse is in a front-line position to manage and prevent delirium.
To this day, the most admired person in nursing history would be Florence Nightingale. She will forever be an influential figure in the world of nursing due to her perseverance and critical thinking skills that saved so many lives during the Crimean War. There is no way to tell how long it could have taken nursing to evolve without the help of Nightingale. In her book, Notes on Nursing: What It Is and What It Is Not, Nightingale described a multitude of factors that must be considered when helping the ill to recover and to have the healthy maintain their well-being (Nightingale, 1860/1969). Four chapters in her book are of high importance, chapter two, on Health of Homes, chapter
“Nursing is an art, and if it is to be made an art, requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work...” (Nightingale, 1868)
There are still many barriers interfering with sleep in the hospital, as the disruption of sleep is common through frequent monitoring and procedures, noise, lighting, and anxiety about being in the hospital (Robinson et al., 2005). Another barrier is the critical care environment, which has more invasive monitoring and tests and noise from monitors and ventilators (Eliassen & Hopstock, 2011).
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
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)
Florence Nightingale is a respected reformer of modern times. The book Notes on Nursing contains the thoughts about Nightingale by nursing-theorists and some of today’s nurse leaders. Florence Nightingale was committed to improving the misery and unhealthy living conditions of people all over the world (Schuyler, 1992, p.3). In this paper I will be using Nightingale’s Thirteen Canons to discuss what nursing is and what it is not.
Her work on environment modification was proven to have improved the hospital mortality rate from 32 % to 2 % in six months indicating the empirical precision of the model (Winkelestein, 2009). Nightingale defined health as the ability to use one’s power well and to be well and believed health is affected by nature stating “nature alone could cure disease” (Butts & Rich, 2015, p. 381). The other element of Nightingale’s model of care was nursing, which was viewed as caring that fostered health and teaching to ensure health promotion for those who are sick and those who are well (Butts & Rich, 2015). The derivable consequence of Nightingale’s model is corroborated by the continued importance of scientific knowledge and critical thinking Florence Nightingale set out that still dictates the practice of nursing in the 21st
Nightingale’s achievements completely changed nursing into an honorable and respectable profession by establishing education and responsibilities into the job. Thereafter, nurses were no longer considered low, but became respected and an important role of human lives. She was contemporary in using her experience during the Crimean War to expose the initial instance of the linkage between research, theory and practice. In the Crimean War, she was a nurse who took notice of the uncleanliness and degradation of the military hospitals. She worked hard to bring the death rate down by making sanitary improvements and organizing levels of standards for clean and safe hospitals. She explained these methods in her Notes on Hospitals to improve increased ventilation, adding windows, improving drainage and increasing