ENVIRONMENTAL THEORY by: Florence Nightingale

Florence Nightingale was born in May 12, 1820 in Florence, Italy. She was well known as the
Founder of Modern Nursing and her book Notes on Nursing. Nightingale studied and trained
nursing in the Institution of Deaconesses at Kaisersworth, Germany for 3 months. In Crimean
war, Nightingale takes care of the wounded soldiers. She established the first professional
nursing school in the world at St Thomas Hospital in London. At the age of 90, Florence
Nightingale died in August 13, 1910.

 "The most important practical lessons that can be given to nurses is to teach them the
what to observe-how-to-observe.”
 In Environmental Theory of Florence Nightingale, she Nursing as "the act of utilizing the
environment of the patient to assist him in his recovery."
 Nightingale discussed the Environmental Theory in her book Notes on Nursing: What it
is, what it is Not.
MAJOR CONCEPTS OF FLORENCE NIGHTINGALE THEORY

 Human Beings
 Human beings are defined in relation to their environment and the impact of the
environment upon them.
 Environment
 Nightingale's writings reflect a community health model in which all that surrounds
human beings is considered in relation to their state of health.
 Health
 She believed that nursing should provide care to the healthy as well as the ill and
discussed health promotion as an activity in which nurses should engage.
 Nursing
 She reflected the art of nursing in her statement that, "the art of nursing, as now
practiced, seems to be expressly constituted to unmake what God had made disease to
be, viz., a reparative process."
5 ENVIRONMENTAL FACTORS:
1. Fresh air - "to keep the air he breathes as pure as the external air without chilling
him."
2. Pure water - "well water of a very impure kind is used for domestic purposes. And
when epidemic disease shows itself, persons using such water are almost sure to
suffer."
3. Effective drainage - "all the while the sewer maybe nothing but a laboratory from
which epidemic disease and ill health is being installed into the house."
4. Cleanliness - "the greater part of nursing consists in preserving cleanliness."
 5. Light (especially direct sunlight) - "the usefulness of light in treating disease is very
important."
MAJOR AREAS OF PHYSICAL, SOCIAL, AND PSYCHOLOGICAL ENVIRONMENT:
1. Health of houses
2. Ventilation and warming
3. Light
4. Noise
5. Variety
6. Bed and beddings
7. Cleanliness of rooms and walls
8. Personal cleanliness
9. Nutrition and taking foods
10. Chattering hopes and advices
11. Observation of the sick
12. Petty management
NIGHTINGALE AND THE NURSING PROCESS:

 Assessment
-Nightingale recommended two essential behaviors by the nurse in the area of assessment
1. Ask the client what is needed or wanted.
2. Observation. She used precise and specific observations concerning all aspects of the client's
physical health and environment.

 Nursing Diagnoses
-Nightingale believed, data should be used as the basis for forming any conclusion. The nursing
diagnosis is the client's response to the environment and not the environmental problem. It
reflects the importance of the environment to health and well-being of the client.

 Outcomes and Planning

-Identifying the nursing actions needed to keep clients comfortable, dry, and in the best state
for nature to act on.
-Planning is focused on modifying the environment to enhance the client's ability to respond to
the disease process. The desired outcomes are derived from the environmental model.

 Implementation
-Takes place in the environment that affects the client and involves taking action to modify that
environment.
-All factors of the environment should be considered, including noise, air odors, bedding,
cleanliness, light, --all the factors that place clients in the best position for nature to work upon
them.

 Evaluation
-Is based on the effect of the changes in the environment on the client's ability to regain his/her
health at the least expense of energy.
-Observation is the primary method of data collection used to evaluate the client's response to
the intervention.
CONCLUSION:
The Environmental Theory of Nursing is a patient care theory. It focuses on the alteration of the
patient's environment in order to affect change in his or her health. The environmental factors
affect different patients unique to their situations and illnesses, and the nurse must address
these factors on a case-by-case basis in order to make sure the factors are altered in a way that
best cares for an individual patient and his or her needs.

BASIC NEED THEORY/ 14 NEEDS THEORY by: Virginia Avenel Henderson

Virginia Avenel Henderson was a nurse, theories, and author. She was born on November 30,
1897 in Kansas City. Henderson studied at Army school of nursing in Washington DC in 1921
and BSN in 1932 and MA in nursing education in 1934 at the Columbia University. She teaches
nursing at Columbia University in 1934 and 1948 and on Yale university school of nursing faculty
in 1953 to 1959. With Bertha Harmer, she revised the 5th edition of the Principle and Practice
of Nursing in 1953, 6th edition in 1966, and Nature of Nursing in 1966. She died on March 19,
1996 at the age of 99. Virginia Henderson was known as “the first lady of nursing”, “the
nightingale of modern nursing”, “the modern-day mother of nursing”, and “the 20th century
Florence Nightingale”.

 "The unique function of the nurse is to assist the individual sector well in the
performance of those activities contributing to health or its recovery that he would
perform unaided if she had the necessary strength will or knowledge."
BASIC NEED THEORY
-The theory focuses on the importance of increasing the patient's independence to hasten their
progress in the hospital. Henderson's theory emphasizes on the basic human needs and how
nurses can assist in meeting those needs.

14 FUNDAMENTAL NEEDS OF PATIENTS:

-first nine components are physiological

-tenth and fourteenth are psychological
-eleventh component is spiritual and moral
-twelfth and thirteenth components are sociological

1. Brief normally
2. eat and drink adequately
3. eliminate body waste
4. move and maintain desirable postures
5. sleep and rest
6. select suitable clothes-dress and undress
7. maintain body temperature within normal range
8. keep the body clean and well-groomed
9. avoid dangers in the environment
10. communicate with others in expecting expressing emotions needs fears or opinions
11. worship according to one's faith
12. work to provide a sense of accomplishment
13. Play or participate in recreation
14. learn discover or satisfy the curiosity that leads to normal development and uses health
facilities
Henderson's 14 components as applied to Maslow’s hierarchy of needs
1-8 physiological needs
9 safety needs
10-11 belongingness and love needs
12-14 self-esteem needs

Assumptions of the Need Theory The assumptions of Virginia Henderson's Need Theory are:
1. Nurses care for patients until they can care for themselves once again.
2. Patients desire to return to health.
3. Nurses are willing to serve and that "nurses will devote themselves to the patient day and
night."
4. Henderson also believes that the "mind and body are inseparable and are interrelated."
CONCLUSION:
She emphasized the importance of basic human needs as the primary motivation for nursing,
which has led to the creation of new theories about human needs and the ability of nursing to
assist patients in attaining those needs.