“Theory of Florence Nightingale”

The goal of nursing is “to put the patient in the best condition for nature to act upon him”. –
Nightingale

INTRODUCTION-
 Born - 12 May 1820

 Founder of modern nursing.

 The first nursing theorist.

 Also known as "The Lady with the Lamp" 

 She explained her environmental theory in her famous book Notes on Nursing: What it is,
what it is not.

 She was the first to propose nursing required specific education and training.

 Her contribution during Crimean war is well-known.

 She was a statistician.

 International Nurses Day, May 12 is observed in respect to her contribution to Nursing.

 Died - 13 August 1910

 While at Embley Park, Florence announced her decision to enter nursing in 1844. In this,
she rebelled against the expected role for a woman of her status, which was to become a
wife and mother. Nightingale worked hard to educate herself in the art and science of
nursing.

CRIMEAN WAR PATIENTS

 During the Crimean campaign, Florence Nightingale gained the nickname "The Lady with
the Lamp", deriving from a phrase in a report in The Times. 

 “She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her
slender form glides quietly along each corridor, every poor fellow's face softens with
gratitude at the sight of her. When all the medical officers have retired for the night and
silence and darkness have settled down upon those miles of prostrate sick, she may be
observed alone, with a little lamp in her hand, making her solitary rounds.”
The Lady with the Lamp : 
 With her lamp, Nightingale traverse the night during the Crimean War. Nightingale
became a heroine in Great Britain as a result of her work in the war.

NURSING IN MODERN INDIA

 Military nursing was the earliest type of nursing.

 Florence Nightingale had a great influence over nursing in India especially in the army.

 St Stephens Hospital at Delhi was the first one to begin training the Indian girls as nurses
in 1867.

 1871, the first School of Nursing was started in Government General Hospital, Madras.

 1897, Dr. B.C. Roy did great work in raising the standards of nursing and that of male
and female nurses.

 1908, the trained nurses association of India was formed

 In 1926, Madras State formed the first registration council

 The first four year basic Bachelor Degree program were established in 1946 at the college
of nursing in Delhi and Vellore.

 The Indian Nursing Council was passed by ordinance on December 31st 1947. The
council was constituted in 1949.

 First master’s degree course, a two-year postgraduate program was begun in 1960 at the
College of Nursing, Delhi.

 1963, the School of Nursing in Trivandrum, institute started the first two years post
certificate Bachelor Degree program.

Assumptions of nightingale's theory

 Natural laws

 Mankind can achieve perfection

 Nursing is a calling

 Nursing is an art and a science

 Nursing requires a specific educational base

Overview of the theoretical framework of Environmental Theory
 Florence Nightingale conceptualized manipulation of the physical environment is a
critical component of nursing. She established several key factors nurses can control to
prevent illness and promote health. 

Major Components of a Healthful Environment

 Ventilation and warming

 Light, Noise

 Cleanliness of rooms/walls

 Health of houses

 Bed and bedding

 Personal cleanliness

 Chattering hopes and advices

 Taking food.  What food?

 Petty management/observation

Health is “not only to be well, but to be able to use well every power we have”
 Health nursing, or general nursing are those activities that promote health which occur in
any care giving situation.

Nightingale’s Nursing Theory :

 Persons are in relation with the environment

 Stresses cured by the healing properties of the physical environment (fresh air, light,
warmth, and cleanliness)

 “Nature alone cures”.

Nightingale’s Nursing Theory

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

 Stresses drain the client of the energy needed for healing

  Viewed disease as a reparative process

 Theory basis:

- - External influences and conditions can prevent, suppress, or contribute to disease or

death

 Theory goal: Nurses help patients retain their own vitality by meeting their basic needs
through control of the environment

 Nursing’s Focus: Control of the environment for individuals, families & the community

Three Types of Environments

Three Types of Environments

 Physical

 Psychological

 Social

Physical Environment : 
 Physical Environment Consists of physical elements where the patient is being treated

 Cleanliness of environment relates directly to disease prevention and patient mortality

 Aspects of the physical environment influence the social and psychological environments
of the person

Psychological Environment:
 Can be affected by a negative physical environment which then causes STRESS

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

 Involves communication with the person, about the person, and about other people

----communication should be therapeutic, soothing, & unhurried!

Social Environment:
 Involves collecting data about illness and disease prevention

 Includes components of the physical environment - clean air, clean water, proper
drainage
  Consists of a person’s home or hospital room, as well as the total community that affects
the patient’s specific environment

NIGHTINGALE’S THEORY & NURSING’S METAPARADIGM

1. PERSON : 
 Referred to by Nightingale as “the patient”

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

 Has reparative powers to deal with disease

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

2. ENVIRONMENT : 
 The foundational component of Nightingale’s theory

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

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

  "Poor or difficult environments led to poor health and disease".

3. HEALTH : 
 Maintained by using a person’s healing powers to their fullest extent

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

 Health & disease are the focus of the nurse

Nurses help patients through their healing process

 Disease is considered as the absence of comfort. 

4. NURSING : 
 Provides fresh air, light, warmth, cleanliness, quiet, and a proper diet

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

 Influences the environment to affect health

 Nursing is a discipline distinct from medicine focusing on the patient’s reparative

process rather than on their disease!!
  Supports the nursing process

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

Nightingale's Theory And Nursing Practice

Application of Nightingale's theory in practice:

 “It is the responsibility of nurses to reduce noise, to relieve patients’ anxieties, and to
help them sleep."

 As per most of the nursing theories, environmental adaptation remains the basis of
holistic nursing care.

Analysis Of The Critical Components Of The Conceptual Nursing Model And

Theory
 Nightingale believed balance between patient and environment is necessary to maintain
health. Her conceptual model focuses on the following components critical to nursing:

Application of the Conceptual Model in the Community 

1. Assessment and data gathering- Patient's living environment

2. Plan of care- Strategies to promote health and prevent illness or disease 

3. Interventions- Implement plan of actions

4. Evaluation of care- Follow up

In-service Education for Health Promotion and Disease Prevention

1.Environmental sanitation- Cleanliness of physical environment eg. Room, equipment, food,
storage areas, air inlets, disposal of garbage , etc.

2. Proper hand washing- Before and after handling food/medications, before and after touching
patients, if hands are soiled with blood or body fluids, dirt, etc., After using the toilet, after
sneezing or blowing your nose.

3. Personal health- Personal hygiene, clean clothes, diet and medication compliance,
vaccinations

4. Mental and emotional health- Can lead to healthy relationship, success in work, and good
health e.g. Good parenting, stress management, relaxation techniques, regular exercises.