Conceptual Model of Nursing

“If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault of not of the disease, but of the nursing. I use the word nursing for want of a better” (Nightingale, 1860, p. 8). While Nightingale stressed the impact of one’s environment to promote healing, Virginia Henderson aimed to establish on the fundamental needs as a knowledge base to guide Professional nursing practice. Henderson emphasized on fourteen components required for effective nursing care which includes: breathing normally, eating and drinking adequately, elimination of body wastes, movement and posturing, sleep and rest, select suitable clothes-dress and undress, maintaining body temperature, keeping body clean and well groomed, avoiding dangers in the environment, communication, worship according to one’s faith, work accomplishments, play or participate in various forms of recreation, and learn, discover, or satisfy the curiosity (Fernandes et al., 2015). Her division of the fourteen components acknowledged patient needs with a holistic approach that is applied through the nursing process in a clinical setting.

Nightingale, F. (1860).Notes on nursing: what it is and what it is not. New York:D.Appleton And Company.

The concept of environment and its integral role in the delivery of nursing care was among the first identified and documented nursing theory since its early days. Florence Nightingale pioneered the profession of nursing and along with it, pioneered the concept of nursing theory. Her environmental theory was patient focused and incorporated five environmental components needed to promote health. Jarrin (2012) supported that the role of nursing is to promote the best possible environment for the patient to assist in their natural reparative process. According to Rahim (2013), as considered as the profession’s first nurse theorist, Florence Nightingale provided the essential foundation in environmental theory. She believed

A quote from Nightingales early writings defined “nursing is the act of utilizing the environment of the patient to assist in recovery” this is not only true in a patient’s recovery but is also true for the well being and the health of the patient and family included (Harvard Libraries, 2012). Nightingales theory of environment is the responsibility of the nurse this in essesence make the nurse in control of the patient’s environment, she has the ability to identify the environmental deficits and apply Nightingale’s concepts directs the nurse to make adjustments and advocate for the patient .(Harvard Libraries, 2012).

Florence Nightingale, born in 1820, revolutionized nursing as it is today. Throughout her time working with the wounded soldiers during the Crimean War, she noted that more soldiers were dying of infections than from wounds. Therefore, she worked to ensure sanitation as well as sufficient health and healing practices amongst her patients. From care to prevention, Nightingale’s practices were able to set the foundation for nurses today. Nightingale distinguished that a healthy environment is essential to one’s health and thus her tenets of ventilation, cleanliness, light, as well as nutrition set the bases of the City of Toronto’s tuberculosis program for the under-housed, homeless, and the correctional population.

Florence Nightingale, or as soldiers on the battlefield would call her the “Lady with the Lamp”, was an inspirational women of the nineteenth century that had many aspirations and dreams concerning the care of others. Achieving these dreams by “facilitating the reparative processes of the body by manipulating the patient’s environment” (Potter & Perry 2009, p. 45); Nightingale laid the foundations of modern nursing and gave the country and many others a system that has stood the test and remains timeless. In this, Florence has become one of the most widely known nursing theorist to this day.

The Environmental Theory by Florence Nightingale defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery” (Alice Petiprin, 2014). It involves the nurse’s initiative to make environmental settings appropriate to aid in the recovery of the patient’s health. According to Nightingale all external factors are somehow associated with the patient and affects their life physically, mentally, and socially (Alice Petiprin, 2014).

I will be summarizing Notes on Nursing: What It Is and What It Is Not by Florence Nightingale. Notes on Nursing: What It Is and What It Is Not was first published in 1860 with the last edition being published in 1969 (Adams-Wending, 2010). Nightingale’s theory addresses the importance of providing an environment that is conducive to the healing process for patients (Nightingale, 1860). Nightingale’s theory of the environment was based off the idea that disease was caused by smell of decomposing matter (Adams-Wending, 2010). The theory is broken down into thirteen “canons” of nursing (Nightingale, 1860). The thirteen topics within this theory are: ventilation and warming, health of houses, petty management, noise, variety, taking food, what food?, bed and bedding, cleanliness of rooms and walls, personal cleanliness, chattering of hope and advices, and observations of the sick. Nightingale (1860) states that ventilation is to make the air the patient breaths as fresh as the air outside. This also goes into detail of removing chamber pots

Throughout history, society has considered women to be the natural caregivers of children, family, and community. Women were naturally thought of as nurses because the act was said to be an extension of their role in the home. They were called in to homes to help deliver babies or as wet nurses to breastfeed. In the 1800’s, women began taking care of soldiers. It was then that Florence Nightingale cared for soldiers in the Crimean War. During this time she revolutionized the role by setting standards of cleanliness and reducing infection. The legacy of nursing continues to be enriched by those who continue to follow the example of nursing pioneers. They refuse to be bound by others’ views

Selanders, 2010 (as cited in Rahim, 2013) concluded that, “Environment is the umbrella concept in the Nightingale theory of nursing. It was her contention that the environment could be altered in such a manner as to improve conditions so that the natural laws would allow healing to occur”. The five environmental components identified by Nightingale, which are necessary to a person’s health, are: clean air, pure water, efficient drainage, cleanliness, and light. These five components are further divided into the following canons: ventilation and warming, health of

Throughout Notes on Nursing, Florence Nightingale expresses the importance of proper care to patients. Another factor of nursing that was effected by Nightingale is the professionalism of nursing and how nursing is not only a science, but an art. Nightingale states how numerous subjects in nursing should be improved upon. The specific chapters that show how Nightingale has improved nursing within Notes on Nursing were Light, Personal Cleanliness, Chattering Hopes and Advices, and Ventilation and Warming. In chapter 9, Light, Florence Nightingale emphasizes the impact of sunlight on the patient and how it improves their health. Personal cleanliness was reviewed in chapter 11. Nightingale explores the importance cleanliness has on a patient. Within chapter 12, Nightingale states how to properly advise the sick, as well as give hope to patients. In chapter 1, Ventilation and Warming, Nightingale states the need for pure air within a patient’s room. These chapters express the importance of properly taking care of patients. The focus of this paper is how it was applied during Nightingale’s time and how it is still relevant today in nursing practice. The chapters within Notes on Nursing have had a profound impact on the practice of nursing today.

The profession of nursing has matured from the time of Florence Nightingale. Nursing has gone from just treating dying soldiers on the battlefield to helping guide people through their entire lives from birth to death. The maturation of nursing has led to changes in nursing philosophy and allowed for practitioners of Nursing to meld these philosophies together to form their own philosophy. In this paper I will explain my philosophy of nursing and compare it to Virginia Henderson 's definition of nursing along with discussing some of the changes to Nurse philosophy I will also discuss some of the difficulties to being a patient advocate.

Florence Nightingale developed the environmental model theory of nursing. Nery, (2015) states that Florence Nightingale’s environmental theory of nursing, “focus primarily on the environment, interpreted as all external conditions and influences that affect the life and development of an organism, that are able to prevent, suppress or contribute to disease and death.” The four metaparadigm concepts of this theory consist of person, environment, nursing, and health. Within this theory, the patient is being cared for by the nurse, has been influenced by the environment, and has reparative powers (“Nursing Theories, 2011). Nightingale’s theory does not have a clear definition of the person; however, it can be inferred that the person correlates “in relation to the environment and the impact of the environment on the person’s health status” (Butts & Rich, 2018). The highlight of Nightingale’s theory is the environment. Both the external and internal environment needs to be in sanitary conditions. The environment concept of this theory contains “physical, psychological, and social” factors (“Nursing Theories, 2011). The goal of the nurse is the control the patient’s environment to achieve ideal health for the patient. Nightingale’s theory did not define health; however, she stated that nature itself can heal ailments (Butts & Rich, 2018). Nightingale (1859) stated that health is ‘not only to be well, but able to use well every power we have to use it.”

Theory is a cluster of concept or ideas that propose a view concerning a phenomenon to guide nursing practice (Chitty, 2005). The four concepts basic to nursing that are incorporated in this paper are nursing, person, health, and environment (Cherry & Jacob, 2005). The goal of this paper is to describe the core concept of nursing shared amongst Dorothea Orem and Virginia Henderson’s theories. The comparison and analysis of concept definitions between these two theories will also examined. Finally Henderson’s theory of concept statement, metaparadigm and her philosophy will be explored.

Theory and practice are said to go hand in hand. Theory is shaped based on practice and insight, while it also gives shape and foundation to practice. Florence Nightingale is acknowledged as the founder of modern nursing and a theorist. She believed in the patient’s capacity for self-healing which is reinforced by the nurse’s ability to create an environment conducive to health (Smith &Parker, 2015, p. 50). Her philosophy of nursing is that one should put the patient in the best position for nature to act on him or her. This paper will identify the five essential components of her theory to draw out an appropriate plan of care for Mrs. Adams in the case study. In addition, discuss the applicability of Nightingale’s