Environmental Theory : A Patient Care Theory Essay

“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.

Florence Nightingale, considered the founder of modern nursing, first began to establish nursing as a profession during the Crimean War. Since then, nursing theorists have continued to expand on the thought that patients are made up of more than just the symptoms they present with, Abraham Maslow, Carl Jung, Dr. Larry Dossey and Dorothy Johnson, but none more so than Jean Watson. She developed a theory of human caring that contained several core concepts, these concepts lay forth the ground work for how we, as nurses, should care for a patient. These concepts included transpersonal caring relationships (going beyond ego to higher “spiritual” caring

Kristen M. Swanson may not be as well-known as Florence Nightingale in the nursing field, but she has made great contributions with the Theory of Caring that has been used in many hospitals, even internationally, for their framework to guide patient care. Through the study of her practice, I have realized much of her practice is reflected in mine. This paper will present the basic concept of nursing known as the metaparadigm concepts of person, health, environment, and nursing as presented by Swanson, as well as provide my own philosophy of nursing, which in many ways mirrors Swanson’s.

This paper will examine the origin of the nursing theory in reference to the Florence Nightingale Theory of Positive Manipulation Of the environment. Initially the paper will introduce the theorist and the context in which the theory was developed. Will critique the theory according to nursing theory critique. The paper will further describe the utility of the theory with respect to practice, administration, education and research will also examine the empirical precision of the theory(testability and logical adequacy). Infact the entire paper demonstrates the understanding of the theory.

Those two theories are Florence Nightingale’s theory of the important of the environment and Katharine Kolcaba’s theory of comfort. Both of these theories are lacking in the emergency room because of the lack a therapeutic environment for these patients. The goal for most emergency room physician is to keep the patient safe until the patient can be moved to an inpatient pscyharitic unit (Nicks & Manthey, 2012, p. 2). By the physicians having this mentality, it does not allow the patient to start his or her healing process in the emergency room while the patient is boarding waiting for an inpatient bed to become available. With the implementation of both of the nursing theories mentioned above this writer believes that it will change the environment that the patient is in and will teach the physicians to start to treat these patients and in turn, it will provide the patients with the quality care that he or she

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

Florence Nightingale’s nursing theory is probably the most well known in the nursing profession. “Patients are to be put in the best condition for Nature to act on them. It is the responsibility of nurses to reduce noise, to relieve patients’ anxiety, and to help them sleep” (Theories of Florence Nightingale, 2012). This theory emphasizes that environmental factors and adaptation is the basis of holistic nursing care. This theory is important in my opinion because it ensures that the center of focus is on the patient. When patients are hospitalized making them comfortable in a new and strange environment is important to me. Eliminating noise at the nursing station and turning down the lighting in the hallways at night are just a few ways that nurses can improve the environmental factors surrounding patients. During hospitalizations I strive to eliminate any anxiety that my patient may be experiencing. Upcoming procedures and treatments can cause tremendous stress. Simply by providing sufficient information regarding treatments or procedures can be beneficial in reducing anxiety or

Grand theories are relatively abstract concepts and help to provide nursing knowledge in a general way. However, this theory is the most complex and widest in scope of the level of theory have been subdivided into Human needs, Interactive and Unitary process theories (McEwen, & Wills, 2014). For this reason, Nightingale’s Environmental theory is part of the grand theory because it encompasses different areas of nursing care. This theory incorporate knowledge made from observing the patient and critical thinking as contrast to empirical and medical care (McEwen, & Wills, 2014). Between these three subdivisions, Nightingale’s theory is also a Human Need Theory because she based her theory on how the environment cause changes in ill patients. Nightingale used inductive reasoning through observation and experiences to obtain laws of health, disease and nursing (pdf).

The environment theory of nursing is a patient-care theory. The delivery of patient centered care is the best delivery of care a patient can receive. Applying Nightingales environmental care theory of manipulation of the patient environment can affect the patient and assist in the delivery of quality of care. The concept of a clean patient environment has an effect on the patient’s recovery and the prevention of spread of diseases (Harvard Libraries, 2012). Using Florence Nightingales environmental theory and concepts will give a

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.

The nursing theory consists of four major concepts including person, health, environment, and nursing. According to the Fundamentals of Nursing, these four concepts “… give nurses a comprehensive perspective that allows you to identify and treat patient’s health care needs at all levels and in all health care settings.” (Potter & Perry, 2009, p. 40) Florence Nightingale’s theory was one of the first models for nursing. The focus of this theory was that nursing consists of caring through the environment and helping the patient overcome their symptoms and changes in function related to their prevailing illness. It also focuses on the manipulation on the environment for the potential benefit of the patient. Florence “… had always seen to the heart of things- that the real nurse must be a dedicated being- that

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

* A patient’s world can become brighter or darker, secure or threatening through nurses attitude. Watson accepts Nightingale’s concept of environment and states the healing environment expands the persons awareness and consciousness, thus promoting mind-body-spirit wholeness and healing (1999,p.254.) This reminds us to keep the patient’s room tidy and comfortable, and provide spiritual support necessary for total healing.

The concept of environment and its integral role in the delivery of nursing care was among the first identified and documented nursing concept 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. It dates back from the time of ancient Greek philosophers and historians, including Plato, Hippocrates, and Aristotle, whose works are studied by Nightingale in her early years. According to Rahim (2013), as considered as the profession’s first nurse theorist, Florence Nightingale provided the essential foundation in environmental theory. She believed that some laws of nature, when applied and integrated into nursing care, can assist individuals in restoring their health during their illness, and, in those who are already healthy, promote health and prevent illness.