Florence Nightingale Case Study

Over the past two decades, EBP has expanded on Florence's theories. EBP constitutes the combination of clinical expertise, patient values, and research evidence when making decisions about patient care. In the 1990's, it was determined that just increasing knowledge was not sufficient for improving patient outcomes. To obtain better patient outcomes "new knowledge must be transformed into clinically useful forms, effectively implemented across the entire care team within a systems context,

Florence Nightingale was an immense impact on nursing, who “became famous for her revolutionary work as a nurse during the Crimean War” (Kent 30). “She dedicated her life to improving conditions in hospitals, beginning in an army hospital during the Crimean War,” (3 Registered). Her actions were then used by “concerned individuals, rather than by professionally trained nurses” during the Civil War, (Registered 279). Many of Nightingale’s ideas were brought into modern times, but with the improvement of technology and licensed nurses. With the influence and patience of Florence Nightingale, nursing has evolved into an outstanding career.

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.

Florence Nightingale’s theory will be used in developing a care plan for this case study, which describes a 68 year old widow, Mrs. Adams, who was discharged home to a not so favorable home environment. Mrs. Adams is a diabetic with a history of hypertension and breast cancer. She is five days post right sided mastectomy, of which she is complaining of pain and drainage from the surgical site. Her home is an apartment located in a low income area where crime is widespread, so noise is likely an issue. Her physician has referred her to case management because he feels she cannot care for herself. The community health nurse’s observations were that Mrs. Adams’ apartment was in disorder with little airflow and light, as well as a lack of food. She owns three cats and a small dog, which she considers family since her husband passed away one year ago, and if the patient is not looking after herself, it is highly unlikely that she is properly caring for her pets.

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).

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

Nursing has evolved as a scientific discipline and is starting to emerge into professional status. One of the great leaders in nursing who helped this change take place was Florence Nightingale. Nightingale is considered as a pioneer in the nursing profession. She has contributed a lot in the field of nursing and her works are considered as assets, and will be remembered for many years.

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.

Nightingale said, “The very first requirement in a hospital is that it should do the sick no harm”. The history of nursing initially begins with Florence Nightingale. Before her era nurses had a tarnished reputation (Glasper, 2017). They were poorly educated and incompetent people. Nurses such as Mrs. Bedford Fenwick wanted to change the image of nursing. They did this by leading a campaign for professionalism. Which led to the culminated Nurse Bill receiving is royal assent in December 1919 (Glasper, 2017). July 27, 1921 was the official opening of the nursing register, there are currently 688,927 nurses registered with the Nursing Midwifery Council (NMC) (Glasper, 2017). The NMC code has four themes of professionalism, “Prioritizing

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.”

Nursing has made much advancement since Nightingale Environmental Theory but the focus on a healthy environment has remained the same. Pulliam (1997) noted in her article that Nightingales’ theory formed a solid foundation for nursing: fresh air, cleanliness, clean water, warmth, proper drainage, plenty of light, and stress free environment provided an optimum environment for healing.

This course really developed my self as a nurse, and it will help me in giving care to actual clients in the real world as well. First of all, this course taught us all about Florence Nightingale, who is viewed as one of the first nursing theorists. Her becoming a nurse, her practices as a nurse, her theory, her tenets, and most importantly, her being one of the most influential figures, even as of this very day. In this course, through essay writing we understood more about how Florence Nightingale’s theory and practices are still relevant today. We were able to connect her tenets to the real world programs. This can really help us in giving care because we learnt about how her practices are applied and so we are also able to apply her practices while providing clients care. Not only that, but we learned about how committed Nightingale was to provide the utmost care for the client and how the client is very important, with knowing this, we can also provide the greatest care that the client deserves. She strived for professional nursing and had laid the foundation, and we need to follow in these footsteps as well. Her achievements can aid in motivating us to become better and improve ourselves as a nurse everyday, as she did emphasize the importance of restoring one’s health.

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