Florence Nightingale's Theory And The Four Concepts Of Nursing

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

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

Florence Nightingale is known as the founder of modern nursing. Her contributions and influence not only to the nursing profession, but to the public health care system, is unparalleled. She was instrumental in establishing multiple processes and practices that are still in current practice. She has influenced many nursing theorist and prevailing theories during her career. Many of her changes continue to influence theory development today.

However, Florence Nightingale changed nursing practice, where she was commonly referred to as lady of the lamp (Finkelman and Kenner, 2013). Nightingale established a domestic mode of nursing training in which education of nurses was about the information of character at the Saint Thomas Hospital (Carol, 2011). According to Nightingale the tasks of every nurse was not only to care for the sick but to act as a public agent of moral reform, and to weaken the power of medical men (Nelson, 2010). Rafferty (1996) argue that, nursing

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.

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

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

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

Each professional discipline has a responsibility to identify concepts that provide a general description of the discipline. It is these concepts that comprise the profession’s metaparadigm (Fawcett, 1984). Much of the philosophy and theory of nursing stems from the work of Florence Nightingale. The diaries, letters, and books that she left behind containing her statements and beliefs have been fundamental to the development of the concepts comprising the nursing metaparadigm (Selanders, 2010). Fawcett’s (1984) stated there was a general consensus among scholars that the concepts of nursing were person, environment, health, and nursing.

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.

Florence Nightingale’s vision of nursing in the mid-1800s began an evolution of nursing philosophies and theories that encouraged the progression and development of nursing knowledge, quality of care, and the advancement of nursing from a vocation to an academic discipline and profession (Alligood, 2013, pp. 3-7). As nursing knowledge and theory flourished, it became necessary to structure nursing theories into an integrated system. Jacqueline Fawcett’s proposal of four global nursing concepts “as a nursing metaparadigm served as an organizing structure for existing nursing frame-works and introduced a way of organizing individual theoretical works in a meaningful structure” (Alligood, 2013, p. 4). The four concepts of the metaparadigm of nursing include: person, environment, health, and nursing. By understanding the history of nursing development and the metaparadigm of nursing, one can explore this author’s personal philosophy of nursing in respect to the four concepts of the metaparadigm of nursing.

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.

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