What Is Florence Nightingale And The First Nurse Theorists?

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

Florence went against her parents wishes of getting married and starting a family; she wanted to leave an impact on the world. She did just that by wanting to improve the profession of nursing and formed the framework for centuries to come. Florence Nightingale has been quoted with saying “every woman is a nurse”(Malka,2007). She believed nursing was a calling for women and that idea later turned nursing into the respectful and trustworthy that we know of today. The impact she left behind is greater than she could ever imagine.

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.

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).

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.

Theories or conceptual frameworks are a group of abstract ideas composed to explain some phenomena in nursing. It is difficult to reference any other theorist without giving recognition to Florence Nightingale, who introduced a paradigm shift the in the profession of nursing. In short, her Environmental Theory proposed that patients need a clean environment along with other simple actions to promote healing. Nightingale’s intellect was revolutionary; her framework and others alike are the foundation of the nursing profession and were developed to guide nursing practice today. Like Florence Nightingale; Imogene King, also a nursing theorist, helped shape standards in nursing education and practice. The

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).

Nursing theory is vital to the nursing profession because it provides a foundation and framework which is reflected in nurses’ caring ideals and practice (William, 2015). Theory provides an understanding of a nurse’s role within the healthcare system. The first nursing theory, formed by Nightingale, was observations of interventions that improved patient outcomes (Mackey & Bassendowski, 2016). Nurses can improve quality of care by implementing theory into their practice (Mackey & Bassendowski, 2016). This paper will discuss the importance of nursing theory, Florence Nightingale’s Notes on Nursing: What It Is and What It Is Not, and the application of this theory in the nurse

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.

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.

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.”

Chitty (2011) stated “Nightingale promoted the view that nurses’ primary responsibility was to protect patients by careful management of their surroundings” (p. 306). Nightingale saw nursing as placing the patient in an environment where nature can assist in providing optimum health conditions. According to Gillette “Nursing functions influence the human environment to affect health” (1996, p. 264). While Nightingale understood the importance of medicine she emphasized the importance of environment on health. Nursing was not just for the patient but the environment and its relationship to the patient.