Born: 1820
TaneT
LETICIA SUAREZ RN
TANESHA HIPPOLYTE RN
SOFIA WARREN RN
GROUP 3
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Florence Nightingale was a pioneer in the nursing field.
Despite parental objections Florence decide to become a
nurse.
Nightingale went to Kaiserworth in Prussia to study
nursing. Even then her views were being noticed.
By 1853 she became the unpaid superintendent of
London’s Institute for the Care of Sick Gentlewomen.
From 1854-1856 Florence Nightingale became a patient
advocate by establishing more sanitary conditions in
patient care settings.
Florence started focusing on nursing administration. She
always made time to make nightly visits to the wards. She
was called “The Lady of The Lamp”.
The mortality rate at the military hospital decreased from
sixty percent to two percent six months after her arrival.
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Florence Nightingale was the first “Nursing Theorist”.
Nightingale began collecting information about her theory by
her experiences in the Crimean War. She maintained written
documentation (statistical analysis).
1860 Nightingale’s theory was published.
Nightingale laid the foundation for professional nursing.
Notes on Nursing summarized the principals of nursing.
1869 Nightingale along with Dr. Blackwell opened the
Women’s Medical College.
1870 Nightingale mentored Linda Richard, “America’s First
trained nurse”.
1883 Nightingale was awarded the Royal Red Cross by
Queen Victoria.
1907 The first women to be awarded the Order of Merit.
1908 Nightingale was given the Honorary Freedom of the
City of London.
1857 Although Nightingale became bedridden due to illness,
she continued pioneer work in the field of hospital planning. 3
CRIMEAN WAR
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The environmental theory, which incorporated the restoration
of the unusual health status of the nurse’s client into the
delivery of heal care – is still practiced today. (Wikipedia)
She viewed the environment as controllable to enhance a
patient recovery.
The nurse was responsible for planning environmental
factors appropriate for restoration of health.
Factors that were included in the environment theory were:
ventilation, warmth, light, noise, bed & bedding, cleanliness
of rooms & patients, nutrition, hope, observation of the sick,
and social consideration.
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VENTILATION
CONTROL
NOISE
LIGHT
WARMTH
CONTROL
ODOR
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THE HEALING ENVIRONMENT
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Person
Environment
Nursing
Health
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The person exists in their environment.
The patient interrelates with the family and their community.
Nursing performs tasks for the patient, aiding in their
recovery by controlling and enhancing the environment.
Patient independence is also promoted.
Nightingale believed nursing was responsible for a patients’
personal choices and behavior.
Nightingale viewed her patients with respect, regardless of
religion, race or wealth.
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The environment is the foundation of Nightingale’s Theory.
Nurses enhance natures healing powers by manipulating the
environment.
Nurses promote a therapeutic environment increasing the
patient’s health.
Nursing promotes the healing process by providing an
environment that is clean, warm, odorless and full of light.
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Nightingale views health as a patients well being.
She viewed illness and disease as occurring when a person
did not attend to their health issues.
The prevention of disease related to environmental control
and social responsibilities.
Nightingale promoted public health nursing and health
prevention and promotion.
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Nursing assist patients in achieving their best physical
condition for natural healing to occur.
Notes on Nursing is a guide for nursing principles and care
for patients at home.
Nurses need to assess, implement, evaluate and document
their patients’ health status.
Nursing induces the health of a patient by promoting an
adequately controlled environment
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NIGHTINGALE’S LATER YEARS
Died: 1910
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Nightingale describes the nursing role in optimizing the
environment for healing.
The model demonstrates Nightingale’s recognition of human
nature, the environment, and the biological and social aspects
of care.
Nightingale focused on the reformation of hospital
sanitation.
Nightingale integrated data collection, use of statics and
mathematical data in evaluation and decision making.
The phenomenon of environment in nursing practice has
impacted the expanding nursing knowledge in the realm of
human health.
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Polar-Area Diagram
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Ventilation
Warmth
Light
Cleanliness
Diet
Noise
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Proper ventilation was one of the greatest concerns of
Nightingale.
As quoted “ keep the air he breathes as pure as the external
air, without chilling him” (Nightingale, 1969, p.12)
Nightingale recognized and placed great emphasis on proper
ventilation as a source of disease and recovery (Marriner,
2010, p. 75)
According to Nightingale, the nurse is to control or
manipulate the environment continually to maintain
ventilation and patient warmth by using good fire, opening
windows and proper positioning of the patient in the
room(Marriner, p. 75)
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of Nightingale’s concepts for
measuring the patient’s body temperature
was through palpation of the extremities
to check for heat loss (Marriner,2010, p 75)
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Nightingale identified direct sunlight as a need of patient.s
As quoted by Nightingale “light has quite as real and
tangible effects upon the human body…Who has not
observed the purifying effect of light, upon the air of a
room?” (Nightingale, 1969, pp84-85)
Beneficial effects of sunlight are achieved if nurses move
and position patients to expose them to sunlight , according
to Nightingale.
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Cleanliness is a critical component of Nightingale’s
environmental theory (Nightingale,1969).
According to Nightingale, dirty floors, carpets, bed linens
,walls etc… are a source of infection through the organic
matter it contained (Marriner, p .75).
Proper handling and disposal of bodily excretions and
sewage are required to prevent contamination of the
environment , as noted by Nightingale (Marriner, p. 75).
Nightingale advocated frequent handwashing, which is now
known as the # 1 prevention of infection.
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Nightingale noted that the nurse is required to assess the
need for quietness (Marriner, p.76).
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According to Nightingale, noise created by physical
activities in area’s around a patients room could be harmful
to the patient and should be avoided (Marriner, p. 76).
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According to Nightingale’s concept of diet, the nurse is to
not only assess the dietary intake of, but also the meal
schedule and the effect of the food on the patient. (Marriner,
p.76)
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Nightingale also noted, “intelligent nurses were those who
were successful in meeting their patient’s nutritional needs”.
(Marriner, p. 76)
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Through evidenced based practices, this model can
be used in clinical practices today with focuses on
 Internal and external components of the environment
 Ventilation
 Food
 Water
 Light
 Temperatures
 Medications
 Sanitation
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Individuals receiving nursing care.
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Conceptualizing that the improvement of health in
individuals and families can lead to a improved health of
society.
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Dirt-refers to general hygiene, and interpersonal contact
Drink—cleanliness of drinking water and the importance of
drinking water
Diet—refers to proper and balanced diet
Damp—refers to a need for a dry, warm environment
Draughts--refers to drafts can precipitate a disease episode
Drains—refers to proper drainage and sewage systems
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Evaluating and assessing the patients needs based upon the
individualized care needed.
Nursing Process
Education
Family centered care
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Nightingale noted that “training is to teach not only what is
to be done, but why it is done”.
Having a balance of hands on experience as well as knowing
the theoretical reasoning is very important according to
Nightingale.
According to Nightingale, nurses must be excellent observers
and were to be trained specifically to provide care for the
sick person. (Marriner, p. 79)
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Development of evidenced-based-practice (EBP)
for nursing with current and best research findings
being used to deliver healthcare.
This model according to current research, has been
building sound knowledge base for nursing
practice through quantitative and qualitative
research.
Outcome research is conducted to examine both
short-term and long-term results of patient care.
Use of intervention research, which examines the
effectiveness of nursing actions in promoting
healthy outcomes for patients and families.
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Strengths of Model
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Universal
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Simplistic
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Logical
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Timeless
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Foundational
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Florence Nightingale’s philosophy of nursing
was derived from working in varied conditions.
Nightingale had been an examiner of hospital
facilities, reformatories, and charitable
institutions as well as caring for the sick in
hospital and on the battlefield, the
conditions of these various environments often
deplorable. Nightingale recognized that ones
environment was universally important to health
and well-being (Alligood and Tomey, 2010, p. 72).
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“Nightingale recognize the potential harmfulness
of an environment, and she emphasized the
benefit of a good environment in preventing
disease” (Alligood & Tomey, p. 82). Thus
the goal being to manipulate the environment to
promote health as well as prevent disease, by
promoting cleanliness, good sanitation and
proper ventilation.
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Nightingale’s philosophy of nursing care
addressed the basic concepts of air quality,
cleanliness and sanitation . Using inductive
reasoning she deduced that a contaminated, dirty,
dark environment breed disease( Alligood & Tomey,
p.79). Through her experiences and
observations she recognized that not only could
disease be prevented from flourishing , by controlling
the environment , but that disease could be prevented
by manipulating the environment (Alligood & Tomey
p. 79).
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Nightingale’s philosophy of nursing care is
foundational to modern nursing theory and
nursing practice. The tenants of environmental
control are as relevant today as they were 150
years ago. As the founder of modern nursing
Nightingale has laid the ground work for
modern nursing theorists.
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Florence Nightingale is recognized as the founder
of modern day nursing. Her Environmental
Model is based on the idea that healing lies within
the individual and the focus of care is to place the
individual in an environment that fosters the
healing process. This basic concept has been the
impetus for the foundation of modern nursing
theory.
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Limitations
One only needs to read Nightingale’s Notes on
Nursing, to deduce the concepts that she intended
to promote. The concepts that are written about
are most often principles that are derived from
anecdotal situations to their meaning and support
their claims (Alligood & Tomey, p. 81). Nightingale’s
writings lack the testing and complexity of modern
nursing theory, but there is no doubt that these early
concepts have served as the basis for modern research
(Alligood & Tomey, p. 81).
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Ventilation and Warming
Health of Houses
Petty Management
Noise
Variety
Taking food
What food?
Bed and Bedding
Light
Cleanliness of Rooms and Walls
Personal Cleanliness
Chattering Hopes and Advices
Observation of the Sick
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Florence Nightingale is recognized as the founder
of modern day nursing. Her basic ideas about
the care of the patient and the environment are
directly or indirectly represented in the works of
many nursing theorists. The environment and
care of the environment will continue to be
relevant far into the future as our world is ever
changing. Although Nightingale’s theory lacked
in complexity and testing it has proven to be
foundational in the development of subsequent
nursing theories.
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AWARDS
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On-line Florence Connection
Florence Nightingale’s Museum website
Woodham-Smith, C. (1983). Florence Nightingale. New York:
Atheneum.
Cohen, I. B. “Florence Nightingale,” Scientific American, (March 1984),
128 -137.
Tomey, A. M., & Alligood, M. R. (2010). Nursing theorists and their
work. (6th ed.). St. Louis, MO: Mosby Elsevier.
Nightingale, F. (1969). Notes on Nursing. New York, NY: Dover
Publications, Inc.
Barnham, Kay. (2003). Florence Nightingale: The Lady of the Lamp.
Austin, TX: Steck- Vaughn.
Small, Hugh. (1998) Florence Nightingale Avenging Angel. New York,
NY: St. Martins Press.
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Group #3
How does Nightingale’s concept of the environment
impact human health?
How did Nightingale’s contributions move nursing into a
profession?
Nightingale is considered the first nursing theorist. How
can you apply her environmental theory in your nursing
practice? Give an example.
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