Environmental Theory of Nursing
Presented by
Michelle Metzger
Bridgett Weldon
Carrie Smith
Purpose

 When sanitation techniques
are not practiced, and when
a healthy diet and adequate
rest periods are not allotted,
illness occurs and can
spread to others.
 Are there simple measures
that a nurse can make to
promote health and healing
in ill persons and how much
of an effect will they have on
healing?
Introduction

 Florence Nightingale’s Philosophy was to focus on
health and healing rather than illness and to
incorporate a patient’s environment into their plan of
care (Chitty & Black, 2011).
Origins of the Model

 Nightingale’s focus on the environmental setting as
being a vital part of patient care began when caring
for those injured and sick during the Crimean War
in 1854.
 At this time, Nightingale included clean laundry
and linens, quality food, adequate rest, and
decreased noise to her nursing care to help with the
healing of her patients.
 In a six month time frame, Nightingale and 38 other
nurses decreased the mortality rate of these patients
from 42.7% to 2.2%.
(Payne, 2010)
Origins continued

 While caring for the injured of the Crimean War,
Nightingale closely recorded observations of her
patients, even at night (This is why she is known at
“Lady of the Lamp”).
 Having a mathematical background, she turned her
observations into statistics and her findings soon
had effects on military and civilian hospitals in
England and the United States, and began
influencing the education for the nursing and
medical professions as well.
(Payne, 2010)
Origins continued

 Nightingale not only focused on the health and
healing aspect of care but also discovered the need to
provide holistic care, including not only a patient’s
body but also their family, environment, mind, and
spirit.
Payne, 2010
Theory Basics

 Nightingale believed in health of the patients, and tried to
integrate holistic care in combination with a clean
environment for the patients.
 With that she was able to promote health with her
patients by having clean air to breathe, clean sheets for
their bedding and available exposure to sunlight.
 She would try to reduce noise in areas of treatment for the
patients.
 Nightingale pushed this care of patients by promotion of
nursing with the idea of health and recovery. (Chitty &
Black, 2011).
 As nurses, we exercise this idea every day in patient care.
Human Being

 People are
multidimensional,
composed of biological,
psychological, social
and spiritual
components.
(Current Nursing, 2012)
Environment

 "Poor or difficult
environments led to
poor health and
disease".
 "Environment could be
altered to improve
conditions so that the
natural laws would
allow healing to occur.“
(Current Nursing, 2012)
Health

 Health is “not only to
be well, but to be able
to use well every power
we have”.
 Disease is considered as
disease or the absence
of comfort.
(Current Nursing, 2012)
Nursing

 Nursing is different from
medicine and the goal of
nursing is to place the
patient in the best
possible condition for
nature to act.
 Nursing is the "activities
that promote health (as
outlined in canons) which
occur in any caregiving
situation. They can be
done by anyone.“
(Current Nursing, 2012)
Theory for Today’s Nurses

 Florence Nightingale’s Environmental Model creates
a basis to which nurses today can follow with the
practice of patient care. Such ideas are stated here:
 “Nightingale delved into the most basic needs of
human beings and all aspects of environment (e.g.,
clean air, water, food, housing). She also used what
today are recognized as Integrative
modalities/therapies such as light, music, relaxation,
aromatherapy, touch, music therapy, pet therapy,
health nutrition, and exercise”(Dossey, 2010).
What Influenced This Model?

 This Environmental model or holistic model of nursing
was tested in the Crimean War between 1854 to 1856.
Nightingale reported back to Britain from the war that
many were wounded and conditions for treatment were
even worse. She had taken more than 38 volunteers to
help with care for the Crimean War. Nightingale found
that mass infection was present probably due to
inadequate medical supplies and sanitary environment or
good hygiene (Chitty & Black, 2011).
 She was also able to gather a statistical analysis of the
data collected consisting of wounded soldiers and
fatalities. (Dossey, 2010). This data gave way to support
reform in the medical system of the British Army.
Where Can This Theory be Used?

 The Environment model can be intended to use in any
hospital setting.
 Nightingale didn’t designate this model to any specific
area; her main intention was creating a suitable
environment for patients and thereby trying to increase
their health.
 This is something that we practice whether it is in a
Critical Care, Hospice or even in the OB.
 What are some things that you do in patient care to
promote a sustainable environment to help your patients
reach optimal health?
Where has This Model Been Used?

 The American Holistic Nurses Association (AHNA)
believes in using Florence Nightingales theory by
stating, “The words ‘Holistic Nursing’ means
nursing in the whole person in the ways of
Nightingale….fresh air, fresh food and water,
spiritual sustenance, and mental and emotional
support leading to clarity for the one being cared
for”(AHNA, 2012).
 Organizations such as this are trying to promote this
holistic care in nursing and influence others to join in
their stride.
Case Study

 A patient is admitted to a post-surgical care unit
following surgical repair of a hip fracture. The patient
was homeless at the time of the incident and was found
lying on the street by a passerby. EMS was called and the
patient was taken to the hospital for treatment. The
patient has a history of alcohol and drug abuse, mental
illness, as well as the recent history of homelessness
resulting from the substance abuse.
 What are some of the issues that Nightingale’s
environmental model would focus on in this situation?
 What are some interventions that would be indicated by the
use of the model?
References

 American Holistic Nursing Association (AHNA) (2012). Retrieved from
www.ahna.org
 Chitty, K. K., & Black, B. P. (2011). Professional nursing: Concepts and challenges (6th
ed.) Maryland Heights, MO: Saunders
 Dossey, B.(2010).Holistic Nursing: From Florence Nightingale’s historical legacy to
21st-centuary global Nursing. Alternative therapies in Health and Medicine.16(5). 146.doi: 755053957
 http://nursingplanet.com/Nightingale/
 Nursing theories: Theory of Florence Nightingale.(2012) Retrieved from
www.currentnursing.com/nursing_theory/Florence_Nightingale_theory.html
 Payne, K. (2010). Science, health, and courage: The legacy of Florence Nightingale.
Tennessee Nurse, 73(2). Retrieved from http://0web.ebscohost.com.libcat.ferris.edu/ehost/pdfviewer/pdfviewer?sid=e2a2e9011936-40d9-b96d-56711f8a1507%40sessionmgr110&vid=4&hid=117
 Selanders, L., Crane, P., (January 31, 2012) "The Voice of Florence Nightingale on
Advocacy" OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 1.
DOI: 10.3912/OJIN.Vol17No01Man01