Nursing Theorists
Group Presentation
Julie Dragt, Megan Strockis, & Wendy DeBruyn
Florence Nightingale
Introduction to Florence Nightingale
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Florence Nightingale lifespan from 1820-1910.
International nurses day is observed on May 12th each
year in honor of Nightingale's contributions to the nursing
field.
Nightingale is known as "the founder of modern nursing."
She completed her nursing training in 1851.
Nightingale was the leader in advocating that nurses
receive formal education and training.
Some refer to Nightingale as "The Lady with the Lamp."
She was a pioneer of statistics in the nursing field by
creating graphs and charts to improve conditions for
patients.
(Alligood &
Marriner Tomey, 2010)
What made Florence Nightingale
who she was?
Florence Nightingale's education was of high quality and
ahead of most other woman of her time. Her father
educated her on mathematics, languages, religion, and
philosophy. Philosophy and statistics were major
influences in her lifelong work as a nurse.
Years before she went to nursing training she wrote in her
diary about how she had a "calling" to give service that
was derived from God.
(Alligood & Marriner Tomey, 2010)
Cont....
In 1854, Nightingale was a nurse for the soldiers in the
Crimean War. She requested that severe modifications
be made to the camps to aid with survival for the
soldiers. The camps needed to be cleaner, the
environment needed to be more acceptable to healing
and free from additional elements of complications. She
would use a lamp at night and perform rounds on the
soldiers. This is how she became known as "The Lady
of the Lamp." For all of her hard work and dedication
she earned high respect from the soldiers, however she
struggled for support from the physicians and military
officers.
Cont....
After the Crimean War Florence Nightingale started
schools with the earnings that she received. The
schools provided nursing training at two hospitals in
London. This was the start in her efforts to promote
nursing as a profession.
(Alligood & Marriner Tomey, 2010)
Concepts to Professional Nursing
Defining the four global concepts:
Nursing: The act of utilizing the environment of the
patient to assist him in his recovery
(Nightingale,1860).
Nightingale considered a clean,well-ventilated, and
quiet environment essential for recovery. Often
considered the first nurse theorist. Nightingale
raised the status of nursing through education.
Nurses were no longer untrained housekeepers
but people educated in the care of the sick.
Defining the four Global Concepts Cont...
Health: Not only to be well, but also to use well
every power that we have, can be used to
describe health for both individuals and
communities (Nightingale, 1860).
Health is highly dependent on where and how
we live. The vision of "health" varies with
each person. it relates to the global concepts
because you need health to complete a state
of physical, mental and social well-being.
Defining the four Global Concepts Cont...
Environment: Internal (within the person) and
external (outside the person) surroundings
and structures that influence quality of human
life.
An environment is constantly changing, it is
never stagnant. A person's environment can
impact their health and in turn relate back to
the global concepts.
Defining the four Global Concepts Cont...
Human Being: Viewed as open energy fields
with unique life experiences.
Humans are complex and diverse and they
enable one to increase knowledge of self and
the environment. Human beings are viewed
to value, respect, nurture and understand
how and when to make the informed choices
regarding their health.
(Loser, 2013)
Nightingale's Philosophy
• Nightingale understood well the elements of
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a healthful environment in which restoration
and preservation of health and prevention of
disease and injury were possible.
Nightingale recognized the need for health,
as she build a nursing school to provide
H others with the knowledge to
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L serve the sick, with this
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H education she helped
improve healthcare for all.
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Nightingale's Philosophy
Florence devoted her life to the service of
others. She had a strong calling to nursing that
allowed her to help and care for all human
beings.
Proper wound care and sterilization all started
with FlorenceNightingale's nursing vision. She
taught her students to not only concentrate on
nursing tasks but to focus
on the patient as a whole,
responding to
psychological and social
aspects as well.
Clarification of Origins
Florence Nightingale wrote:
"Nursing ought to signify the proper use of fresh air, light,
warmth, cleanliness, quiet, and the proper selection and
administration of diet" (Domrose, 2011).
The philosophy is not necessarily unique to nursing.
- Can be used in many disciplines involving the care,
comfort, or education of others. For example, schools
ensure these same outcomes in the classroom and in
the school feeding program.
Nightingale Model of Nursing Practice
Nurse
Observe
Patient
Document
Identify Environmental
Alteration
Determine Outcome
and Environmental
Change
Change
Document
(Selanders, 2010)
What Influenced Nightingale's Model?
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Environment is the umbrella concept of this theory of
nursing.
The model grew from Nightingale's observation of poor
environments that led to poor health and disease.
These observations included: dirty water, inappropriate
sewage disposal, poor nutrition, filth, and poor
ventilation.
This model was also influenced by the need to develop
nursing into a profession.
(Selanders, 2010)
Does the Model describe the 4
global concepts?
-Nightingale did not specifically write in terms of the
paradigm of nursing but each component is clearly
addressed.
- The model was developed well before the paradigms of
nursing were formally established but Nightingale, being
the visionary that she was, believed in holistic health.
- Nightingale perceived that people were multi-dimensional,
being composed of biological, psychological, social, and
spiritual components.
(Selanders, 2010)
Examples of the Model in Nursing
Practice
This model is used daily when providing nursing care in any patient care area. These
areas could include OB, OR, med surg units, long-term care, critical care, hospice or
any other patient care area.
This model is used daily when providing nursing care
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Control visitors under certain circumstances
Room is tidy, bed is clean and not soiled
Patient is bathed
Halls and nursing unit are free of excessive noise
Patient's are provided fluids and food with intake documented
Patient is not awakened unless necessary
Primary nursing is appropriately administered if applicable
Other Theories Generated from
Nightingale's Model
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Roy Adaptation Model
- This model focuses on the adaptation of the
patient to the environment.
- Consistent with Nightingale's emphasis on the
environment in relation to ones health.
Virginia Henderson
- She has been called the Florence Nightingale of
the 20th century.
- Henderson continued to define the role of nursing
that Nightingale initiated.
(Selander, 2010)
Cont....
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Maslow's Hierarchy of Needs
- Nightingale's Model is philosophically consistent
with Maslow. This is demonstrated by nursing's role
in meeting the needs of the patient.
- Maslow's physiological, safety, and security
needs are addressed by Nightingale's 13 Canons.
- Maslow's love/belonging and self esteem needs
are addressed by Nightingale's Function of Nursing.
- Maslow's self actualization level is addressed
by Nightingale's Place of Women in Society.
(Selanders, 2010)
Cont....
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Jean Watson Model on Caring
- This model is also based on the environment and
the need for harmony to promote health or prevent
disease.
Conclusion
Florence Nightingale is often overlooked because she
is viewed as "what was." In reality, her contribution
was wisdom through vision. She prompted the
question, "What is nursing?" and "What is the
nursing profession?" These questions have been
researched extensively but still are relevant and are
not totally answered today.
(Chitty & Black, 2011)
(Selanders, 2010)
Resources:
Alligood, M. R., & Marriner Tomey, A. (2010). Nursing Theorists and Their Work (Seventh
ed., pp. 71-84).
Chitty, K.K., & Black, B.P. (2011). Professional nursing: Concepts and challenges (6th ed.)
Maryland Heights, MO: Saunders
Domrose, C. (2011). Healing force: Florence Nightingale's teachings crossed Atlantic and the
mason-dixon line during the American civil war. Retrieved from
http://www.nurse.com/apps/pbcs.dll/article?AID=2011110622001
Florence Nightingale, (1860). Nursing-Resource.com.
Lee, G., Clark, A. M., & Thompson, D. R. (2013). Florence Nightingale - never more relevant
than today. Journal of Advanced Nursing, 69(2), 245-246. doi:http://0dx.doi.org.libcat.ferris.edu/10.1111jan.12021
Resources Cont....
Loser, P. (2013). Metaparadigm Concepts: Nursing. In College of New Jersey. Retrieved
February 13, 2013, from http://nursing.pages.tcnj.edu/about/missionphilosophy/metaparadigm-concepts/#header
Masters, Kathleen. Role Development in Professional Nursing Practice. Sudbury, MA:
Jones and Bartlett Publishers, 2009. 75. Web. 13 Feb. 2013.
<http://nursing.jbpub.com/roledevelopment>.
Selanders, L.C. (2010). The power of environmental adaptation: Florence Nightingale's
original theory for nursing practice. Journal of Holistic Nursing, 28, 81. doi:
10.1177/0898010109360257
Case Study
1.
You are a new nurse in orientation with a preceptor
on the general medical-surgical floor of a 25 bed ward.
You come in at the start of your night shift with a patient
load of five patients. When you start your patient rounds
you find that three of your patients haven't had a shower in
three days, two of your patients dinner trays are still on
their bedside tables, and there hasn't been any Intake or
output charted on any patient since the admission charting.
What do you see that doesn't fit into the concepts of
Florence Nightingale's theory of nursing?
Cont....
2.
The next night you come into work for your shift on
the same unit. Tonight you have four different patients.
When you get report from the day nurse she informs you
that the patient in room two has been complaining of the
unit being very noisy. When you go into room two to do
your assessment Mr. Smith is very upset because he has
been woken up multiple times throughout the day due to
noise and nurses laughing in the hallway. He also
mentions that no one would help him with his shower
today.
Is this patient response an appropriate response to how
patients should respond to a hospital stay according to the
concepts of Florence Nightingale's nursing theories?
Cont....
3. The third night you come into your night shift to five
patients again. You get report on your patients and then
start your rounds. You find that all of your patients have
been bathed, fresh bedding, intake and output are up-todate, the hallways remain quite, two of your patients are
visiting with family at the bedside, and the other three of
your patients are resting comfortably without complaints
or concerns.
Does this patient assignment assessment follow the
nursing theory concepts of Florence Nightingale?