Post on 21-Dec-2015
Florence Nightingale
By: Megan Cottrell, Karen Theus, Emily Cornell and Elizabeth Klynstra
Image from http://todayinsci.com/N/Nightingale_Florence/NightingaleFlorence-PictureLarge.htm
Introduction
“Nightingale’s unique perspective on nursing practice focused on the relationship of patients to their surroundings” (Chitty and Black, 2011)
Historical Background
Religious inspiration called Florence Nightingale to the nursing profession
She is most remembered for her contributions to nursing during the Crimean War
In 1854, Nightingale received a letter from the Secretary of State at war for the British government requesting her to organize and lead a group of nurses to tend to the soldiers of the Crimean War who were being poorly treated
In six months, Nightingale and her team of nurses greatly improved the mortality rate of the British soldiers
Historical Background (continued)
Nightingale healed through providing a clean environment, personal hygiene, clean linens and dressings, adequate food and housing, and recreation
She turned her observations into statistics and diagrams, using her evidence-based practice to change medicine and nursing
She developed the philosophy that changing patients’ conditions can promote positive changes in their health
Philosophic Views About Nursing
Nightingale described nursing as a divine calling to serve others Her philosophies on the general nature of nursing include:
Nursing is defined as a unique profession that is both art and science
The basic nursing activity is the alteration of the internal and external nursing environment
Nursing is autonomous within the defined scope of practice Nursing is collaborative with all other healthcare professions The goal of nursing is to foster health within the patient Individuals are complex, holistic beings The power of nursing comes from decision-making activities
based on empirical observation of the patient The practice of nursing should not be limited by gender,
spiritual beliefs, or values The nurse should be allowed to develop to the maximum of
his or her potential (Selanders, 2012)
Philosophical views on Knowledge Development
• Nursing has specialized educational requirements with theoretical and clinical components
• Nurses should be educated by nurses who specialize in education
• Nurses should have a grounding in basic sciences• Nursing education should be controlled by the
school, not the hospital• Students are to be regularly evaluated and
apprised of this evaluation during the course of the education (Selanders, 2012)
What Influenced Nightingale’s Philosophy?
Nightingale’s philosophy on utilizing the environment to assist in patient recovery was influenced by her education, experiences, and observations during her nursing career
Information and Concepts
Nightingale's philosophy focused nursing on what is known as the metaparadigm of nursing. She looked at the individual in their surroundings and observed how the environment impacted their health. Considered the founder of modern nursing, Florence Nightingale lead a team of nurses appointed to help at an unsanitary British military hospital. The wards were overcrowded, unsanitary, they had poor lighting, the water was contaminated, the food inedible not to mention the general filth, from bloody rags on the floor to dead animals in the courtyard. Florence Nightingale led a team of nurses to improve the health of the individuals and relieve suffering in a healing environment that consisted of a cleanliness, fresh water, sunlight and a caring attitude of the nurses who worked there.
(Winklestein,2009)
Use of Four Global Concepts
Human: The patient is the focus of care Environment: Making sure patients have
clean air, water,linens, proper ventilation, and sunlight.
Health: Positive changes in health. Nursing: Florence Nightingale set the
foundation for nursing that is still relevant today.
Does the model define the four global concepts?
Nightingale’s model describes the four global concepts;
providing rest and an environment to allow for proper healing for
allowing for rest hand washing, maintaining a sterile field providing patients with proper supply's
for care.
Interpretation, Influence, Implications & Consequences
Through her discipline and determination, Nightingale earned respect for women as nurses.
philosophy shaped nursing into the profession it is today.
Created the first documentation of nursing because of the notes she took.
She started a training school for nurses and this educational model influenced nursing education in both the US and England.
provided a basis for nursing theories and an impact on the future of nursing
Evaluation of the Nursing Model
Evaluation of Theory
• Origin of Theory
Florence nightingale felt that God had influenced her, and nursing was her calling.
The poor reputation for nurses and the lack of occupations for women.
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Education and distinction
between nurses in physicians
Sanitation in hospitals
Metaparadigm of
nursing
Recording of information and statistical data
The relationship of patients in
their surroundings.
Chitty, K. K., & Black, B. P. (2011). Professional
nursing concepts & challenges (6th ed.).
Maryland Heights, MO: Saunders Elsevier
Practice situations of Florence Nightingale’s approach
Florence’s model consisted of the four global concepts.
Person- Florence viewed
patients as multidimensio
nal and needed to be
treated holistically
Health- Florence did
not view health as only the
absence of disease.
Environment- This is the foundation
of Florence's nursing
philosophy; nurses need to adjust the
environment to the patient to
promote health and good outcomes.
Nursing- Florence described “ what
nursing is and what nursing is not” and
gave nursing a whole other
dimension. Before Florence, nursing
was viewed as work of the servants or
working class.
Selanders LC. The power of
environmental adaptation:
Florence Nightingale's
original theory for nursing practice. .J Holist Nurs. 2010 Mar; 28(1):81-8.
Nursing Theories emerging from Florence’s model
Holistic nursing care
Disease management and
sanitation
Professional nursing
Proper training
and education for nurses
Nursing is separate
from medicine
Nursing is a art and a science
Practice Examples
Cleanliness- Hospitals prioritize “wash in, wash out” method. Making sure to wash hands when going in or out of a patients room to prevent the spread of infection among patients.
Nightingale promoted the view that nurses primary responsibility was to protect patients by careful management of their surroundings (Chitty & Black, 2011).
Rest- quiet environment is promoted to allow for quicker healing times. Clustering work together throughout night to allow for less interruptions and more sleep.
Practice Examples
Positive Environment PromotionMaintaining a positive environment
promotes optimal healing. Maintain a positive attitude with patients.Nightingale recognized the effect of the environment on the patient's health or recovery(Chitty & Black, 2011).
Conclusion
Florence Nightingale was a pioneer to modern nursing and her practices is currently still being used.
first to use theoretical foundation in nursing.
Provided a professional nursing model for nursing organizations.
Case Study
Florence Nightingale was a pioneer in nursing in the 19th century. Her focus on environment and its impact on health is still relevant in today’s nursing practice. She taught us how to promote health and to focus on the improvement of healthy environments in all practice settings (Beck, 2010). The following case study seeks to assist us in focusing on healthy environments and how to change the environment for the good of the patient. Answers include a nursing diagnosis and interventions.
Case Study
Mr. Jones has recently evaluated by a home care nurse after being requested by the patients wife. Mr. Jones has recently had an increased number of falls. Three weeks ago Mr. jones got a hip fracture with an ORIF following a fall.
Mr. Jones has a hx of Parkinson's disease, BPH, HTN, falls and recent ORIF.
Medication Mr Jones takes is Carbidopa/levodopa 10/100mg QID, Diovan (valsartan) 160mg QD, Multi vit QD, Flomax 0.4mg QD and Norco 5/325 1 or 2 q6h PRN (has been taking 2 as prescribed)
Lives with wife, has two children who live in town and assist when necessary.
Former machinist, woodworking as a hobby.
Case Study Continued
Pt is being evaluated for home care services r/t recent fall and disease progression. Wife is struggling to care for him r/t unsteady gait, need for support while ambulating.
Nurse inspects home for potential danger zones. She notices rugs on the hardwood floor, a sunken living room where the pt and his wife are sitting. Dimly lit hallway, heavy drapes pulled in the bedroom (wife states to keep the summer heat out) stairs at exits, no hand rails. Bathtub not handicap accessible.
Wife states she leaves pt alone sometimes to run errands
Case Study Question
1. Based on Nightingale’s theory what can be changed to Mr Jones’ care to promote a safety?
2. What teaching needs to be completed to the patient and wife to promote a safer living environment? List three
References
Chitty, K. K., Black, B. P. (2011). Professional Nursing: Concepts and Challenges. Maryland Heights, MO. Saunders Elsevier.
Florence Nightingale. (2013). In Encyclopedia Britannica. Retrieved from http://www.britannica.com/EBchecked/topic/415020/Florence-Nightingale/280687/Nursing-in-peace-and-war
Nightingale, F. Notes on nursing: What it is and what it is not. 1860.
Payne, K. (2010). Science, healing, and courage: the legacy of Florence Nightingale. Alabama Nurse, 37(3), 10 Retrieved from http://0-web.ebscohost.com.libcat.ferris.edu/ehost/pdfviewer/pdfviewer?vid=3&sid=bc11d590-8d29-4a3c-9360-e74455d2417b%40sessionmgr104&hid=103
Selanders LC. The power of environmental adaptation: Florence Nightingale's original theory for nursing practice. .J Holist Nurs. 2010 Mar; 28(1):81-8.
Selanders, L. (2012). The voice of florence nightingale on advocacy. The online journal of issues in nursing,17(1), Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Florence-Nightingale-on-Advocacy.html
Winklestein, W. (2009). Florence Nightingale: Founder of modern nursing and hospital epidemiology. Epidemiology , 20 (2), 311. doi: 10.1097/EDE.0b013e3181935ad6 & (Chitty & Black, 2011).