Jayson G. Celerio RN,MAN

“God spoke to me and called me to

His service”.Florence Nightingale

Considered as the Matriarch of Modern Nursing

Daughter of a wealthy landowner, William Nightingale

Born in Florence, Italy on May 12, 1820 Her father took responsibility for her

education and taught her Greek, Latin, French, German, Italian, History, Philosophy and Mathematics.

At the age of 25, she wanted to become a nurse, but her parents totally opposed to the idea because they viewed nursing as associated with the working class women. She was then 31, when her father gave her the permission to train as a nurse.

Began her nursing training in 1851 in Germany

Her experience in treating sick/injured soldiers in the Crimean War strongly influenced her philosophy of nursing

To achieve her mission of providing nursing care, she needed to address the environmental problems (overcrowding, poor ventilation, rats and insects crawling, lack of basic supplies such as coats, mattresses, washbasins, soaps, towels, water available in inadequate amount and others.)

Because of prejudiced among women involvement in medicine, her views were rejected, her comments were believed to be direct attacks on the professionalism of military officers and doctors.

She receive little support from the military so she used her contacts at the newspaper, The Times, to report the way that the British Army treated its diseased, wounded soldiers and who eventually dies.

After a great deal of publicity, she was then given the task of organizing the barrack’s hospital, she then began the improvements in the quality of sanitation wherein she was able to reduced the death rate of her patients.

To communicate her opinions on reform she…

published Notes on Hospital and Notes on Nursing (1859)

Considered the first “nursing theorist” Information on her theory has been

obtained through interpretation of her writings.

Was a guide to help organize & manipulate the environment for persons requiring nursing care

Nightingale originally wanted women to teach themselves to nurse and viewed Notes on Nursing as “hints” to enable them to do so

Based her ideas on individual, societal, and professional values

Her strongest influence was education, observation, and hands-on experience She formulated her values through years of working with charities, hospitals, & the military. Pioneered the formal concept of nursing education. “Lady with the Lamp”

“I thank you sincerely & kindly for what you have to say about my Notes on Nursing —you do not know how, in the midst of much disappointment, such words cheer & strengthen us. The only possible merit of my little book is that there is not a word in it written for the sake of writing, but only forced out of me by much experience in human suffering.”

Source: Florence Nightingale: Mystic, Visionary, Healer (B.M. Dossey), p. 231.

With the support of wealthy friends Nightingale was able to raise enough funds to improve the quality of nursing..

In 1860, she used this money to establish the Nightingale School of Nursing and Home for Nurses at St. Thomas’s Hospital.

She had strong opinions on women’s rights. In her book Suggestions for Thought to

Searchers after Religious Truths (1859) she argued strongly for the removal of restrictions that prevented women having careers.

She died on 13th day of August 1910 in London.

The first published nursing theory (1860) Persons are in relation with the environment Stresses the healing properties of the

physical environment (fresh air, light, warmth, and cleanliness)

Nursing puts patients in the “best conditions” for nature to act upon them

Health is “the positive of which the pathology is the negative”

“Nature alone cures”

When aspects of the environment are out of balance, the client must use energy to counter these environmental stresses

Stresses drain the client of the energy needed for healing

The health of the home/community are critical components in an individual’s health

Theory basis: the inter-relationship of a healthful environment with nursing ◦ External influences and conditions can prevent,

suppress, or contribute to disease or death Theory goal: Nurses help patients retain

their own vitality by meeting their basic needs through control of the environment

Nursing’s Focus: control of the environment for individuals, families & the community

PhysicalPsychological

Social

Consists of physical elements where the patient is being treated

Affects all other aspects of the environment Cleanliness of environment relates directly

to disease prevention and patient mortality Aspects of the physical environment

influence the social and psychological environments of the person

Can be affected by a negative physical environment which then causes STRESS

Requires various activities to keep the mind active (i.e, manual work, appealing food, a pleasing environment)

Involves communication with the person, about the person, and about other people ◦ communication should be therapeutic, soothing,

& unhurried!

Involves collecting data about illness and disease prevention

Includes components of the physical environment - clean air, clean water, proper drainage

Consists of a person’s home or hospital room, as well as the total community that affects the patient’s specific environment

1. Proper ventilation2. Adequate light3. Sufficient warmth4. Control of noise5. Control of effluvia (noxious

odors)

Health of Houses Ventilation and

Warming Light Noise Bed and Beddings Cleanliness of

Rooms and Walls

Personal Cleanliness

Nutrition and Taking Food

Chattering Hopes and Advices

Observation of the Sick

Referred to by Nightingale as “the patient”. A passive patient who depends wholly on

the nurse for tasks and control of his environment.

A human being acted upon by a nurse, or affected by the environment

Has reparative powers to deal with disease Recovery is in the patient’s power as long

as a safe environment exists The nurse is totally in control of the patient

and his environment.

The foundational component of Nightingale’s theory

The external conditions & forces that affect one’s life and development

Includes everything from a person’s food to a nurse’s verbal & nonverbal interactions with the patient

Central to the theory is the concept of a therapeutic environment that will enhance the comfort and recovery of the patient.

Maintained by using a person’s healing powers to their fullest extent

Maintained by controlling the environmental factors so as to prevent disease

Disease is viewed as a reparative process instituted by nature

Health & disease are the focus of the nurse Nurses help patients through their

healing process. This lay the foundations for health nursing

that is aimed at health promotion and disease prevention.

Her view of nursing was comparable to that of motherly instincts. She believed that every woman will be a nurse because nursing is having the responsibility for someone’s else’s health – a characteristic shared by women, especially of mothers

Provides fresh air, light, warmth, cleanliness, quiet, and a proper diet

Facilitates a patient’s reparative process by ensuring the best possible environment

Influences the environment to affect health

Supports the nursing process (even though it was not even developed yet!)

Nursing education belongs in the hands of nurses!

Nursing is a discipline distinct from medicine focusing on the patient’s reparative process rather than on their disease!!

The principle of nursing practice by Nightingale are continuously used to this very day. Ventilation, warmth, quiet, diet and cleanliness are still important aspects of nursing care. With the advent of technology and with it, globalizations, come threats from the environment. Global warming, industrial noise, air pollution, fad diets and vanity continue to pose challenges to the nurse practitioner of today.

The same principles is still relevant to this very day.

By establishing the St. Thomas Hospital and King’s College Hospital in London, she was able to provide a framework for the establishment of nursing training schools through a universal template that contains principles of nursing training. These principles included instruction in scientific principles and practical experience for the mastery of skills.

She also advocated the separation of nursing training from the hospital to a more appropriate learning environment in the school or university setting. This was advocated because she believed that nursing student’s role is to learn the art and science of nursing before being employed in the nursing service. She addressed the concern that hospitals might take advantage of the presence of the presence of nursing students in their service areas in the form of assigning clients / patients to these students of their regular employed nursing personnel.

Nightingale is also a strong proponent of practice nursing education. She believed that good nursing can only come from good education. Although she did not believed in licensure examinations, she used other methods of evaluation like case studies to monitor the progress of nursing students.

She is considered the mother of nursing research because of her interest in the scientific methods of inquiry and statistics. She was able to gather, analyze data efficiently and resourcefully. However, her theory lack complexity and testability which limits her theory in that it cannot generate the nursing research that is employed to test modern theories. However the concepts still serves as bases for current research. This can add to understanding modern nursing science and practice.