Florence NightingaleFlorence Nightingale

ENVIRONMENTAL THEORY

FOUNDER OF NURSING

FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE

Born -12th may 1820Born -12th may 1820‘‘‘‘Founder of modern nursingFounder of modern nursing””The The First First Nursing TheoristNursing TheoristKnown as the Known as the ‘Lady with the ‘Lady with the

Lamb’Lamb’She stated She stated ‘Nature Alone ‘Nature Alone

Cures’Cures’

FLORENCE FLORENCE NIGHTINGALENIGHTINGALEBegan her nursing training in Began her nursing training in

1851 1851 in Germanyin GermanyPioneered the concept of Pioneered the concept of

formalformal nursing educationnursing educationHer experience in treating Her experience in treating

sick/injured soldiers in the sick/injured soldiers in the Crimean WarCrimean War strongly influenced strongly influenced her philosophy of nursingher philosophy of nursing

DEFINITIONDEFINITION

‘‘ ‘‘The goal of nursing The goal of nursing is to put the patient is to put the patient in the best possible in the best possible condition for the condition for the nature to act upon nature to act upon him.him.’’’’

Florence NightingaleFlorence Nightingale

In 1860 Nightingale published In 1860 Nightingale published ‘‘Notes on Nursing’ Notes on Nursing’

””What It Is What It Is not’’What It Is What It Is not’’Her theory significantly Her theory significantly

influenced 3 other groups of influenced 3 other groups of theories - Adaptation Theory, theories - Adaptation Theory, Need Theory, & Stress TheoryNeed Theory, & Stress Theory

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

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

their own vitality by meeting their their own vitality by meeting their basic basic needsneeds through control of the environmentthrough control of the environment

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

Nightingale’s canons Nightingale’s canons or or

conceptsconcepts Ventilation and Ventilation and

WarmingWarming LightLight NoiseNoise Bed and BeddingBed and Bedding Cleanliness of Cleanliness of

Rooms and WallsRooms and Walls Health of HousesHealth of Houses

Personal Personal CleanlinessCleanliness

Nutrition and Nutrition and Taking FoodTaking Food

Chattering Hopes Chattering Hopes and Advicesand Advices

Observation of the Observation of the SickSick

Social Social ConsiderationsConsiderations

PHILOSOPHICAL PHILOSOPHICAL ASSUMPTIONS AND BELIEFS ASSUMPTIONS AND BELIEFS

REGARDING REGARDING Nursing Paradigms

Three Types of Three Types of EnvironmentsEnvironments

PhysicalPhysicalPsychologicalPsychologicalSocialSocial

Physical EnvironmentPhysical Environment

Consists of physical elements where the Consists of physical elements where the patient is being treatedpatient is being treated

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

to disease prevention and patient mortalityto disease prevention and patient mortality Aspects of the physical environment Aspects of the physical environment

influence the social and psychological influence the social and psychological environments of the personenvironments of the person

Psychological EnvironmentPsychological Environment

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

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

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

soothing, & unhurried!soothing, & unhurried!

Social EnvironmentSocial Environment

Involves collecting data about illness and Involves collecting data about illness and disease preventiondisease prevention

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

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

Example :Example :

5 Major Components of a 5 Major Components of a Healthful EnvironmentalHealthful Environmental

1.1. Proper ventilationProper ventilation

2.2. Adequate lightAdequate light

3.3. Sufficient warmthSufficient warmth

4.4. Control of noiseControl of noise

5.5. Control of effluvia (noxious odors)Control of effluvia (noxious odors)

APPLICATION OF APPLICATION OF NIGHTINGALE THEORY IN NIGHTINGALE THEORY IN

PRACTICEPRACTICE

ASSES-MENT NURSING DIAGNOSIS

GOAL INTERVEN-TION

RATIONALE NURSING BEHAVIOR

EVALUATION

SUBJECTIVE DATA

Patient complaints that he is unable to sleep at night

OBJECTIVE DATA

Dark big eye brows weak and pale, drowsy.

Disturbed sleep pattern related to fear of therapeutic regimen.

The patient will take enough rest and sleep

Keep environment quiet for sleeping by ,eliminating noise.

Perform nursing procedures before pt go to sleep.

Adjust lighting by providing curtains.

Provide more relaxing and comfortable environment for sleeping.

Reduces disturbance in sleep.

Light may alter or disturb patient sleep.

Changing or manipulating the environment to facilitate health.

Goal met , patient had adequate undisturbed sleep during night.

Consider a patient you have recently cared for. Identify areas where you can implement nightingale theory ?

E.g.: Avoiding noise in patients with increased ICP.

Exercise 1Exercise 1

NURSING DIAGNOSISNURSING DIAGNOSIS

Potential for Hypothermia Potential for Hypothermia related to heat loss related to heat loss secondary to skin injurysecondary to skin injury..

INTERVENTIONSINTERVENTIONS

……………………………………………………… ………………………………………………………....

……………………………………………………………………………………………………………………..

……..?..?

Exercise 2Exercise 2

NURSING DIAGNOSISNURSING DIAGNOSIS

High risk for injury related High risk for injury related to altered level of to altered level of consciousness.consciousness.

INTERVENTIONSINTERVENTIONS

……………………………………………………… ………………………………………………………....

……………………………………………………………………………………………………………………..

……..?..?