1. Theorist Selected: Florence Nightingale born on 5/12/1820, a writer, a philosopher, a theorist, a “reformer, a statistician, an administrator, a researcher” (Attewell, 1998), an educator, and a nurse leader.
2. Description of key points of the theory: Nightingale was one of the first theorist to connect the environment with the patient’s well being. Nightingale believed a persons health depended on their environment and that patients will be compliant to treatment because they wanted to be cared for and be healthy. Nightingale believed (as cited by Alligood, 2010, p.101), “that the person was a holistic individual and thus had a spiritual dimension. She believed nursing was a spiritual calling, and with that belief she assumed that nurses could help those clients who were in spiritual distress.” She believed that the way the home, community or hospital room was kept affected the patient’s healing process.
She created “13 cannons: Ventilation and warmth, light, cleanliness of rooms and walls, health of houses, noise, bed and bedding, personal cleanliness, variety, chattering hopes and advices, taking food, what food, petty management and observation of the sick” (Alligood, 2010, p.101-102) that help aid in the care of the patient and the environment to help promote good health. She also believed that nurses should be caring in nature and want to care for the ill and not for personal gain. Nightingale promoted a well balanced diet to help the patient with the healing process.
3. Theory’s historical background: Nightingale developed her passion young in life. Cook wrote (as cited by Selanders, 2010) “She records in her diary an interaction with God at age 16 when He “called her to His service”. Nightingale clarified (as cited by Alligood, 2010, p.98), “nursing knowledge is distinct from medical knowledge.” Nursing focuses on the patient and the environment to promote health where medicine focuses on disease process and medicinal use for health. In 1854-60 Nightingale cared for the wounded soldiers in the Crimean War with “emphasis on hygiene” (Attewell, 1998).
During her time in the Crimean war she persuaded the education of army soldiers and doctors, which then lead to an opening of a pathology lab. She was an advocate for nursing education and clinical experience. “In 1860 founded 1st program to educate nurses in St. Thomas Hospital in London” (Alligood, 2010, p.98). In 1882 she wrote 2 articles “nurses, training of”, “nursing the sick”, they were in reference to how nursing school should be training. Let us not forget how she help analyze data she collected. “Statistics were a vital component of Nightingale’s systemic approach to health care” (McDonald, 2010).
Complete the following grid based on the selected theorist information.
Define each term according to the selected theorist.
Explain how the selected theorist’s approach to each element of the metaparadigm applies to the following:
Applied to Nursing Practice
Applied to Nursing Education
Applied to Nursing Research
According to Alligood (2010, p98), “most of Nightingale’s writings refer to the person as the one who is receiving care, she did believe that the person is a dynamic and complex being”. The one whose health is affected by the environment. The patient allows the nurse to provide care and help promote a healthier environment. McDonald noted (as cited by Hegge, 2013) “Nightingale realized that working-class women needed education to become competent nurses, so she began designing educational elements that would later be used in the Nightingale School of Nursing.” Nightingale’s research and data collection was done for the benefit of the patient. Creating evidence based practices.
According to Alligood (2010, p 98) Nightingale wrote, “Health is not only to be well, but to be able to use well every power we have.” Nightingale created the 13 canons to help promote health. Getting patients back to their functioning status before they fell ill. Nightingale promoted patient health education, especially in the young women so her children could be healthy. Nightingale statistical expertise help make changes to improve a patients care and overall health.
Whall noted (as cited by Alligood, 2010, p. 99)“Nightingale saw nursing as the “science of environmental management.” Nightingale set four steps for nursing process: observation of patient’s health status, identification what needs changing in the environment, implementation of nursing care plan, reassessment of patient’s health status with documentation of all steps. Nightingale advocated for nursing education. Schools taught nurses how to observe a patient, how to alter the environment and implement changes. We report back to the physician from our assessments and reassessments. Nightingale had the hospital collecting data report data such as mortality and length of stay. The data was analyzed and then changes in practices were implemented.
Selanders stated (as cited by Alligood, 2010, p98) that “environment can be defined as anything that can be manipulated to place a patient in the best possible condition for nature to act”. Placing the patient in the appropriate environment.
For example, Creating a pleasant, calm, soothing and quiet environment in a nursery so babies can rest and stay healthy without distress. Schools created to help educate the future nurses. In those teachings were the “how to change, alter, or improve the patient’s immediate environment. Nightingale’s collected statistics on the environment in which the soldiers dwelled in and analyzed it creating changes.
Alligood, M.R. (2010). Nursing theory: Utilization & application (4th ed.). Maryland Heights, MO: Mosby Elsevier. pgs 98. Retreived from the UOP ebook collection. Attewell, A. (1998). Florence nightingale (1820-1910). Prospects, 28(1), 151-166. doi:http://dx.doi.org/10.1007/BF02737786. Retrieved from the UOP online library Selanders, L. C. (2010, March). The Power of Environmental Adaptation: Florence Nightingale’s Original Theory for Nursing Practice. Journal of Holistic Nursing, 28(1), 81-88. doi:10.1177/0898010109360257. Retrieved from the UOP online library Hegge, M. (2013, July). Nightingale’s Environmental Theory. Nursing Science Quarterly, 26(3), 211-219. doi:10.1177/0894318413489255. Retrieved from the UOP online library McDonald, L. (2010, March). Florence Nightingale Passionate Statistician. Journal of Holistic Nursing, 28(1), 92-98. doi:10.1177/0898010109358769. Retrieved from the UOP online library