Florence Nightingale and Environmental Sanitation

'Health is wealth' is a saying that is used in common parlance. This statement is profound when we take a view of the contributions of Florence Nightingale to Health Promotion especially in the times when the field of nursing was not considered a noble profession by those from the top echelons of the society. Born to an aristocratic family in Florence, Italy in 1820, Florence's parents disapproved of her choice of profession and barred her from pursuing nursing until hen a new opportunity presented itself (Dossey, 2010).

In the article Florence Nightingale and Mary Seacole on nursing and health care, McDonald (2014) eulogizes the contributions of Nightingale in the area of health promotion. He notes that Nightingale's efforts to reform hospitals, which he terms in his own words was 'notoriously unsafe', paved way for the development measures that promoted health especially at that early point in history.

Florence Nightingale's theories, according to Jetha (2014), place emphasis on health promotion as opposed to curative focus. Pivotal to Nightingale's theory, Jetha continues, are four central themes which are centers around nursing, person, health and most especially environmental sanitation.

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The interaction that existed between these themes, and how neglecting one aspect could impact the functioning of the other central ideas, is of great importance to a person's recovery process. Nightingale believed that the four themes highlighted above play a critical role in determining and promoting optimal health. Through this paper, I shall take a view these four central pillars of Nightingale's theory that has shaped the field of nursing as we know it today, and more importantly, the impact of Nightingale's theory on environmental health promotion.

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O'Donnell (1986), defines health promotion as 'the science and art of helping people change their lifestyle to move towards a state of optimal health'. This position by O'Donnell in reference to health promotion suggests that optimal health is a conscious product of collaborative efforts between different parties including the patient towards achieving a desirable outcome that includes dietary and lifestyle changes that are promoters of optimal health. An optimal state of health is not cast in stones but is achievable through a conscious determination to be disciplined and follow through. Nightingale's first opportunity to turn her flair for philanthropy and care into professional nursing presented itself in 1844 at the Lutheran Hospital in Kaiserwerth, Germany. From there, Nightingale served as a nurse in Middlesex hospital and her duties required her to attend to sick governesses. While serving, Nightingale put in place sanitary processes and procedures that helped put an end to the cholera epidemic that was ravaging that area (Davies, 2012). In the 1850's, after returning to London, Nightingale received a call to serve in the Crimean war where there was an acute shortage of nurses and medical workers due to the increasing injuries being sustained by those at war. Nightingale took the opportunity and did not waste time in assembling a thirty- eight-member team to accompany her in this important task which formed the very core of her being: giving and caring. This assignment in Crimea afforded her the opportunity to revolutionize nursing from what it was back then to what it is today.

On setting foot in Constantinople, the condition and environment that Nightingale and her team found at the hospital left much to be desired. The hospital was in a deplorable state: the wards were infested with insects, the level of sanitation present was comparable those seen in slums, and supplies were grossly inadequate. In addition, the number of injured soldiers was increasing by the day with fewer hands to tend to them (as cited in Davies 2012). Being a leader who leads by example, Nightingale always sets the example by leading by doing. She believeds the best way to lead is was by demonstrating what neededs to be done. Nightingale was a woman given to the Bbible and this greatly influenced her thoughts processes and the way she conducted herself (Attewell, 1998). Taking her cue from a bible assertation where it is said that cleanliness is next to godliness, Nightingale set about to turn around the sanitary environment of the hospital and from there, she developed models of what an ideal sanitary condition of any hospital should be. Nightingale advocated that the environment a sick person is placed in should not be a contributing factor to their illness, but rather one that promotes good health (McDonald, 2014). To this end, she advised that the sun is good for the patients and that a bright environment will cheer and lift up their spirits thereby contributing to their recovery, as opposed to keeping them in the dark which will have the opposite effect on the health of the sick (McDonald, 2014).

Nightingale employed her knowledge of statistics and mathematics in health record data collection while at Crimea. Before Nightingale's work, there was no adequate record keeping of injured and mortality rate which made it was quite difficult to know how many of the injured soldiers were dying daily. Her records showed that the hospital was losing more than half of the injured soldiers brought in to be treated due to the unhygienic condition of the hospital, in addition to contracting infections while in the hospital (Dossey, 2010). Nightingale also made requests for more supplies and medical equipment to be made available to the hospital in other to meet the demands of the increasing number of injured soldiers. The provision of these supplies coupled with portable drinking water saw to the a reduction in the mortality rate (Dossey, 2010). Furthermore, Nightingale's quest to promote cleanliness as the foundation on which nursing stands introduced the creation of laundry unit for the hospital to cater to all areas that pertains to patient's hygiene (Davies, 2012). The laundry section was tasked with the responsibilities including patients' beddings and all clothing that was used in the hospital including the doctors' coats. She was of the opinion that the hygiene of all parties involved in giving care to the patients must be top notch as they played a huge role in patients' road to recovery (Davies, 2012).

Another area where Nightingale made her mark is was in respect to the advocation of a specialized meal for the convalescent. Different patients in the hospital for different reasons and so therefore to nourish them back to health, it was only wise and fair that different patients will require different meals and diets to aid them to quick recovery. Nightingale's advocacy for an invalid kitchen was a step in the right direction, she believed hygienic meals play a key role in preventing complications, supplying the essential energy and nourishing a convalescent back to good health. As an advocate for wellness, Nightingale focused on health care reforms as recorded during her nursing duties at Crimea provided her with the impetus that was needed to put her ideas into writing. These ideas led to a two-hundred and twenty-one paged note in which she highlighted and advocated for various changes that would ill culminate in the effective and efficient management of hospitals and issues in respect to health (Davies, 2012). Nightingale's notes on how hospitals can be effectively managed and what nursing ought to be has become a manual that is highly consulted in the field of health and nursing today.

In her 'Notes on nursing' Nightingale itemized five areas that nurses should strictly adhere to. (Karimi & Masoudi, 2015). The first of these areas was confidentiality where she advised nurses to be reliable and dependable people, and to discharge their duties and responsibilities with utmost discretion. Discretion, she noted, was very important and forms one of the cardinals of the profession of nursing. Moving away from that, the issue of trust was discussed, and she placed primacy on for nurses. To Nightingale, nurses are people that can be trusted by their patients to do exactly what the tenets of nursing requires of them as one of the agents that nursed them back to health while in the hospital. Following closely on the heels of trust is observation in recording whatever she observed from patients. The role that observation plays in the medical field cannot be over emphasized. A nurse, she saidys, should be avid observer and as an observer she is supposed to make good use of her five senses (Karimi & Masoudi, 2015). Nightingale believed that nurses should be able to communicate effectively without using too many words. The need for effective communication skills cannot be over emphasized and this is also applicable to those in the medical field. Nurses or health care workers should take adequate care not to stress their patients in a bid to communicate with them on their health. She advocated that nurses should position themselves in the right direction so as not to place undue stress on their patients and thereby aggravate their illness.

1860 saw the founding of St Thomas Hospital home to The Nightingale Training School which was designed for nurses. Due to the physical strain she experienced as a result of the demands made on her health by the Crimean fever she contacted at age 38 (Dossey,2010). Being one not to be pitied and not given to idleness, Nightingale even on her sick bed devoted her time to contributing to her first love: nursing. She continued to act in consulting capacity especially when the US civil war broke out. She did not let the wealth of experience and knowledge she garnered during her active days as a nurse go to waste. Nightingale was ever happy to put her weight behind causes that were in favor of health promotion. Though she was disabled physically, her heart which housed her love was always at work. Nightingale, according to Dossey (2010), became an 'activist, catalyst and leader in sanitation reform (now known as public health) in England, India and throughout the world' (p.112). This quote goes to show the far-reaching impact of Nightingale on health promotion for years after she passed on.

ConclusionMany a woman have etched their names in the annals of history for various accomplishments the world over, however, none comes close as Florence Nightingale in her pursuit of excellence in the field of nursing and care giving. The above submission clearly lends credence to Davies's (2012) claim that in which she says 'Nightingale is probably the most famous woman in the world after Queen Victoria' after a diligent study of Nightingale's contributions to the field of modern nursing. During the Crimean war, it was said that Nightingale had a routine of visiting injured soldiers in their wards in the middle of the night carrying a lamp. It was no wonder that she was referred to as the 'Lady with a lamp' (Davies, 2012) which is one of the many fond terms that she is known by. The Crimean fever left her bedridden for the remainder of her life and the Lady with a lamp passed on August 13, 1910. Hers was a life devoted to caring, she chose to forgo marriage to be fully available to serve others which she believed is a calling from God (Dossey, 2010). To say Nightingale was an advocate for health reformation, and more especially in the field of nursing, would be an understatement. Most of her personal teachings have become widely accepted in the modern nursing profession. Given that environmental factors significantly affect the emotional, physical and physiological well-being of patients, Nightingale noted that it was important for nurses to ensure there was clean and fresh air to aid recovery. One thing stands out clear, Nightingale was born a revolutionary and one who hads a heart of gold who gave her all to caregiving. Her notes on hospital attests to the giant strides she made as an advocate of sanitary conditions. Nightingale would will forever be remembered as an icon who worked efficiently with her heart to change advocate for environmental sanitation and health promotion.


  1. Attewell, A. (1998). Florence Nightingale's relevance to nurses. Journal of Holistic Nursing, 16(2), 281-291. /doi:10.1177/089801019801600217
  2. Davies, R. (2012). 'Notes on nursing: What it is and what it is not'. (1860): By Florence Nightingale. Nurse Education Today,32(6), 624-626.
  3. Dossey, B. M. (2010). Florence Nightingale: A 19th-Ccentury Mmystic. Journal of Holistic Nursing, 28(1), 10-35. doi: 10.1177/0898010109356474
  4. Garofalo, M., & Fee, E. (2010). Florence Nightingale (1820-1910): Feminism and hospital reform. 2010. American Journal of Public Health, 100(9), 1588.
  5. Jetha, Z. (2014). Nursing Ccare in the Lance of Florence Nightingale. I-Manager's Journal on Nursing, 4(4), 32-36.
  6. Karimi, H., & Masoudi A., N. (2015). Florence Nightingale: The Mmother of Nnursing. Nursing and mMidwifery sStudies, 4(2) doi:10.1779529475
  7. Mcdonald, L. (2014). Florence Nightingale and Mary Seacole on nursing and health care. Journal of Advanced Nursing 70(6), 1436-1445. doi: 10.1111/ jan.12291
  8. O'Donnell, M. (1986). Definition of health promotion. American Journal of Health Promotion: AJHP, 1(1), 4-5.


Updated: Mar 11, 2022

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Florence Nightingale and Environmental Sanitation. (2019, Dec 09). Retrieved from https://studymoose.com/florence-nightingale-and-environmental-sanitation-essay

Florence Nightingale and Environmental Sanitation essay
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