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
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……………………………………………………………………………………………………………………..
……..?..?
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
……………………………………………………… ………………………………………………………....
……………………………………………………………………………………………………………………..
……..?..?