Nightingale Theory

Florence Nightingale
Madeline N. Gerzon, RN, MM

BSN 11C
TFN, Davao Doctors College
*****
Religious inspiration
called her to focus
on the health of
the masses
 Began her nursing training in 1851 in
Germany
 Pioneered the concept of formal
nursing education
 Her experience in treating sick/injured
soldiers in the Crimean War strongly
influenced her philosophy of nursing
 First to use statistics to guide care
delivery
Florence Nightingale…
“All sciences of observation
depend upon statistical methods
—without these, are blind
empiricism. Make your facts
comparable before deducing
causes. Incomplete, pell-mell
observations arranged so as to
support theory; insufficient
number of observations; this is
what one sees.”
 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
 In 1860 Nightingale published Notes
on Nursing
 Considered the first “nursing
theorist”
 Information on her theory has been
obtained through interpretation of
her writings
 Her theory significantly influenced 3
other groups of theories - Adaptation
Theory, Need Theory, & Stress
Theory
Nightingale’s Notes on Nursing:
 Was not written as a nursing text

 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
Nightingale on Notes on Nursing…
“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.”
Nightingale’s Nursing Theory
 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
 Viewed disease as a reparative process
 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
Three Types of Environments
 Physical
 Psychological
 Social
Physical Environment
 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
Psychological Environment
 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!
Social Environment
 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
5 Major Components of a
Healthful Environmental
1. Proper ventilation
2. Adequate light
3. Sufficient warmth
4. Control of noise
5. Control of effluvia (noxious
odors)
Components of Nightingale’s
Environmental Theory:
 Health of Houses  Personal
 Ventilation and Cleanliness
Warming  Nutrition and
 Light Taking Food
 Noise  Chattering Hopes
 Variety and Advices
 Bed and Bedding
 Observation of the
Sick
 Cleanliness of  Social
Rooms and Walls
Considerations
Nightingale’s Theory & Nursing’s
Metaparadigm - PERSON
 Referred to by Nightingale as “the
patient”
 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
Metaparadigm - 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
Metaparadigm - HEALTH
 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
Metaparadigm - NURSING
 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!)
Metaparadigm - NURSING
 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!!
Critical Thinking Exercise
 Complete an environmental assessment of
this learning environment. Develop a plan
for repair or maintenance.
 Consider a patient you have recently cared
for. Identify areas of the environment that
Nightingale’s theory guides you to assess.
Did you consider these before in your own
model of practice?
*****
 Using Nightingale’s model, compare and

contract the practice of nursing in the late
1800’s with nursing in present times.

Nightingale Theory

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What were Nightingale's influences and experiences that shaped her philosophy of nursing?

How did Nightingale's views on nursing education and the nursing profession develop?

Florence Nightingale

Madeline N. Gerzon, RN, MM

 Was not written as a nursing text

distinct from medicine

 Using Nightingale’s model, compare and

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