G O O D M O R N I N G

Florence Nightingale
(1820-1910)
Who is Florence Nightangle?
Biography

 Born in Florence, Italy on

May 12, 1820.
 Belong in a upper-
middle class family
 Her father William Edward
Nightingale is a wealthy
landowner.
Biography

 At the age of 16 she had an interest in

philanthropy, ministering to the ill, knew her
calling was nursing
 Religious inspiration called her to focus on
the health of the masses.
 A call from God last February 1837 while at
Embley Park.
Biography

1851- finished her nursing training at Germany

1860- published Notes on Nursing
Mother of Modern Nursing
First Nursing Theorist
First Nurse Educator.
She was a linguist, educated in science,
mathematics, literature and arts.
Biography

The Lady with the Lamp

Excellent writer
Expert Statistician using bar and pie
 August 13 1910- She died peacefully at the
age of 90 in South Street Park, London.
Major Works and Awards
Unrelenting care given to the soldiers of
Crimean War.
Royal Red Cross by Queen Victoria 1883
Order of Merit 1907
2ND Famous British Person
“Lady with the Lamp”
Major Works and Awards
 Famous Nurse During Crimean War
 Badge of Honour of the Red Cross Society 1910
 Her Birthday marks as International Nurses Day)”
ENVIRONMENTAL
THEORY

By: Florence Nightingale

 Overview of the Theory
Nightingale's theory was the first published
nursing theory in 1860.
Nightingale viewed the manipulation of the
physical environment as a major component of
nursing care.
Nightingale explained this theory in her book,
Notes on Nursing: What it is, What it is Not.
 Overview of the Theory

Theory basis: the inter-relationship of a

healthful environment with nursing.
 Overview of the Theory

Theory goal: nurses helps patients retain

their own vitality by meeting their basic need
through the control of the environment.

Nursing focus: control of the environment for

individuals, families, and the community.
5 Essential Components of a Environment Health

(The absence of one produced lack of health or sickness)

1.) Pure Air

2.) Pure Water
3.) Efficient Drainage
4.) Cleanliness
5.) Light
1.) Pure Air
Source of disease and recovery.
“To keep the air he breathes as pure as the
external air without chilling him.”( Nightingale
1969, p.12)
2.) Light
 Direct sunlight is particular needs of patients.
 “Light has a quite as real and tangible effect
upon the human body.”( Nightingale, 1969 pp.
84-85)
3.) Cleanliness
 Nightingale notes that the a dirty
environment ( floors, carpets, walls and bed
linens) was a source of infections through
organic matter is contained.
4.) Effective drainage
 Appropriate handling of and disposal of bodily
excretions and sewage were required to
prevent contamination of the environment.
5.Pure Water
She required that nurses also bathe daily, that
their clothing be clean and they should wash
their hands frequently .(Nightingale 1969)
Added Concepts:
6.)Quite and Diet
Nurses required to asses the need for quite and
to intervene as needed to maintain it.
She instructed nurses to asses not only in
dietary intake but also the meal schedule and
it’s effect on the patient.
Added Concepts:
7.) Petty Management
The nurse was to protect the patient from
receipt of upsetting news, seeing visitors who
could negatively affect recovery, and
experiencing sudden disruption of sleep.
 Nightingale’s Canon

Environmental Factors Affecting Health

 Ventilation  Chattering hopes and advices
 Warmth  Observation of the sick
 Light  Petty Management
 Cleanliness  Taking Foods
 Noise
 Bed and bedding
 Health of Houses
 Variety
 1.Ventilation and Warmth
 Check the patient's body temperature, room
temperature, ventilation and foul odors.
 Create a plan to keep the room well ventilated
and free from odor while maintaining the
patient’s body temperature.
2.Light
Check room for adequate light( sunlight is
beneficial to the patient).

3. Cleanliness
Check room for dust, dampness and dirt.
4.Health of Houses
Check surrounding environment for fresh air,
pure water, drainage, cleanliness and light.

5.Noise
Check level noise in the room surroundings.
6.Bed and Bedding
Check the bed and bedding for dampness,
wrinkles and soiling
Keep the bed dry , wrinkle free, and lowest hei
to ensure comfort.
7.Personal Cleanliness
Attempt to keep the patient dry and clean.
Frequents assessment of the patient’s skin is
essential to maintain good skin integrity.
 8.Variety
Attempt to accomplish variety in the room with
the client.
Done with cards, flowers, pictures, and books.
 Encourage friends to do stimulating activities.
9.Chattering hopes and advices
 Avoid talking without a giving advice that is without
facts.
10.Taking Foods
 Check the diet of the patient. Note the amount of
food and fluid ingested by the patient every meal.

11.Petty Management
Ensure continuity of care.
Document the plan of care and evaluate the
outcomes of ensure continuity.
12.Observation of the sick
Observe and record anything
about the patient.
Major Assumptions
– Florence Nightingale believed that five points
were essential in achieving a healthful house.
– A healthy environment is essential for healing.
– Nursing achieved through environmental
alteration
– Nursing is an art, whereas medicine is a
science. Nurses are to be loyal to the medical
plan but not servile.
Metaparadigm of the Theory

1.) Person
2.) Environment
3.) Health
4.) Nursing
 1.) Person

 Referred as “ Patient”
Recipient of Nursing Care
 A human being acted upon by a nurse, or
affected by the environment,
 Has a reparative power to deal with diseases.
2.) Environment

 Can be external or internal as well.

Fundamental component of Nightingale’s
Theory.
She believed that sick, poor people could
benefit from environmental improvement.
Poor or difficult environments led to poor
health and diseases.
 Everything from the patient’s food, and
flowers to the patient’s verbal and non verbal
interactions with the patients.
 3.) Health

 “ Health is a well being and using every power

that the person has to the full extent in living life.”
Diseases- is a reparative process that the nature
instituted when a person did not attend to health
concerns.
Maintenance of health can be done through the
prevention of disease by controlling the
environment.
 4.) Nursing

 Almost every woman is a nurse.

Responsible for someone’s health
Nightingale’s Note on Nursing book provided
women with guidelines fro caring for their loved
ones at home and to give advice on how to “
think like a nurse”( Nightingale ,1969 p 4).
IV. Acceptance by Nursing Community
 A. Practice
 Nursing principles remain the foundation of nursing
practice today.
 Her environmental aspects of her theory remain
integral component of nursing care as it was still
observe until 21st century.
 Disease control
 Waste disposal
 Control of room temperature
 Sanitation and water treatment
 B. Education

Nightingale principles developed of nursing

training developed a universal pattern for early
nurse training schools beginning with St.
Thomas Hospital and King’s College Hospital in
London.
 Nightingale understood that good practice could
result only from good education.
C. Research

 Nightingale’s interest in scientific inquiry and

statistics continues to defines the scientific
inquiry used in nursing research.
Concepts that Nightingale identifies served as
the basis of research to test modern theories.
 Notes on Nursing
V. Analysis to Evaluation
A. Simplicity

 The theory is simply explained as the

nurse, patient, and environment interacts
with each other.
The roles of environmental management to
patient recovery is greatly emphasized.
Manipulating environment to prevent
disease
Nurse- patient relationship focus on
cooperation and collaboration.
B. Generality

 The universality of the concepts

provide general guidelines and
still applicable and relevant
today.
 C. Empirical Precession

 The theory is stated completely with

presented facts. She uses quantitative
research method. She focus on observation
and experiences rather than systematic
empirical research.
D. Derivable Consequences

Measures of independence and accuracy of

care. Nurse-patient relationship towards
wellness, environmental manipulation and
psychological care.
APPLICATION OF THE THEORY
 Nena is a 19 year old female from the rural are of
Batanggas, was injured in an accident related to farm machinery.
She had a head injury and was conscious but she’s not oriented
to place and time. She has multiple bruises and deep leg wounds
with dirt and debris from the farm equipment that injured her. She
was transported to the nearest hospital and admitted to a
crowded intensive care unit ( ICU ). In the ICU, lights were on 24
hours a day, noises from equipment can be heard continously
from the unit, and visits by her parents were limited. After 2 days
and nights of disturbed sleep, Nena become increasingly
confused and her legs have become infected , requiring dressing
changes and antibiotics.
Analysis of the data:
 Major concern for Nena is the lack of sleep and
infected wound.

Nursing Diagnosis
 Disturbed sleeping pattern related to environmental
light and noise and separation from the family.
Planning and Implementation

Change the environment to support normal sleep.

Encouraged her to listen to her favorite music and
encourage her parents to visit Nena to the hospital
and talk about the future when she will return to
home and school.
Planning and Implementation

Nurse should teach Nena about her dressing

change and help her adjust her environment.
Sleep should support with just dimming
lights, reducing noise including lowering the
volume of the alarms, and avoid to do some
activities that would awaken Nena.
 Evaluation:
– After 2 nights of uninterrupted sleep, normal
sounds and parental encouragement, Nena will
demonstrate increased orientation to place by
being able to identify the she is in the hospital.
Nena will begin participating in her dressing
changes by the 3rd day of the care plan.
References:

 Books
• Octaviano, Eufemia F. and Balita, Carl E. (2008). Theoretical
Foundations of Nursing : Philippine Perspective. Philippine: Ultimate
Learning Center
• Alligood, M. R, Nursing Theorist and their work 9th ed. Elsevier 2018
(Singapore) Pte.Ltd.P.No. 50-60
THANK YOU!