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TFN05 Florence Nightingale Modern Nursing and After the War, she returned to England
Environmental Theory
• She was awarded funds which she used to
Florence Nightingale establish schools for nursing training at St.
Thomas’ Hospital and King’s College in London
• Born on May 12, 1820, in Florence, Italy
• Until 80 years old she wrote between 15,000 to
• Nightingales were a well-educated, affluent,
20,000 letters to friend, acquaintances, allies, and
aristocratic Victorian family with residences in
opponents.
Derbyshire and Hampshire.
- She wrote about her strong, clear written
• She was able to complete her nursing training in
word conveyed her beliefs, observations,
1851 at Kaiserwerth, Germany, a protestant
and desire for change in health care and in
religious community with a hospital facility.
society. Through these writings, she was
• Her Father – taught her more broadly than other able to influence issues in the world that
girls of her age. (Mathematics, Languages, Religion concerned her.
and Philosophy)
• She was able to work into her 80s until she lost her
• Background (Educational, Family)– influenced and vision.
developed her philosophies.
• she died in her sleep on August 13, 1910, at 90 years of
During the Crimean War age.

• She received a request from Sidney Herbert to THEORETICAL SOURCES

travel to Scutari, Turkey, with a group of nurses Influences:
to care for wounded soldiers (November 1854)
• Her criteria for professional nursing: • Education
a) Young - tutelage by her well educated, intellectual father in
b) Middle-class women subjects such as mathematics and philosophy provided
c) With basic general education her with knowledge and conceptual thinking abilities.
- additional tutoring from well-respected
• To achieve her mission of providing nursing care, she
mathematicians.
needed to address the environmental problems that
- Her aunt Mai, a devoted relative and companion,
existed, including the lack of sanitation and the described her as having a great mind.
presence of filth.
• Nightingale family’s social status – easy access to
- Other problems: frostbite, louse infestations, people of power and influence.
wound infection, and opportunistic diseases. - learned to understand the political processes of
Note: Victorian England through the experiences of her father
during his short-lived political career and through his
- Her work in these deplorable conditions made her popular and continuing role as an aristocrat involved in the political
revered to the and revered person to the soldiers, but the and social activities of his community.
support of physicians and military officers was less enthusiastic- - also recognized the societal changes of her time and
they believed that her ways need additional work and resources. their impact on the health status of individuals.
She was called The Lady of the Lamp, as immortalized in the • Religious affiliation and beliefs – greater/stronger
poem “Santa Filomena” (Longfellow, 1857), because she made
source and impact.
ward rounds during the night, providing emotional comfort to
- a Unitarian, her belief that action for the benefit of
the soldiers.
others is a primary way of serving God served as the
- In Scutari, Nightingale became critically ill with Crimean fever, foundation for defining her nursing work as a religious
which might have been typhus or brucellosis, and which may calling.
have affected her physical condition for years afterward.
MAJOR ASSUMPTION

Nursing
- being responsible for someone else’s health
STUART. V
- To provide women with guidelines for caring for their 3. Nursing caring behaviors influence the
loved ones at home and to give advice on how to “think like patient’s reparative process.
a nurse” (Nightingale, 1969)
a) Observing patients at night
- Trained nurses: learn additional scientific principles to be b) Sitting with patients during the dying
applied in their work and were to be more skilled in process
observing and reporting patients’ health status while c) Standing beside patients during
providing care as the patient recovered.
surgical procedures.
-Nurse: Active role d) Writing letters for them
Person e) Providing a reading room and
materials during recuperation.
- Patient: Passive role, nurses perform tasks, control of and
4. Nurses should be moral agents.
responsible for the patient’s environment.
a) Professional relationship with patients.
- Respect for persons of various backgrounds and not b) Clear and concise decision making by
judgmental about social worth. nurses and physicians regarding the
Health patient.
- being well and using every power to the fullest extent in ACCEPTANCE
living life.
Practice
- she saw disease and illness as a reparative process that
nature instituted when a person did not attend to health • Nightingale’s nursing principles remain the
concerns. foundation of nursing practice today.
- Viewpoint: Nature will act upon a person if they help or - good ventilation
work with themselves. - proper disposal of waste
- Maintenance of health means prevention of disease via - control room temperature
environmental control and social responsibility. - warm and quiet environment for rest
and healing
Environment
• McPhaul and Lipscomb (2005) applied
- Nursing was “to assist nature in healing the patient.” Nightingale’s environmental principle to
- Create and maintain a therapeutic environment that practice in occupational health nursing.
would enhance the comfort and recovery of the patient. • Lorentzon (2003) focused on Nightingale’s role
for mentoring and professional development.
THEORETICAL ASSERTIONS
• Feminist theory development – provided
1. Disease was a reparative process. women with opportunist to contribute to the
- Disease was nature’s effort to remedy a society.
process of poisoning or decay, or it was
reaction against the conditions in which a Education
person was placed. • Nightingale’s principles of nursing training
2. Committed to nursing education/training. provided a universal template for early
- She emphasized the important of education nurse training schools.
and training. • Good practice results only from good
a) Nurses needed to be excellent education.
observers of patients and their
environment. Research
b) Nurses should use common sense in • Nightingale’s interest in scientific inquiry and
practice. statistics continues to define the scientific
c) People desire good health. inquiry used in nursing research.
STUART. V
- her ability to gather and analyze data; her ability Empirical Precision
to represent data graphically was first identified in
the polar diagrams, the graphical illustration style • Concepts and relationship within Nightingale’s
that she invented theory are frequently stated implicitly and are
- Her empirical approach to solving problems of stated as truths rather than as tentative,
health care delivery is obvious in the data that she testable statements.
included in her numerous reports and letters. • Nightingale advised the nurses of her day that
• Nightingale’s writings are defined and analyzed as their practice should be based on their
theory; they are seen to present a philosophical observations and experiences.
approach that is applicable in modern nursing.
Derivable consequences
CRITIQUE
• Nightingale’s writings direct the nurse to act
Clarity on behalf of the patient and the nurse.
• Nightingale’s work is clear and easily • She believed in creative, universal humanity
understood with the potential and ability for growth and
• Areas: change.
a) Environment to patient • Nightingale’s basic principles of environmental
b) Nurse to environment manipulation and care of the patient can be
c) Nurse to patient applied in contemporary settings. Her theories
and her principles are relevant to the
Nightingale believed that the environment professional and identity of nursing.
was the main factor that created illness in
a patient and regarded disease as “the SUMMARY:
reactions of kindly nature against the Nightingale is a unique figure in the history of the
conditions in which we have placed world. The nursing profession embraces her as the
ourselves” (Nightingale, 1969, p. 56). founder of modern nursing. She defined the skills,
Nightingale recognized the potential knowledge and behavior require for professional
harmfulness of an environment, and she nursing; she is the first person to set a criteria. after
emphasized the benefit of a good closer analysis that her underlying beliefs, philosophy,
environment in preventing disease. The and observations continue to be valid. Professionals
nurse’s practice includes manipulation of increasingly identify her as their matriarch.
the environment in a number of ways to Mathematicians revere her for her work as an
enhance patient outstanding statistician. Epidemiologists, public
• Act of Elimination health professionals, and lay health care workers
trace the origins of their disciplines to Nightingale’s
Simplicity descriptions of people who perform health promotion
• Nightingale provided a descriptive, explanatory and disease prevention. The logic and common sense
theory. that are embodied in Nightingale’s writings serve to
• Nightingale could be said to have tested her stimulate productive thinking for the individual nurse
theory in an informal manner by collecting data and the nursing profession.
and verifying improvements.
Generality

• The universality and Timeliness of

Nightingale’s concepts remain pertinent.