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Florence Nightingale's Environmental Theory
Florence Nightingale stands out as the mother of modern nursing. In most of the cases, Florence used her life experiences to construct modern nursing theories. She viewed the manipulation of the physical environment as a crucial factor in nursing care. The theorist identified ventilation and warmth, light, noise, bed and bedding, cleanliness as important aspects of the environment the nurse could improve to enhance the quality of care. If one or more of the aspects goes out of balance, nurses will have to increase energy in an effort to counter the environmental stress (Nightingale, 1859).
The concepts of nursing, such as person, environment, and health emerged from an evaluation of nursing curricula (Nightingale, 1859). Nightingale advocated for two behaviors, which she felt were important in nursing practice (George, 1995). The first nursing behavior, which the theorist felt was important, was to ask the client their need. For instance, if the client complains of pain, the nurse should ask of the location of the pain. If the patient is not eating, the nurse should inquire why the patient is not eating; or rather ask the patient what they would like to eat.
The second area of the evaluation was central to observation. This refers to the observations about the client's physical health and the environment. Nightingale felt that it was essential for nurses to have observation skills. This would help them know what to observe, how to observe, and to identify the symptoms that suggest an improvement of health. Observation is important because, in some instances, the client may be weak, or shy to make or give the needed information, and this would require intervention from the nurse. Similarly, Molloy College indicates that the nurses' duty is to the patient regardless of family acquaintance (Molloy College, 2013).
Importantly, diagnosis in nursing relies on the evaluation of the conclusions gained from the evaluations (George, 1995). From the environmental perspective, planning should be central to identification of the actions, which nurses will undertake to keep the clients comfortable, dry and in the best for nature to provide care to patients. Therefore, Nightingale felt that planning should aim at modifying the environment in order to enhance the client's capacity to respond to the disease process. When implementing ways that will modify the environment, it is important to contemplate on all facets of the environment.
Such include noise, air, odors, bedding, cleanliness, light, and all other factors, which may place clients in a good position for nature to work on them. When the nurse is evaluating the changes in the environment, the nurses should base their evaluation on the ability of the patient's capacity to regain their health at the least expense of effort. Apparently, observation remains as the most appropriate method of collecting data during the evaluation of the client's reaction concerning the intervention (George, 1995).
Concepts of Environmental Theory
When she wrote the notes for nursing practice, her intention was not to develop a manual, but to provide basic concepts for women because they often nursed people, and it was their duty to manipulate the environment for nature to heal the victim. Her concepts are widely applicable to nursing education how to enhance the patient environment. Currently, most of her concepts on nursing are applicable in nursing practice. This is because they address the physical, mental, and social elements of the environment, which contributes to a holistic view of nursing today.
For example, clean air, water, home, clothing and personal hygiene are essential and useful in promoting healthy living. In addition, adequate nutrition and sunlight are important for the body (Nightingale, 1859). Noise can influence mental health, and nurses do observe the sick, monitor their progress, and record observable symptoms. All this happen in the same way Nightingale did during her time. In comparison to modern theory, her theory does not meet the guidelines, and may not have invoked substantial research, but her concepts have affected nursing theorists and their contemporary models.
Nurses developed the living tree of nursing theories to demonstrate the influence of Nightingale on current nursing theorists. The theory postulates that person, environment, health, and nursing are the roots, whereas Nightingale is the trunk, which supports the branches. Branches represent the modern theorists. This means that Nightingale's works and concepts are the origin of nursing. Without Nightingale, nursing theory would not have achieved the level it has currently. This is why modern theories show substantial similarities to the Nightingale model. Therefore, it is conclusive that Nightingale helped to define what nursing was and what it was not (Nightingale, 1859).
The theorist felt that ventilation and warming are the first rule of nursing. The air inside the healthcare facility should be pure similar to the air outside. In the effort to provide pure air, the nurses should take the patients outside, or open the windows to allow free flow of air. The healthcare staff should also strive to maintain the healthcare environment clean, by disinfecting the floors, providing pure air, pure water, proper sanitation, and provision of light. This would also imply the embracement of hand hygiene practices.
Conversely, noise is a significant factor in the environment and a quiet environment is vital because it plays a vital role in the recovery process. Therefore, Nightingale recommends the elimination of noise by preventing unnecessary walking to ensure appropriate rest. The theorist emphasized the importance of giving appropriate diets to the patients (Nightingale, 1859). They should not only evaluate the dietary intake, but also the meal schedule and its influence on the patient. The diet is important because it will help the patient in reparation of the waste, and provision of energy.
Nightingale suggests that clean beds and clean linens are essential. Therefore, the nurses should air out sheets and place the patients in the sunlight. In the theory, Nightingale stressed the importance of light, especially sunlight (Nightingale, 1859). The nurses should assist the patients go out the healthcare facility, or open windows for light to come in when possible. In addition, hygiene was important to Nightingale, and she emphasized, in her theory, proper and regular maintenance of a clean environment. Apart from a clean healthcare environment, the theory stresses on the importance of personal cleanliness.
Personal cleanliness includes the clean clothes, and clean skin. In addition, cleanliness could influence the environment, and subsequently influence the quality of care because of the potential predisposition of hospital-acquired infection. In her theory, Nightingale felt observation skills were helpful, and observing the patient is crucial. She suggests that observation important nursing lesson, and such skills are significant aspects in nursing care (Nightingale, 1859). Nurses should use hopeful messages to distract the patients, in an attempt to help them cope. However, the nurses should limit such advices, or messages to help the patients save energy for recovery.
Weakness of the theory and rationale
All over the theory, the environment is the core theme. The theory describes the concepts to refer in order to manipulate the environment and improve the quality of patient care. The view of person and environment achieves compatibility. Yet, the theory does not follow a hierarchical approach, but Nightingale feels that ventilation stands out as the main notion. In reference to the models of nursing, Nightingale should have provided a hierarchical arrangement. The concepts provided lack particular definitions within the theory. Due to this, it is likely that nurses can make different and varying damaging inferences for the concepts provided.
Although some of the concepts are straightforward, and may not require a definition, for instance, light, and personal cleanliness, some of the concepts are not as concrete. Therefore, theory lacked clarity. Nonetheless, Nightingale provided a guideline, which would help the nurse explain the concepts, and it lacks a common structure. This is because the theory is central to the concept of environment, whereby, the theorist provides basic concepts, which describe how the nurse can manipulate the environment to improve patient care (Selandars, 2010).
Care is central to the connection in the environment and the patient care (Selandars, 2010). The lack of definitions for the concepts contributes to the uncommon structure, which further contributes to the lack of clarity. There is an assumption in the theory, which presumes that the patient will remain disease free through a healthy environment. For instance, Nightingale suggested that in instances when a patient has cold, fever, or one is faint, the environment might have contributed to the illness (Nightingale, 1859, p.2). This assumption, whereby all diseases may have resulted due to the environment, lacks empirical evidence. Nonetheless, the environment may contribute to some of the conditions.
The assumption suggests that a nurse has the capacity to manipulate the environment, and the environment has the ability to cure the patient. Therefore, these capacities result to a healthy patient. The provided assumptions come before theoretical reasoning (Selandars, 2010), adding to the disorganization of the theory. In this case, the assumptions have shown their necessity in the theory. Prior to studies in this area, the…[continue]
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