Evidence Based Practice Nursing Theories

Nursing Theories: Florence Nightingale’s Environment Theory
To a large extent, the Crimean War significantly contributed towards the development of Florence Nightingale’s Environment Theory. This particular war “was fought mainly on the Crimean Peninsula between the Russians and the British, French, and Ottoman Turkish, with support from January 1855 by the army of Sardinia-Piedmont” (Encyclopedia Britannica, 2017). In essence, the war came about as a consequence of dispute and squabbles between powerful nations in the Middle East, with Russia being the main trigger of the conflict after it sought to “exercise protection over the Orthodox subjects of the ottoman sultan (Encyclopedia Britannica, 2017). The war lasted over a 3 year period (between October 1853 and February 1856).
Florence Nightingale was granted permission by the then Secretary of War to take a team of nurses on a volunteer mission to treat and generally take care of British personnel injured during the war. According to Fee and Garofalo (2010), Nightingale and the team she came with were met by terrible sanitary conditions on their arrival at the Scutari war hospital. In the author’s own words, “ten times more soldiers were dying of diseases such as typhus, typhoid, cholera, and dysentery than from battle wounds” (Fee and Garofalo, 2010). This was the experience that informed Nightingale’s new found perspective of nursing and led to the formulation of the Environment Theory. Nightingale and her team immediately set about to better the sanitary conditions of the military hospital – which eventually led to a significant decline in the death count. In that regard, therefore, Nightingale had a firsthand experience of the correlation existing between the death rate of patients at the facility and the facility’s environmental state/conditions. It is important to note that despite the theory having been formulated more than a century ago, its relevance cannot be overstated in modern nursing practice.
In essence, the significance of this particular theory on nursing is founded on its insistence or attentiveness to preventive care for populations. Doctoral program graduates ought to make the relevant connections between better health outcomes and such factors as hygiene and nutrition. This, when applied alongside other social services including, but not limited to, better health care as well as education is likely to further enhance clinical outcomes.
The basic concept of Nightingales Environment Theory is that health is not likely to be regained, optimized, or maintained under poor environmental conditions. Environment in this case, as Dossey and Keegan (2008) point out “is emphasized in relation to healing properties of the physical environment, such as fresh air, light, warmth, and cleanliness” (p. 116). Therefore, this particular theory is, in essence, a patient-care theory – in that its focus is not largely on the process of nursing, but on patient care. According to Masters (2015), the theory is founded upon what are referred to as the 13 cannons which the author terms “central to Nightingale’s theory” (p. 52). These are identified as ventilation and warming, health of houses, petty management, noise, variety, taking food, what food, bed and bedding, light, cleanliness of rooms and walls, personal cleanliness, chattering hopes and advices, and observation of the sick (Masters, 2015). In basic terms, the theory advances the view that an alteration of the patients environment is likely to improve the health of the patient. The 13 factors highlighted above can all be altered to create conditions optimal for recovery. Thus through the setting up of an environment that is stimulating, one creates the conditions necessary for the patient’s body to recover. In the final analysis, for its move to immerse an individual into a framework focused on the restoration of health, Nightingale’s Environmental Theory could be seen as being consistent with the basic tenets of nursing practice.

References
Dossey, B. & Keegan, L. (2008). Holistic Nursing: A Handbook for Practice (3rd ed.). Boston: Jones & Bartlett Publishers.
Encyclopedia Britannica (2017). Crimean War. Retrieved from https://www.britannica.com/event/Crimean-War
Fee, E. & Garofalo, M.E. (2010). Florence Nightingale and the Crimean War. Am J Public Health, 100(9), 1591.
Masters, K. (2015). Role Development in Professional Nursing Practice (4th ed.). Boston: Jones & Bartlett Publishers.