Florence Nightingale and Martha Rogers Ripley: nursing pioneers

Florence Nightingale was born in 1820 in Florence, Italy, the daughter of a wealthy landowner who was involved in the anti-slavery movement. He saw that she was educated in the classics as well as math and science. At the age of 17, she felt that she was called by God to some higher unknown purpose. (Ferrence and Nick, 2000)

Florence rejected many proposals of marriage. Going against her upper class parents' wishes, at the age of 25 she decided to become a nurse, a job usually reserved for the lower classes. It wasn't until age 31 that her parents relented. She went to Germany to study nursing. Two years later, she was appointed as superintendent of a hospital for invalid women in London. When the Crimean War broke out in 1854, Florence took 38 nurses to Turkey. She found the conditions deplorable.

In these conditions, it was not surprising that in army hospitals, war wounds only accounted for one death in six. Diseases such as typhus, cholera and dysentery were the main reasons why the death-rate was so high amongst wounded soldiers." (Ferrence and Nick)

She met great resistantce from doctors on the front when she attempted to improve conditions. Finally, when London newspapers took up her cause, she was allowed to reorganzie the barracks hospital, dramatically reducing the death rate by improving sanitation standards. Her continued crusading after the war resulted in the formation of the Army Medical College. She also published two books, Notes on Hospital (1859) and Notes on Nursing (1859). She went on to found the Nightingale School & Home for Nurses at St. Thomas's Hospital. She also instituted training for nurses employed in the workhouses for the poor. She was a staunch supporter of women's rights throughout her life. Suffering from poor health in her later life, she ultimately went blind and eventually became a total invalid, requiring full-time nursing care for 15 years until her death in 1910.

Nighingale's main intent was twofold: to focus on training those who took care of the sick and improving and controlling the environmental conditions of hospitals, and sickrooms. She was adamant about sanitation, good ventilation, and warmth. Her thought was to set the stage and employ good health practices that would allow for nature to take its course in the healing process, encouraging the individual's recuperative powers to take over.

Martha Rogers Ripley

Martha Rogers Ripley decided to become a doctor when she witnessed all the illness in the New England mill towns where her husband was a paper mill operator. In 1883 she received her M.D. from Boston University Medical School. When her husband became injured, the support of her family fell upon her shoulders. Moving to Minneapolis with her family she started a medical practice with emphasis on obstetrics and pediactrics. She opened a maternity hospital, which served all women regardless of their economic or marital state. In addition to medical care, social services were offered to the patients.

Ripley was a strong suffragist, a member of the Woman's Christian Temperance Union, a fighter for public hygiene, well-known and respected far beyond her own city and state. The memorial plaque, installed in 1939, speaks of her as a 'champion of righteousness and justice' serving; with farsighted vision and sympathy.'"(Tinling 1986)

According to their own web site (Unitary Health Care, 2002), The Science of Unitary Human Beings provides a radical vision of nursing reality. It provides a framework for nursing practice, education and research that promises a move away from the previously predominant medical model approach to the delivery of nursing care." (Unity Health Care) It is based on regarding and individuals as a "unified whole which is more than and different from the sum of the parts."

The intention of nursing, according to Rogers, is that it should be both creative and scientific with the emphasis on achieving overall "well-being." (Unitary Health Care) The universe or environment is all about a continuous active flow of energy and matter, that can be tapped and encouraged by creative practioners. According to Rogers "The environmental field is integral with the human field. Each environmental field is specific to its given human field." (Unitary Health Care)

Jean Watson

Dr. Jean Watson is one of the most honored and educated practioners and theorists in the field of nursing today. She is a widely published author and had conducted research and instructed all across the world. She is the founder of the Center for Human Caring in Colorado and was past president of the National League for Nursing. Her Theory of Human Carins is used all across the world and she is currently highly active in the field. Much of her work has been considered radical and even controversial.

Caring science encompasses a humanitarian, human science orientation to human caring processes, phenomena, and experiences. Caring science includes arts and humanities as well as science. A caring science perspective is grounded in a relational ontology of being-in-relation, and a world view of unity and connectedness of All." (Theory of Jean Watson Website, 2002).

Watson's approach focuses on curative factors as derived both from scientific knowledge as well as a humanistic point-of-view with emphasis on the intergrated human being as a fully-functional entity that should be nurtured and cared for and just as importantly, understood. It emphasizes social well being in additon to mental and physical health. Sickness is referred to as 'Illness experiences" tht are not necessarily cured but rather mediated by healthcare professionals who pay attention to the whole human experience including ethics and aesthetics. (Theory of Jean Watson Website). Watson puts paramount importance on the well being of the individual's social enviornment

Sister Calista Roy

Calista Roy was born into a very large and deeply religious family in Los Angeles in 1939. Her mother was a licensed vocational nurse. At age 14, she started working in a hospital, first as a maid, and then as a nurse's aid. She then entered the order of the Sisters of Saint Joseph of Carondelet to which she still belongs 40 years later. She earned a BA with a major in nursing. As a Sister nurse, she worked in various hospitals out west. She worked primarily with children and went on to further her education in pediactric nursing at the UCLA, where she began to develop the idea of nursing as a "service." (Carey, 2003) After an illness kept her bedridden, in 1968 she put forth her ideas about Adaptation Nursing. In 1971 she was made chair of the nursing department at Mt St. Mary'scollege. She continued on with her own education to complete her PhD in sociology.

Her ideas quickly spread. "In 1987 it was estimated that over 100,000 nurses had graduated from schools emphasizing the Roy Adaptation Model." (Carey) She has lectured all across the world and her work has been translated into 12 languages. She is presently teaching at Boston College and continuing to update the Roy Adaptation Model. In her own words,

The model provides a way of thinking about people and their environment that is useful in any setting. It helps one prioritize care and challenges the nurse to move the patient from survival to transformation." (Carey)

The model starts off with identifying and classifying the demands placed on a patient and the patient's ability to adapt to those demands. Roy sees the patient as a complete biopsychosocial individual, but also as a recipient of nursing practice. In her model there are any environmental factors that impact or have the potential to impact the patient must be considered relevant. The challenge for the patient and attendent caretakers is in coping with adptation problems or adjustments which are continual. To interecede, the nurse must first analyze and assess the situation, both present and potential, and create a plan of action, but always with the understanding that further adaptation may be required. (Carey)