Florence NightingaleFlorence Nightingale
ENVIRONMENTAL
THEORY

FOUNDER OF
NURSING

FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE
Born -12th may 1820Born -12th may 1820
‘‘‘‘ Founder of modern nursingFounder of modern nursing””
TheThe FirstFirst Nursing TheoristNursing Theorist
Known astheKnown asthe ‘Lady with theLamb’‘Lady with theLamb’
ShestatedShestated ‘NatureAloneCures’‘NatureAloneCures’

FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE
Began her nursing training inBegan her nursing training in 18511851 inin
GermanyGermany
Pioneered theconcept ofPioneered theconcept of formalformal
nursing educationnursing education
Her experiencein treating sick/injuredHer experiencein treating sick/injured
soldiersin thesoldiersin the Crimean WarCrimean War stronglystrongly
influenced her philosophy of nursinginfluenced her philosophy of nursing

DEFINITIONDEFINITION
‘‘‘‘The goal of nursing is toThe goal of nursing is to
put the patient in the bestput the patient in the best
possible condition forthepossible condition forthe
nature to act upon him.nature to act upon him.’’’’

Florence NightingaleFlorence Nightingale
In 1860 NightingalepublishedIn 1860 Nightingalepublished ‘‘ NotesNotes
onNursing’onNursing’
””WhatItIs WhatItIs not’’WhatItIs WhatItIs not’’
Her theory significantly influenced 3Her theory significantly influenced 3
other groupsof theories- Adaptationother groupsof theories- Adaptation
Theory, Need Theory, & StressTheory, Need Theory, & Stress
TheoryTheory

 Theory basisTheory basis: the inter-relationship of a: the inter-relationship of a
healthful environment with nursinghealthful environment with nursing

External influences and conditions canExternal influences and conditions can
prevent, suppress, or contribute to disease orprevent, suppress, or contribute to disease or
deathdeath
 Theory goalTheory goal:: Nurses help patients retainNurses help patients retain
their own vitality by meeting theirtheir own vitality by meeting their basicbasic
needsneeds through control of the environmentthrough control of the environment
 Nursing FocusNursing Focus:: control of thecontrol of the
environmentenvironment forfor individuals, families & theindividuals, families & the
communitycommunity

Nightingale’s canonsNightingale’s canons
oror
conceptsconcepts
 Ventilation andVentilation and
WarmingWarming
 LightLight
 NoiseNoise
 Bed and BeddingBed and Bedding
 Cleanlinessof RoomsCleanlinessof Rooms
and Wallsand Walls
 Health of HousesHealth of Houses
 Personal CleanlinessPersonal Cleanliness
 Nutrition and TakingNutrition and Taking
FoodFood
 Chattering HopesChattering Hopes
and Advicesand Advices
 Observation of theObservation of the
SickSick
 SocialSocial
ConsiderationsConsiderations

PHILOSOPHICALPHILOSOPHICAL
ASSUMPTIONS AND BELIEFSASSUMPTIONS AND BELIEFS
REGARDINGREGARDING
Nursing
Paradigms

Three Types of EnvironmentsThree Types of Environments
PhysicalPhysical
PsychologicalPsychological
SocialSocial

Physical EnvironmentPhysical Environment
 Consists of physical elements where theConsists of physical elements where the
patient is being treatedpatient is being treated
 Affects all other aspects of the environmentAffects all other aspects of the environment
 Cleanliness of environment relates directlyCleanliness of environment relates directly
to disease prevention and patient mortalityto disease prevention and patient mortality
 Aspects of the physical environmentAspects of the physical environment
influence the social and psychologicalinfluence the social and psychological
environments of the personenvironments of the person

Psychological EnvironmentPsychological Environment
 Can be affected by a negative physicalCan be affected by a negative physical
environment which then causes STRESSenvironment which then causes STRESS
 Requires various activities to keep theRequires various activities to keep the
mind active (i.e, manual work, appealingmind active (i.e, manual work, appealing
food, a pleasing environment)food, a pleasing environment)
 Involves communication with the person,Involves communication with the person,
about the person, and about other peopleabout the person, and about other people

communication should be therapeutic,communication should be therapeutic,
soothing, & unhurried!soothing, & unhurried!

Social EnvironmentSocial Environment
 Involves collecting data about illness andInvolves collecting data about illness and
disease preventiondisease prevention
 Includes components of the physicalIncludes components of the physical
environment - clean air, clean water,environment - clean air, clean water,
proper drainageproper drainage
 Consists of a person’s home or hospitalConsists of a person’s home or hospital
room, as well as the total community thatroom, as well as the total community that
affects the patient’s specific environmentaffects the patient’s specific environment

Example :Example :

5 Major Components of a5 Major Components of a
Healthful EnvironmentalHealthful Environmental
1.1. Proper ventilationProper ventilation
2.2. Adequate lightAdequate light
3.3. Sufficient warmthSufficient warmth
4.4. Control of noiseControl of noise
5.5. Control of effluvia (noxious odors)Control of effluvia (noxious odors)

APPLICATION OFAPPLICATION OF
NIGHTINGALE THEORY INNIGHTINGALE THEORY IN
PRACTICEPRACTICE

ASSES-MENT NURSING
DIAGNOSIS
GOAL INTERVEN-
TION
RATIONALE NURSING
BEHAVIOR
EVALUATI
ON
SUBJECTIVE
DATA
Patient
complaints
that he is
unable to
sleep at night
OBJECTIVE
DATA
Dark big eye
brows weak
and pale,
drowsy.
Disturbed
sleep pattern
related to
fear of
therapeutic
regimen.
The
patient
will take
enough
rest
and
sleep
Keep
environme
nt quiet for
sleeping
by
,eliminatin
g noise.
Perform
nursing
procedure
s before pt
go to
sleep.
Adjust
lighting by
providing
curtains.
Provide
more
relaxing and
comfortable
environment
for sleeping.
Reduces
disturbance
in sleep.
Light may
alter or
disturb
patient
sleep.
Changing
or
manipulati
ng the
environme
nt to
facilitate
health.
Goal
met ,
patient
had
adequat
e
undistur
bed
sleep
during
night.

 Consider a patient you have recently cared for.
Identify areas where you can implement
nightingale theory ?
E.g.: Avoiding noise in patients with increased
ICP.

Exercise 1Exercise 1
 NURSING DIAGNOSISNURSING DIAGNOSIS
Potential for Hypothermia related to heatPotential for Hypothermia related to heat
loss secondary to skin injuryloss secondary to skin injury..
 INTERVENTIONSINTERVENTIONS
………………………………………………………………………………………………………………....
……………………………………………………………………………………………………………………..
……..?..?

Exercise 2Exercise 2
 NURSING DIAGNOSISNURSING DIAGNOSIS
High risk for injury related to altered level ofHigh risk for injury related to altered level of
consciousness.consciousness.
 INTERVENTIONSINTERVENTIONS
………………………………………………………………………………………………………………....
……………………………………………………………………………………………………………………..
……..?..?