Florence Nightingale

• Florence Nightingale's theory is environmental theory.
• She is also known as the lady with the lamp.
• She was born in May 12, 1820 in Florence, Italy
• Nursing Education: trained in Kaiserwerth, Germany at a Protestant religious community with a hospital and after 3 months she was declared trained as a nurse (1851).

  • One day she visited a hospital and that CHANGED HER LIFE.
• Defined nursing as: “the act of utilizing the environment of the patient to assist him in his recovery”, that involves the nurse's initiative to configure environmental settings appropriate for the gradual restoration of the patient's health, and that external factors associated with the patient's surroundings affect life or biologic and physiologic processes, and his development.
• Hospitals in 1830’s

  • Often people who went into hospital died
  • They were Dirty
  • Badly run
  • Nurses didn’t know what to do
• Turned down several offers of marriage to pursue her career.

  • Harry Nicholson
  • Richard Monckton Milnes
  • Harry Verney
• Crimean War

  • Broke out when Florence was 34 years old
  • War Russia vs Turkey (Britain and France)
  • Reports were coming through about terrible conditions in hospitals
  • Florence left London with 38 nurses
  • Scutari Barrack Hospital
  • Mortality rate at the hospital was 42.7% of those treated
  • Mortality rate dropped to 2.2%
  • She got to work

  • Scrubbed the floors

  • Cleaned the wards

  • Washed the bedclothes

  • Made the men comfortable
• In the night she carried a lamp, so she was called “The Lady with the Lamp”
• Soldiers kissed her shadow. They began to get better sitting up, cheerful and happier.
• Letter from Queen Victoria

  • Thanking “Miss Nightingale and her ladies” for all their hard work.
• Notes on Nursing: What it is and What it is Not was a book first published by Florence Nightingale in 1859.
• On the purpose of nursing.” ...the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet- all at the least expense of vital power to the patient”
• On the empowering partnership with clients in the community.” “We must not talk to them or at them but with them”
• Origins of Nightingale’s Theory for Nursing Practice

  • Prolific writer.
  • Her ideas, values, and beliefs on a wide range of topics can be identified in her documents.
  • In 1859, she was the first to conceptualize nursing work into a theoretical framework.
• Assumptions of Florence Nightingale's Theory

  1. Law - "Thoughts of god"

  • This is reflective of Nightingale’s profound belief in God. She defined a law as “the thought of God” and discussed the predictability of nature.
• 2. Natural laws

  Natural Laws are universal natural laws that govern the ways in which the world works.
• 3. Mankind can achieve perfection

  • Mankind can achieve perfection relates to her strongly held beliefs in self- determination, in self-realization, and that ultimately, mankind does seek self- perfection, which means perfect health. The route to perfection is through strict adherence to the natural laws.
  • The role of the nurse was to alter the environment in such a way as to obey the natural laws, and thus provide the environment in which perfection might be achieved.
• Nursing is a calling

  • She defined a calling as doing work in such a way as to do what is right and best.
  • Nursing work is to be done with enthusiasm and is so important it should be thought of as a religious vow.
• 5. Nursing is an art and a science

  By identifying nursing as having components of art and science, she provides the profession with the expectation that nursing will be practiced by educated individuals using current research and methods as well as compassion and common logic.
• 6. Nursing is achieved through environmental alteration

  Environmental alteration-see canons (which are laws or rules).
• 7. Nursing requires a specific educational base

  • Nursing cannot be taught by books alone. 
  • Nurses need a combination of clinical and theoretical training.
• 8. Nursing is distinct and separate from medicine

  • Although the physician and nurse my deal with the same population, nursing is not to be viewed as subservient to medicine, as the purposes of the two are distinctly different.
  • Nursing’s focus is on caring through environmental alteration, whereas medicine’s focus is cure of the disease.
  • Nursing and medicine are most effective when working in a collaborative manner.
• Major Concepts and Definitions

  Environment - concepts of ventilation, warmth, light, diet, cleanliness and noise.

  • She focused on the physical aspects of the environment.
  • She believed that "Healthy surroundings were necessary for proper nursing care."
  • She stated that “Nursing is an act of utilizing the environment of the patient to assist him in his recovery”
• What is the first essential component of a healthy environment?

  Pure fresh air
• Why is pure fresh air important for health?


  To keep the air he breathes as pure as the external air without chilling him
• What is the second essential component of a healthy environment?

  Pure water
• What is the consequence of using very impure well water for domestic purposes?


  Persons using such water are almost sure to suffer when epidemic disease shows itself
• What is the third essential component of a healthy environment?

  Effective drainage
• How can ineffective drainage contribute to health issues?


  The sewer may become a laboratory from which epidemic disease and ill health are installed into the house
• What is the fourth essential component of a healthy environment?

  Cleanliness
• Any deficiency in one or more of these factors could lead to impaired functioning of life processes or diminished health status.
• What role does cleanliness play in nursing?


  The greater part of nursing consists in preserving cleanliness
• What is the fifth essential component of a healthy environment?


  Light (especially direct sunlight)
• Why is light, particularly direct sunlight, important in treating disease?


  The usefulness of light in treating disease is very important
• What are the 5 essential components of a healthy environment?


  • Pure fresh air
  • Pure water
  • Effective drainage
  • Cleanliness
  • Light (especially direct sunlight)
• The factors posed great significance during Nightingale's time, when health institutions had poor sanitation, and health workers had little education and training and were frequently incompetent and unreliable in attending to the needs of the patients.
• What are the issues with public hospitals now?

  • Pure Water?
  • Pure fresh air?
  • Effective drainage
  • Light?
  • Control of noise?
• FIVE MAJOR COMPONENTS OF A HEALING ENVIRONMENT

  1. Ventilation
  2. Light
  3. Warmth
  4. Control noise
  5. Control odor