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Original Nursing Theories of Florence Nightingale


Original Nursing Theories of Florence Nightingale By Mary B. Knutson, RN, BSN, FCP MSN Student Viterbo University Origins of Nightingale s Theory for Nursing ... – PowerPoint PPT presentation

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Title: Original Nursing Theories of Florence Nightingale

Original Nursing Theories of Florence Nightingale
  • By Mary B. Knutson, RN, BSN, FCP
  • MSN Student
  • Viterbo University

Origins of Nightingales Theory for Nursing
  • Florence Nightingale was a prolific writer. She
    lived from 1820 to 1910 in Victorian England.
  • Her ideas, values, and beliefs on a wide range of
    topics can be identified in her documents.
  • They contain philosophical assumptions and
    beliefs regarding all elements found in the
    metaparadigm of nursing.
  • In 1859, she was the first to conceptualize
    nursings work into a theoretical framework.
  • She was credited with founding the practice of

Relevance to Nursing Today
  • Florence Nightingale developed a body of nursing
    knowledge clearly expressed in the 79 pages of
    Notes on Nursing What It Is and What It Is Not
    (Nightingale, 1969).
  • A 221 page second edition (Nightingale, 1992) was
    intended for the professional nurse, and is
    relevant to nurses today who are searching for
    wisdom on her perspectives on illness, the
    person, their environment, and holistic nursing.

  • 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
  • On the empowering partnership with clients in the
    community. We must not talk to them or at them
    but with them

Relevant to Nursing Organization
  • Florence Nightingale provided a professional
    model for nursing organization in Britain that
    spread across much of the world.
  • She emphasized subservience to doctors, allowing
    nursing to gain a foothold within a hospital.
  • Her plan was that nurse training would not
    threaten the status of the doctors, but crucially
    that they should accept the disciplinary
    authority of the matron and the new hierarchy of
    nurses within the hospital.

Relevance to Nursing Education
  • The idea that nursing required specific education
    was revolutionary in 19th-century England.
  • Nightingales nursing education emphasized the
    need to blend a mixture of theoretical and
    clinical experiences.
  • Schools of nursing were established on her model
    throughout the world.
  • They emphasized the moral qualities of nursing
    and introduced humanitarian, patient-centered
    values that are still relevant today.

Individual Relevance of Florence Nightingale
  • Besides getting the science right, Florence
    Nightingale made it comprehensible to lay people,
    especially the politicians and senior civil
    servants who made and administered the laws.
  • She was empowered through her personal
    philosophy, which was deeply spiritual and at the
    same time fundamentally practical and related to
    everyday life.
  • She was a systematic thinker and passionate
    statistician, using bar and pie charts,
    highlighting key points.

Relevant to Nursing Knowledge
  • The body of knowledge left by Florence
    Nightingale includes an environmental adaptation
    theory, which is entirely relevant to the modern
  • Regardless of whether the environment is high
    tech, the nurse remains responsible for altering
    the environment to improve it for the benefit of
    the client

Assumptions of Florence Nightingales Theory
  • Natural laws
  • Mankind can achieve perfection
  • Nursing is a calling
  • Nursing is an art and a science
  • Nursing is achieved through environmental
  • Nursing requires a specific educational base
  • Nursing is distinct and separate from medicine

Major Premises of Environmental Adaptation Theory
  • People are multidimensional, composed of
    biological, psychological, social and spiritual
  • Disease is more accurately portrayed as dys-ease
    or the absence of comfort.
  • Symptoms alert nurses to the presence of illness,
    which allows for appropriate interventions.
  • Breaking the natural laws will cause disease.
  • Improvement in the health of individuals and
    families lead to the improved health of society.

The Environmental Adaptation Concepts
  • Florence Nightingales original theory for
    nursing practice was holistic.
  • Her concepts included human/individual,
    society/environment, health/disease and nursing.
  • She focused more on physical factors than on
    psychological needs of patients because of the
    nature of nursing practice during her time.

Six Ds of Dys-ease Dirt Drink (need clean
drinking water) Diet Damp Draughts
(Drafts) Drains (need proper drainage and sewer
A Comparison of Nightingales Canons and
Origin of Nightingales Environmental Concepts
  • Nightingale believed that the environment could
    be altered to improve conditions so that the
    natural laws would allow healing to occur.
  • This grew from empirical observation that poor or
    difficult environments led to poor health and
  • In her Crimean experience, filth, inadequate
    nutrition, dirty water, and inappropriate sewage
    disposal led to a situation in which more British
    soldiers died in the hospital than of battlefield

Concepts of Nursing
  • The goal of nursing is to place the patient
    in the best possible condition for nature to act.
  • Health is not only to be well, but to be able to
    use well every power we have
  • Health nursing, or general nursing are those
    activities that promote health (as outlined in
    canons) which occur in any caregiving situation.
    They can be done by anyone.
  • Nursing proper is reserved for those individuals
    who are educated in the art and the science of

The Holistic Person Model
Nightingales Model for Nursing Practice
How Watsons Theory of Transpersonal Human Caring
was Influenced
  • Jean Watson said that Nightingales blueprint for
    transpersonal meanings and models of caring
    transcend history.
  • It called forth the full use of self, connecting
    the divine within and without as a source of
    inspiration as well as the foundation for a
    professional code.
  • Watson also said that Nightingale made explicit
    the connections between and among all aspects of
    self, other, humanity, the environment, nature,
    and the cosmos as a means of learning,
    understanding, and connecting health, caring, and

Many Other Theories Use Nightingales Holistic
  • Neumans Systems Model
  • Roys Adaptation Model
  • Levines Conservation Theory
  • Modeling and Role Modeling (MRM) Theory
  • The listed theories differ in environmental
    influences and other aspects of nursing, but
    share holistic concepts.

Research Article
  • Shades of Florence Nightingale Potential impact
    of noise stress on wound healing was chosen.
  • This article examines the potential effects of
    noise stress on wound healing.
  • It explains theoretical linkages between the
    normal processes of wound healing, endocrine
    aspects of the stress response, and the effects
    of stress hormones on the biological function of
    leukocytes involved in wound healing.
  • The effects of noise on patient sleep and
    cognitive function are well-documented.

Research Findings
  • Exposure to increased or novel environmental
    noise has been shown to elicit neuroendocrine
    changes indicative of the stress response.
  • They are associated with alterations in the
    biological functions of cells involved in wound
  • Clinical research studies have shown that levels
    of environmental noise in patient care units
    exceed those recommended by the EPA and are
    disturbing to patients.

Research Conclusions
  • Recovery rate of patients would be greatly
    enhanced by reduction of noise stress.
  • If, as Nightingale stated, the patients are to be
    put in the best condition for nature to act on
    them, it is the responsibility of nurses to
    reduce noise, to relieve patients anxieties, and
    to help them sleep.

In Nursing Today
  • Nurses old and young have been influenced by
    Florence Nightingales Theories.
  • Environmental Adaptation remains the basis of our
    holistic nursing care.
  • I am proud to follow in the important work of of
    The Lady with the Lamp.

Reference List
Attewell, A. (1998) Florence Nightingales
relevance to nurses. Journal of Holistic Nursing,
16 (2), 281-291
McDonald, L. (2001). Florence Nightingale and the
early origins of evidence-based nursing, EBN
Notebook 4(3), 68-9
McCarthy D, Ouimen M, Daun J. (1991) Shades of
Florence Nightingale Potential impact of noise
stress on wound healing. Holistic Nursing
Practice. 5(4) 39-48
Nightingale, F. (19690. Notes on nursing What it
is and what it is not. New York Dover. (original
work published 1860)
Selanders, L. (1998) The power of environmental
adaptation. Journal of Holistic Nursing, 16,(2)
Watson J. (1998), Florence Nightingale and the
enduring legacy of Transpersonal Human Caring.
Journal of Holistic Nursing, 16(2), 292-294
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