Question

Write a 1000-word essay discussing how Nightingale's work can be applied by nursing students.

Answer 1

Nightingale’s Theory of Nursing (1820-1910)
Florence nightingale’s theory focused on the environment
and she gave a detailed description of each aspect of environment
in his theory. Nightingale did not specifically define the four
major concepts of nursing theory; however, each component was
evolved from her various documents.
Seven assumptions of Nightingale’s theory were identified,
several of them are discussed. Natural Laws; Nightingale defined a law as the thought of God. Mankind can achieve perfection;
Nightingale viewed the role of the nurse was to provide
environment in which perfection might be achieved. Nursing is
an art and a science; Nightingale indicated that nursing will be
practiced by educated individuals using current research and
common logic. Further assumptions include; Nursing is distinct
and separate from medicine, Nursing is achieved through
environmental alteration and requires a specific educational base.

application of this theory in clinical setting inmy point ofview.

When I assessed the case scenario, keeping in mind the Nightingale’s environmental theory, I came to know
that few aspects of physical environment was ignored which
pushed the patient to critical situation.
When I reflect back to the scenario, I realized that if I had
modified the patient’s environment during my first interaction,
his condition might not have deteriorated. emphasized that,
“the most important practical lesson that can be given to nurses
is to teach them what to observe-how to observe….which are the
evidence of neglect-and of what kind of neglect” . From
nightingale’s different aspects of environment, my patient’s
ventilation, food and room cleanliness was adversely affected.
Nightingale cited in that when one or more aspects of the
environment are out of balance, the patient uses his increased
energy to balance it; however, this extra effort drains his energy
which put delays in his healing. Patients’ with COPD are always
instructed to save their energy because, unlike healthy people,
breathing for a COPD patient involves a conscious effort which is
extremely challenging and consume more energy.I realized
that if I could have modified the environment then my patient’s
energy level could have been saved and it would have helped him
in improving his condition.
One of the important concepts of Nightingale theory is
cleanliness of room and walls. She pointed out, “greater part of
nursing consists in preserving cleanliness” Moreover,
Nightingale linked the ventilation with cleanliness. She
emphasized, “Without cleanliness, you cannot have all the effect
of ventilation; without ventilation, you can have no thorough
cleanliness” . In current scenario, patient’s room was
crowded and windows were closed so there was no proper
ventilation which made my patient sick. At that time I could
have opened the windows for certain period of time and then
closed it. As nightangle stated that ventilation of the sick room meansopen the windows with the alternative intervals and closed
them after intervals of time so that room should be adequately
fresh aired. Other than that, I could have limited the attendants
and gave teaching to patient and his family members regarding
importance of proper ventilation. believed that the person
who repeatedly breathed his or her own air would become sick
or remain sick.
Another concern of my patient was his limited food intake.
Patient was unable to take his food due to dyspnea. According
to Nightingale, “let the food come at the right time, and be taken
away, eaten or uneaten, at the right time”. Though I
noticed that patient’s meal tray was having more than half food
left, I thought that when patient will feel better he will take it.
Nightingale cited in “Chronically ill patients may be starved
to death because their incapacitation can make them unable to
feed themselves and attention is not given to what will enhance
their ability to eat” . I feel that if I had given attention to
patient’s diet then he might have eaten some food. Nightingale
also instructed nurses that, “have a rule of thought about your
patient’s diet; consider, remember how much he has had, and
how much he ought to have today”. May be if I had
considered my patient’s food preferences then it might have
worked as Nightingale emphasized that patient desire a different
pattern of taking foods like eating breakfast food at lunch time.
Unclean room was another important factor which has
affected the patient’s health. Patient was suffering from COPD and
had severe cough so in that situation dust acts as allergen which
has exacerbated the patient’s condition. Patient did not open his
windows because he thought that dust from outside will affect
negative on his health; however, he was not aware of inside dust.it addressed that proper arrangement of sunlight in the room is
beneficial for both health and recovery. Moreover, a small dustbin
was placed beside patient’s bed which was full of garbage. That
was also a source of infection and irritant for the patient. I could
have given awareness on importance of environmental hygiene
to patient and especially the family members because patient
was dependent on them.It stated that Nightingale has emphasized the importance
of looking beyond the individual to the social environment
in which he lived. My patient belongs to interior part of rajasthan
where literacy rate is very low and economical condition is poor.
According to rajasthan Education Foundation , in rural rajasthan, the
reasons for low literacy rate are lack of access, social attitudes

and poor quality of the physical infrastructure and educational
services. Although my patient was financially well off but they
did not have awareness of basic health precautions. Their social
context does not include things which can help them realize
the importance of basic environmental aspects in human lives.
Further, most of the people belong to agriculture field and they
spent their childhood to adulthood in this profession. Another
important aspect is that they do not have access to primary health
care centre which deprived them from environment health care
awareness.
In addition, because of poor economic condition their
education levels were limited to primary or secondary and were
unable to access to higher education. In my patient scenario,
patient’s family background including his sons who were not
educated because their social environment does not permit
them to give importance to education. When I requested family
members to limit attendant, they started arguments and were not
ready to separate. They were thinking that if they remain with
patient then it will help patient to improve his health. They did
not understand that COPD patients should avoid crowd because
it precipitates his condition, making it the fourth
leading cause of death. In my patient’s scenario the cause of
COPD was smoking. A study shows that approximately 85 to 90
percent of COPD deaths are caused by smoking . I think there
was an urgent need to aware the patient regarding importance of
environment in the management of COPD.

Conclusion and summary

Nursing theories assist health care professionals to provide
unique contribution in caring for their patients. In this paper, a
clinical scenario was described and analyzed through Florence
Nightingale’s Environmental theory. Florence Nightingale
emphasized on manipulation of physical environment as a basic
component of nursing care. Nightingale defined 13 canons of
environment and she gave a detailed description of each aspect.
Her major canons include: ventilation, light, noise, cleanliness
of rooms/walls, bed and bedding, personal cleanliness, and
taking food. According to Nightingale, if nurses modify patients
environment according to her 13 canons, she can help patient
to restore his usual health or bring patient in recovery. Hence,
Nightingale provided a basis for providing holistic care to the
patients and it is still applicable today. It is recommended that
awareness regarding basic environmental hygiene should be
given at community and hospital level.