Florence Nightingale

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Florence Nightingale

• NUR 3006

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• Religious inspiration called her to focus on the
  health of the masses

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Florence Nightingale

• Began her nursing training in 1851 in Germany
• Pioneered the concept of formal nursing education
• Her experience in treating sick/injured soldiers
  in the Crimean War strongly influenced her
  philosophy of nursing
• First to use statistics to guide care delivery

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Florence Nightingale

• All sciences of observation depend upon
  statistical methodswithout these, are blind
  empiricism. Make your facts comparable before
  deducing causes. Incomplete, pell-mell
  observations arranged so as to support theory
  insufficient number of observations this is what
  one sees.
• Source Florence Nightingale Mystic, Visionary,
  Healer (B.M. Dossey), p. 230.

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Florence Nightingale

• Based her ideas on individual, societal, and
  professional values
• Her strongest influence was
• education, observation, and
• hands-on experience
• She formulated her values
• through years of working
• with charities, hospitals,
• the military

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Florence Nightingale

• In 1860 Nightingale published Notes on Nursing
• Considered the first nursing theorist
• Information on her theory has been obtained
  through interpretation of her writings
• Her theory significantly influenced 3 other
  groups of theories - Adaptation Theory, Need
  Theory, Stress Theory

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Nightingales Notes on Nursing

• Was not written as a nursing text
• Was a guide to help organize manipulate the
  environment for persons requiring nursing care
• Nightingale originally wanted women to teach
  themselves to nurse and viewed Notes on Nursing
  as hints to enable them to do so

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Nightingale on Notes on Nursing

• I thank you sincerely kindly for what you
  have to say about my Notes on Nursing you do not
  know how, in the midst of much disappointment,
  such words cheer strengthen us. The only
  possible merit of my little book is that there is
  not a word in it written for the sake of writing,
  but only forced out of me by much experience in
  human suffering.
• Source Florence Nightingale Mystic, Visionary,
  Healer (B.M. Dossey), p. 231.

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Nightingales Nursing Theory

• The first published nursing theory (1860)
• Persons are in relation with the environment
• Stresses the healing properties of the physical
  environment (fresh air, light, warmth, and
  cleanliness)
• Nursing puts patients in the best conditions
  for nature to act upon them
• Health is the positive of which the pathology is
  the negative
• Nature alone cures

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Nightingales Nursing Theory

• When aspects of the environment are out of
  balance, the client must use energy to counter
  these environmental stresses
• Stresses drain the client of the energy needed
  for healing
• Viewed disease as a reparative process
• The health of the home/community are critical
  components in an individuals health

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Nightingales Nursing Theory

• Theory basis the inter-relationship of a
  healthful environment with nursing
• External influences and conditions can prevent,
  suppress, or contribute to disease or death
• Theory goal Nurses help patients retain their
  own vitality by meeting their basic needs through
  control of the environment
• Nursings Focus control of the environment for
  individuals, families the community

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Three Types of Environments

• Physical
• Psychological
• Social

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Physical Environment

• Consists of physical elements where the patient
  is being treated
• Affects all other aspects of the environment
• Cleanliness of environment relates directly to
  disease prevention and patient mortality
• Aspects of the physical environment influence
  the social and psychological environments of the
  person

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Psychological Environment

• Can be affected by a negative physical
  environment which then causes STRESS
• Requires various activities to keep the mind
  active (i.e, manual work, appealing food, a
  pleasing environment)
• Involves communication with the person, about the
  person, and about other people
• communication should be therapeutic, soothing,
  unhurried!

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Social Environment

• Involves collecting data about illness and
  disease prevention
• Includes components of the physical environment -
  clean air, clean water, proper drainage
• Consists of a persons home or hospital room, as
  well as the total community that affects the
  patients specific environment

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5 Major Components of a Healthful Environmental

• Proper ventilation
• Adequate light
• Sufficient warmth
• Control of noise
• Control of effluvia (noxious odors)

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Components of Nightingales Environmental Theory

• Health of Houses
• Ventilation and Warming
• Light
• Noise
• Variety
• Bed and Bedding
• Cleanliness of Rooms and Walls

• Personal Cleanliness
• Nutrition and Taking Food
• Chattering Hopes and Advices
• Observation of the Sick
• Social Considerations

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Nightingales Theory Nursings Metaparadigm -
PERSON

• Referred to by Nightingale as the patient
• A human being acted upon by a nurse, or affected
  by the environment
• Has reparative powers to deal with disease
• Recovery is in the patients power as long as a
  safe environment exists

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Nightingales Theory Nursings Metaparadigm -
ENVIRONMENT

• The foundational component of Nightingales
  theory
• The external conditions forces that affect
  ones life and development
• Includes everything from a persons food to a
  nurses verbal nonverbal interactions with the
  patient

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Nightingales Theory Nursings Metaparadigm -
HEALTH

• Maintained by using a persons healing powers to
  their fullest extent
• Maintained by controlling the environmental
  factors so as to prevent disease
• Disease is viewed as a reparative process
  instituted by nature
• Health disease are the focus of the nurse
• Nurses help patients through their healing
  process

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Nightingales Theory Nursings Metaparadigm -
NURSING

• Provides fresh air, light, warmth, cleanliness,
  quiet, and a proper diet
• Facilitates a patients reparative process by
  ensuring the best possible environment
• Influences the environment to affect health
• Supports the nursing process (even though it was
  not even developed yet!)

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Nightingales Theory Nursings Metaparadigm -
NURSING

• Nursing education belongs in the hands of nurses!
• Nursing is a discipline distinct from medicine
  focusing on the patients reparative process
  rather than on their disease!!

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Critical Thinking Exercise

• Complete an environmental assessment of this
  learning environment. Develop a plan for repair
  or maintenance.
• Consider a patient you have recently cared for.
  Identify areas of the environment that
  Nightingales theory guides you to assess. Did
  you consider these before in your own model of
  practice?

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• Using Nightingales model, compare and contract
  the practice of nursing in the late 1800s with
  nursing in present times.

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Nightingale Resources

• On-line Florence Connection
• Florence Nightingale Museum
• Her Gravesite, Website
• Interesting Stories
• Collection of Her Letters
• Her Impact on Rural Hygiene