ENVIRONMENTAL THEORY

Florence Nightingale (1820-1910)

Founder of Modern Nursing

The first nursing theorist

Also known as The Lady with the Lamp

She was the first to propose nursing

required specific education and training

Origins of the Theory

Nightingale developed her Environmental

Model in 1859 and titled it Notes on
Nursing: What It Is and What It Is Not,
based
on
her
observations
and
experiences while treating the soldiers
during the war.

She used inductive reasoning from her

experiences and observation, addressed
with logical thinking and philosophy.

MAJOR CONCEPTS

"Environment could be altered to improve

conditions so that the natural laws would
allow healing to occur."
Health
The goal of all nursing activities should
be client health

Nursing should provide care to the

healthy as well as the ill

Disease is considered as dys-ease or

the absence of comfort.

Nursing as the act of utilizing the environment

of the patient to assist him in his recovery.
SUBCONCEPTS

Nursing

Health of Houses
Badly constructed houses do for the healthy
what badly constructed hospitals do for the sick.

Nursing is the "activities that promote

health which occur in any caregiving
situation. They can be done by anyone."
It signifies the proper use of fresh air,
light, warmth, cleanliness, quiet, and the
proper selection and administration of
diet.

Ventilation and Warming

Keep the air he breathes as pure as the
external
air,
without
chilling
him.

Human Beings
People are multidimensional, composed
of biological, psychological, social and
spiritual components.

Light
Second to fresh air, the sick need light. Direct
sunlight was what patients wanted.

Environment
Poor or difficult environment led to poor
health and disease

Noise
Patients should never be waken intentionally or
accidentally during the first part of sleep.
Whispered or long conversations about patients

Nightingale was very concerned about noxious

air or effluvia or foul odors that came from
excrement and fumigations.

are thoughtless and cruel. Unnecessary noise,

including noise from female dress, as cruel and
irritating to the patient.
Variety
The need for changes in color and form,
including bringing the patient brightly colored
flowers or plants. Nightingale also advocated
reading, needlework, writing, and cleaning as
activities to relieve the sick of boredom.
Bed and Bedding
Adult in health exhales about three pints of
moisture through the lungs and skin in 24-hours.
Bed should be placed in the lightest part of the
room and placed so the patient could see out of
a window. Caregiver should not lean against, sit
upon, or unnecessarily shake the bed.
Personal Cleanliness
it is necessary to keep pores of the skin free
from all obstructing excretions.
Every nurse ought to wash her hands very
frequently during the day.
Nutrition and Taking Food
Individuals desire different foods at different
times of the day and that frequent small servings
may be more beneficial to the patient than a
large breakfast or dinner.
Chattering Hopes and Advices
To falsely cheer the sick by making light of their
illness and its danger is not helpful.
The nurse should heed what is being said by
visitors, believing that sick persons should hear
good news that would assist them in becoming
healthier.
Social Considerations
The importance of looking beyond the individual
to the social environment in which he or she
lived.

OVERALL EVALUATION

The Environmental Theory of Nursing is a

patient-care theory. It focuses in the alteration of
the patients environment in order to affect
change in his or her health. Caring for the
patient is of more importance rather than the
nursing process, the relationship between
patient and nurse, or the individual nurse.

The environmental factors affect different

patients unique to their situations and illnesses,
and the nurse must address these factors on a
case-by-case basis in order to make sure the
factors are altered in a way that best cares for
an individual patient and his or her needs.

Strengths:
Nightingales theory has broad applicability to
the practitioner. Her model can be applied in
most
complex
hospital
intensive
care
environment, the home, a work site, or the
community at large.

Weaknesses:
The application of her concepts in the twentieth
century is in question.
The environmental conditions that is progressing
along with the technologys advancement out
the theorys applicability in question. The
components of the theory can only be reached
in a very ideal scenario.

USEFULNESS

Environmental adaptation remains

basis of holistic nursing care.

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 promote
patients wellbeing by making sure all
components of the environment has been
properly set up.

Reading her work raises a consciousness in the

nurse about how the environment influences
client outcomes.

ENVIRONMENTAL FACTORS
1. Pure fresh air
2. Pure water
3. Effective drainage
4. Cleanliness
5. Light (especially direct sunlight)

the

It is true that a healthy environment heals as

what Nightingale stated but the question now is
how our environment would remain health

amidst the negative effects of the progress of

technology and industrialization.
Research Based on Nightingales theory
The Legacy of Florence Nightingales
Environmental Theory: Nursing Research
Focusing on the Impact of Healthcare
Environments: Descriptive statistics reveal that
topics and settings most frequently cited are in
keeping with the current healthcare foci of
patient care quality and safety in acute and
intensive care environments

Nightingale theory and intentional comfort touch

in management of tinea pedis in vulnerable
populations: This describes methods for
mitigating the severity of fungal growth,
decreasing the risk of secondary infections, and
improving skin integrity by manipulating the
micro-environment of the patients' feet.
Incorporating Florence Nightingale's theory of
nursing into teaching a group of preadolescent
children about negative peer pressure: This
clinical practicum project successfully used
Nightingale's primary tenets, such as building
trust, self-assessment, and group leadership, as
a theoretical framework in a nursing practice
group for the purpose of teaching a group of
preadolescent children about negative peer
pressure. The children and their parents
reported positive outcomes from the nurse-led
group sessions.