At the end of this session, the B.Sc.

Nursing 1st year students will be able to: Introduce Florence Nightingale State the four major concepts of Nursing Theory according to Nightingale. Explain 5 major elements of environment affecting patients health according to Nightingale. Discuss the application of nursing process using Nightingales theory. Analyze the strength and weakness of Nightingales theory.

 Born

to wealthy English parents on trip to Florence, Italy on 1820 May 12. William Edward Nightingale Frances Nightingale of educated and scientific nursing.

Parents-

Founder

The

first nursing theorist.

 At

the age of seventeen, Florence Nightingale felt called by God to become a nurse

Announced

her decision to enter nursing in the year 1844 1854 she was requested to care for wounded soldiers during the Crimean War

(Lady with the Lamp) was given special attention by Henry Wadsworth Longfellow.

Notes

on Nursing: What it is, What is not

(1860)

In 1860, Nightingale found the Nightingales School and home for nurses at Saint Thomass Hospital in London . The work of her School of Nursing continues today as the Florence Nightingale School of Nursing and Midwifery at Kings Hospital London By 1896, Florence Nightingale was bedridden: Chronic Fatigue Syndrome Aug 13, 1910 - Florence Nightingale died in her sleep at the age of 90.

 1.

Person Patient who is acted on by nurse Affected by environment Has reparative powers Environment Foundation of theory. All the external conditions and influences affecting the life and development of an organism and capable of preventing, suppressing or contributing to disease or death.

2.

 3.

Health Maintaining well-being by using a persons powers Maintained by control of environment Nursing Provided fresh air, warmth, cleanliness, good diet, quiet to facilitate persons reparative process.

4.

 The

core concept is environment.

She

tends to emphasize the physical more than social and psychological environment. death rate went from a staggering 42 per 100 to a low of 22 per 1000.

The

Major Areas of concentration Ventilation

Examples

Fresh air, which is of primarily importance, can be achieved through open windows, corrupt, stagnant and musty air breeds disease. An outlet is needed for impure air. Drafts caused by open windows and doors are to be avoided. Dirty carpets and furniture are a source of impurity in the air.

Warmth

Guarding against the loss of vital heat is essential to the patients recovery. Chilling is to be avoided. Hot bottles, bricks, and drinks should be used to restore lost heat.

Effluvia (smells)

Sewer air is to be avoided and care is needed to get rid of noxious body order caused by disease. Chamber utensils should be order free and out of sight. Fumigation and disinfectant should not be used but the offensive substance removed. Intermittent sudden noise causes greater excitement than continuous noise, especially during the patients first sleep. The more the patient sleep peacefully, the greater the patients ability to sleep will be. Walking lightly, whispering or discussing a patients condition just outside his room is cruel. Beds should be placed in such a position as to allow the patient to see out the window- the sky and sunlight.

Noise

Light

Physical Environment

Cleanliness, ventilation. Air, light, noise, water, bedding, drainage, warmth, diet

Patient Condition and nature

Communication, advice variety Mortality data, prevention of disease

Psychological Environment

Social Environment

 Cleanliness room

should not be dusty, smoky or have close odor. bed must be clean, aired, warm, dry and free from odor. One should provide an environment in which the patient can be easily cared for by others or self. The width, height, and placement of bed should facilitate the activities of the patient. bed should be placed in the best lighted spot, away from sudden noises and the odor of drainage. The position of the patient on the bed should be viewed in the context of the supporting ventilation.

The effect of mind on body was fairly well accepted in Nightingales time. Nightingale did recognize that a negative environment could cause physical stress, there by affecting the patients emotional climate. Offering the patient a variety of activities to keep his/her mind stimulated. The view of sunlight, the attractiveness of food, and offering of manual activities that stimulate the need of labour are all factors that assist the patient to survive emotionally. Boredom is viewed as painful.

 Communication

with the patient is viewed in the context of the total environment. not be hurried, it is important to sit down in front of them. the patients room or within the hearing distance is viewed as in appropriate. not encourage the sick with false hopes and

Should

Outside

Should

advice.
Communicating

about the world around them that they miss, or about good news that visitors can share.

 Specific

data collections related to illness

Each

nurse must use observational power in dealing with specific cases rather than be comfortable with average patients. as mentioned in physical environment such as clean air, water, and proper drainage and sewage in context of society.

Notions

Assessment
Ventilation Cleanliness of body, cloths, linen, surrounding Adequacy of light Noise Sleep pattern Odor Condition of wound and dressing Communication pattern of relatives and treatment team members Area of patient placement Way of offering food

Nursing Diagnosis
Altered body temperature Sleep pattern disturbances Inadequate nutrition Social Isolation Risk for infection

Planning Intervention Evaluation

 Simple

and applicable, has caught the basic and important concepts in nursing. the condition at the time of Nightingale, may not be compatible to the sophisticated environment of modern western hospital. subservience to doctors. factors than on

Represents

Emphasized Focused

more on physical psychological needs of patient.

 Environmental Theory

is of vital importance.

According

to this theory the nurses try to keep the environment of the patient clean and hygienic. environment is kept free of germs so that the health of the patient cannot be affected. warmth, noise, light, effluvia are the most highlighted concept to provide care to the patient who himself possess reparative power.

The

Ventilation,

Lo! in that hour of misery A lady with a lamp I see Pass through the glimmering gloom, And flit from room to room

1.

George JB. Nursing Theories: The Base for Professional Practice. Appleton and Lange. Norwalk, 3rd Edition Attewell A. Florence Nightingale. Prospect: the quarterly review of comparative education. UNESCO. International Bureau of Education. Vol XXVIII no 1. March 1998; 153-66 Nightingale F. Notes on Nursing: What it is and what it is not. Harrison. 59. Pull Mall. London; 1860. Available from http://books.google.com/

2.

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