Objectives
The given presentation is focused on the environmental theory introduced by Florence Nightingale in the 19th century. The nursing theory became one of the most significant theories in the nursing field and continues to be valuable to this day, which necessitates its analysis to gain deeper insights and see its application in contemporary studies. While the nursing theory tends to be abstract, it reveals the origins of nursing practices that rely on both the physical and mental conditions of the patient. In this sense, the work aims to give an overview of the theory and its background. Furthermore, it is vital to review metaparadigm concepts and philosophical ideas of nursing theory. Lastly, the work targets current research that is based on the Nightingale theory and, thus, will review the findings.
An Overview of the Theory
The germ theory, as well as other present health theories, were not widely accepted when Nightingale’s nursing model was created, along with other concepts of the medical field. The writings of Nightingale are regarded as a comprehensive philosophy (McEwen & Wills, 2017). Her fundamental concept was that of healing, with the principles of leadership and global engagement following closely behind it as things that must be done to assist profound levels of healing (McEwen & Wills, 2017). For almost 160 years, Nightingale’s research has had an impact on nursing practice and clinical nursing (Riegel et al., 2021). Nightingale believed that nursing was both a woman’s sphere and a distinct profession in and of itself. Nevertheless, nurses were required to practice in accordance with doctors’ orders, which they were obligated to follow carefully (Riegel et al., 2021). Nurses were not intended to be subordinate to doctors, according to Nightingale. Instead, she thought that nursing constituted a distinct field of work or vocation in and of itself.
The germ theory, as well as other present health theories, were not widely accepted when Nightingale’s nursing model was created, along with other concepts of the medical field. The writings of Nightingale are regarded as a comprehensive philosophy (McEwen & Wills, 2017). Her fundamental concept was that of healing, with the principles of leadership and global engagement following closely behind it as things that must be done to assist profound levels of healing (McEwen & Wills, 2017). For almost 160 years, Nightingale’s research has had an impact on nursing practice and clinical nursing (Riegel et al., 2021). Nightingale believed that nursing was both a woman’s sphere and a distinct profession in and of itself. Nevertheless, nurses were required to practice in accordance with doctors’ orders, which they were obligated to follow carefully (Riegel et al., 2021). Nurses were not intended to be subordinate to doctors, according to Nightingale. Instead, she thought that nursing constituted a distinct field of work or vocation in and of itself.
The germ theory, as well as other present health theories, were not widely accepted when Nightingale’s nursing model was created, along with other concepts of the medical field. The writings of Nightingale are regarded as a comprehensive philosophy (McEwen & Wills, 2017). Her fundamental concept was that of healing, with the principles of leadership and global engagement following closely behind it as things that must be done to assist profound levels of healing (McEwen & Wills, 2017). For almost 160 years, Nightingale’s research has had an impact on nursing practice and clinical nursing (Riegel et al., 2021). Nightingale believed that nursing was both a woman’s sphere and a distinct profession in and of itself. Nevertheless, nurses were required to practice in accordance with doctors’ orders, which they were obligated to follow carefully (Riegel et al., 2021). Nurses were not intended to be subordinate to doctors, according to Nightingale. Instead, she thought that nursing constituted a distinct field of work or vocation in and of itself.
Grand Theory
The foundation of Nightingale’s teaching model is recognizing and satisfying patient requirements, and it is focused on the tasks a nurse should perform in order to do so. The majority of nursing authors classify Nightingale’s worldview, which was inductively generated and abstract but detailed in character, as a grand theory or philosophy. Since she thought that a good lifestyle was crucial for recovery, Florence Nightingale’s environmental theory is founded on five principles that she considered to be necessary to attain a healthy environment (Riegel et al., 2021). She stated that at the time, loudness was bad and bothered the other people, so nurse discourse should be eliminated, as should irritation and pointless queries. Florence also advised patients to eat healthily, sleep in beds with the right linen, and practice good personal cleanliness (Riegel et al., 2021). Nursing was viewed in this practical and theoretical setting as a way to place people’s bodies in such a condition that they experience no sickness or may recuperate from the illness (McEwen & Wills, 2017). It was, therefore, necessary to place individuals in an environment wherein nature can maintain or restore health – avoiding or healing illness or damage.
Health and Nursing Practice
Florence described health as the capacity of an individual to effectively employ all of their abilities and strengths in the context of caring for both oneself and others. Florence argued that nursing knowledge should be firmly rooted in concepts; otherwise, it would be like constructing a house on shaky ground, and it would collapse (Riegel et al., 2021). When implemented in nursing practice, this concept becomes even more relevant. In other words, professionals educated with solid foundations and concepts will have the resources to give quality healthcare, employing their critical thinking to make judgments that are right for the patients they are caring for (McEwen & Wills, 2017). Florence stated that nurses must carefully examine their patients and inform the doctor of the patient’s actual health in a timely way.
Nightingale and Human Dignity
On the basis of Nightingale’s ideals, it may be demonstrated that Florence Nightingale was in pursuit of social justice and human dignity via her defense of respect for all people, regardless of social status, physical limitations, living conditions, or employment. Her faith urged her to help common people even though her family wanted to integrate her into an elite culture (Riegel et al., 2021). According to Nightingale, a real nurse should give up making class differences and always put the patient first (Riegel et al., 2021). In this sense, the essence of the environmental theory is to prioritize both the mental and physical health of the patient.
Metaparadigms
The patient, health, nursing, and environment are the fundamental ideas of nursing metaparadigm concepts. This could cover aspects like a patient’s socioeconomic situation, relatives, friends, faith, and culture. The four metaparadigms are included in all of the different nursing theories and approaches. Each theorist presents certain ideas and claims in their own unique style. The metaparadigm of nursing offers a comprehensive method of treatment. The metaparadigm takes into account all aspects of patient care, including the patient, their surroundings, their illness, and the nursing practice itself. In this sense, metaparadigm concepts are core fundamentals of any nursing theory and indicate its main focus. Florence Nightingale’s environmental theory has concepts as well that pertain to patients, nursing, the environment, and health.
The patient, health, nursing, and environment are the fundamental ideas of nursing metaparadigm concepts. This could cover aspects like a patient’s socioeconomic situation, relatives, friends, faith, and culture. The four metaparadigms are included in all of the different nursing theories and approaches. Each theorist presents certain ideas and claims in their own unique style. The metaparadigm of nursing offers a comprehensive method of treatment. The metaparadigm takes into account all aspects of patient care, including the patient, their surroundings, their illness, and the nursing practice itself. In this sense, metaparadigm concepts are core fundamentals of any nursing theory and indicate its main focus. Florence Nightingale’s environmental theory has concepts as well that pertain to patients, nursing, the environment, and health.
As for the person concept, it involves putting the interests of the patient first since it is the core of the model. For instance, it is necessary to avoid loud sounds when speaking in the patient’s ear, the swishing of the broad garments that were fashionable at the period, twitching, asking pointless inquiries, and a heavy stride when walking (Riegel et al., 2021). As for the health concept, Nightingale believed that factors like nourishing meals, comfortable mattresses and bedding, and personal hygiene were crucial, and she was also sure that social interaction was crucial to recovery (McEwen & Wills, 2017). Nightingale did not directly mention the germ hypothesis in his papers, despite the fact that it had been put forward (McEwen & Wills, 2017). Nevertheless, her views on care suggest that she understood and agreed that sanitation reduces morbidity.
According to Nightingale, another concept, the one of nursing, dictates that nurses should accurately observe their clients and adequately communicate any changes in their condition to the treating physician. She clarified that nurses should exercise critical thought when providing care for patients and should take the proper and essential steps to aid in the patient’s recovery (McEwen & Wills, 2017). In order to put them in the finest possible circumstances for environmental repair or to keep health—to avoid or to treat sickness or damage, nursing was formerly thought of as a technique to place the body in such a condition that there will be no illness, or that it could heal from illness (McEwen & Wills, 2017). She asserted that nurses should be faithful to the healthcare plan without being subservient and that she thought of nursing as an artwork rather than a science (Riegel et al., 2021). Many of the duties Nightingale listed for nurses to perform in order to care for patients are still applicable today. She did this throughout her books.
Application
Since Nightingale covered both real and abstract notions, her theory can serve as a foundation for testable hypotheses. Studies on noise (Murphy, Bernardo, & Dalton, 2013), the environment (Zborowsky, 2014), and spirituality are all in line with her concepts of caregiving (Tanyi & Werner, 2008). Her analytical expertise has lately been the subject of study articles, which demonstrate that it is still as relevant now as it was in the 19th century (McEwen & Wills, 2017). In this sense, her work continues to advance studies around the globe.
Study on Noise
Nurses have long understood the negative impact of noise on people and the value of keeping a calm, peaceful atmosphere. In the study conducted by Murphy et al. (2013), the researchers encouraged a calm environment and worked with healthcare workers to maintain a calm, therapeutic environment. The significance of including all associates in the improvement process, such as the late night and night shift staff nurses, along with departments that provide assistance and services on the team, is among the main learnings discovered through this action plan. The understanding that there is no one magic cure or answer to the issue and that effectiveness relies instead on maintaining constant attention to the task and maintaining the endeavor in the workforce’s minds is also crucial.
Additionally, the researchers discovered that strong unit management that values the project and is dedicated to its promotion is crucial for long-term success. The vital role played by nursing staff in ensuring that units stay quiet at night is possibly the most significant lesson learned (Murphy et al., 2013). The study claims that nurses play a critical role in fostering an atmosphere that encourages patient relaxation and wellness by recognizing variables that contribute to the sound, lobbying for necessary changes, and driving the creation and implementation of solutions (Murphy et al., 2013). A trained professional will always ensure that no door or window in the patient’s room will screech; no curtains or blinds should flap due to wind. Nightingale may have best described the importance of nurses when she wrote the following findings in Notes on Nursing.
Study on Environment
Nurses are uniquely qualified to use their powers of observation to comprehend the function of the built environment in promoting recovery in their clients. As a result, nursing staff has the chance to participate in research projects that directly relate to nursing. The goal of this study was to examine nursing knowledge that has relevance to Florence Nightingale’s environmental theory and is concerned with the effects of healthcare settings. According to descriptive data, the most commonly mentioned subjects and contexts are in line with the current healthcare priorities of patient quality and safety in acute and emergency environments (Zborowsky, 2014). The most popularly referenced research approaches and methods are consistent with a field’s early stages of development.
The study findings by Zborowsky can be used to support a few claims. To start, education is crucial for advancing knowledge in this field (Zborowsky, 2014). Lastly, bedside nurses are in the greatest possible opportunity to begin assisting everybody in understanding how the physical environment affects patients throughout the act of nursing through study (Zborowsky, 2014). In this sense, quality healthcare can only be provided with proper education and qualifications.
Study on Spirituality
The comprehensive phenomenological study by Tanyi and Werner (2008) aims to examine how end-stage renal disease and hemodialysis affect women’s actual spiritual experiences. Sixteen women who were part of a purposeful voluntary sample frequently went to two outpatient dialysis clinics in a sizable Midwestern metropolis. Colaizzi’s approach was used to assess audiotaped and written interviews (Tanyi & Werner, 2008). The women stated that having a strong spiritual foundation helped them cope with their sickness and follow their prescribed treatment plans (Tanyi & Werner, 2008). Tolerance, empathy, strengthening, and emotion regulation were the four main clusters of themes connected to the women’s spiritual experiences inside their disease that came to light. Findings indicate that spirituality could be a crucial factor in nursing and multidisciplinary universal healthcare and demonstrate the value of spirituality in coping with ESRD while doing hemodialysis (Tanyi & Werner, 2008). These results could help advance holistic nursing practice and instruction in adjacent fields.
The comprehensive phenomenological study by Tanyi and Werner (2008) aims to examine how end-stage renal disease and hemodialysis affect women’s actual spiritual experiences. Sixteen women who were part of a purposeful voluntary sample frequently went to two outpatient dialysis clinics in a sizable Midwestern metropolis. Colaizzi’s approach was used to assess audiotaped and written interviews (Tanyi & Werner, 2008). The women stated that having a strong spiritual foundation helped them cope with their sickness and follow their prescribed treatment plans (Tanyi & Werner, 2008). Tolerance, empathy, strengthening, and emotion regulation were the four main clusters of themes connected to the women’s spiritual experiences inside their disease that came to light. Findings indicate that spirituality could be a crucial factor in nursing and multidisciplinary universal healthcare and demonstrate the value of spirituality in coping with ESRD while doing hemodialysis (Tanyi & Werner, 2008). These results could help advance holistic nursing practice and instruction in adjacent fields.
Review
Hence, it was found that Florence Nightingale’s environmental theory is a grand theory since it incorporates many of the abstract concepts that are the foundation of a quality nursing concept. Her central idea was that of healing, closely followed by the notions of leadership and global participation as actions that had to be taken to support significant levels of healing. Despite the fact that the phrase “metaparadigm” was not established for nearly 130 years, it was also recognized that Nightingale explicitly addressed the concepts of person, environment, health, and nursing in her writings. The first idea, environment, is centered on having a good environment and being mentally well. The personal idea, which forms the basis of the paradigm, calls for prioritizing the needs of the patient. According to Nightingale, another idea, the one of nursing, requires nurses to precisely watch their patients and effectively inform the treating physician of any changes in their health. In terms of the health concept, Nightingale was certain that social connection was essential to healing and that things like healthy meals, cozy beds and bedding, and personal hygiene were essential. Lastly, the environmental theory was applied to studies on noise, spirituality, and the environment.
Hence, it was found that Florence Nightingale’s environmental theory is a grand theory since it incorporates many of the abstract concepts that are the foundation of a quality nursing concept. Her central idea was that of healing, closely followed by the notions of leadership and global participation as actions that had to be taken to support significant levels of healing. Despite the fact that the phrase “metaparadigm” was not established for nearly 130 years, it was also recognized that Nightingale explicitly addressed the concepts of person, environment, health, and nursing in her writings. The first idea, environment, is centered on having a good environment and being mentally well. The personal idea, which forms the basis of the paradigm, calls for prioritizing the needs of the patient. According to Nightingale, another idea, the one of nursing, requires nurses to precisely watch their patients and effectively inform the treating physician of any changes in their health. In terms of the health concept, Nightingale was certain that social connection was essential to healing and that things like healthy meals, cozy beds and bedding, and personal hygiene were essential. Lastly, the environmental theory was applied to studies on noise, spirituality, and the environment.
References
McEwen, M., & Wills, E. M. (2017). Theoretical basis for nursing (5th ed.), pp.142-145.Wolters Kluwer Health.
Murphy, G., Bernardo, A., & Dalton, J. (2013). Quiet at night: Implementing a nightingale principle. The American Journal of Nursing, 113(12), 43-51.
Riegel, F., Crossetti, M. D. G. O., Martini, J. G., & Nes, A. A. G. (2021). Florence Nightingale’s theory and her contributions to holistic critical thinking in nursing. Revista Brasileira de Enfermagem, 74(2), 1-5.
Tanyi, R. A., & Werner, J. S. (2008). Women’s experience of spirituality within end-stage renal disease and hemodialysis. Clinical Nursing Research, 17(1), 32–49.
Zborowsky, T. (2014). The legacy of Florence Nightingale’s environmental theory: Nursing research focusing on the impact of healthcare environments. Health Environments Research & Design Journal, 7(4), 19-34.
The germ theory, as well as other present health theories, were not widely accepted when Nightingale’s nursing model was created, along with other concepts of the medical field. The writings of Nightingale are regarded as a comprehensive philosophy (McEwen & Wills, 2017). Her fundamental concept was that of healing, with the principles of leadership and global engagement following closely behind it as things that must be done to assist profound levels of healing (McEwen & Wills, 2017). For almost 160 years, Nightingale’s research has had an impact on nursing practice and clinical nursing (Riegel et al., 2021). Nightingale believed that nursing was both a woman’s sphere and a distinct profession in and of itself. Nevertheless, nurses were required to practice in accordance with doctors’ orders, which they were obligated to follow carefully (Riegel et al., 2021). Nurses were not intended to be subordinate to doctors, according to Nightingale. Instead, she thought that nursing constituted a distinct field of work or vocation in and of itself.
The germ theory, as well as other present health theories, were not widely accepted when Nightingale’s nursing model was created, along with other concepts of the medical field. The writings of Nightingale are regarded as a comprehensive philosophy (McEwen & Wills, 2017). Her fundamental concept was that of healing, with the principles of leadership and global engagement following closely behind it as things that must be done to assist profound levels of healing (McEwen & Wills, 2017). For almost 160 years, Nightingale’s research has had an impact on nursing practice and clinical nursing (Riegel et al., 2021). Nightingale believed that nursing was both a woman’s sphere and a distinct profession in and of itself. Nevertheless, nurses were required to practice in accordance with doctors’ orders, which they were obligated to follow carefully (Riegel et al., 2021). Nurses were not intended to be subordinate to doctors, according to Nightingale. Instead, she thought that nursing constituted a distinct field of work or vocation in and of itself.
