Florence Nightingale : Environmental Theory

Florence Nightingale 1820-1910, English nurse, the founder of modern nursing, b. Florence, Italy. Her life was dedicated to the care of the sick and war wounded. In 1844, she began to visit hospitals; in 1850, she spent some time with the nursing Sisters of St. Vincent de Paul in Alexandria; and a year later she studied at the institute for Protestant deaconesses in Kaiserswerth, Germany. In 1854, she organized a unit of 38 woman nurses for service in the Crimean War. By the end of the war she had become a legend. With the testimonial fund collected for her war services she established (1860) the Nightingale School and Home for training nurses at St. Thomas’s Hospital, London. She was called “The Lady with the Lamp” because she believed that a nurse’s care was never ceasing, night or day; she taught that nursing was a noble profession, and she made it so.
Florence Nightingale was the first woman to be given the British Order of Merit(1907). She wrote Notes on Hospital (1857), Notes
on Hospitals (1859), Notes on Nursing (1860), and Notes on Nursing for the Labouring Classes (1861). After her death the Crimean Monument, Waterloo Place, London, was erected (1915) in her honor, and the Florence Nightingale International Foundation was inaugurated (1934).

Nightingale’s 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”
  • 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 individual’s health

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
Nursing’s Focus: control of the environment for individuals, families & the community

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

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!

Social Environment:
Involves collecting data about illness and disease prevention
Includes components of the physical environment – clean air, clean water, proper
Consists of a person’s home or hospital room, as well as the total community
that affects the patient’s specific environment

Components of Nightingale’s 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

Nightingale’s Theory & Nursing’s Metaparadigm

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 patient’s power as long as a safe environment exists

The foundational component of Nightingale’s theory
The external conditions & forces that affect one’s life and development
Includes everything from a person’s food to a nurse’s verbal & nonverbal
interactions with the patient

Maintained by using a person’s 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

Provides fresh air, light, warmth, cleanliness, quiet, and a proper diet
Facilitates a patient’s reparative process by ensuring the best possible
Influences the environment to affect health