Florence Nightingale
ENVIRONMENTAL THEORY Person:
She is the founder of Modern Nursing.
 Born on May 12, 1820 in Florence, Italy and was named
after her birthplace.
 She is well educated, affluent and belong to an
Aristocratic family.
 Her father educated her more broadly than other girls.
 She was tutored in mathematics, languages, religion and
philosophy.
 She developed the sense that her life should become
more useful.
 She had a calling from God to his service.
She became a nurse after completing her nursing training
in
 1851 at Kaiserwerth, Germany, a Protestant religious
 Community with a hospital facility.
 She trained as a nurse for approximately 3 months.
In her return to England, Nightingale was employed to
examine hospital facilities, reformatories and charitable
charitable institutions.
 She became the superintendent of the Hospital for
Invalid Gentlewomen in London.
 Travelled to Scutari Turkey with a group of nurses to
care for wounded British soldiers.
 She addressed the environmental problems that existed
in that place.
lack of sanitation
Exposure to frostbite
House infestations
Wound infections
Opportunistic disease from battle wounds
Presence of filth few chamber pots
contaminated water
contaminated bed linens
overflowing cesspools
She was called “ The Lady of the Lamp “
 Made ward rounds during the night.
 provide emotional comfort to the soldiers.
 She was ill with Crimean Fever { Typhus or Brucellosis }
which affected her physical condition for years.
 She was awarded with funds in recognition of her works
and used it to establish schools for nursing training at
St. Thomas Hospital and Kings College Hospital in
London.
Metaparadigm /Major Assumptions in Nursing
Nursing:
= She believed that every woman, at one time in
life, would be a nurse.
= is having the responsibility for someone else’s health.
= in her Notes on Nursing to provide women with
guidelines for providing nursing care and to give
advice on how to “ think like a nurse.
= she referred to the person as a patient.
= nurses performed task to and for the patient and controlled
the patient’s environment to enhance recovery.
= ask the patient about his or her preferences and saw the
patient as individual.
= she in control of some personal choices and behaviour.
=Has respect for persons of various backgrounds and was not
judgmental about social worth and religious beliefs.
Health:
= being well and using power that the person has
to the fullest extent in living life.
= she envisioned the maintenance of health
through the prevention of disease via environ-
mental control.
Environment:
= are those elements external to and which
affect the health of the sick and healthy person
and included everything from the patient’s
food and flowers to the patient’s verbal and
nonverbal interaction with the patient.
= she believed that the sick, poor people would
benefit from environmental improvements that
addressed both their bodies and minds.
 Nightingale’s definition of environment as
“ All the external conditions and influences
affecting the life and development of an
organism and capable of preventing,
suppressing or contributing to disease,
accidents and death.”
= components of environment are:
 Ventilation
 Warmth
 Light
 Cleanliness
 Diet
 Noise
 Proper ventilation:
= keep the air he breathes as pure as the
external air without chilling him.
 Concept of Light:
= position patients to expose them to sun
light because of its benefits.
 Cleanliness:
= daily bath of the patient
= adequate sewage
=frequent hand washing
= access to pure H20
=provision of clean clothing.
 Warmth:
= maintain room temperature.
= provide blankets when patient is chilling
 Quiet Place:
= avoid /control unnecessary noise.
  Diet:
= meeting patient’s nutritional needs.
Virginia Henderson
14 BASIC HUMAN NEEDS
NURSE
• Is temporarily the consciousness of the unconscious
• The love of life for the suicidal
• The leg of the amputee
• The eyes of the newly blind
• A means of locomotion for the infant
• Knowledge of confidence for the mother
• The mouthpiece for those too weak or withdrawn to
speak and so on
HENDERSON
• Called the “First Lady of Nursing” and the “First Truly
International Nurse”
• Her writing, presentations, research and contacts with
nurses have profoundly affected nursing and gave an
impression on the recipient of care by nurses
throughout the world
• she began her career in public health nursing in the
Henry Street Settlement and in the visiting nurse service
in Washington, D.C.
• She was the first full-time instructor in nursing in
Virginia when she was at Norfolk Protestant Hospital
• An early advocate for the introduction of Psychiatric
Nursing in the curriculum and served in the committee
to develop such a course at Eastern State Hospital in
Williamsburg, Virginia in 1929
• Nurses through the US studied with her without ever
leaving their home schools when her revision of Bertha
Harmers’ textbook of the Principles and Practice of
Nursing became widely used.
• Other important publications grew out of Henderson’s
years at Yale University including Nursing Research; A
Survey and Assessment
• She also directed a twelve-year project entitled Nursing
Studies Index, four volumes recognized as an essential
reference for many years
• Nature Nursing, this book expressed for belief about the
essence of nursing and influenced the hearts and minds
of those who read it.
• At 75 years old, she directed her career to international
teaching and speaking. Another generation harvested
the benefits of contact with this outstanding nurse of
20th century
• Numerous honors bestowed on Henderson
• Honorary degrees from 13 universities
• Selected to the American Nurse Association Hall of
Fame
• Sigma Theta Tau International Library named her honor
• Historical Nurse Leadership Award was presented to her
by the Virginia Nurses in 1988
• Recognized Henderson as one of the 51 Pioneer Nurses
in Virginia Nurses Association in 2000
• Halloran, a nurse theorist write “Henderson was to the
20th Century as Nightingale was 19th century. Both
wrote extensive works that have influenced the world.
Metaparadigm in Nursing
Person:
• The person is an individual who requires assistance to
achieve health and independence in some cases, a
peaceful death
• Introduced the concept of mind and body of a person as
inseparable. For a person to functions to the utmost, he
must be able to maintain physiological and emotional
balance
Health:
• Viewed health as a quality of life and is very basic for a
person to function fully
• As a vital need, health requires independence and
interdependence
• Gave emphasis in prioritizing health promotion
Environment:
• It is important for a healthy individual to control the
environment but as illness occur, this ability is
diminished and affected
• In caring for the sick, the responsibility of the nurse to
help the patient manage his surroundings to protect
him from harm or mechanical injury
• Nurses must provide physicians data about the safety
needs of the patient
Nursing:
• She asserted that nurse function independently from
the physician but they must promote the treatment
prescribed by the physician
• Special role of the nurse is to help both the sick and well
individuals. Care must include people from all walks of
life from the well to the sides new-born to the dying
• Role of the nurse as a health care provider
The nurse must be knowledgeable in both
biological and social sciences
Must have the ability to assess basic human
needs
 Her definition of nursing was considered as the
signature of the profession
14 BASIC NEEDS
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body wastes
4. Moving “maintaining a desired position”
5. Sleeping and rest
6. Selecting suitable cloths
7. Maintaining normal body temperature by
adjusting clothes in modifying the environment
8. Keeping the body clean and well groomed to
promote integument (skin)
9. Avoiding dangers in the environment and
avoiding injury to others.
10. Communicating with others in expressing
emotions, needs, fears with opinions
11. Worshipping according to one’s faith
12. Working in such a way that one feels a sense of
accomplishment
13. Playing or participating in various forms of
recreation
14. Learning, discovering or satisfying the curiosity
that leads to normal development a health, or
using available health facilities
3 TYPES OF RELATIONSHIP
A. 3 LEVELS OF NURSE-PATIENT RELATIONSHIP
1. The nurse as a substitute for the patient:
• Provide knowledge, will and strength in order to
make him complete, whole and independent once
again
2. The nurse as a helper to the patient:
• Nurse focuses her attention in assisting the patient
meet these needs so as to regain independence as
quickly as possible
3. The nurse as a partner with the following:
• As partners, formulates the plan of care together
• Both an advocate or as a resource person, the nurse
can empower the patient to make effective
decisions regarding his care plans
• As partners, their interest are the same having the
patient achieve health and independence
B. THE NURSE-PHYSICIANS RELATIONSHIP
• Though the nurse and patient are partners, the plan
of care must be implemented in such a way that will
promote the physicians prescribed therapeutic plan
• She insisted that nurse do not follow doctor’s orders
to patients or other health care team members
C. NURSE AS A MEMBER OF THE HEALTH CARE TEAM
• As member of the team, the nurse works and
contributes in carrying out the total program of care
ACCEPTANCE BY THE NURSING COMMUNITY
1. PRACTICE
• Henderson’s approach focuses on decision-making
A. Assessment phase
• She gathers data by observing, smelling, feeling and
hearing
• The nurses use critical thinking and analysis of the
condition of the patient.
B. Planning phase
• Plan of care to meet the needs and personality.
• To make the plan same with the goals of the health
care team, the notes and responsibilities of each
professional member must be included and
integrated to the care of plan.
C. Implementation phase
• Nurse uses the 14 basic needs in answering the factors
that are contributing to the illness state of the patient
• Interventions are focused on:
o Maintaining health
o To recover from illness
o To aid in peaceful death
• She performs activities that are directed in helping the
patient attain his independence as fast possible
D. Evaluating phase
• Nurse-patient reviews the relationship and decides
whether the goals are met or not
• Assess if the patient attained independence and if
health is achieved
2. EDUCATION
• Developed 3 phases of curriculum development
A. First phase
• Emphasis is made on helping the patient perform ADL
• Priorities are given on the fundamental needs of the
patient and planning of nursing care
B. Second phase
• Importance is placed on assisting patients achieve their
needs in times of mark body disturbance
• The approach becomes more medical and the nurse
understands the rationale behind the prescribed
therapeutic plans made by the doctor
C. Third phase
• Centered on the patient and his family together with
the dynamics affecting the relationship in the side unit
 RESEARCH

• Henderson supported the use of research in improving

the practice of nursing

• The nurse responsibility is to identify problems,

continuously validates her practice, improving the
methods used, a reassuring the effectiveness of the care

ANALYSIS

A. SIMPLICITY

• Her work “The Principles and Practice of Nursing” has

given an extremely comprehensive and well explanation

GENERALITY

• They work in such a way that they cover all areas of

nursing practice and could be applied in every setting

DERIVABLE CONASEQUENCES

• She emphasized the importance of nursing

independence from and interdependent on the different
health care profession

• Advocated curriculum development and at the same

time viewed research as an important tool in improving
the clinical practice of nursing