Nightingale Environmental Theory

The Environmental Theory by Florence Nightingale defined

Nursing as “the act of utilizing the environment of the patient
to assist him in his recovery.” It involves the nurse’s initiative to
configure environmental settings appropriate for the gradual
restoration of the patient’s health and that external factors
associated with the patient’s surroundings affect the life or
biologic and physiologic processes and his development.
Nightingale discussed the Environmental Theory in her book

Watson's Theory of Human Caring

According to Watson (1997), the core of the Theory of
Caring is that “humans cannot be treated as objects and
that humans cannot be separated from self, other,
nature, and the larger workforce.” Her theory
encompasses the whole world of nursing; with the
emphasis placed on the interpersonal process between
the care giver and care recipient. The theory is focused
on “the centrality of human caring and on the caring-to-
caring transpersonal relationship and its healing potential
for both the one who is caring and the one who is being
cared for” (Watson, 1996).
Benner Novice to Expert Theory

Dr. Patricia Benner is a nursing theorist who first

developed a model for the stages of clinical competence
in her classic book “From Novice to Expert: Excellence
and Power in Clinical Nursing Practice”. Her model is one
of the most useful frameworks for assessing nurses’
needs at different stages of professional growth. She is
the Chief Faculty Development Officer for Educating
Nurses, the Director of the Carnegie Foundation for the
Advancement of Teaching National Nursing Education
and honorary fellow of the Royal College of Nursing.
Patricia Benner was born in Hampton, Virginia, and
received her bachelor’s degree in Nursing from Pasadena
College in 1964, and later a master’s degree in Medical-
Surgical Nursing from the University of California,
Berkeley. After completing her doctorate in 1982, she
became an Associate Professor in the Department of
Physiological Nursing at the University of California, San
Francisco. Dr. Benner is an internationally known lecturer
and researcher on health, and her work has influenced
areas of clinical practice as well as clinical ethics.
This nursing theory proposes that expert nurses develop
skills and understanding of patient care over time
through a proper educational background as well as a
multitude of experiences. Dr. Benner’s theory is not
focused on how to be a nurse, rather on how nurses
acquire nursing knowledge – one could gain knowledge
and skills (“knowing how”), without ever learning the
theory (“knowing that”). She used the Dreyfus Model of
Skill Acquisition as a foundation for her work. The
Dreyfus model, described by brothers Stuart and Hubert
Dreyfus, is a model based on observations of chess
players, Air Force pilots, army commanders and tank
drivers. The Dreyfus brothers believed learning was
experiential (learning through experience) as well as
situation-based, and that a student had to pass through
five very distinct stages in learning, from novice to
expert.
Dr. Benner found similar parallels in nursing, where
improved practice depended on experience and science,
and developing those skills was a long and progressive
process. She found when nurses engaged in various
situations, and learned from them, they developed “skills
of involvement” with patients and family. Her model has
also been relevant for ethical development of nurses
since perception of ethical issues is also dependent on
the nurses’ level of expertise. This model has been
applied to several disciplines beyond clinical nursing, and
understanding the five stages of clinical competence
helps nurses support one another and appreciate that
expertise in any field is a process learned over time.