Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar

College of Nursing and Allied Health Sciences

Activity in THEORETICAL FOUNDATION OF NURSING

1st Semester, SY 2022-2023

FLORENCE NIGHTINGALE'S ENVIRONMENTAL

THEORY AND BIOGRAPHY

Rebese, John Lloyd G.

(BSN 1-E)

Danhill C. Donoga, RN, PhD

(Subject Instructor)

November 30, 2022

(Date of Submission)
 Who is Florence Nightingale?

Florence Nightingale, the Matriarch of Modern Nursing, was

born in Florence, Italy, on May 12, 1820. As she grow up, her
father provided her with a reputable education, which was
uncommon for a Victorian woman because women in those
times were often not educated as well as men.

According to her biographer, Sir Thomas Cook, Nightingale was

a linguist; had a vast knowledge of Science, Mathematics,
Literature, and the Arts; was well read in Philosophy, History, Politics and Economics;
and was well- Informed about the workings of government and Political Bolence. She
wanted to do more with her life than become an Inactive wife of an aristocrat. Florence
had a firm faith in God as she was a Unitarian Christian, and for a time believed she had
a religious calling.

First Nurse Educator

While Nightingale was struggling with decisions about her life, the seeds of modern
nursing were being planted in Germany.

Germany was the place of the first nursing school. In 1936, Pastor Theodor Fleidner,
a protestant pastor in Kaiserswerth, Germany, opened a hospital in a "vacant textile
factory with one patient, one nurse, and a cook" (Hegge, 1990). When Fleidner
recognized there was no staff for the hospital, he decided to design a school of
nursing.

Nightingale went to Kaiserswerth and stayed for 14 days in 1850 after a trip to Egypt.
She applied for admission to the school with a 12-page, handwritten "curriculum"
showing her interest of becoming a nurse and entered the nursing program July 6,
1851, as the 134th nursing student to attend the Fleidner School of Nursing.

She left Kaiserswerth on October 7, 1851, and was considered to be educated as a

nurse. During the three months of studying with the sisters of Kaiserswerth, she
developed skills in both nursing care and management which she look back to England.
When Nightingale went back to England, she used the knowledge from Kaiserwerth to
prove her cause as a reformer for the well-being of the citizens.

The "Lady with the Lamp" (Crimean War)

With her lamp, Nightingale traversed the night during the Crimean War - the battle of
English versus Turkish to look for the wounded soldiers and to heal them with her
consoling hands. Nightingale went to the front of the Crimean war at the request of her
friend, Sir Sidney Herbert, Secretary at War at Great Britain. She arrived in Scutari on
November 5, 1854, accompanied by 38 nurses.

Nightingale's 19th month stay at military was hard for many to accept. The hospital
barracks were infested with fleas and rats, and sewage flowed under the wards. She
used her superb statistical and managerial skills to make drastic changes in the
mortality rate of soldiers and victims of war. The mortality rate at the hospital was 42.7%
of those treated; a mortality rate which was higher from disease than from war injuries
(Cohen, 1984). Six months after, the mortality rate at the hospital went down to 2.2%.
She achieved this drop in mortality by attending to the environment of the soldiers.

Nightingale became a heroine in Great Britain as a result of her work in the Crimean
War. Her depiction of the very poor sanitary conditions in the hospital wards at Scutari is
overwhelming. She fought the bureaucracy for food, bandages, fresh bedding, and)
cleaning supplies for the soldiers. At times she bought supplies from her finances.

She showed concern for the comfort of the English soldiers - well, injured, or sick,
Including supporting the establishment of a laundry, library, assistance with letter
writing, a banking system so the soldiers could save their pay, and a hospital for the
families who go with the soldiers to war. Also, she provided comfort and security to the
seriously sick and dying. Her skills in decision-making were often better than those of
many officers in the army She spent the years after the Crimean War establishing
schools of nursing and influencing public policy by lobbying her acquaintances about
several of her concerns.

In Scutari, Nightingale became critically ill with Crimean fever, which might have been
typhus or brucellosis and which may have affected her physical condition for years
afterward.

Nurse Statistician

Nightingale was truly a skilled nurse; she was an expert statistician who used statistics
to present her case for hospital reform. She was viewed as a pioneer in the graphlo
display of statistics and was selected a fellow of the Royal Statistical Society in 1858.

In 1874 an honorary membership in the American Statistical Association was bestowed

unto her. Given her dependence on observable data to support her position, it can be
said that Nightingale was the first nurse researcher.

Besides that, she was also an excellent writer. Her writings, Notes on Matters Affecting
the Health, Efficiency and Hospital Administration of the British Army founded chiefly on
the experience of the late war, Notes on Hospitals, and Report on Measures Adopted
for Sanitary Improvements in India from June 1869 to June 1870, showed her ongoing
concerns about these issues, particularly for the military.

Also, her most frequently cited work, Notes on Nursing, was written not as a nursing text
but to "give hints for thoughts of women who have personal charge of the health of
others" (Nightingale, 1859).

Award and Later Life

In her lifetime, Nightingale's work was recognized through the numerous awards she
gained from Great Britain and many other countries. Notably, she was the first woman
to be granted the Order of Merit (OM) and the Royal Red Cross (RRC) by no less than
Queen Victoria of Great Britain. During her time, she was the second most famous
British, after the Queen herself. Recipients of the awards are entitled to use the post-
nominal letters (OM RRC) on their names.

She was able to work into her 80's and died in her sleep on August 13, 1910 at the pe
age of 90. She is honored each year in a commemorative service at St. Margaret's
Church, East Wellow, Great Britain, where she is buried. The news of her death spread
ross the world, and she instantly became a celebrated and legendary person:

"Florence Nightingale, the famous nurse of the Crimean war, and the only woman who
ever received the Order of Merit, died yesterday afternoon at her London home.
Although she had been an invalid for a long time, rarely leaving her room, where she
passed the time in a half-recumbent position, and was under the constant care of a
physician, her death was somewhat unexpected. A week ago she was quite sick, but
then improved, and On Friday was cheerful. During that night alarming symptoms
developed, and she gradually Sank until 2 o'clock Saturday aftemoon, when the end
came" (The New York Times, 1910). Her birthday marks the International Nurses Day
celebration each year.

What are the major concepts of Nightingale's Environmental Theory?

The major concepts of Florence Nightingale’s Theory are:

 Nursing. Nightingale had always considered that nursing is very essential for
everybody's well-being. One of her masterpieces, Notes on Nursing, provided
essential principles for Tendering and implementing an efficient and effective
nursing care. Moreover, she instilled an ideal attitude of thinking and acting like a
real nurse.

Person. Nightingale viewed the essence of a person as a client. She believed

that nurses should perform tasks to and for the client as well as control the
client's environment to facilitate easy recovery. Predominantly, she explained a
passive client in this relationship However, when there are definite references to
the client performing self-care when possible the nurse is particularly instructed
to ask the client about his or her preference. However Nightingale gives
emphasis to the nurse who is in control of the client's environment.

Health. Nightingale's statement regarding health is "being well and using every
power that the person has to the fullest extent." In addition, she defined disease
as "a reparative process that nature instituted from a want of attention". She
believed that prevention of disease through environmental control will greatly
uplift the maintenance of health. Furthermore, she illustrated modern public
health nursing and the more modern concept of health promotion She compared
these concepts of nursing as different from caring a sick client to living better and
increasing recovery.

Environment. Nightingale's statements about conditions in the community are

also applicable to her theory. She believed that the sick and poor people would
benefit from environmental improvements that addressed their physical and
mental aspects. She stressed that nurses could have a pecial role in uplifting the
social status of the poor by improving their living situations. Furthermore, her
concept of environment was described by Fitzpatrick and Whall (2005) as "Those
elements external to and which affect the health of the sick and healthy person"
and Includes "everything from the patient's food and flowers to the nurse's verbal
and non-verbal Interactions with the patient."

Explain the conceptual framework of Nightingale's Environmental Theory.

The following are the Subconcepts of Florence Nightingale’s theory:

Ventilation and warmth

Check the client's body temperature, room temperature, ventilation and foul
odors. Create a plan to keep the room well-ventilated and free of odor while
maintaining the client's body temperature.

Light

Assess the room for adequate light, Sunlight works best. Develop and implement
adequate light without placing the client in direct light.

Cleanliness of rooms and wall

Assess the room for dampness, darkness and dust or mildew. Keeping the
environment clean (free from dust, dirt, mildew and dampness)

Health of houses

Check surrounding and environment for fresh air, pure water, drainage,
cleanliness and light. Remove garbage, stagnant water and ensure clean water
and frosh air.

Noise

Avoidance of sudden/startling noises. Keeping noise in general to a

minimum.Refrain from whispering outside the door.

Bed and bedding

Check bed and bedding for dampness, wrinkles and soiling. Comfort measures
related to keeping the bed dry, wrinkle-free and at the lowest height to ensure the
client’s comfort.

Personal cleanliness

Keeping the patient clean and dry at all times. Frequent assessment of client’s
skin is needed to maintain adequate moisture. “Every nurse ought to wash her
hands very frequently during the day.”

Chattering hopes and advices

Avoidance of talking without reason or giving advice that is without fact. Continue
to talk to the client as a person. And to stimulate the client’s mind  Avoid
personal talks.

Variety
 Provide variety in the patient’s room to help him/her avoid boredom and
depression. This is accomplished by cards, flowers, pictures, books or puzzles
(presently known as diversional therapy) Encourage significant others to engage
with the client.

Food intake

Assess the diet of the client. Note the amount of foods and liquids ingested at
every meal.

Petty management

Continuity of the care, when the nurse is absent. Documentation of the plan of
care and all evaluation will ensure others give the same care to the client in your
absence.

Observation of the sick

Making and documenting observations. Continue to observe the client’s

surrounding environment.

Give your thoughts about one of Florence Nightingale's Assumptions that states: A
healthy environment is essential for healing. She stated that "nature alone cures."

The assumptions of Florence Nightingale in her Environmental Theory are as follows:

Florence Nightingale believed that five points were essential in achieving a

healthful house: “pure air, pure water, efficient drainage, cleanliness, and light.”

A healthy environment is essential for healing. She stated that “nature alone
cures.”

Nurses must make accurate observations of their patients and report the state of
the patient to the physician in an orderly manner.

Nursing is an art, whereas medicine is a science. Nurses are to be loyal to the

medical plan but not servile.

Strengths

Florence Nightingale’s language to write her books was cultured and flowing, logical in
format, and elegant in style. Nightingale’s Environmental Theory has broad applicability
to the practitioner. Her model can be applied in most complex hospital intensive care
environments, the home, a worksite, or the community. Reading Nightingale’s
Environmental Theory raises consciousness in the nurse about how the environment
influences client outcomes.

Weaknesses

In Nightingale’s Environmental Theory, there is scant information on the psychosocial

environment compared to the physical environment. The application of her concepts in
the twentieth century is in question.

Conclusion

This theory is based on the concept of patient care and is called the Environmental
Theory of Nursing. The goal is to improve the patient's health by changing the
environment. Nursing is more important than the nursing process, the nurse-patient
relationship, or the nurse personally.

This makes it necessary to tailor the model to meet the individual needs of patients. A
patient's specific circumstances and illness can affect the environmental factors that
affect him or her. There are a number of factors that the nurse needs to consider on a
case-by-case basis in order to ensure that a patient's care is tailored to meet the
specific needs of that patient.
 Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar

College of Nursing and Allied Health Sciences

Activity 2A in THEORETICAL FOUNDATION OF NURSING

1st Semester, SY 2022-2023

FLORENCE NIGHTINGALE'S LIFE AND WORKS

(FILM CRITIQUE)

Rebese, John Lloyd G.

BS in Nursing 1-E

Danhil C. Donoga, RN, PhD

Instructor

November 30, 2022

Guide Questions:

What did Florence Nightingale do to save the wounded soldiers?

She brought fresh food to the soldiers, cleaned hospital beds and applied clean
bandages to the wounded. Soon fewer and fewer people died. Florence walked
up and down the hospital at night. She spoke to wounded soldiers and helped
them write letters to their families.

How did Florence Nightingale improve the quality of health care?

She used statistics about characteristics of nurses to document the need for
professional nurses and advocated for the rights of patients and the public health
of the community by stressing the cleanliness of individuals and their dwellings.
She taught nurses the skills and habit of observation, including what and how to
observe and to report facts rather than opinions.

How did nursing become an occupation or a career of people from all social
classes?

Nursing emerged as a profession in the mid-19th century. Historians credit

Florence Nightingale, a well-educated woman from Britain, as the founder of
modern nursing. Nightingale challenged social norms – and her wealthy parents
– by becoming a nurse. She believed they could use their education and
scientific knowledge to improve patient care while gaining personal
independence.

Despite her health condition and old age, what did she do which gave birth of
modern nursing and the English health system?

In order for her patients to get better, she worked tirelessly. In order to establish
sanitary working environments for nurses and patients, her Environmental
Theory revolutionized nursing and revolutionized the profession of nursing. A
social reformer and statistician, Florence Nightingale invented modern nursing.

Expound this line: "Care for one, that's love; Care for hundreds, that's nursing"
A nurse is someone who provides hands-on care to patients, monitors patient’s
condition, maintain records and communicate with doctors, but apart from all
these above duties, she has the ability to brighten everyone’s day with just a
small gesture. They are the one who spends a lot of time with the patients
keeping worries aside and carries a lovely smile on their face all the time.
Ultimately, the bulk of the patient’s care and safety falls onto the shoulders of the
nurse. They are responsible for the majority of the care given by everyone else
on the floor even the doctors.

It is rightly said when you care for one, that’s love and when you care for
hundreds, that’s Nursing so let us be grateful to all the nurses around the world.
 Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar

College of Nursing and Allied Health Sciences

Activity 2B in THEORETICAL FOUNDATION OF NURSING

1st Semester, SY 2022-2023

FLORENCE NIGHTINGALE'S LIFE AND WORKS

(REFLECTIVE JOURNAL)

Rebese, John Lloyd G.

BS in Nursing 1-E

Danhil C. Donoga, RN, PhD

Instructor

November 30, 2022

Guide Questions:

Why was Florence Nightingale called the Lady with the lamp?

Florence was very dedicated to her job. She would often visit the soldiers at night
when every one was asleep just to make sure they were ok. She was then
referred to as “The Lady of the Lamp” because she hardly took time off to sleep.
Florence became a true hero to the soldiers and everyone back home in
England. During the Crimean War, she was put in charge of nursing. She carried
a lamp as she walked the halls of the battlefield hospital and became known as
the "lady with the lamp".

Why was she called the Mother of Modern Nursing?

She worked tirelessly to ensure that the patients in her care had all they needed
to get well. Her Environmental Theory revolutionized nursing by establishing
sanitary working environments for patients and nurses. Florence Nightingale, the
creator of modern nursing, was an English social reformer and statistician.

Why is nursing a noble profession?

Nursing is a noble profession which requires strong commitment, a great deal of

tolerance and a deep sense of immolation for humanity. A nurse is a person
whose job is to take care of the sick. While both males and females work as
professional nurses, the latter are there in majority.

How Florence Nightingale changed your perspectives about nursing?

 My view on nursing care, improving quality means solving problems that matter
to patients – Nightingale's call to reduce human suffering helps set the standard
for compassionate, patient-centered care to meet patients' needs and desires.
She supports innovations aimed at treating patients with dignity and respect.

In what instance/situation in your life where you think Nightingale's Environmental

Theory can be applied the most? Why?

Her work focuses mostly on the patient and the environment but also includes the nurse
and health. For instance, it was the nurse’s duty to alter the patient’s environment so
that nature could act on the patient and repair health
.