FLORENCE NIGHTINGALE NOTES

Florence Nightingale, the founder of modern nursing, was born on May 12, 1820, in Florence, Italy,
while her parents were on an extended European tour; she was named after her birthplace

Despite being known as the heroine of the Crimean War, Florence Nightingale felt ill in August 1910.
She seemed to recover and was reportedly in good spirits, however, she developed an array of
troubling symptoms a week later, on the evening of Friday, August 12, 1910. She died unexpectedly at
2 pm the following day, Saturday, August 13, at her home in London

Respecting her last wishes, her relatives turned down a national funeral and the “Lady with the Lamp”
was laid to rest in her family's plot at St. Margaret' s Church, East Wellow, in Hampshire, England.

The Nightingales were a well-educated, affluent, aristocratic Victorian family with residences in
Derbyshire (Lea Hurst their primary home) and Hampshire (Embley Park). This latter residence was
near London, allowing the family to participate in London’s social seasons.
Although the extended Nightingale family was large, the immediate family included only Florence
Nightingale and her older sister, Parthenope.

During her childhood, Nightingale’s father educated her more broadly than other girls of the time. Her
father and others tutored her in mathematics, languages, religion, and philosophy (influences on her
lifework). Although she partcipated in the usual Victorian aristocratic activities and social events
during her adolescence, Nightingale developed the sense that her life should become more useful.

Nightingale developed the sense that her life should become more useful. In 1837, Nightingale wrote
about her “calling” in her diary: “God spoke to me and called me to his service” The nature of her
calling was unclear to her for some time.

After she understood that she was called to become a nurse, she was able to complete her nursing
training in 1851 at Kaiserswerth, Germany, a Protestant religious community with a hospital facility.

After she understood that she was called to become a nurse, she was able to complete her nursing
training in 1851 at Kaiserwerth, Germany, a Protestant religious community with a hospital facility.
She was there for approximately 3 months, and at the end, her teachers declared her trained as a
nurse.

After her return to England, Nightingale was employed to examine hospital facilities, reformatories
and charitable institutions. Only two years after completing her training (in 1853), she became the
superintendent of the hospital for Invalid Gentlewomen in London.

During the Crimean war, Nightingale received a request from Sidney Herbert (a family friend and the
secretary of War) to travel to Scutari, Turkey, with a group of nurses to care for wounded british
soldiers. She arrived there in November 1854, accompanied by 34 newly recruited nurses who met
her criteria for professional nursing – young middle – class women with a basic general education.

To achieve her mission of providing nursing care, she needed to address the environmental problems
that existed, including the lack of sanitation and the presence of filth, (few chamber pots,
contaminated water, contaminated bed linens, and overflowing cesspools.) in addition, the soldiers
were faced with exposure, frostbite louse infestation, wound infections, and opportunistic diseases as
they recoverde from their battle wounds.

Nightingale’s work in improving these deplorable conditions made her a popular and revered person
to the soldiers, but the support of physicians and military officers was less enthusiastic. She was called
The Lady of the Lamp, as immortalized in the poem “Santa Filomena” (Longfellow, 1857), because she
made ward rounds during the night, providing emotional comfort to the soldiers
Nightingale’s work in improving these deplorable conditions made her a popular and revered person
to the soldiers, but bthe support of physicians and military officers was less enthusiastic. She was
called the lady of the lamp, as immortalized in the poem “Santa Filomena” because she made ward
rounds during the night, providing emotional comfort to the soldiers.

In 1907, she was conferred the Order of Merit by King Edward, becoming the first woman to receive
the honor.
International nurses day observed annually on May 12, commemorates her birth and celebrates the
important role of nurses in health care.

Nightingale’s theory focused on environment, however Nightingale used the term surroundings in her
writing. She defined and described the concepts of ventilation, warmth, light, diet, cleanliness, and
noise—components of surroundings usually referred to as environment in discussions of her work.

Her theoretical work on five essential components of environmental health (pure air, pure water,
efficient drainage, cleanliness, and light) is as relevant today as it was 150 years ago.

Proper ventilation for the patient seemed to be of greatest concern to Nightingale; her charge to
nurses was to“keep the air he breathes as pure as the external air, without chilling him” (Nightingale,
1969, p. 12). Nightingale's emphasis on proper ventilation indicates that she recognized the
surroundings as a source of disease and recovery. In addition to discussing ventilation in the room or
home, Nightingale provided a description for measuring the patient's body temperature through
palpation of extremities to check for heat loss (Nightingale, 1969). The nurse was instructed to
manipulate the surroundings to maintain ventilation and patient warmth by using a good fire,
opening windows, and properly positioning the patient in the room.

The concept of light was also of importance in Nightingale’s theory. In particular, she identified direct
sunlight as a particular need of patients. She
noted that “light has quite as real and tangible effects upon the human body . To achieve the
beneficial effects of sunlight, nurses were instructed to move and position patients to expose them to
sunlight.

Cleanliness is another critical component of Nightingale’s environmental theory (Nightingale, 1969).

In this regard, she specifically addressed the
patient, the nurse, and the physical environment. She noted that a dirty environment (floors, carpets,
walls, and bed linens) was a source of infection through the organic matter it contained. Even if the
environment was well ventilated, the presence of organic material created a dirty area; therefore,
appropriate handling

the sub concepts o the environmental theory.

Conceptual Framework of Nightingale’s Environmental Theory. Note that the client, the nurse, and
the major environment concepts are in balance; that is; the nurse can manipulate the environment to
compensate for the client’s response to it. The goal of the nurse is to assist the patient in staying in
balance. If the environment of a client is out of balance, the client expends unnecessary energy.

1. Health of Houses
“Badly constructed houses do for the healthy what badly constructed hospitals do for the sick. Once
ensure that the air is stagnant and sickness is certain to follow.”

2. Ventilation and Warming

“Keep the air he breathes as pure as the external air, without chilling him.”
Nightingale believed that the person who repeatedly breathed his or her own air would become sick
or remain sick. She was very concerned about “noxious air” or “effluvia” and foul odors that came
from excrement. She also criticized “fumigations,' for she believed that the offensive source, not the
smell, must be removed.
The importance of room temperature was also stressed by Nightingale. The patient should not be too
warm or too cold. The temperature could be controlled by an appropriate balance between burning
fires and ventilation from windows.

3. Light Nightingale believed that second to fresh air, the sick needed light. She noted that direct
sunlight was what patients wanted.

4. Noise
She stated that patients should never be “waked intentionally” or accidentally during the first part of
sleep. She asserted that whispered or long conversations about patients are thoughtless and cruel.
She viewed unnecessary noise, including noise from female dress, as cruel and irritating to the patient.

5. Variety
She discussed the need for changes in color and form, including bringing the patient brightly colored
flowers or plants. She also advocated rotating 10 or 12 paintings and engravings each day, week, or
month to provide variety for the patient. Nightingale also advocated reading, needlework, writing,
and cleaning as activities to relieve the sick of boredom.

6. Bed and Bedding

Nightingale noted that an adult in health exhales about three pints of moisture through the lungs and
skin in a 24-hour period. This organic matter enters the sheets and stays there unless the bedding is
changed and aired frequently.

She believed that the bed should be placed in the lightest part of the room and placed so the patient
could see out of a window. She also reminded the caregiver never to lean against, sit upon, or
unnecessarily shake the bed of the patient.

7. Personal Cleanliness
“Just as it is necessary to renew the air round a sick person frequently to carry off morbid effluvia
from the lungs and skin, by maintaining free ventilation, so it is necessary to keep pores of the skin
free from all obstructing excretions.”

“Every nurse ought to wash her hands very frequently during the day.”

8. Nutrition and Taking Food

Nightingale noted in her Environmental Theory that individuals desire different foods at different
times of the day and that frequent small servings may be more beneficial to the patient than a large
breakfast or dinner. She urged that no business be done with patients while they are eating because
this was a distraction.

9. Chattering Hopes and Advice

Florence Nightingale wrote in her Environmental Theory that to falsely cheer the sick by making light
of their illness and its danger is not helpful. She encouraged the nurse to heed what is being said by
visitors, believing that sick persons should hear the good news that would assist them in becoming
healthier.

10. Social Considerations

Nightingale supported the importance of looking beyond the individual to the social environment in
which he or she lived.