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TaneT LETICIA SUAREZ RN TANESHA HIPPOLYTE RN SOFIA WARREN RN
GROUP 3 Born: 1820
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Florence Nightingale was a pioneer in the nursing field.
Despite parental objections Florence decide to become a nurse.
Nightingale went to Kaiserworth in Prussia to study nursing. Even
then her views were being noticed. By 1853 she became the unpaid
superintendent of Londons Institute for the Care of Sick
Gentlewomen. From 1854-1856 Florence Nightingale became a patient
advocate by establishing more sanitary conditions in patient care
settings. Florence started focusing on nursing administration. She
always made time to make nightly visits to the wards. She was
called The Lady of The Lamp. The mortality rate at the military
hospital decreased from sixty percent to two percent six months
after her arrival. 2
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Florence Nightingale was the first Nursing Theorist.
Nightingale began collecting information about her theory by her
experiences in the Crimean War. She maintained written
documentation (statistical analysis). 1860 Nightingales theory was
published. Nightingale laid the foundation for professional
nursing. Notes on Nursing summarized the principals of nursing.
1869 Nightingale along with Dr. Blackwell opened the Womens Medical
College. 1870 Nightingale mentored Linda Richard, Americas First
trained nurse. 1883 Nightingale was awarded the Royal Red Cross by
Queen Victoria. 1907 The first women to be awarded the Order of
Merit. 1908 Nightingale was given the Honorary Freedom of the City
of London. 1857 Although Nightingale became bedridden due to
illness, she continued pioneer work in the field of hospital
planning. 3
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CRIMEAN WAR
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The environmental theory, which incorporated the restoration of
the unusual health status of the nurses client into the delivery of
heal care is still practiced today. (Wikipedia) She viewed the
environment as controllable to enhance a patient recovery. The
nurse was responsible for planning environmental factors
appropriate for restoration of health. Factors that were included
in the environment theory were: ventilation, warmth, light, noise,
bed & bedding, cleanliness of rooms & patients, nutrition,
hope, observation of the sick, and social consideration. 5
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VENTILATIONLIGHTWARMTH CONTROL NOISE CONTROL ODOR 6
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7 THE HEALING ENVIRONMENT
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Person Environment NursingHealth 8
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The person exists in their environment. The patient
interrelates with the family and their community. Nursing performs
tasks for the patient, aiding in their recovery by controlling and
enhancing the environment. Patient independence is also promoted.
Nightingale believed nursing was responsible for a patients
personal choices and behavior. Nightingale viewed her patients with
respect, regardless of religion, race or wealth. 9
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The environment is the foundation of Nightingales Theory.
Nurses enhance natures healing powers by manipulating the
environment. Nurses promote a therapeutic environment increasing
the patients health. Nursing promotes the healing process by
providing an environment that is clean, warm, odorless and full of
light. 10
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Nightingale views health as a patients well being. She viewed
illness and disease as occurring when a person did not attend to
their health issues. The prevention of disease related to
environmental control and social responsibilities. Nightingale
promoted public health nursing and health prevention and promotion.
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Nursing assist patients in achieving their best physical
condition for natural healing to occur. Notes on Nursing is a guide
for nursing principles and care for patients at home. Nurses need
to assess, implement, evaluate and document their patients health
status. Nursing induces the health of a patient by promoting an
adequately controlled environment 12
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13 NIGHTINGALES LATER YEARS Died: 1910
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Nightingale describes the nursing role in optimizing the
environment for healing. The model demonstrates Nightingales
recognition of human nature, the environment, and the biological
and social aspects of care. Nightingale focused on the reformation
of hospital sanitation. Nightingale integrated data collection, use
of statics and mathematical data in evaluation and decision making.
The phenomenon of environment in nursing practice has impacted the
expanding nursing knowledge in the realm of human health. 14
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15 Polar-Area Diagram
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Ventilation Warmth Light Cleanliness Diet Noise
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Proper ventilation was one of the greatest concerns of
Nightingale. As quoted keep the air he breathes as pure as the
external air, without chilling him (Nightingale, 1969, p.12)
Nightingale recognized and placed great emphasis on proper
ventilation as a source of disease and recovery (Marriner, 2010, p.
75) According to Nightingale, the nurse is to control or manipulate
the environment continually to maintain ventilation and patient
warmth by using good fire, opening windows and proper positioning
of the patient in the room(Marriner, p. 75) 17
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One of Nightingales concepts for measuring the patients body
temperature was through palpation of the extremities to check for
heat loss (Marriner,2010, p 75)
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Nightingale identified direct sunlight as a need of patient.s
As quoted by Nightingale light has quite as real and tangible
effects upon the human bodyWho has not observed the purifying
effect of light, upon the air of a room? (Nightingale, 1969,
pp84-85) Beneficial effects of sunlight are achieved if nurses move
and position patients to expose them to sunlight, according to
Nightingale. 19
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Cleanliness is a critical component of Nightingales
environmental theory (Nightingale,1969). According to Nightingale,
dirty floors, carpets, bed linens,walls etc are a source of
infection through the organic matter it contained (Marriner, p.75).
Proper handling and disposal of bodily excretions and sewage are
required to prevent contamination of the environment, as noted by
Nightingale (Marriner, p. 75). Nightingale advocated frequent
handwashing, which is now known as the # 1 prevention of infection.
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Nightingale noted that the nurse is required to assess the need
for quietness (Marriner, p.76). According to Nightingale, noise
created by physical activities in areas around a patients room
could be harmful to the patient and should be avoided (Marriner, p.
76). 21
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According to Nightingales concept of diet, the nurse is to not
only assess the dietary intake of, but also the meal schedule and
the effect of the food on the patient. (Marriner, p.76) Nightingale
also noted, intelligent nurses were those who were successful in
meeting their patients nutritional needs. (Marriner, p. 76) 22
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Through evidenced based practices, this model can be used in
clinical practices today with focuses on Internal and external
components of the environment Ventilation Food Water Light
Temperatures Medications Sanitation 24
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Individuals receiving nursing care. Conceptualizing that the
improvement of health in individuals and families can lead to a
improved health of society. 25
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Dirt-refers to general hygiene, and interpersonal contact
Drinkcleanliness of drinking water and the importance of drinking
water Dietrefers to proper and balanced diet Damprefers to a need
for a dry, warm environment Draughts--refers to drafts can
precipitate a disease episode Drainsrefers to proper drainage and
sewage systems 26
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Evaluating and assessing the patients needs based upon the
individualized care needed. Nursing Process Education Family
centered care 27
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Nightingale noted that training is to teach not only what is to
be done, but why it is done. Having a balance of hands on
experience as well as knowing the theoretical reasoning is very
important according to Nightingale. According to Nightingale,
nurses must be excellent observers and were to be trained
specifically to provide care for the sick person. (Marriner, p. 79)
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Development of evidenced-based-practice (EBP) for nursing with
current and best research findings being used to deliver
healthcare. This model according to current research, has been
building sound knowledge base for nursing practice through
quantitative and qualitative research. Outcome research is
conducted to examine both short-term and long-term results of
patient care. Use of intervention research, which examines the
effectiveness of nursing actions in promoting healthy outcomes for
patients and families. 29
Florence Nightingales philosophy of nursing was derived from
working in varied conditions. Nightingale had been an examiner of
hospital facilities, reformatories, and charitable institutions as
well as caring for the sick in hospital and on the battlefield, the
conditions of these various environments often deplorable.
Nightingale recognized that ones environment was universally
important to health and well-being (Alligood and Tomey, 2010, p.
72). 33
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Nightingale recognize the potential harmfulness of an
environment, and she emphasized the benefit of a good environment
in preventing disease (Alligood & Tomey, p. 82). Thus the goal
being to manipulate the environment to promote health as well as
prevent disease, by promoting cleanliness, good sanitation and
proper ventilation. 34
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Nightingales philosophy of nursing care addressed the basic
concepts of air quality, cleanliness and sanitation. Using
inductive reasoning she deduced that a contaminated, dirty, dark
environment breed disease( Alligood & Tomey, p.79). Through her
experiences and observations she recognized that not only could
disease be prevented from flourishing, by controlling the
environment, but that disease could be prevented by manipulating
the environment (Alligood & Tomey p. 79). 35
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Nightingales philosophy of nursing care is foundational to
modern nursing theory and nursing practice. The tenants of
environmental control are as relevant today as they were 150 years
ago. As the founder of modern nursing Nightingale has laid the
ground work for modern nursing theorists. 36
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Florence Nightingale is recognized as the founder of modern day
nursing. Her Environmental Model is based on the idea that healing
lies within the individual and the focus of care is to place the
individual in an environment that fosters the healing process. This
basic concept has been the impetus for the foundation of modern
nursing theory. 37
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Limitations
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One only needs to read Nightingales Notes on Nursing, to deduce
the concepts that she intended to promote. The concepts that are
written about are most often principles that are derived from
anecdotal situations to their meaning and support their claims
(Alligood & Tomey, p. 81). Nightingales writings lack the
testing and complexity of modern nursing theory, but there is no
doubt that these early concepts have served as the basis for modern
research (Alligood & Tomey, p. 81). 40
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Ventilation and Warming Health of Houses Petty Management Noise
Variety Taking food What food? Bed and Bedding Light Cleanliness of
Rooms and Walls Personal Cleanliness Chattering Hopes and Advices
Observation of the Sick 42
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Florence Nightingale is recognized as the founder of modern day
nursing. Her basic ideas about the care of the patient and the
environment are directly or indirectly represented in the works of
many nursing theorists. The environment and care of the environment
will continue to be relevant far into the future as our world is
ever changing. Although Nightingales theory lacked in complexity
and testing it has proven to be foundational in the development of
subsequent nursing theories. 43
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55 AWARDS
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On-line Florence Connection Florence Nightingales Museum
website Woodham-Smith, C. (1983). Florence Nightingale. New York:
Atheneum. Cohen, I. B. Florence Nightingale, Scientific American,
(March 1984), 128 -137. Tomey, A. M., & Alligood, M. R. (2010).
Nursing theorists and their work. (6th ed.). St. Louis, MO: Mosby
Elsevier. Nightingale, F. (1969). Notes on Nursing. New York, NY:
Dover Publications, Inc. Barnham, Kay. (2003). Florence
Nightingale: The Lady of the Lamp. Austin, TX: Steck- Vaughn.
Small, Hugh. (1998) Florence Nightingale Avenging Angel. New York,
NY: St. Martins Press. 73
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Group #3 How does Nightingales concept of the environment
impact human health? How did Nightingales contributions move
nursing into a profession? Nightingale is considered the first
nursing theorist. How can you apply her environmental theory in
your nursing practice? Give an example. 74