Abstract

The Environment Theory, as discovered by the founder of modern nursing, Florence Nightingale, places great emphasis on the individual needs of patients as it pertains to their surrounding environment. It establishes the nurse’s role in providing an environment suitable for optimal patient recovery and allowing the body to self-heal. This places a great emphasis on a holistic approach to patient-centered care. Nightingale’s theory addresses each of the aspects of the nursing metaparadigm as well as outlines how it is utilized in every day clinical practice. Many of the techniques developed by Nightingale were adopted by modern nursing and continue to be crucial practices throughout the healthcare field. The Environment Theory also aligns with integrative nursing principles one and three: human beings are whole systems inseparable from their environments and nature has healing and restorative properties that contribute to health and well-being, respectively. Altering the environment of the patient reinforces the natural laws in which promote recovery from illness.

Nursing Theorist Analysis

Introduction

Florence Nightingale (1820-1910) served as a nurse during the Crimean War when she became the founder of the Environment Theory of nursing. This theory was based on the idea that in order to allow the natural laws to implement healing, the environment in which a patient resides must be altered in a way that allows for optimal recovery. These speculations were established when Nightingale noticed a relationship between the death of the soldiers she was caring for and the conditions of the environment they were placed. These conditions included “inadequate nutrition, dirty water, and inappropriate sewage disposal” (Selanders, 2010, p. 84). The theory strictly focuses on patient care and emphasizes the need to take into account how some factors may affect individuals differently. So having the capacity to alter these situations the best way possible in order to provide the necessary care for that individual patient’s needs and reach his or her desired health outcomes. Nightingale later concluded that there are internal and external components of the environment. Concerning aspects include elements like “food, water, and medications— as those that directly [affect] the external being, such as ventilation, light, noise control, stimulation, and room temperature” (Selanders, 2010, pg. 84). The presence of unsanitary environments greatly impacts the health status of an individual which has evolved through evidence-based research and become a huge practice and safety concern in modern nursing.

Nursing Metaparadigm

The nursing metaparadigm is a nursing discipline that includes four concepts that address the holistic approach of caring for patients. Nightingale’s theory of nursing places most of the focus and emphasis on the environment component of the metaparadigm. Nurses are to provide a clean setting for rehabilitation in order to restore complete health. This is an aspect of patient care that is implemented in every day clinical practices. For example, ensuring the patient is entering a clean room with clean sheets and blankets, proper ventilation, and controllable temperatures. The healthcare staff is also following all patient safety protocols including hand hygiene, maintaining sterile fields and changing soiled linens when appropriate. All to provide the best possible environment to promote recovery for the patient, which is what Nightingale was striving to do through the development of her theory.

The next component of the metaparadigm is the client. Nightingale viewed individuals as being multidimensional and composed of “biological, psychological, social, and spiritual components” (Selanders, 2010, p. 85). She mainly addressed the psychological component which consisted of feelings and intellect being able to directly cause illness amongst individuals. The third component is health, which Nightingale perceived as being at the best state of health possible at any specific point in time. She considered health as a relative state. For a person to be healthy, they do not have to be free of disease or illness, just “maximize optimal potential to be in a healthy state” (Selanders, 2010, p. 85).

The final component is the nursing practice. Nightingale outlines the role of the nurse as being responsible for placing the patient in the most suitable conditions in which allow nature to act on. This promotes a very patient-centered relationship. The health status of the patient is maintained through the proper preservation of the environment and relationship built by the nurse. An example of this aspect performed in everyday practice performing hourly rounds on patients and making sure the nurse call light is within reach of each patient at all times so if anything is needed to improve the comfort of the patient, the nurse is accessible at all times.

Integrative Nursing Principles

Per Nightingale’s theory, poor health results from poor environments (Selanders, 2010, p. 84). The first integrative nursing principle states that human beings are whole systems inseparable from their environment. The general definition of environment, which Nightingale used to form her theory reveals “environment is anything that through manipulation, assists in putting the individual in the best possible condition for nature to act” (Selanders, 2010, p. 84). This addresses crucial aspects of everyday nursing practices including hand hygiene, providing proper nutrition and fluids, cleansing the patient, etc. These are all important skills that are now required of nurses to obtain prior to licensing in order to ensure the safety of the patient and assisting staff as well as prevent the spread of infection.

Nightingale’s theory includes thirteen canons, a few of which specifically pertain to nature itself. She placed emphasis on the idea that natural elements could aid in the restoration of health. This concept coincides with the third integrative principle which states nature has healing and restorative properties that contribute to health and well-being. The canons that directly correspond are ventilation, temperature, light, and noise. Nightingale believed that the absence of fresh air would eventually lead to sickness and the patient would stay that way, hindering the healing process. Also, becoming ill could be promoted by whether an individual is too hot or cold, lack of exposure to direct sunlight, and disruption of sleep by any kind of noise. All of these components are considered natural healing interventions.

Florence Nightingale made huge contributions to modern-day nursing. The observations she made in the mid-Victorian era were quickly adopted by the healthcare field and have continued to evolve to shape the nursing profession as we know it today.

References

• Selanders, L. (2010). The Power of Environmental Adaptation: Florence Nightingale’s Original Theory for Nursing Practice.
  
  Journal of Holistic Nursing 18
  
  (1), 81-88. doi: 10.1177/0898010109360257