Nightingale’s Philosophy in Nursing

Practice Theory Overview.

Nightingale’s philosophy primarily focuses on the environment, and the patient’s
response to their environment. Nightingale’s theory is founded on the
belief that a patient’s environment could be altered in order “to allow
nature to act on the patient” (Alligood, 2002, p. 84). The nurse and
health are also important components in Nightingale’s theory.
Environment, person, health, and nursing—the foundation of
Nightingale’s theoretical framework.

“I use the word nursing for want of a better word. It has been limited to signify little
more than the administration of medicines and the application of
poultices. It ought to ought to signify the proper use of fresh air,
light, warmth, cleanliness, quiet, and the proper selection and
administration of diet—all at the least expense of vital power to the
patient.” Florence Nightingale ("Florence Nightingale", n.d.)
 Nightingale’s Philosophy in Nursing
Practice Conclusion.
Nightingale was a nursing pioneer (the first nursing theorist) and a healthcare/ hospital
reformer . Her revolutionary sanitation methods improved the hospital
environment; she applied her theory to practice and reduced disease
and mortality rates (a considerable accomplishment since the germ
theory was only just beginning to emerge during this time). She
focused on preventative measures and statistical analysis of real data
to support her arguments for change. Nightingale’s visionary ideas
defined and elevated nursing, and improved healthcare dramatically
during her lifetime. Even today, over a century later, Nightingale’s
Philosophy in Nursing Practice continues to influence nursing and
healthcare. ("Biographies", n.d.)

“…it does no good to pray to God to save us from disease as we continue to drain our
sewage into the lakes from which one drinks.” & "Diseases are not
individuals arranged in classes like cats and dogs, but conditions
growing out of one another. The specific disease is the grand refuge of
the weak, uncultured, unstable minds, such as now rule in the medical
profession. There are no specific diseases; there are specific disease
conditions.” Florence Nightingale ("Florence Nightingale", n.d.)
 Nightingale’s Philosophy in Nursing
Practice Theory Overview.
Environment
Environment can be defined as anything that can be manipulated to place a patient
in the best possible condition for nature to act—to promote health and
healing.

Physical components include areas such as ventilation, warmth, light, nutrition,

medicine, temperature, stimulation, and activity.

Psychological components include stimulating the patient’s mind, avoiding chattering

hopes and advices (needless talk or false information), and providing variety.

Nightingale’s Philosophy in Nursing

Practice
Person
The one who is receiving care—Nightingale believed in a holistic view of a dynamic and
complex being, comprised of the following components:

•Physical •Intellectual •Emotional •Social •Spiritual

Health
Nightingale viewed health as natural, a ‘reparative process’ and disease as the
interruption of nature’s process (explained as the lack of some need,
such as ventilation, or warmth—the canons) (Nightingale, 1860).
Nightingale also believed in health prevention and promotion
(inferred from the following quote) “Health is not only to be well, but
to be able to use well every power we have.” Florence Nightingale
("Florence Nightingale", n.d.)
 Nightingale’s Philosophy in Nursing
Practice

Nursing
Nightingale worked diligently to define nursing and delineate the boundaries of nursing
care. As the first nursing theorist, her pioneering efforts in this area
set the standard for others who followed. Nightingale’s beliefs were
historically significant for nursing, she believed that: 1) nursing was a
spiritual calling requiring ethics and a societal commitment to help
those suffering, 2) nurses should be formally educated to provide
quality care (in contrast to the ‘lay-person nurse’ of that time era).

She also defined three different types of nursing:

1. Nursing proper- nursing the sick

2. General nursing- health promotion
3. Midwifery nursing

Nightingale viewed nursing as the ‘science of environmental management’ (with nurses

altering the patient’s environment to promote health and healing).
(Alligood, pp. 84-85)
 Nightingale’s Philosophy in Nursing
Practice
Nightingale identified 13 canons to form the boundaries of nursing practice and
expected nurses to be ‘clear thinkers’ and ‘independent’ in their
judgments.

1. Ventilation and warmth: The circulating air should be as pure as the

outside air and at an adequate temperature to keep the patient warmed.
2. Light: Direct light contains healing properties for the patient and purifies the
air of the room.
3. Cleanliness of rooms and walls: Rooms should be kept clean and free of
dust/debris associated with the ventilation necessary for health.
4. Health of houses: Maintaining a healing environment goes beyond just
cleanliness, this also includes the air, water, sanitation and light.
5. Noise: Any loud noise that jars a patient awake and subjects them to a state
of excitement is more harmful than continuous noises, however loud.
6. Bed and bedding: The sick should be provided with clean bedding every 12
hours, beds should be narrow and safe in height, positioned in lightest area of
the room or near windows, and have adequate pillow support to the head and
back to promote breathing.
7. Personal cleanliness: Allowing patients to be soiled and unclean hinders
the natural process of health and contributes to the condition in which disease
flourishes.
8. Variety: Monotony and redundancy of surroundings are harmful to patients
mental state of being, variety in surroundings are most beneficial to health.
9. Chattering hopes and advices: Visitors, families and caregivers should not
attempt to cheer patients by giving false hopes.
10. Taking food: The amount of food taken and the amount of food needed
should always be considered.
11. What food: We shouldn’t analyze the types of food, but rather analyze the
patient’s tolerance and system reactions to foods.
12. Petty Management: Knowing what to do when you are there, and what
shall be done when you are not there (providing continuity of care through your
documentation).
13. Observation of the sick: Observing the patient for indications of condition
change, and to know how to judge the importance of such changes.
While Nightingale’s canons do not specifically address spirituality, she viewed the patient in
a holistic manner having a spiritual dimension as well. (Alligood, pp. 86-
87)