1. Nursing Theorists Group Presentation
Julie Dragt, Megan Strockis, & Wendy DeBruyn

2. Florence Nightingale

3. Introduction to Florence Nightingale
Florence Nightingale lifespan from
International nurses day is observed on May 12th each year in honor of Nightingale's contributions to the nursing field.
Nightingale is known as "the founder of modern nursing."
She completed her nursing training in 1851.
Nightingale was the leader in advocating that nurses receive formal education and training.
Some refer to Nightingale as "The Lady with the Lamp."
She was a pioneer of statistics in the nursing field by creating graphs and charts to improve conditions for patients.
(Alligood & Marriner Tomey, 2010)

4. What made Florence Nightingale who she was?
Florence Nightingale's education was of high quality and ahead of most other woman of her time. Her father educated her on mathematics, languages, religion, and philosophy. Philosophy and statistics were major influences in her lifelong work as a nurse.
Years before she went to nursing training she wrote in her diary about how she had a "calling" to give service that was derived from God.
(Alligood & Marriner Tomey, 2010)

5. Cont....
In 1854, Nightingale was a nurse for the soldiers in the Crimean War. She requested that severe modifications be made to the camps to aid with survival for the soldiers. The camps needed to be cleaner, the environment needed to be more acceptable to healing and free from additional elements of complications. She would use a lamp at night and perform rounds on the soldiers. This is how she became known as "The Lady of the Lamp." For all of her hard work and dedication she earned high respect from the soldiers, however she struggled for support from the physicians and military officers.
(Alligood & Marriner Tomey, 2010)

6. Cont....
After the Crimean War Florence Nightingale started schools with the earnings that she received. The schools provided nursing training at two hospitals in London. This was the start in her efforts to promote nursing as a profession.
(Alligood & Marriner Tomey, 2010)

7. Concepts to Professional Nursing

8. Defining the four global concepts:
Nursing: The act of utilizing the environment of the patient to assist him in his recovery (Nightingale,1860).
Nightingale considered a clean,well-ventilated, and quiet environment essential for recovery. Often considered the first nurse theorist. Nightingale raised the status of nursing through education. Nurses were no longer untrained housekeepers but people educated in the care of the sick.

9. Defining the four Global Concepts Cont...
Health: Not only to be well, but also to use well every power that we have, can be used to describe health for both individuals and communities (Nightingale, 1860).
Health is highly dependent on where and how we live. The vision of "health" varies with each person. it relates to the global concepts because you need health to complete a state of physical, mental and social well-being.

10. Defining the four Global Concepts Cont...
Environment: Internal (within the person) and external (outside the person) surroundings and structures that influence quality of human life.
An environment is constantly changing, it is never stagnant. A person's environment can impact their health and in turn relate back to the global concepts.
(Masters, 2009)

11. Defining the four Global Concepts Cont...
Human Being: Viewed as open energy fields with unique life experiences.
Humans are complex and diverse and they enable one to increase knowledge of self and the environment. Human beings are viewed to value, respect, nurture and understand how and when to make the informed choices regarding their health.
(Loser, 2013)

12. Nightingale's Philosophy
Nightingale understood well the elements of a healthful environment in which restoration and preservation of health and prevention of disease and injury were possible.
Nightingale recognized the need for health, as she build a nursing school to provide others with the knowledge to
serve the sick, with this
education she helped
improve healthcare for all. E
NVIRONMENT H E A L T

13. Nightingale's Philosophy
Florence devoted her life to the service of others. She had a strong calling to nursing that allowed her to help and care for all human beings.
Proper wound care and sterilization all started with Florence Nightingale's nursing vision. She taught her students to not only concentrate on nursing tasks but to focus
on the patient as a whole,
responding to
psychological and social
aspects as well. P
ERSON
NURS I NG

14. Clarification of Origins
Florence Nightingale wrote:
"Nursing ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet" (Domrose, 2011).
The philosophy is not necessarily unique to nursing.
- Can be used in many disciplines involving the care, comfort, or education of others. For example, schools ensure these same outcomes in the classroom and in the school feeding program.

15. Nightingale Model of Nursing Practice
Nurse Observe Document
Patient
Identify Environmental
Alteration
Determine Outcome Change Document
and Environmental
Change (Selanders, 2010)

16. What Influenced Nightingale's Model?
Environment is the umbrella concept of this theory of nursing.
The model grew from Nightingale's observation of poor environments that led to poor health and disease. These observations included: dirty water, inappropriate sewage disposal, poor nutrition, filth, and poor ventilation.
This model was also influenced by the need to develop nursing into a profession.
(Selanders, 2010)

17. Does the Model describe the 4 global concepts?
-Nightingale did not specifically write in terms of the paradigm of nursing but each component is clearly addressed.
- The model was developed well before the paradigms of nursing were formally established but Nightingale, being the visionary that she was, believed in holistic health.
- Nightingale perceived that people were multi-dimensional, being composed of biological, psychological, social, and spiritual components.
(Selanders, 2010)

18. Examples of the Model in Nursing Practice
This model is used daily when providing nursing care in any patient care area. These areas could include OB, OR, med surg units, long-term care, critical care, hospice or any other patient care area.
This model is used daily when providing nursing care
Control visitors under certain circumstances
Room is tidy, bed is clean and not soiled
Patient is bathed
Halls and nursing unit are free of excessive noise
Patient's are provided fluids and food with intake documented
Patient is not awakened unless necessary
Primary nursing is appropriately administered if applicable

19. Other Theories Generated from Nightingale's Model
Roy Adaptation Model
- This model focuses on the adaptation of the patient to the environment.
- Consistent with Nightingale's emphasis on the environment in relation to ones health.
Virginia Henderson
- She has been called the Florence Nightingale of the 20th century.
- Henderson continued to define the role of nursing that Nightingale initiated.
(Selander, 2010)

20. Cont.... Maslow's Hierarchy of Needs
- Nightingale's Model is philosophically consistent with Maslow. This is demonstrated by nursing's role in meeting the needs of the patient.
- Maslow's physiological, safety, and security needs are addressed by Nightingale's 13 Canons.
- Maslow's love/belonging and self esteem needs are addressed by Nightingale's Function of Nursing.
- Maslow's self actualization level is addressed by Nightingale's Place of Women in Society.
(Selanders, 2010)

21. Cont.... Jean Watson Model on Caring
- This model is also based on the environment and the need for harmony to promote health or prevent disease.

22. Conclusion
Florence Nightingale is often overlooked because she is viewed as "what was." In reality, her contribution was wisdom through vision. She prompted the question, "What is nursing?" and "What is the nursing profession?" These questions have been researched extensively but still are relevant and are not totally answered today.
(Chitty & Black, 2011)
(Selanders, 2010)

23. Resources:
Alligood, M. R., & Marriner Tomey, A. (2010). Nursing Theorists and Their Work (Seventh ed., pp ).
Chitty, K.K., & Black, B.P. (2011). Professional nursing: Concepts and challenges (6th ed.) Maryland Heights, MO: Saunders
Domrose, C. (2011). Healing force: Florence Nightingale's teachings crossed Atlantic and the mason-dixon line during the American civil war. Retrieved from
Florence Nightingale, (1860). Nursing-Resource.com.
Lee, G., Clark, A. M., & Thompson, D. R. (2013). Florence Nightingale - never more relevant than today. Journal of Advanced Nursing, 69(2), doi: dx.doi.org.libcat.ferris.edu/ jan.12021

24. Resources Cont....
Loser, P. (2013). Metaparadigm Concepts: Nursing. In College of New Jersey. Retrieved February 13, 2013, from philosophy/metaparadigm-concepts/#header
Masters, Kathleen. Role Development in Professional Nursing Practice. Sudbury, MA: Jones and Bartlett Publishers, Web. 13 Feb <
Selanders, L.C. (2010). The power of environmental adaptation: Florence Nightingale's original theory for nursing practice. Journal of Holistic Nursing, 28, 81. doi: /

25. Case Study
1. You are a new nurse in orientation with a preceptor on the general medical-surgical floor of a 25 bed ward. You come in at the start of your night shift with a patient load of five patients. When you start your patient rounds you find that three of your patients haven't had a shower in three days, two of your patients dinner trays are still on their bedside tables, and there hasn't been any Intake or output charted on any patient since the admission charting.
What do you see that doesn't fit into the concepts of Florence Nightingale's theory of nursing?

26. Cont....
2. The next night you come into work for your shift on the same unit. Tonight you have four different patients. When you get report from the day nurse she informs you that the patient in room two has been complaining of the unit being very noisy. When you go into room two to do your assessment Mr. Smith is very upset because he has been woken up multiple times throughout the day due to noise and nurses laughing in the hallway. He also mentions that no one would help him with his shower today.
Is this patient response an appropriate response to how patients should respond to a hospital stay according to the concepts of Florence Nightingale's nursing theories?

27. Cont....
3. The third night you come into your night shift to five patients again. You get report on your patients and then start your rounds. You find that all of your patients have been bathed, fresh bedding, intake and output are up-to- date, the hallways remain quite, two of your patients are visiting with family at the bedside, and the other three of your patients are resting comfortably without complaints or concerns.
Does this patient assignment assessment follow the nursing theory concepts of Florence Nightingale?