Nightingale's Environmental Theory

The Environmental Theory

Theoretical Sources

Education: Nightingale is a very good mathematician (a nurse statistician) and a philosopher.
Her aunt Mai describes her as "a woman with great mind."

Literature: Her political inclinations were from the ideologies of Stanley Herbert (family friend).
Dicken's novel "The Adventures of Martin Chuzzlewit", a novel with a that portrays a victorian drunken, untrained and inexpert nurse causes an stigma and bad impressions about nurses. The novel greatly affects her beliefs about being a nurse and pursue the battle to change the negative stigma about nurses.

Intellectuals: Political leaders like John Stuart Mill, Benjamin Jowett, Edwin Chadwick and Harriet Marinue greatly affects and influence her beliefs of changing things as she viewed as unacceptable to society.

Religious Beliefs: For Nightingale, an action for the benefit fo others is called "God's Calling". As stated in her diary, "God spoke to me in silence and he called me to services" - DUM VIVIMUS, SERVIMUS.

Use of Empirical Evidence
She uses the polar diagram (statistical diagram) in her reports, books and letters.
She is a very good researcher and a great statistician.

According to Palmer, Nightingale has a very excellent research skills, she is good in recording, communicating, ordering, coding, conceptualizing, inferring, analyzing and synthesizing. Her focus is on the observation of social phenomena. She highlighted the use of observation and the performance of tasks in the nursing education.

Major Concepts and Definitions
Environment - concepts of ventilation, warmth, light, diet, cleanliness and noise. She focus o the physical aspect of environment.

She believed that "Healthy surroundings were necessary for proper nursing care."

5 essential components of healthy environment:
1. pure air
2. pure water
3. efficient drainage
4. cleanliness
5. light

Concerns of Environmental Theory
1. Proper ventilation focus on the architectural aspect of the hospital.
2. Light has quite as real and tangible effects to the body. Her nursing intervention includes direct exposure to sunlight.
3. Cleanliness and sanitation. She assumes that dirty environment was the source of infection and rejected the "germ theory". Her nursing interventions focus on proper handling and disposal of bodily secretions and sewage, frequent bathing for patients and nurses, clean clothing and handwashing.
4. Warmth, quiet and diet environment. She introduce the manipulation of the environment for patient's adaptation such as fire, opening the windows and repositioning the room seasonally, etc.
5. Unnecessary noise is not healthy for recuperating patients.
6. Dietary intake.
7. Petty management proposed the avoidance of psychological harm, no upsetting news. Strictly war issues and concerns should not be discussed inside the hospital. She includes the use of small pets of psychological therapy.

Nursing Metaparadigm

Nursing
Nursing is very essential for everybody's well-being. Notes on nursing focus on the implementation and rendering efficient and effective nursing care.

Person
The patient is the focus of the environmental theory. The nurse should perform the task for the patient and control environment for easy recovery. She practice nurse-patient passive relationship.

Health
Health is the being well and using every power that the person has to the fullest extent. A healthy body can recuperate and undergo reparative process. Environmental control uplifts maintenance of health.

Environment
People would benefit form the environment.

Theoretical Assertions
Prevention of interruption is very vital in the reparative process of the patient. Her focus is on nursing education that required even more training.

Nursing Practice is the application of common sense, observation, perseverance and ingenuity.

"If the person wants to recuperate, he needs to cooperate with the nurse."

Disease came from the organic materials from the patient and environment not on the germ theory. She totally disagree and rejected the germ theory.

Sanitation means the manipulation of the environment to prevent diseases.

Nursing is the commitment to the nursing works.

She gives a little focus on the interpersonal relationship and nurse caring behavior.

She believed that the nurse should be moral agents. "Think and act like a nurse."

Professional relationships, principles of confidentiality and care for the poor to improve health and social condition were the focus of her nursing care.

Logical Form
She used inductive reasoning from her experiences and observation with is address with logical thinking and philosophy.

Importance of Environmental Theory

Practice
1. Disease control
2. Sanitation and water treatment
3. Utilized by modern architecture in the prevention of "sick building syndrome" applying the principles of ventilation and good lighting.
4. Waste disposal
5. Control of room temperature.
6. Noise management.

Education
1. Principles of nursing training. Better practice result from better education.
2. Skills measurement through licensing by the use of testing methods, the case studies.

Research
1. Use of graphical representations like the polar diagrams.
2. Notes on nursing.

Evaluation of the Environmental Theory
Hardy evaluated the environmental theory as a grand theory because it explains the totality of the behavior. It is classified as lower-level theory but it provided the greates foundation of nursing education, practice and theories.

The Analysis

Simplicity: The theory is simply explained as the nurse, patient and environment interacts with each other. There are dangers in the environment and benefits from the good environment. The roles of environmental management to patient recovery is greatly emphasized. Manipulating the environment to prevent diseases. Nurse-patient relationship focus on cooperation and collaboration. Her care focus on eating patterns and food preferences of the patients, provision of comfort, protection from emotional distress and conservation of energy.

Generality: The universality of the concepts provide general guidelines and is still applicable and relevant today.

Empirical Precision: The theory is stated completely and presented facts. She uses quantitative research method. She focus on observation and experiences rather than systematic empirical research.

Derivable Consequences: Measures of independence and accuracy of care. Nurse-patient relationship towards wellness, environmental manipulation and psychological care.


References
Octaviano, E.F. & Balita, C.E. (2008). Theoretical Foundations of Nursing: The Philippine
Perspective, 63–72. Philippines: Ultimate Learning Series.

Tomey, A.M. & Alligood, M.R. (2002). Nursing Theorists and Their Work. 5th ed. Missouri:
Mosby, 65–75.