Florence Nightingale is the first person to present a nursing theory. Since her early age, she felt an inclination towards helping the poor and sick people. Her interest motivated her to study the subject of nursing. After getting her degree she visited several hospitals and understood their ways of healthcare delivery, and diagnoses of the diseases. She practised as a nurse in various hospitals in Italy, Germany and United Kingdom (Mackey, A., & Bassendowski, S, (2017). Her motivation can be best described by her services in Russia and Turkey when France and United Kingdom helped Turkey. Thousands of wounded soldiers got injured in this war and needed medical attention.
Florence Nightingale was asked to provide her services based on her good performance in the nursing field. Her service as a nurse for the wounded soldiers of England caused a great stress on her mind and she decided to devote her life to the field of nursing. Her love for the field of nursing motivated her to present a theory in 1859, called the Environmental Model, which contains her observations and experiences when she served wounded soldiers of the war (Butts, J. B., & Rich, K. L., 2013). She never intended to present the theory, rather she wanted to record her observations as a nurse and how according to her nursing should be practised. Her model took the shape of a theory due to its practical and descriptive nature. This paper will describe the Environment theory of nursing and provide a nursing practice model that can be used to deliver health care to people in modern age, the theory will be explained by graphical model and practical application methods will be described.
The delivery of healthcare to patients is greatly influenced by the environmental factors in which patients are kept. For patients’ comfort and quick recovery, the environment should be carefully maintained and optimized to ensure that patient does not feel any discomfort during his stay at the hospital and has mental satisfaction. For patients that have serious injuries, purified environments are needed so that no contamination or infection happens in open wounds. Similarly, the patients who are suffering from mental trauma or other nervous disorders need a peaceful and organized environment free of excessive noise and chatter. Therefore based on these special needs, every patient needs a specific environment adjusted for him so that he does not experience any physical or mental tension. Florence nightingale’s environmental theory provides a model that can be used in the nursing care of patients
Florence Nightingale’s Environmental model
The Environmental model of Nursing provided by Florence Nightingale is based on the thirteen cannons that she thought are necessary for the perfect nursing care of patients. These cannons are a collection of environmental factors that ensure patient’s maximum comfort. The model focuses on providing the best environment to the patients so that they can recover quickly and do not have to spend excessive energy to overcome the environmental factors (Butts, J. B., & Rich, K. L, 2013). For example, if a nurse treats the patient without ensuring proper cleanliness she is taking risk of a possible infection to the patient who might get infected. This will create new problems for the patient and his body will have to do excessive work to fight infection.
The major concepts of the environmental theory are as follows:
The concept of nursing as explained by environmental theory is to provide all necessary measures against the disease. The nurse on service is obliged to provide her best care to the patient so that he does not get exposed to any risks and stays in the optimized environment. This optimized environment includes proper bedding, cleanliness, diet, air, hygiene, light and several other necessary factors.
Human beings are defined by the theory based on their relationship with the environment and how environments act upon them. Although the model depicts nurse and patient to be the two main influencers in the process it does not directly involve them, rather than by their actions or the factors acting upon them.
The concept of health is not directly included in the theory but its importance can be observed in the model as the aim of the whole nursing practice is to ensure the health of the patient. If a patient does not improve health in a hospital due to poor nursing facilities the whole purpose of nursing care fails.
The environment is the most important part and the main focus of the model. It includes the factors that actively or passively affect patient’s health and may become a possible reason for extra exertion (Butts, J. B., & Rich, K. L, 2013). The model surrounds the patient with these factors and places the nurse as the force who is responsible for ensuring proper management of these factors. The factors take input from the nurse and act upon the patient whereas the patient reacts to those factors either positively i.e. by improved health or negatively i.e. by deteriorating health.
- The patients should not be disturbed by any noise and discussions between nurses should never disturb patients.
- The air of environment should be free of any smell and pollution and proper ventilation should be ensured.
- The building and furniture should be carefully maintained.
- Variety in practices should be introduced and patients should be kept busy in positive activities to avoid boredom.
- The Light source should be enough in day and night time and patients should not have any problem in sleeping.
- The beds of patients should be carefully maintained and changed regularly
- Cleanliness should be ensured
- Nurses should improve motivation of patients by providing positive news and motivation.
- Proper nutrition and diet of patients should be maintained. patients with special food should receive carefully made food.
The Six Forces Nursing Model
Six Forces Nursing Model
The six force nursing model that I present is based on the environmental theory model and it has six additional forces, that are the facilities nurses will provide to the patients in addition to the suitable environment. these forces are inspired by Jean Watson’s nursing care model (Turkel et al., 2018). as the environmental model specifically focuses on the environment of the patient but not the other important nursing responsibilities so I have included the additional six services that nurses should provide to the patients. the six force model provides the following six forces to be acted upon the client:
the patients who have incurable diseases and are spending their end of life period should be taken care of properly, as it is the most important thing in palliative care (Virdun et al., 2015). the nurses on duty should ensure that they live in the proper environment and should take measures to decrease their pain and suffering.
the nurses should take care of the patients irrespective of their race, ethnicity and cultural or religious belonging and should provide services unconditionally to all patients. personal hate or grudges should not be kept while providing care to patients.
the patients should be provided proper spiritual care. for this purpose, the nurses can take help of a proper religious person of the patient’s religion and include therapies that help patients recover quickly and improve their spiritual self. the patients at never cost should be under stress and nurses should remove any problems that patients are suffering from.
Encourage Family Support
the nurses should encourage their family support and motivate them about their patient. they should ensure that family does not become a cause of distress and suffering of patient and patient gets his necessary sleep and rest. family members should be advised to help improve patient’s mental peace.
The nurses should ensure that patient gets improvement in body, mind and spirit. This practice of nursing does not directly relate to her services but nurses should try that no factors affect negatively on the patient’s holistic treatment.
Knowledge and Intervention
the nurses should provide necessary knowledge to the patient and his family. deliver to them the proper schedule of their care and notify important points and changes timely.
- Analysis of holistic treatment in patients and their effectiveness in improving the health of trauma patients.
Hypothesis: Holistic treatment has a positive impact in bringing health improvement among the trauma patients.
- Analysis of spiritual therapy in the improvement of patients with lung cancer
Hypothesis: Spiritual therapy has decreased mental stress in patients with lung cancer.
- Impact of palliative care for cancer patients over 60 years of age.
Hypothesis: Palliative care has decreased death desires in patients and made their End Of Life (EOL) therapy easy for nurses
Florence nightingale’s services in nursing need appreciation. her work in providing best healthcare to patients is helping the nursing professionals as a practical guide to nursing service (Zborowsky, T., 2014). her environmental theory provides us with a complete environment structure for patients that help in their quick recovery. it helps nurses in maintaining a proper schedule of important services to patients and patients get proper treatment with least mental stress during their time in the hospital (Pirani, S. A., 2016). The six forces model of nursing is inspired by the environmental theory and Jean Watson’s theory of nursing care. it provides a complete structure of nursing services with all the major points covered by the services. this model can be used as a basis for research in the nursing field and can prove helpful if used as a practical model of nursing in hospitals.
Butts, J. B., & Rich, K. L. (2013). Philosophies and theories for advanced nursing practice. Jones & Bartlett Publishers.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55.
Pirani, S. A. (2016). Application of Nightingale’s theory in nursing practice. Annals of Nursing and Practice, 3(1), 1040.
Turkel, M. C., Watson, J., & Giovannoni, J. (2018). Caring Science or Science of Caring. Nursing science quarterly, 31(1), 66-71.
Virdun, C., Luckett, T., Davidson, P. M., & Phillips, J. (2015). Dying in the hospital setting: A systematic review of quantitative studies identifying the elements of end-of-life care that patients and their families rank as being most important. Palliative Medicine, 29(9), 774-796.
Zborowsky, T. (2014). The legacy of Florence Nightingale’s environmental theory: Nursing research focusing on the impact of healthcare environments. HERD: Health Environments Research & Design Journal, 7(4), 19-34.