Florence Nightingale developed one of the first nursing theories based on her experiences as a nurse in the Crimean War. Her environmental adaptation theory emphasized the importance of sanitation, ventilation, clean water and drainage in preventing disease and promoting patient healing. Nightingale believed the nurse's role was to alter the environment for the patient's benefit. Her theory shaped the modern organization and education of nursing. Nightingale established the first nursing school and promoted evidence-based practice through data collection. She viewed nursing as a calling and developed the foundation for nursing as a respected profession.

1. Nursing Theory of
Florence
Nightingale

2. Origins of Nightingale’s Theory
for Nursing Practice:
Florence Nightingale was a prolific writer. She
lived from 1820 to 1910 in Victorian England.
Her ideas, values, and beliefs on a wide range of
topics can be identified in her documents.
They contain philosophical assumptions and
beliefs regarding all elements found in the
metaparadigm of nursing.
In 1859, she was the first to conceptualize
nursing’s work into a theoretical framework.
She was credited with finding the practice of
nursing.
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3. Relevance to Nursing Today
A 221 page second edition (Nightingale, 1992)
was intended for the professional nurse, and is
relevant to nurses today who are searching for
wisdom on her perspectives on illness, the person,
their environment, and holistic nursing.
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4. Relevant to Nursing
Organization:
Florence Nightingale
provided a professional
model for nursing
organization in Britain
that spread across much
of the world.
She emphasized
subservience to doctors,
allowing nursing to gain
a foothold within a
hospital.
Her plan was that
nurse training would
not threaten the status
of the doctors, but
crucially that they
should accept the
disciplinary authority
of the matron and the
new hierarchy of
nurses within the
hospital.
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5. Relevance to Nursing Education:
The idea that nursing
required specific
education was
revolutionary in 19th-
century England.
Nightingale’s nursing
education emphasized
the need to blend a
mixture of theoretical
and clinical
experiences.
Schools of nursing
were established on her
model throughout the
world.
They emphasized the
moral qualities of
nursing and introduced
humanitarian, patient-
centered values that are
still relevant today.
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6. Individual Relevance of
Florence Nightingale:
She was empowered
through her personal
philosophy, which was
deeply spiritual and at the
same time fundamentally
practical and related to
everyday life.
She was a systematic
thinker and passionate
statistician, using bar and
pie charts, highlighting key
points.
Besides “getting
the science right”,
Florence
Nightingale made
it comprehensible
to lay people,
especially the
politicians and
senior civil
servants who made
and administered
the laws.
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7. Relevant to Nursing Knowledge:
The body of
knowledge left
by Florence
Nightingale
includes an
environmental
adaptation
theory, which is
entirely relevant
to the modern
setting.
Regardless of
whether the
environment is
high tech, the
“nurse remains
responsible for
altering the
environment to
improve it for
the benefit of the
client”
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8. Assumptions of Florence
Nightingale’s Theory:
Natural laws
Mankind can achieve perfection
Nursing is a calling
Nursing is an art and a science
Nursing is achieved through environmental
alteration
Nursing requires a specific educational base
Nursing is distinct and separate from medicine
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9. Major Premises of Environmental
Adaptation Theory:
People are multidimensional, composed of
biological, psychological, social and spiritual
components.
Disease is more accurately portrayed as dys-ease or
the absence of comfort.
Symptoms alert nurses to the presence of illness,
which allows for appropriate interventions.
Breaking the natural laws will cause disease.
Improvement in the health of individuals and
families lead to the improved health of society.
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10. The Environmental
Adaptation Concepts:
Florence Nightingale’s original
theory for nursing practice was
holistic.
Her concepts included
human/individual,
society/environment, health/disease
and nursing.
She focused more on physical
factors than on psychological needs
of patients because of the nature of
nursing practice during her time.
Six D’s of Dys-ease:
Dirt
Drink (need clean
drinking water)
Diet
Damp
Draughts (Drafts)
Drains (need proper
drainage and sewer
systems)
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11. Origin of Nightingale’s
Environmental Concepts:
Nightingale believed that the environment could be
altered to improve conditions so that the natural
laws would allow healing to occur.
This grew from empirical observation that poor or
difficult environments led to poor health and
disease.
In her Crimean experience, filth, inadequate
nutrition, dirty water, and inappropriate sewage
disposal led to a situation in which more British
soldiers died in the hospital than of battlefield
wounds.
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12. Concepts of Nursing:
The goal of nursing is to place the patient
in the best possible condition for nature to act.
Health is “not only to be well, but to be able to
use well every power we have”
Health nursing, or general nursing are those
activities that promote health (as outlined in
canons) which occur in any caregiving
situation. They can be done by anyone.
Nursing proper is reserved for those individuals
who are educated in the art and the science of
nursing.
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13. The Holistic Person Model:
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14. Nightingale’s Model for Nursing
Practice:
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15. Florence and the Patient
Nightingale believed that
caring for the sick was a
component of Christianity
Cures were not limited to
medical acts but also acts
of God
Patient’s needs should be
prioritized according to
Maslow’s Hierarchy
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16. Florence and the Patient
Health Promotion occurred through providing a
sanitary environment, adequate nutrition, patient
comfort, and conservation of the patient’s energy
Considered a client to have the capability to be
healthy, however, he/she did not have the power
to control their unsanitary environment or poor
access to essential nutrients
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17. Florence’s Theory and Health
• Although Florence Nightingale was bedridden, she
continued to campaign to
improve the heath standards, publishing 200 books, reports
and pamphlets.
• She believed that infection arose spontaneously in
dirty and poorly ventilated places
• Her belief led to improvements in hygiene and
healthier living and working environments
• Florence Nightingale’s vision of health care included
professional nursing for the sick and the poor
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18. Florence’s Theory and Health
• One of the first people to examine data on
occupationalhealth and safety
• Systemic approach to health care with a major
role for prevention, clean air, clean water, decent
housing and good infant care
• Promoted uniform hospital statistics so that
results could be compared
by country, institution and type of treatment
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19. Florence and the Environment
Mother’s responsibility to teach her children
cleanliness in mind, body, and spirit
This included waste management and tidiness
in and around the home
Bad smells were to be considered a sign of
danger
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20. Florence and the Environment
In order for healing to
occur, all environmental
and sanitary conditions
must improve
Ventilation/ Clean Air and
light were considered key
factors in hygiene
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21. Florence and Nursing
Florence Nightingale is the reason why nursing is
considered a profession today and recognized that
educated nurses would be viewed by the public as
professional.
First nursing school at St. Thomas Hospital in
London
She believed that God called her to be a nurse and
that He had natural laws that were to be followed
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22. Florence and Nursing
According to Nightingale, the aim of
nursing education was to train women to
become nurses in order to serve society for
the alleviation of the suffering of the sick,
for the amendment of the living conditions
of the poor, and for the improvement of the
health of the population (Nightingale 1859).
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23. The Effect on Nursing Practice
Stressed the importance of hygiene and
believed that it aided in the prevention of
disease spreading
Focused on a holistic caring perspective
Aseptic practices
Nursing is a continuous learning process
because new and better practices are always
being developed
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24. What it is, or what it should be?
BOTH!
Maintaining a clean environment within
the healthcare setting is essential to
prevent nonsocomial infections
Gloves and other PPE, bed linens,
handwashing
Keeping a clear path for fire safety
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25. What it is, or what it should be?
However, not everyone always follows
the rules:
Carts, etc. obstructing the hallways
Not everyone wears gloves when they are
supposed to
Handwashing
Florence Nightingale’s Theory is one
that every nurse should strive to achieve
by maintaining a healthy environments
not only for their patients, but also for
themselves.
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