Florence Nightingale developed an environmental theory of nursing in the 1850s based on her experiences as a nurse in the Crimean War. She observed that many soldiers were dying from preventable infections and illnesses caused by poor sanitation and living conditions in the hospital. Nightingale implemented changes to improve ventilation, cleanliness, drainage and other environmental factors, which dramatically reduced mortality rates. Her theory emphasizes that the nurse should control and manipulate the patient's environment and external conditions to support their health and facilitate healing. Nightingale identified five key environmental factors - clean air, pure water, efficient drainage, cleanliness, and light. Her theory formed the basis for modern nursing practice and professional nursing education.

1. NIGH
FLORENCE
NIGHTINGALE’S
ENVIORNMENTAL
THEORY

2. INTRODUCING THE THEORIST
 Florence Nightingale came in this world on May 12th
,1820.
 Began her training in nursing in 1851 at
Kaiserswerth in Germany and later in Paris.
 She was dubbed “The Lady with the Lamp”
 Laid the foundation of professional nursing with
establishment of her school at St. Thomas hospital
in London in 1860.

3. CONT…..
 In 1860 published her first notes on nursing and
considered as first Nursing Theorist
 Her theory works as a guide to help, manipulates
and organize the environment.
 Died in her sleep at the age of 90years on August
13, 1910.
 International Nurses week (6-12 May)

4. RELEVANCE TO NURSING EDUCATION
 The idea that nursing requires specific education
was revolutionary in 19th century in England.
 Schools of nursing was established on her model
throughout the world.
 Emphasized on moral quality of nursing and
introduced humanitarian patient centered
care.

5. ORIGIN OF NIGHTINGALE’S
ENVIRONMENTAL CONCEPT
 During Crimean war 1854 Florence nightingale and
team of 38 nurses arrived at British army hospital,
Scutari.
 Found 10,000 men lying in dirt and filth throughout
the hospital.
 Medicine were in short supply.
 Hygiene was been neglected.
 Mass infections were common.

6. CONTD……
Nightingale collected and analyzed soldier
morbidity and mortality during war.
Made some major changes like:-
 testing of public water
 improving sanitation
 starvation prevention
 clean rooms, bedding
and clothing
THE MORTALITY RATE REDUCED FROM 43%
TO 2%

7. GOAL OF ENVIRONMENTAL THEORY
Assisting the patient in retention of “vital powers”
by meeting his/her needs & putting him/her in best
condition for nature to act upon.

8. NIGHTINGALE’S THEORY
ASSUMPTIONS
 Nursing is separate from medicine.
 Nurses should be trained.
 Environment is important to the health of patient.
 Nursing should support environment to promote
healing.
 Nursing is both art and science.

9. CONT….
 Nursing is concerned with the person in the
environment.
 Nurse should be observant and confident.
 Research should be utilized through observation.

10. ESSENTIAL FACTORS
5 ENVIRONMENTAL FACTORS :
1. clean air
2. pure water
3. efficient drainage
4. cleanliness
5. light

11. MAJOR PREMISES FOR
ENVIORMENTAL ADAPTATION
 People are multidimensional.
 Disease is more portrayed as dys-ease meaning
absence of comfort.
 Symptoms alert nurses to the presence of illness
interventions.
 Breaking natural laws illness.

12. ENVIRONMENTAL CONCEPT INCLUDE
6 D’s OF DYS-EASE
 Dirt
 Drink(need clean drinking water)
 Diet
 Damp
 Drains(need proper drainage system)
 Draughts

13. TYPES OF ENVIRONMENT
PHYSICAL ENVIRONMENT: consist of 1.
physical elements where patient is
treated
2. influences both social and
psychological environment.

14. CONTD…….
PSYCHOLOGICAL ENVIRONMENT:
Stress
negative physical
environment

15. CONTD……..
SOCIAL ENVIRONMENT:
1. Data collection about illness and disease prevention
2. Components of physical
environment
eg. Clean air
Clean water
Proper drainage

16. NIGHTINGALE THEORY AND NURSING METAPARADIGM
1. PERSON:

17. 2. ENVIRONMENT
EXTERNAL CONDITIONS FORCES
PERSON

18. 3. HEALTH:
 additive process, the result of environment,
physical, and psychological factors and not
merely absence of disease.
 by maintaining the environmental
factors disease can be prevented.

19. NIGHTINGALE MODEL OF NURSING PRACTICE
HOLISTIC PERSON
NURSE
OBSERVATION
IDENTIFICATION OF
NEEDS
INTERVENTIONS
DOCUMENTA
TION
HEALTH STATUS
ANALYSIS
DESIRED
OUTCOME
DOCUMENTATION

20. NIGHTINGALE’S MODEL OF NURSING AND THE
ENVIRONMENT
OBSERVATION
PERSONAL CLEANLINESS
PETTY MANAGEMENT
LIGHT
HEALTH OF HOUSES
CLEANLINESS OF ROOMS
VENTILATION AND WARMING
BED AND BEDDING
TAKING FOOD
WHAT FOOD?
NOISE
CHATTERING HOPES
VARIETY

21. APPLICATION EXAMPLE ON NIGHTINGALE’S
THEORY
ASSESSMENT OF THE PATIENT
ON CHEMOTHERAPY
CLIENT WITH CARCINOMA LUNGS AND BRONCUS(B/L)

22. NURSING ASSESSMENT
Identify the factors that
can promote infection
nutritional concerns
psychosocial status

23. NURSING PROCESS
risk for infections related to altered
immunological response
1. Placing patient in private room
2. Avoiding contact with others
3. hand hygiene by care takers
4. fresh food, boiled water
5. clean and ventilated room
6. personal hygiene by patient

24. IMBALANCED NUTRITION: LESS THAN BODY
REQUIREMENT
a. adjust diet
b. administer prescribed medicine
c. oral hygiene
d. pain relief measures
e. limit fluid at mealtime
f. small frequent meals
g. position patient properly
MAINTENANCE OF
NUTRITIONAL STATUS

25. Anticipatory grieving related to
disease
1. Maintain a good IPR
2. Encourage verbalization of fears,
ventilation of negative feelings.
3. Involve a spiritual advisor
Appropriate progression
from grieving process

26. IN NURSING TODAY:
 Nurses old and young
have been influenced by
Florence Nightingale’s
Theories.
 Environmental
Adaptation remains the
basis of our holistic
nursing care.
 I am proud to follow the
important work of “The
Lady with the Lamp.”

27. REFERENCE LIST:
McCarthy D, Ouimen M, Daun J. (1991) Shades of Florence
Nightingale: Potential impact of noise stress on wound healing.
Holistic Nursing Practice. 5(4) 39-48
McDonald, L. (2001). Florence Nightingale and the early origins of
evidence-based nursing, EBN Notebook 4(3), 68-9
Watson J. (1998), Florence Nightingale and the enduring legacy of
Transpersonal Human Caring. Journal of Holistic Nursing, 16(2), 292-294
Attewell, A. (1998) Florence Nightingale’s relevance to nurses.
Journal of Holistic Nursing, 16 (2), 281-291
Selanders, L. (1998) The power of environmental adaptation. Journal
of Holistic Nursing, 16,(2) 247-263
Nightingale, F. (19690. Notes on nursing: What it is and what it is
not. New York: Dover. (original work published 1860)

28. THANK YOU