Florence Nightingale: The Original Nursing Theorist, Essay Example

Considered by historians and health care professionals as the founder of modern nursing, Florence Nightingale (1820 to 1910) has been described in many ways, such as a mystic and visionary for her insights into helping to heal the sick and the unfortunate; a healer and social reformer far ahead of her time during the reign of Queen Victoria; and of course, a skilled and dedicated nursing practitioner (Dossey, 2005, p. 56).

The main reason for choosing this outstanding human being is due to the fact that Nightingale was the first to offer valid theories related to the practice of nursing, nursing research, public health and well-being, and how to reform the profession of nursing for the good of all. As B. Dossey describes her, Florence Nightingale was a “brave risk-taker who possessed uncommon vision, focus, dedication, and commitment” to her nursing principles and her patients (2005, p. 56).

Historically, Nightingale first conceived of her nursing theories in 1854 in the Crimea during the Crimean War. As W.D. Glanze relates, when Nightingale arrived at the British Army hospital, she found “5000 men crowded into dilapidated and filthy buildings without beds, food, or medical supplies” (2005, p. 812). This inspired her to write Notes on Hospitals and Notes on Nursing in 1856 which contained some of Nightingale’s earliest observations on the professional practice of nursing.

Nightingale also founded the first training school for nurses at St. Thomas’ Hospital, where she taught her nursing principles and theories, thus “raising the standards of nursing across Great Britain and eventually around the world” (Glanze, 2005, p. 813). Today, most nurses are required to pledge their commitment to helping others through the Nightingale Pledge which “embodies her ideals and has inspired other nurses to develop theories” related to health, the nursing environment, the person or patient, and the profession of nursing (Glanze, 2005, p. 814).

Since Nightingale lived during a time when nursing theories were practically non-existent, her basic theoretical premise revolves around systematic and holistic health care practices and ideas that stress health promotion and the prevention of disease. As L. McDonald relates, Nightingale believed that the foundations for good health care must include 1), decent and clean housing, whether in a patient’s own home, a clinic, or a hospital which in Nightingale’s time was often called a home hospital that treated nearby residents in an urban setting (the concept of Environment); 2), clean water and air, due to many communicable diseases that flourished during Nightingale’s lifetime and often led to premature death from illnesses like typhoid and cholera (another concept of environment); 3), good nutrition for a healthy body and mind (the concepts of Health and the Person), especially for those living in poverty and squalor without adequate food; 4), safe childbirth (the concepts of Person and Health), due to the high level of mortality from various types of fever in newborns; and 5), a clean and safe environment for all children (2006).

Nightingale also devised a nursing strategy based on holistic health care which Glanze (2005, p. 346) defines as “A system of total patient care that considers the physical (i.e., the Person), emotional, social (i.e., the Environment), economic, and spiritual needs” of the individual, how a patient responds to an illness, and the impact of an illness on the patient’s ability to care for themselves (i.e., the concept of Health). This strategy is made up of three specific areas–1), the importance of home visits by a professional nurse or physician; 2), a minimal use of hospitals because of high mortality rates (especially during Nightingale’s day); and 3), the linking of general or home hospitals with convalescent hospitals, such as hospices and long-term health care facilities (McDonald, 2006).

Despite the fact that Nightingale’s theories and approaches to nursing originated  more than one hundred and fifty years ago, they nonetheless remain relevant and applicable in today’s nursing world, especially related to education, practice, and research. As Dossey explains it, Nightingale insisted that in order to become what she referred to as a therapeutic nurse or one that focuses on providing medical treatment through specific techniques, one is required to draw upon nursing knowledge that has been acquired through either education or experience, “nursing theory, research, expertise, intuition, and creativity” (2005, p. 57).

Also, as a professional nurse, one is required to openly encourage “peer review of professional practice in various clinical settings” which adds value to and increases a nurse’s knowledge base, and integrate “knowledge of current professional standards, laws, and regulations governing nursing practice” (Dossey, 2005, p. 57), meaning that a professional nurse infuse not only legal standards but also ethical and moral standards into his/her nursing practice.

In essence, the four main areas of nursing, being the profession itself, the Person or patient, Health, and Environment, must be fully understood by the nursing professional, either through how others have defined these areas, such as Nightingale, or through personal reflection which as Dossey relates will positively impact a nurse’s professional career and personal life while also strengthening one’s purpose, meaning, and mission as a caring and practicing professional nurse (2005, p. 57).

There is also the “Nightingale Method” that highlights the importance of social research or conducting an investigation into the social aspects of nursing. Certainly, as Nightingale herself understood it, this method adds considerable value to the profession of nursing, the relationship between the nurse and the patient, the overall health of the patient, and how the environment plays such a crucial role in determining how a patient responds to treatment and the future course of a specific illness or disease.

In basic terms, this method involves four activities–1), obtaining the most reliable and up-to-date information and data concerning the pathology of a disease and how it should be treated. In Nightingale’s time, this would be books and treatises written by qualified doctors and researchers, such as Gray’s Anatomy (1858), and Mental Maladies: A Treatise on Insanity by Jean Esquirol (1838); 2), interviewing experts in the fields of basic medicine and those that specialize in certain maladies and illnesses, such as cholera which was rampant during Nightingale’s lifetime; 3), creating a questionnaire as a way to determine the viewpoints and opinions of hospitals, clinics, and  practitioners who are familiar with up-to-date material; and 4), after writing a paper or a report on a specific medical illness or condition, “send out a draft to experts for vetting before publication,” a early form of peer review (McDonald, 2006).

In regards to my personal values and beliefs systems related to being a professional nurse, the theories of Florence Nightingale resonates deeply, due to knowing and appreciating her nursing concepts in relation to the profession of nursing, the care and treatment of patients, the general health of patients, and the environment, either in a hospital, a clinic, or at-home. First of all, Nightingale’s basic foundations for good health are still relevant today, such as maintaining a healthy environment that is clean, orderly, and as a germ-free as possible, particularly in a hospital setting. Good nutrition is also very important, for it affects the overall health and well-being of a person or patient and helps to stave off many communicable diseases and illnesses. Also, children deserve a safe and clean environment in which to grow up and become healthy adults, something that Nightingale realized after witnessing the deplorable housing conditions in early nineteenth century England and America.

I also believe that Nightingale’s nursing strategy on holistic health care is just as important today as it was during her professional nursing career when most doctors viewed the mind and body as separate entities, rather than as two systems interdependent on each other. As holistic practitioners, nurses must understand the connections between the physical self (the Person or patient), the social environment in which a patient lives and works, and the impact that an illness or disease may have on a patient’s physical and emotional responses to treatment and their ability to care for themselves in the long-term after treatment.

As to education, practice, and research, the theoretical concepts of Florence Nightingale adds great value to a nurse’s ability to care for and treat his/her patients on a daily basis. For example, to become a competent and skilled nursing professional, one must constantly draw upon special knowledge that has been acquired through a higher education or by personal experience in the field. Also, a nurse must be able to think critically in order to utilize the “Nightingale Method,” especially related to obtaining, examining, understanding, and putting into action the most up-to-date information and data on the pathology and outcomes of diseases, how they can be treated effectively, and the possible consequences of disease on the future well-being of every patient.

References

Attewell, A. (1999). Florence Nightingale (1820-1910). (1999). Retrieved from http://www.ibe.unesco.org/fileadmin/user_upload/archive/publications/ThinkersPdf/nightingalee.PDF

Dossey, B. (2005). Florence Nightingale and holistic nursing. NSNA Imprint. Retrieved from http://www.nsna.org/portals/0/skins/nsna/pdf/imprint_febmar05_feature_nightingale.pdf

Glanze, W.D., ed. (2005). Mosby’s medical and nursing encyclopedia. St. Louis, MO: C.V. Mosby & Company.

McDonald, L. (2006). Florence Nightingale and public health policy: Theory, activism, and public administration. Retrieved from http://www.uoguelph.ca/~cwfn/nursing/theory.html