Florence Nightingale’s Nursing Philosophy
Nightingale’s nursing philosophy centered the focus of nursing care around the
environment. Her theory includes the
person, health, nursing, and the environment itself. In reference to the person, Nightingale
thought of the person as the patient we care for and states that “the person is
a dynamic and complex being” (Alligood, 2014, p. 85). In addition, I strongly believe that in
current practice, with most patients I have encountered we are also treating
the family as well. Families and loved
ones play a key role in wellness of the patient and nurses should be inclusive
of family members in treatment. When
discussing nursing itself, Nightingale believed that nursing had a spiritual
calling and that nurses aided nature to heal the patient (Alligood, 2014,
p.85). Nightingale (1969, p.6) stated
that “nursing ought to assist the reparative process.”
(1969) discussed in various ways of how prevention and health promotion plays a
crucial role in our well-being. Health
included prevention, promotion, and nursing those who have illnesses back to
health (Alligood, 2014, p.85). In doing
so, she truly identified the role of the nurse through primary, secondary, and
tertiary forms of care that we discuss in modern day nursing. The concept of health strongly ties in to her
concept of the environment. The
environment consisted of thirteen` canons which included ventilation and
warmth, light, cleanliness, health of houses, noise, bedding, personal
cleanliness, variety, chattering hopes and advices, taking food, what food,
petty management, and observation of the sick (Nightingale, 1969).
(1969, p.8) states that “the first rule of nursing, to keep the air within as
pure as the air without.” The air of a
patient’s room, unit, and the hospital should be at a comfortable temperature
with no foul odors in order to maintain a proper body temperature for the
patient. In my current workplace, each room and unit has a temperature control
center. Patients have the ability to
control their room temperature but checking body temperature every two hours is
essential in our critically ill patients.
Noise is a major factor in a patient’s environment that needs to
constantly be monitored. Nightingale
(1969, p. 26) states that she is “often surprised by the thoughtlessness” of
colleagues who have conversations outside of patient’s doorways. Currently, this is a major issue on my unit
and unit managers have purchased a “yacker tracker” to show ourselves and
physicians how loud we truly are. It is
in the shape of a stop light and turns red when it reaches a higher decibel
point than is acceptable for our unit.
During night shift, we have “hush hours” from 2200 to 0600 to ensure
that patients are able to adequately rest.
management is an essential part of care.
It ensures the continuity of patient care by documenting the plan of
care and all assessments that will allow others to deliver the same amount of
care (Alligood, 2014, p. 87). In my
current practice, continuity of care is essential to building a rapport and
delivering optimal care for the patient.
If our patients are not transferred to the floor, we typically have the
same patients for all three shifts. As a
part of our unit standards, we also complete bedside shift report everyday with
the oncoming nurse and are inclusive of the patient and family.
suffer to excess from mental as well as bodily pain” (Nightingale, 1969, p.
34). By variety, Nightingale simply
means stimulation of the patient. In my
unit, many patients are sedated and families play a critical role in
stimulation of the patient to prevent ICU delirium. Personally, I always encourage family members
to stay and talk with their loved ones.
Although this is typically a very difficult subject to approach, the
stimulation of the patient of the patient is vital for their healing.
is portrayed in Nightingale’s theory in two different forms: cleanliness of
walls and rooms and of the nurse. In all of the health care facilities I have
been employed by, there are professional dress codes for nurses. Examples include no facial piercings, only
two piercings per ear, no visible tattoos, etc. These are expectations set
forth so that as nurses we appear professional to our patients, their families,
and other staff members. Cleanliness of
rooms in general is currently a major concern in my workplace. Many of our
rooms have mold in the air conditioning systems, Nightingale would strongly
disapprove of this. However, renovations
are being made room by room to eliminate the dust, mildew, and mold.
my personal practice, I use all of these canons on an everyday basis. While the patient is critically ill, it is my
responsibility to care for them in every way possible, including the
environment. For many patients who are
sedated or comatose, I encourage family to participate in care as much as
possible and leave notes, flowers, music, etc.
In my future practice, I want to continue to include the environment as
a healing tool. Most patients I
encounter have limited neurological response but I treat them as I would a
patient with no deficits. All of
Nightingale’s canons are essential to patient healing.