Being a distinct profession, the discipline of nursing consists of knowledge about theories, research, special methods and practice. The practice of nursing is based on theories that ensure the guidance for structuring its professional practice as well as education and research. Nurses usually apply different theories in their practice regarding to the clinical situations they are facing with. In such case, they need to define a theory, identify its main concepts, frameworks, and conceptual model. There are various theorists that make their input to the practice of nursing, but Florence Nightingale is the most recognized name in this field of studying. Her investigations in the work of nursing were fundamental for developing a modern practice of nursing. This paper presents Florence Nightingale’s Environmental Theory by describing the background of the theorist and the assumptions made by her, identifying major concepts of the theory, and applying the theory to a clinical situation and its influence to a nursing care.

The Background of the Nurse Theorist

First and foremost, it is necessary to note that Florence Nightingale is a founder of the modern practice of nursing, a philosopher in this field of studying, a statistician, and a social reformer. During the Crimean War, Florence was in charge of nursing British and allied soldiers in Turkey by spending a lot of time in the wards. Giving personal care tirelessly day and night (by carrying lamp lighted her way to the patients) to the wounded prescribed her an image of “Lady with the Lamp”. Nightingale’s efforts to formalize the education of nursing helped her set up the first scientifically based nursing school that is called “the Nightingale School of Nursing” located at St. Thomas’ Hospital in London. She also played an essential role in creating training for nurses and midwives in the infirmaries. As a result of her fruitful work in the field of heath care, Nightingale was the first woman awarded the Order of Merit. 

Having a strong calling by God in helping sick and poor people, Florence worked insistently by caring ill and wounded. She was very upset by some died soldiers from infectious disease and even started avoided communication. As a result, Nightingale declined all her offers of marriage in regards to devote her life to the care of sick patients as well as social reform. After that, she wrote, “Notes on Nursing” that were the basis for her Environmental Theory.

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Major Concepts and Relational Statement of the Theory

According to the conceptual framework of Nightingale’s Environmental Theory, the nurse, the client, and environment concepts should be in balance. The nurse can influence the surroundings to compensate the patient’s reply to it. The nurse’s aim is to help the client to stay in a balance. Hence, the relational statement of Nightingale’s Theory is the following: if the client’s environment is out of balance, he/she spends unnecessary energy. 

Most nursing theories include main four concepts such as nursing, human beings, the environment, and health. Nightingale assured that nursing should mean the right use of light, quiet, fresh air, cleanliness, warmth, and diet with minimum expenses of viable power to the client. The theorist presented the art of nursing in personal statement: “the art of nursing, as now practised, seems to be expressly constituted to unmake what God had made disease to be, viz., a reparative process”. 

Florence has defined a human being in the relationship to the environment and its impact on the patients. She thought that difficult surroundings led to poor health and different illnesses. Therefore, healthy environment is necessary for qualified nursing care. In this case, the theorist identified five important environmental factors: fresh air, pure water, cleanliness, effective drainage, and light. 

Considering the concept of health, Nightingale noted that nursing should ensure care to both healthy and ill people; she discussed the promotion of health as an activity with the participation of nurses in it.

Except major concepts, Florence has defined such subconcepts as: 

• the health of houses (houses and hospitals should be constructed well), 
• light (direct sunlight is necessary for sick patients), 
• variety (different activities that can alleviate the sick of boredom), 
• noise (all kinds of unnecessary noise are irritating to the patients),
• ventilation and warming (appropriate temperature in the rooms are required), 
• bed and bedding (it is better to place the bed in the lightest part of the room near the window),
• nutrition and taking food (frequent little servings with different food are beneficial to the clients), 
• cleanliness (nurses must wash their hands frequently throughout the day), 
• social considerations (social environment is also important to the individuals),
• chattering hopes and advice (good news would assist patients in their healing).

The Assumptions Made by Nightingale

In her theory, Florence Nightingale identified such assumptions as:

• nurses should be well-educated, trained, confidential, and observant;
• the environment is essential to the patient’s health. Hence, nursing should support it to help the client in healing;
• nurse’s caring has to be to the patient in the healthy environment;
• the laws of health are the same to wellness and sickness;
• nursing is an art as well as a science;
• it is necessary to use observation and empirics during the research.

Some of the described assumptions are compatible with my personal philosophy of nursing, especially those that relates to the environment. I am totally agreed that the profession of nursing concerns humans and nurses are responsible for ensuring qualified caring. It is better to achieve such results in a healthy environment. To my mind, the environment has a considerable impact on the patients’ health because they all are the members of the community with their personal characteristics. Thus, nurses should do their best in improving the clients’ surroundings.

Applying the Theory to the Clinical Situation

Florence Nightingale’s Environmental Theory can be successfully applied to almost all clinical situations because proper environment serves as good medicine for the patients. Here is the situation in which using given theory will improve nursing care as well as patient’s healing. A 41year- old pregnant woman came to the non-profit hospital with some respiratory conditions that are suspected for pneumonia. The nurse insisted on patient’s staying in the hospital for a week of a bit longer for further diagnosis and effective treatment that are necessary to save her pregnancy. The nurse convinced the woman about the healthy environment she will get there. During patient’s treating in that hospital, the medical staff tried to create home conditions with all conveniences for a pregnant woman. The client was placed in a well-lighted part of the room near the window and was provided with short everyday walking outside (fresh air is essential for her). As there was only one neighbor in her room, the client did not suffer from unnecessary noise. Moreover, the woman had a personal diet, so she could eat desired food due to her needs. As a result, nurse’s caring with the proper treatment made the qualified environment that facilitated patient’s healing.

In conclusion, Florence Nightingale’s Environmental Theory explains the relationships between a nurse, a patient, and the environment. The surroundings present danger as well as benefits for people. Given theory focuses on changing the client’s environment to affect it positively. The role of environmental management regarding to patients’ recovery is emphasized through the assumptions, concepts, and subconcepts that were identified by the theorist.  

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