Analysis of Nursing Theory Suggested Florence Nightingale - Research Paper Example

Nursing Theory Several scholars in the recent times have contributed to the body of knowledge relating to the definition or explanation of various aspects of the profession of nursing and the nursing theory has evolved on a number of levels in the past several decades. Florence Nightingale (1820 – 1910), popularly known as the founder of modern nursing, is one of the most important theorists who have influenced the modern nursing theory and practice, although debates still remain as to whether or not she had an actual theory of nursing. It is commonly believed today that Nightingale was posthumously accredited with a theory of nursing science, although she never actually formulated any. The theory of nursing science accredited to her today consisted originally in Nightingale’s personal journaling and communications, which were later categorized into a theoretical framework under her name. The pioneering work of in nursing Nightingale came to be recognized during the Crimean War and she laid the foundation of professional nursing when she started her nursing school at St Thomas’ Hospital in London in 1860. According to this celebrated English nurse, nursing is an art and a science, and, more than anything else, it is a divine calling, because she believed that God had called her to be a nurse. Nightingale defined nursing as distinct and separate from medicine and it can be achieved through environmental alteration. To her, nursing requires a specific educational base and she discussed her theoretical principles, later known as the Nightingale model, in her celebrated work Notes on Nursing: What It Is, and What It Is Not. Through this relatively short and concise work, Nightingale puts forward some of the most celebrated nursing hints which aid individuals entrusted with the health care of human beings. In the preface of the work, she maintains that these notes “by no means intended as a rule of thought by which nurses can teach themselves to nurse, still less as a manual to teach nurses to nurse. They are meant simply to give hints for thought to women who have personal charge of the health of others. Everyday sanitary knowledge or the knowledge of nursing… takes a higher place. It is recognized as the knowledge which every one ought to have – distinct from medical knowledge, which only a profession can have.” (Nightingale, 1860, p v). A careful reading of this book brings out Nightingales’ understanding of the spiritual nature of human beings and she provides a convincing explanation of the environmental, biological, psychological and social aspects of nursing care to the patients. This paper makes a reflective exploration of the nursing theory suggested by Florence Nightingale, in her work Notes on Nursing: What It Is, and What It Is Not, regarding what nursing is and what it is not. In a profound analysis of the nursing theory as proposed by Florence Nightingale, it becomes lucid that it is the earliest work written on nursing and the various practices related to it. In order to realize the development of Nightingale’s philosophy of nursing, it is important to consider her biographical background, because several factors from her personal, societal, and professional background influenced her nursing theory. As Barbara Cherry and Susan R. Jacob maintain, “Nightingale did not deliberately set out to develop theory; rather her goal was to ease the suffering of soldiers and citizens of England. However, many important influences in her life directed her toward theory development.” (Cherry and Jacob, 2005, p 55). Some of the major influences in her life included a classic education in philosophy, French, Italian, Greek, Latin, the arts, and history, her upper-class background, wealth, prominent social life, religion and spirituality, and an era of reform throughout England. Significantly, Florence Nightingale, popularly known as the founder of modern nursing, incorporated in her philosophy of nursing the values from her personal, societal, and professional background. “Many factors influenced the development of Nightingale’s philosophy of nursing. Her personal, societal, and professional values and concerns were all integral to the development of her beliefs. She combined her individual resources and concerns with the societal and professional resources available to her to produce change.” (Marriner-Tomey and Alligood, 2006, pp 73-4). Florence Nightingale was greatly concerned with the well-being of the patients and she maintains that the fundamental goal of nursing is to lay the patient in the preeminent promising condition in which the nature can act the best. In the background of contemporary nursing theory and practice, it is fundamental to realize that the present-day scholars in the field explore Nightingale’s Notes on Nursing: What It Is and What It Is Not as a potential theoretical and conceptual model for nursing today. According to some of the prominent contemporary scholars, “Nightingale’s concept of environment as the focus of nursing care and her admonition that nurses need not know all about the disease process are early attempts to differentiate between nursing and medicine… Nightingale’s “descriptive theory” provides nurses with a way to think about nursing or a frame of reference that focuses on patients and environment” (Heath, 1995, p 4). Rather than viewing nursing as limited merely to the administration of medications and treatments, Nightingale laid emphasis on providing the right environment for the phenomenon called nursing. Most significantly, the principles and concepts of nursing proposed by this pioneering nursing-theoretician shaped and delineated nursing practice as an important vocation. Through her nursing theory, Nightingale was able to guide the practice of professional nursing and she called these principles or standards as canons of nursing. “Nightingale’s theory of practice was documented for nurses and laypersons alike and served as the foundation for the promotion of health. This theory was referred to by Nightingale as the ‘Canons of Nursing’ and guided the practice of professional nursing.” (Cherry and Jacob, 2005, p 55-6). Originally written as a body of nursing knowledge in 79 pages, Notes on Nursing: What It Is and What It Is Not offers most useful hints on nursing to those entrusted with the health of others. Although Florence Nightingale did not mean to provide a comprehensive guide to nursing practitioners, her nursing principles have been of great relevance to the people in the practice of treating others. Through her book, Nightingale offers pertinent advice and practice-guidelines relating to ventilation and warming, health in houses, petty management, noise, variety (environment), taking food and different kinds of food, bed and bedding, light, cleanliness of rooms, personal cleanliness, chattering hopes and advices, and observation of the sick. Rather than giving a general theory or ‘rule of thought by which nurses can teach themselves to nurse’, Florence is concerned with giving useful “hints for thought to women who have personal charge of the health of others.” (Nightingale, 1860, p v). Thus, Florence Nightingale considers every woman as a nurse and she requests women to teach themselves on how to place the patient in the best possible condition. The hints for thought offered by Nightingale can best help women who are in charge of the personal health of somebody, whether child or the patients. Although written in the background of the nursing practice of several decades early, the recommendations by Nightingale relate to the most basic and fundamental aspects of nursing, and they are most valuable guidelines to the nursing practitioners of the world, irrespective of their period. As Elizabeth M. McFetridge observes, the book by Nightingale has a quaint sound and the instructions are given in the background of an early time. Thus, there are guidelines and pleas for fresh air in the sick room and reiterated thought and warnings as to diet in those days of no refrigeration. There is also condemnation of the dresses of the day. “These things are of another day. But modern hospital administrators might wish that all hospital visitors were familiar with the section ‘How to visit the sick and not hurt them.’ Thoughtful physicians and nurses alike know the truth of the statement that irresolution on the part of their attendants is what patients dread most… Perhaps the ranks of nurses might be better filled today if there were similar emphasis upon the vocation and less upon the material benefits to be gained from it. (McFetridge, p 136-7). Therefore, it is essential to comprehend that Florence Nightingale has offered, through her famous work Notes on Nursing: What It Is and What It Is Not, the most useful guidelines and practical recommendations to assist the nursing practice and care of the patients in different backgrounds. In an analysis of the theory proposed by Nightingale, it becomes lucid that it has immense utility to the advanced nursing practice of the day with respect to its components, propositions, and comprehensiveness. In other words, Nightingale’s nursing principles, contained in her Notes on Nursing: What It Is and What It Is Not, have great relevance as a nursing theory contributing to the advanced nursing practice of the day. A careful investigation of the various principles and guidelines (hints) provided by Florence Nightingale in her Notes on Nursing: What It Is and What It Is Not confirms that her theory of nursing has an important place in the advanced nursing practice of the modern world, just as it was relevant in her own time. The theory of nursing as suggested by Nightingale in her book focuses on the everyday sanitary knowledge, or the knowledge of nursing, which will help the nursing practitioners in preparing the most suitable environment for nursing practice. Nightingale offers convincing advices and practices for the various areas related with nursing practice such as ventilation and warming, health in houses, bed and bedding, light, cleanliness of rooms, personal cleanliness, etc. In the introductory section of the work, Nightingale considers the general principle that disease is a reparative process and challenges the possibility of this principle. According to her, an experienced observer can most effectively realize that the symptoms or the sufferings which are generally regarded as inevitable are, in reality, caused by the lack of fresh air, light, warmth, quietness, cleanliness, punctuality and care in the administration of diet, etc. In other words, these symptoms or the sufferings cannot be realized as symptoms of the disease at all, but merely as the lack of effective nursing care. “The reparative process which Nature has instituted, and which we call disease, has been hindered by some want of knowledge or attention, in one or in all of these things, and pain, suffering, or interruption of the whole process sets in. If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease, but of the nursing.” (Nightingale, 1860, p 2). Thus, Nightingale’s principles concerning nursing practice are based on the elementary aspects of patient care and these principles are the basis of every advanced practice and theoretical model in nursing. Contrary to the general estimation that every woman makes a good nurse and it is a well-known profession, Florence Nightingale observes that the basic elements of nursing are all but unknown. According to her, nursing the sick is little understood. Through her theory of nursing, Nightingale fills the gap in the understanding of these basic elements of nursing, relating to “the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet--all at the least expense of vital power to the patient.” (Nightingale, 1860, p 2). Whereas several factors such as bad sanitary, bad architectural, and bad administrative arrangements may contribute to the lack of effective nursing care to the patients, the issues connected with the art of nursing cannot be ignored. Thus, it is fundamental to realize that Nightingale proposes some pertinent principles in order to make the art of nursing an effective practice of assisting the reparative process.  In a profound analysis of the nursing theory propounded by Florence Nightingale, one realizes that she offered the first published theory which reflects nursing practice, although it cannot be considered as a theory of nursing as theory is defined today. In fact, the contribution of Nightingale to nursing theory is that she offered the nursing profession the philosophical basis from which other theories have emerged and developed. As Rick Daniels maintains, Nightingale “provided the nursing profession with the philosophical basis from which other theories have emerged and developed. Nightingale’s ideas about nursing have guided both theoretical thought and actual nursing practice throughout the history of modern nursing.” (Daniels, 2003, p 53). Through her writing, Nightingale emphasized the fact that, in nursing practice, caring for the ill person rather than illness should be given priority. The theoretical nursing practice propounded by Nightingale the primary focus is on the manipulation of the patient’s environment in order to help him attain and maintain a state of health. In this nursing practice, the role of the patient is merely that of a passive recipient of care and it focuses on the treatment of the patient’s environment. Nightingale offered convincing explanation of the practice of nursing and she described it as an art as well as science. “Nightingale described nursing as both an art and a science. The art is the practice, the interaction between nurse and the client, whereas the science speaks to the empirical, or scientific, knowledge of nursing. In addition, theory is identified as being necessary to guide practice, education, and research.” (Daniels, 2003, p 53). In the contemporary nursing studies, there have been several recognized nursing theories and Nightingale’s theory nursing, known as the theory of environmental adaptation, is among the most pertinent and commonly used by holistic nurses. Nightingale is known for providing the first published theory of nursing and she presented her views regarding various important concepts of nursing. As aforementioned, the most essential goal of nursing care, according to Nightingale, is to provide the best environment for the patients. She emphasized environment in relation to healing properties of environment such as fresh air, light, warmth, and cleanliness. Significantly, nature alone cures, but we must create the right environment for the nature to work. “For Nightingale, the focus of nursing care was the creation of an environment so that natural healing may take place. Cleanliness, fresh air, and order are emphasized, as are the patient’s needs for nutrition. Although not stated as such in her writings, Nightingale and her nurses regularly provided emotional and interpersonal supports.” (Dossey and Keegan, 2008, p 116). In conclusion, Florence Nightingale is appropriately known as the founder of modern nursing, because she not only pioneered the practice of nursing care when she set up St Thomas’ Hospital in London in 1860, but also provided the nursing profession with the philosophical basis from which the modern nursing theories have emerged and developed. Through her Notes on Nursing: What it is and What it is Not Florence Nightingale emphasized that a clean environment, warmth, ventilation, sunlight, and a quiet environment, etc can help the patient attain and maintain good health.  Her main aim in writing the work was to offer, to nursing practitioners as well as laymen, everyday sanitary knowledge or the knowledge of nursing regarding patient care. However, the useful hints provided by this illustrious nursing practitioner have become the basic principles for the theories that have emerged and developed in the recent years and her theory of environmental adaptation remains the most fundamental theory of nursing until today. References Cherry, Barbara and Jacob, Susan R. (2005). Contemporary nursing: issues, trends, & management.  Elsevier Health Sciences. p 55. Daniels, Rick. (2003). Nursing Fundamentals: Caring & Clinical Decision Making. Cengage Learning. p 53. Dossey, Barbara Montgomery and Keegan, Lynn. (2008). Holistic nursing: a handbook for practice. Jones & Bartlett Learning. p 116. Heath, Hazel B. M. (1995). Potter and Perrys foundations in nursing theory and practice. New York: Elsevier Health Sciences. p 4. Marriner-Tomey, Ann and Alligood, Martha Raile. (2006). Nursing Theorists and Their Work. Missouri: Elsevier Health Sciences. pp 73-4. McFetridge, Elizabeth M. “Reviews and Book Notes.” p 136-7. Retrieved December 2, 2010, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC194656/pdf/mlab00252-0038b.pdf Nightingale, Florence. (1860). Notes on Nursing: What It Is, And What It Is Not. London: Harrison. p 1. Read More