Florence Nightingale

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How are Florence Nightingale's theories relevant to modern nursing?

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Florence Nightingale's Environmental Theory still shapes the way nurses treat patients over 150 years later.

One facet of this theory states that it is important to consider the context of the patient when determining treatment. For example, a patient who is elderly and lives alone should be given ample support before a nurse recommends a complicated medication schedule or suggests that they undertake a physical therapy regimen. Likewise, a single mother returning home following a Cesarean section will likely be unable to maintain the restrictions forbidding lifting, so a nurse should help this mother make accommodations that will allow her to both recover and take care of her new child.

Another tenet states that nurses should offer encouragement, but not false hope, to patients. Even patients facing terminal illnesses should be allowed to know the truth of their own personal health, but a nurse should deliver the care in the most encouraging means possible. Patients who have a positive mental state are often better able to tolerate their illness and even pain than those who are surrounded by negative energy and hopelessness.

Nightingale also identified the importance of natural sunlight and noise reduction for patients. Now it is clear that exposure to sunlight strengthens a patient's immune system and improves symptoms related to depression. Nightingale didn't have decades of recent research to support this, yet she understood that sunlight plays an important role in recovery. She also saw the importance of quiet time and suggested that patients not be encumbered with lots of extraneous noise during periods of recovery; most hospitals have "quiet hours" in effect today, aligning with this theory.

From the importance of changing bed linens to the importance of hand washing, Florence Nightingale's theories relating to the importance of a patient's environment in the healing process continue to impact healthcare today.

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Florence Nightingale achieved fame while tending to the needs of soldiers during the Crimean War in the mid-19th century. She became known as "The Lady with the Lamp," an iconic designation depicting a nurse making her solitary rounds, comforting patients. After the war, she wrote books and established a school to train nurses in their care of patients. She believed that nursing was a calling apart from medicine that required specific training and education.

Nightingale's theories revolutionized nursing and are as relevant today as when she first proposed them, so much so that she is considered to be the founder of modern nursing. One of the most important of her contributions is the Environmental Theory, which refers to the role that environment plays in the recovery of a patient.

The Environmental Theory proposes that the fundamental needs of patients include fresh air, pure water, efficient drainage of sewage materials, cleanliness of the patients and their surroundings, and plenty of light, particularly direct sunlight. Patients also require warmth and quietness.

Nurses have to assess other environmental factors, such as specific diets, on an individual basis. Overall, Nightingale believed that it is the duty of nurses to provide the best possible conditions so that patients can recover naturally. These all remain standards at modern hospitals, clinics, and other places of healing.

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Florence Nightingale created or started many of the nursing theories that became properly accepted medicine in later years. One of her major theories was the idea that nursing itself was a separate field from "medicine" or "doctoring," in that nursing is more about the facilitation of medical care than about the medical care itself. Nurses, in her eyes, should be informed and educated about the care of patients, but should focus their attentions making treatment easy, beneficial, and available. She also believed that nursing was a care-giving philosophy first, and that it could be performed by anyone; however, she strove for better education and training for nursing students so they could properly help both patients and doctors.

Perhaps her most important theory was that of environmental nursing; Nightingale believed that nursing "is an act of utilizing the environment of the patient to assist him in his recovery" (Nightingale 1860/1969) (Wikipedia). In other words, the environment of the patient is as important as the care given by doctors and nurses; if the patient is in an environment that exacerbates the condition -- such as mold or low temperatures -- the care given will not be as effective. Today, nurses strive to make sure their patients have an environment that allows fast and easy treatment. Technologies such as blood-pressure monitoring allow the nurse to quickly understand patient discomfort, and then treat it or inform a doctor. In this manner, nurses still use their environment to help them care for patients, instead of simply acting on the patient alone.

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