Florence Nightingale's Life and Work PDF

**NURSE\'S PRAYER** Dear Jesus, Model and inspiration of the nursing profession, I know that when you ascended into heaven, You left the care of the sick to those of us whom you have blessed with the Holy Vocation of nursing. Please help me to be faithful to that calling so that I can always do the...

**NURSE\'S PRAYER** Dear Jesus, Model and inspiration of the nursing profession, I know that when you ascended into heaven, You left the care of the sick to those of us whom you have blessed with the Holy Vocation of nursing. Please help me to be faithful to that calling so that I can always do the things you want me to do and in the manner that you want me to do them. Grant that my voice be gentle, that my hands may have the softness and sympathy of Your hands. That my presence may bring something for the hope and consolation, which Your presence brought to the sufferers of Your day. I want to do all these things Lord, but I know that I am weak and can do little without your aid. Please give that aid this day and every day of my life so that I can always be what you want me to be, an angel of the sick room. AMEN **NIGHTINGALE'S ENVIRONMENTAL THEORY** **NIGHTINGALE PLEDGE** \- I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care. **Florence Nightingale** (12 May 1820 to 13 August 1910) - Nursing is the art of utilizing one's environment for his or her recovery." - "Nightingale is the first nurse theorist well-known for developing the "Environmental Theory". **FLORENCE NIGHTINGALE** **EARLY LIFE** - Known as the "Mother or Founder of Modern Nursing". - "The Lady with the Lamp". - Born in Florence, Italy on the 12th day of May 1820 and was named after the city of her birth. - She is the younger of two children and her older sister is Frances Parthenope. - Her mother is Frances (Fanny) Nightingale, from a family of merchants and took pride in socializing with people of prominent social standing. - Her British family belonged to a rich, upper-class, well-connected British family. - Her father, William Nightingale, a wealthy landowner who had inherited two estates one at Lea Hurst Derbyshire and the other in Hampshire, Embley Park (now a school) - when Nightingale was 5 years old. **NIGHTINGALE'S EDUCATION** - Her father provided her with a classical education, including studies in German, French and Italian. - She is also excellent in Mathematics. - From a very young age, Nightingale was active in Philanthropy, ministering to the ill and poor people. - Inspired by what she took as a call from God in February 1837 (17 y/o), and entered nursing in 1844 (24y/o). - Motivated by Elizabeth Blackwell at St. Bartholomew's Hospital, the first woman doctor in US. - Despite the objections of her parents Nightingale enrolled as a nursing student in 1844 at the Lutheran Hospital of Pastor Fliedner in Kaiserswerth, Germany. **NIGHTINGALE'S WORKS AND APPOINTMENT** - Lutheran Hospital in Germany: A TURNING POINT IN HER LIFE, and her findings anonymously in 1851; The Institution of Kaiserswerth on the Rhine, for the Practical Training of Deaconesses, etc. was her published work. - In 1853, Florence Nightingale accepted the position of superintendent at the Institute for the Care of Sick Gentlewomen (Invalid women) in Upper Harley Street, London and held the position until October 1854. **CRIMEAN WAR** - During the Crimean War (1853-1856), British and French forces fought against Russia many soldiers fell ill from cholera and malaria. - In October 1854, she led a team of 38 trained female nurses to the front lines in the Crimea, arriving at a hospital in Scutari (modern-day Istanbul) in November. - There, she found appalling conditions: poor hygiene, overcrowding, and inadequate supplies, which contributed to high death rates. - During the Crimean War (1853-1856), British and French forces fought against Russia many soldiers fell ill from cholera and malaria - On 21 October 1854, she and a staff of 38 women volunteer nurses, trained by Nightingale and including her aunt Mai Smith, we sent across the Black Sea from Balaklava in the Crimea, where the main British camp was based - Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari (modern-day Uskudar in Istanbul) - She and her nurses found wounded soldiers being badly cared for by overworked medical staff in the face of official indifference. - Medicines were in short supply, hygiene was being neglected, and mass infections were common, many of them fatal. - There is no equipment to process food for the patient's. Rats and insects crawled the floor and walls - Wounded soldiers still wearing their amy uniform "stiff with dirt'" - During her first winter at Scutari, 4077 soldiers died there. - Ten times more soldiers died from illnesses such as typhus, typhoid, cholera and dysentery than from battle wounds - Conditions at the temporary barracks hospital were so fatal to the - patients because of overcrowding and the hospital's defective sewers and lack of ventilation. - Through her tireless efforts the mortality rate among the sick and the wounded was greatly reduced from 42% to 2%. - She advocated sanitary living conditions as of great importance. - Consequently, she reduced deaths in the army during peacetime and turned attention to the sanitary design of hospitals. **THE LADY WITH THE LAMP** - During the Crimean War, Florence Nightingale gained the nickname "The Lady with the Lamp", deriving from a phrase in a report in The Times. - "She is a '**ministering angel'** without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds." **NIGHTINGALE'S ENVIRONMENTAL MODEL** - defined Nursing as "the act of utilizing the environment of the patient to assist him in his recovery." - It involves the nurse's initiative to configure environmental settings appropriate for the gradual restoration of the patient's health. - She viewed the manipulation of the physical environment as a major component of nursing care. - Discussed in her book Notes on Nursing: What it is, what it is Not. **SUB-CONCEPTS OF ENVIRONMENTAL THEORY** 1\. Health of House 2\. Ventilation & Warming 3\. Light 4\. Noise 5\. Variety 6\. Bed and Bedding 7\. Cleanliness of Rooms & Walls 8\. Personal Cleanliness 9\. Nutrition and Taking food 10\. Chattering Hope and Advices 11\. Observation of the Sick 12\. Petty Management - Nightingale believed that when one or more aspects of the environment are out of balance, the client must use increased enery to counter the environmental stress. - These stresses drain the client of energy needed for healing. **NIGHTINGALE'S ENVIRONMENTAL MODEL** - **HEALTH OF HOUSES** \- Is closely related to the presence of pure air, pure water, efficient drainage, cleanliness and light. \- "badly constructed houses do for the healthy what badly constructed hospitals do for the sick - Nightingale" \- Cleanliness outside the house affected the inside. - **VENTILATION AND WARNING** \- "keep the air he breathes pure as the external air, without chilling him" \- Person who repeatedly breathes his/her own air would be sick or remain sick \- "Noxious air" or "effluvia" or foul odors affect the client's health (excrement, bedpans, urinals) \- Emphasized the importance of room temperature (should not be too warm or too cold). - **LIGHT** \- The sick needs both fresh air and light direct sunlight was what the clients wanted. \- Has quite real and tangible effects upon the human body. \- Lack of environment stimuli (e.g. isolation, NICU and ICU) can lead to confusion or "intensive care psychosis" related to the lack of the usually cycling of day and night. - **NOISE** \- Patients should never be waked intentionally or accidentally during the first part of sleep. \- Noise that may irritate patients are jewelries worn by nurses, keys that jingle, snapping of rubber gloves, the clank of the stethoscope against metal bed rails telephones ringing. - **VARIETY** \- Affects patients' recovery \- Provide variety in the patient's room to help him/her avoid boredom and depression \- Encourage significant others to engage with the client. Need for changes in color and form (e.g. Bringing brightly colored flowers or plants, rotating 10-12 paintings & engravings) (presently known as diversional therapy) \- Advocated reading, writing and cleaning to relieve the sick of boredom. - **BED AND BEDDING** \- An adult exhale about 3 pints of moisture through the lungs & skin in a 24 hr period -T his matter enters the sheets and stays there unless the bedding is changed and aired frequently. \- Beds must be placed in the lightest part of the room \- Caregiver must never lean against, sit upon or unnecessarily shake the bed, wrinkle free bed. \- Nurses must keep bedding clean, neat, dry and to position for maximum support. - **CLEANLINESS OF ROOMS AND WALLS** \- The greater part of nursing consists in preserving cleanliness. \- Removal of dust with a damp cloth rather than feather duster. \- Floors should be easily cleaned. \- Furniture and walls be easily washed. \- Clean room is a healthy room. - **PERSONAL CLEANLINESS** \- Unwashed skin poisons the patient \- Bathing & drying the skin provide great relief to the patient. \- "keep the pores of the skin free from all obstructing excretions" \- "every nurse ought to wash her hands very frequently during the day" -- Nightingale. - **NUTRITION AND TAKING FOOD** \- Variety of foods served to patients \- Individuals desire different foods at different times of the day \- Frequent small servings may be more beneficial than a large breakfast or dinner. \- No business must be done with the patient while they are eating distraction \- Right food at the right time. - **CHATTERING HOPES AND ADVICE** \- False hopes are depressing to patients \- Sick persons should hear good news that would assist them in becoming healthier. **- OBSERVATION OF THE SICK** - Nurses must be taught - what to observe - how to observe (what symptoms indicate improvement) - What is the reverse - Which are of importance - Which is evidence of neglect - It is important to obtain complete and accurate information about patients - " If you cannot get the habit of observation one way or other, you had better give up being a nurse, for it is not your calling however kind and anxious you maybe." The most important **practical lesson** than can be given to Nurses is to **teach them what to observe.** (*Florence Nightingale)* - PETTY MANAGEMENT \- Continuity of the care, when the nurse is absent \- Documentation of the plan of care and all evaluation will ensure others give the same care to the client in your absence. \- Ways to assure "what you do when you are there, shall be done when you are not there." **MAJOR CONCEPTS (METAPARADIGM)** **A. Environment** \- anything can be manipulated to placed a patient in the best possible condition for nature to act. - Physical components - ventilation, warmth, light, nutrition, medicine, stimulation, room temperature and activity. - Psychological - avoid chattering hopes and advices and providing privacy **B. Person** \- the one who is receiving care a dynamic and complex being. **C. Health** \- "Healthy is not only to be well, but to be able to use well every power we have." - For nightingale, health is "not only to be well, but to be able to use well every power we have". - Disease is considered as dys-ease or the absence of comfort. - Prevention of diseases and health promotion **D. Nursing** \- Spiritual calling; Nurses were to assist nature to repair the patient responsible to provide physicians with accurate information about the patients. **Different Types of Nursing** A. Nursing Proper - nursing the sick B. General Nursing - Health promotion C. Midwifery Nursing - Nurses must use their power of observation in caring for patients - Nurses must have educational background and knowledge that were different from those of physicians. - She rallied for nursing education to be combination of clinical experience and classroom learning. **APPLICATION TO NURSING PRACTICE** - With the advent of technology, and withit, globalization, comes threats from the environment. - Global warming, industrial noise, air pollution, nuclear radiation threats, man-made environmental calamities and FAD diets continue to pose challenges to nurse practitioners of today. - **OID** -- Every other day. - **BID** -- Twice a day. - **TID** -- Three times a day. - **QID** -- Four times a day. - **PRN** -- \"As needed\" (standard medical term). - **RX** -- \"Prescription or doctor\'s order\" - **NPO** -- Nothing by mouth. - **STAT** -- Immediately. - **OBJECTIVE** -- Measurable findings in assessment. - **SUBJECTIVE** -- Patient-reported symptoms. - **TIVF** -- Total Intravenous Fluids. - **IM** -- Intramuscular. - **SC** -- Subcutaneous. - **ST** -- \"Skin testing\" - **TAHBSO** -- Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy.