Florence Nightingale PDF

Eleen Grace C. Manalese-Castillo, RN  I THEORETICAL FOUNDATIONS OF NURSING Florence Nightingale 1820 - 1910 MODERN NURSING  Florence Nightingale CREDENTIALS AND BACKGROUND Founder of Modern Nursing Birthdate: May 12, 1820 Birthplace: Florence, Italy Night...

Eleen Grace C. Manalese-Castillo, RN  I THEORETICAL FOUNDATIONS OF NURSING Florence Nightingale 1820 - 1910 MODERN NURSING  Florence Nightingale CREDENTIALS AND BACKGROUND Founder of Modern Nursing Birthdate: May 12, 1820 Birthplace: Florence, Italy Nightingale’s father educated her more broadly than other girls of the time. Accdg. to her biographer, Sir Thomas Cook, Nightingale was a linguist  Florence Nightingale Had a vast knowledge of science, mathematics, literature, and the arts. She wanted to do more with her life than become an inactive wife of an aristocrat. Florence had a firm faith in God (she was a Unitarian Christian ), and for a time believed she had a religious calling. At the age of 17, she wrote about her diary “God spoke to me and called me to his service”  Florence Nightingale’s School She entered as a 134th nursing student at Fleidner School of Nursing, Kaiserwerth, Germany, a Protestant religious community with a hospital facility At the age of 31, (1851) she was there for approximately 3 months and her teachers declared her trained as a nurse. Florence Nightingale’s Training After her return to England, Nightingale was employed to examine hospital facilities, reformatories, charitable institutions. Only 2 yrs after completing her training (1853 ), she became the superintendent of the Hospital for Invalid Gentlewomen in London.  The Lady with the Lamp The Crimean War Sir Sidney Herbert ( a family friend and the Secretary of War ) requested Florence with the 34 newly recruited nurses to care for the wounded soldiers.  The Lady with the Lamp With her lamp, Nightingale traversed the night during the Crimean War to look and heal for the wounded soldiers.  The Lady with the Lamp The Crimean War ENVIRONMENTAL PROBLEMS Florence 1. Lack of Sanitation addressed her 2. Presence of filth (few mission of chamber pots, contaminated providing nursing water, contaminated bed linens, care through the and overflowing cesspools. ENVIRONMENTAL 3. Frostbite PROBLEM existed 4. Louse infestations 5. Wound infections 6. Opportunistic Diseases Nightingale – The Nurse Statistician The Crimean War She was viewed as pioneer in the graphic display of statistics She treated this activity --- counting no. of soldiers killed, injured or diseased The first year (shown on the right of the diagram) was 1854–5, following her arrival in the region. The second (on the left) was 1855–6, after she had implemented a series of reforms to the hospital and nursing practices. Nightingale – The Nurse Statistician The Crimean War Selected a fellow of the Royal Statistical Society in 1858. She was the first female fellow of the Society member until her death Nightingale – The Nurse Statistician The Crimean War She was an excellent writer. 1. Notes on Matters Affecting the Health 2. Efficiency and Hospital Administration of British Army. 3. Notes on Hospitals 4. Report on Measures Adopted for Sanitary Improvements in India. Nightingale – The Nurse Statistician The Crimean War Notes on Hospitals  Nightingale – Awards The Crimean War First woman to be granted the Order of Merit ( OM ) and the Royal Red Cross ( RRC ) 1907 2. Second most famous British person * Her birthday marks the International Nurses Day celebration each year.  Nightingale – Awards The Crimean War First woman to be granted the Order of Merit ( OM ) and the Royal Red Cross ( RRC ) 1907 2. Second most famous British person * Her birthday marks the International Nurses Day celebration each year.  THEORETICAL SOURCES OF NIGHTINGALE’S THEORY FACTORS INFLUENCING NIGHTINGALE’S THEORY: 1. Individual/ personal 2. Societal 3. Professional values The Environmental Theory METAPARADIGM IN NURSING  METAPARADIGM IN NURSING PERSON ENVIRONMENT HEALTH NURSING Essence of a Believed that the Being well and Provided sick, poor people using every essential person as a would benefit power that the principles for patient. from the environmental person has to rendering and improvements the fullest implementing that addressed extent. an efficient and their physical and effective mental aspects. nursing care. Nurses should Nurses could have Illustrated Instilled an perform tasks to a special role in modern public ideal attitude and for the patient uplifting the social as well as control status of the poor health nursing of thinking and the patient’s by improving their and concept of acting like a real environment to living situations. health nurse. facilitate easy promotion. recovery.  THEORETICAL SOURCES for THEORY DEVELOPMENT 1. EDUCATION – Victorian girl who study Mathematics and Philosophy ( she was considered having a unique formal education) 2. LITERATURE- access to persons of power and influence Ex. Charles Dicken’s novel The Adventures of Martin Chuzzlewit 3. INTELLECTUALS- political leaders, intellectuals, and social reformers like John Stuart Mill, Benjamin Jowett, Edwin Chadwick and Harriet Marineu  THEORETICAL SOURCES OF NIGHTINGALE’S THEORY 4. RELIGIOUS BELIEFS - Action for the benefit of others is a primary way of serving God which is a basis for nursing work as a religious calling. - Her Unitarian faith strongly supports the education of a person as a means of developing their divine potential and serving them toward perfection in their lives and in the service to God Nightingale – Empirical Evidence Excellent scientist and researcher Generated throughout her lifetime on the different subjects of healthcare, nursing and social reform. Efficacy of her hospital nursing system and organization during the Crimean War Nightingale – Empirical Evidence Nightingale – Empirical Evidence Her unique written report on the experiences and collected data Helped to pioneer the revolutionary notion that social phenomena could be objectively measure and subjected to mathematical analysis. Research skills includes recording, communicating, ordering, coding, conceptualizing, inferring, analyzing, and synthesizing. Nightingale Theoretical Assertion A. DISEASE - Believed that a disease was a reparative process Reparative process- nature’s effort to remedy a process of poisoning or decay, or a reaction against the conditions in which a person was placed. - nursing role was to prevent an interruption of the reparative process and to provide optimal conditions for its enhancement. Nightingale Theoretical Assertion B. NURSE - Women were to be specifically trained to provide care for the sick person. - nurse should be moral agents. - Addressed their professional relationship with their patients. - Instructed the principle of confidentiality. - Concise and clear decision making regarding the patient Nightingale Theoretical Assertion B. NURSE - Nurses providing preventive healthcare ( public health nursing ) required even more training. - Nurses needed to be excellent at the observation of their patients and the environment - Nurses needed to use common sense in their nursing practice, coupled with their observation, perseverance and ingenuity.  Nightingale Theoretical Assertion C. INFECTION - Understood the concept of contagion and contamination through organic materials from the patient and/ or the environment  Nightingale Theoretical Assertion C. INFECTION - Nightingale embrace the concept of vaccination against various disease. - Appropriate manipulations of the environment would prevent disease- modern sanitation activities.  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 12 Factors Affecting Environmental Principles 1. Ventilation and Warmth 7. Personal Cleanliness 2. Light 8. Variety 3. Cleanliness 9. Chattering Hopes and Advices 4. Health of Houses 10. Taking Food 5. Noise 11. Petty Management 6. Bed and Bedding 12. Observation of the Sick  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 1. Ventilation and Warmth NURSING PROCESS AND THOUGHT: - Check the patient’s body temperature, room temperature, ventilation and foul odors. - Create a plan to keep the room well ventilated and free of odor while maintaining the patient’s body temperature. - “Keep air he breathes pure as the external air, without chilling him. “ FN - Person who repeatedly breathes his own would be sick or remain sick  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 2. Light NURSING PROCESS AND THOUGHT: - Check room for adequate light. Sunlight is beneficial to the patient. - Direct sunlight was the clients wanted - Has quite real and tangible affect on human body - Lack of environmental stimuli in such units may have “intensive care psychosis” r/t lack of usual cycling day and night  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 3. Cleanliness NURSING PROCESS AND THOUGHT: - Check room for dust, dampness and dirt. - Keep room free from dust, dirt and dampness  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 4. Health of Houses NURSING PROCESS AND THOUGHT: - Check surrounding environment for fresh air, pure water, drainage, cleanliness and light. - Remove garbage, stagnant water and ensure clean water and fresh air. - “Badly constructed houses do for the healthy what badly constructed hospitals do for the sick”- FN - CLEANLINESS outside house affected inside  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 5. Noise NURSING PROCESS AND THOUGHT: - Check noise level in the room and surroundings. - Attempt to keep noise level in minimum. - Pts should never be waked intentionally or accidentally during the first part of sleep - Noises may irritate pts s/a jewelries, keys, snapping of rubber gloves, Clank of stethoscope against bed rails, telephone ringing  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 6. Bed and Bedding NURSING PROCESS AND THOUGHT: - Check bed and bedding for dampness, wrinkles and soiling. - Keep the bed dry, wrinkle- free and lowest height to ensure comfort. - An adult exhales 3 pints of moisture thru lungs and skin in 24 hr period - Never lean against, sit, upon, or make unnecessarily shake bed  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 7. Personal Cleanliness NURSING PROCESS AND THOUGHT: - Attempt to keep the patient dry and clean at all times. - Frequent assessment of the patient’s skin is essential to maintain good skin integrity - Unwashed skin poisons the pt - Bathing and drying skin free from all obstructing excretions - “Every Nurse wash hands very frequently during the day” -FN  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 8. Variety NURSING PROCESS AND THOUGHT: -This is done with cards, flowers, pictures and books. Also encourage friends or relatives to engage in stimulating activities -need for changes in color and form (diversional therapy) -provide pts room to help her avoid boredom -advocate reading, writing, cleaning to relieve sick or boredom  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 9. Chattering Hopes and Advices NURSING PROCESS AND THOUGHT: - Avoid talking without giving advice that is without a fact. - Respect the patient as a person and avoid personal talk. - False hopes are depressing to pts - Sick pts should hear good news that would assist them in becoming healthier  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 10. Taking Food and Nutrition NURSING PROCESS AND THOUGHT: - Check the diet of the patient. Note the amount of food and fluid ingested by the patient at every meal. - Variety of food served to pt - Ind. Desire diff. Foods at diff times of the day - Frequent small servings may be more beneficial than a large bfast or dinner - Right food at the right time  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 11. Petty Management NURSING PROCESS AND THOUGHT: - This ensures continuity of care, when the nurse is absent - Document the plan of care and evaluate the outcomes to ensure continuity. - Ways to assure “what you do when you are there, shall be done when you are not there” -FN  NIGHTINGALE’S ENVIRONMENTAL PRINCIPLES: 11. Observation of the Sick NURSING PROCESS AND THOUGHT: - Observe and record anything about the patient - Continue observation in the patient’s environment and make changes in the plan of care if needed. - What is “reverse”, “Importance”, “evidence of neglect” - “If you cannot get the habit of observation, one way or another, you had better give up being a nurse, for it is not your calling, however kind and anxious you may be” – FN  5 ESSENTIAL COMPONENTS OF ENVIRONMENTAL HEALTH: 1. Ventilation – surroundings as a source of dse and recovery 2. Light – exposure in the sun 3. Cleanliness – dirty env’t was a source of infxn. 4. Efficient Drainage – appropriate handling and disposal of body secretions 5. Pure water –bathe pts, wash frequently  ACCEPTANCE BY THE NURSING COMMUNITY 1. PRACTICE – environmental aspects of her philosophy remain integral component of nsg care -21st century relevance continues due t rises of disease, worldwide, pandemic, epidemic -covid19 change the physcial env’t of hospitals -loud noise due to modern technology, equipment and alarms, staff interaction -OCCUPATIONAL HEALTH NSG occurs  ACCEPTANCE BY THE NURSING COMMUNITY 2. EDUCATION - Firmly considered that better practice could result only from better education. - Measurement of the art of nursing could not be accomplished through licensing examinations like testing methods, and case studies - Established nursing schools 3. RESEARCH -  ANALYSIS SIMPLICITY- believed that the environment was the major component creating illness in a patient. 3 major relationships of Nightingale theory: 1. Environment to patient 2. Nurse to environment 3. Nurse to patient - She recognized not only the dangers of the environment, highlighted the benefit of good environments in preventing illness. - Her definition for the nurse and patient- relationship suggest cooperation and collaboration bet. Nurse and patient.  GENERALITY- has been used to provide general guidelines for all nurse practitioners for a number of years. - The concept of the nurse, patient and environment are still applicable and relevant in all nursing setting today  EMPIRICAL PRECISION - Are often stated completely and are presented as truths rather than tentative, testable statements DERIVABLE CONSEQUENCES - Support for a measure of independence and accuracy previously unknown in nursing may still guide and stimulate nurse today as the profession. - Consistently viewed humanity with her theories in nursing. - Nursing as a means of doing the will of God. Nursing as a divine calling that has good nurse- patient relationship towards wellness. Nightingale’s fundamental principles of environmental manipulation and psychological care of the patient can be applied in modern nursing settings.  Her writings continue to motivate creative thinking nurses and her works gives food for thought that continues to encourage the profession  END OF THE LESSON “Recognition of nursing as a professional endeavour distinct from medicine began with Nightingale” Chinn & Kramer, 2018 ASSIGNMENT (Deadline: Thursday) Read the following client’s scenario. Based on the 12 principles of FN‘s Environmental Theory, apply and write the appropriate nursing intervention/s for each principle in long bond paper. Make a table with 2 columns and write down legibly. ASSIGNMENT (Deadline: Thursday) CLIENT’S SCENARIO: Mrs. Tan, a 60 year old lady who had recently undergone coronary artery bypass grafting was the eldest member of the family who was the author’s client in community clinical during her undergrad studies in 2009. It was a middle class family of four members, living in a two room apartment. On entering the house for the first time, the author experienced an unpleasant ASSIGNMENT (Deadline: Thursday) CLIENT’S SCENARIO: odor through the house, as only window of the house was open due to which the house was although bright but was not well ventilated. While assessing Mrs. Tan, it was revealed that since last one day she was feeling pain, itching and redness in her stitches and her body temperature was also raised. ASSIGNMENT (Deadline: Thursday) Her wound was red and had little purulent discharge, and her temperature was 38 degree celsius. Mrs. Tan actually had developed infection in the wound and required hospitalization without any delay. While mobilizing Mrs. Tan on bed to chair it was noticed that her bed linen was also dirty and wrinkled. On inquiring from her daughter-in-law, it was identified that the bedding was not ASSIGNMENT (Deadline: Thursday) changed since last one week as she does not come out of her bed for so long that the bed linen could not be changed. Also on inquiry, it was told that Mrs. Tan is being given assisted bath only twice a week and even her clothes are not changed daily. As intervention, the author helped Ms. Tan’s daughter in law changing the bedding and giving bath to Mrs. Tan. ASSIGNMENT (Deadline: Thursday) She also taught her techniques for sponging, as if she cannot take Mrs. Tan bath everyday she can give her sponge daily twice a day. She made all the windows open and made the house brighter and more ventilated and took personal and bed hygiene as a topic and provided a session to whole community.