Florence Nightingale (PDF)

FLORENCE NIGHTINGALE “THE MOTHER OF MODERN NURSING”  FLORENCE NIGHTINGALE 12 MAY 1820 – 13 AUGUST 1910 LIFE AND WORKS ENVIRONMENTAL THEORY MAJOR AND SUBCONCEPTS ASSUMPTIONS CONCLUSION  NURSING DEFINED “NURSING IS THE NIGHTINGALE IS ART OF THE FIR...

FLORENCE NIGHTINGALE “THE MOTHER OF MODERN NURSING”  FLORENCE NIGHTINGALE 12 MAY 1820 – 13 AUGUST 1910 LIFE AND WORKS ENVIRONMENTAL THEORY MAJOR AND SUBCONCEPTS ASSUMPTIONS CONCLUSION  NURSING DEFINED “NURSING IS THE NIGHTINGALE IS ART OF THE FIRST NURSE UTILIZING ONE’S THEORIST WELL- ENVIRONMENT KNOWN FOR DEVELOPING THE FOR HIS OR HER ENVIRONMENTAL OWN RECOVERY.” THEORY. 3  Born on May 12, 1820, in Florence, Italy She was the younger of two children. (Older Sister: Frances Parthenope Nightingale) Her British family belonged to elite social circles Her father, William Shore Nightingale, a EARLY LIFE wealthy landowner who had inherited two estates. Her mother, Frances Nightingale, hailed from a family of merchants and took pride in socializing with prominent social standing people. 4  Raised on the family estate at Lea Hurst, her father provided her with a classical education, including German, French, and Italian. (Excellent in Math) Nightingale was active in philanthropy from a EDUCATION very young age. At age 17 (Feb. 1837), she decided to dedicate her life to medical care for the sick resulting in a lifetime commitment to speak out, educate, overhaul and sanitize the appalling health care conditions in England. 5  EDUCATION ENROLLED AS A NURSING STUDENT IN 1844 (@ AGE 24) AT THE LUTHERAN HOSPITAL OF PASTOR FLIEDNER IN KAISERSWERTH, GERMANY. MOTIVATED BY ELIZABETH BLACKWELL AT ST. BARTHOLOMEW’S HOSPITAL, FIRST WOMAN DOCTOR IN U.S. 6  Her mother and sister were against her chosen career, but Nightingale stood strong and worked hard to learn more about her craft despite society’s expectation that she become a wife and mother. However, she rejected a suitor, Richard PERSONAL Monckton Milnes, 1st Baron Houghton, because LIFE she feared that entertaining men would interfere with the process. The allowance given to her by her father of £500 (roughly £25,000/US $50,000 in present terms) allowed her to live comfortably and pursue career. 7  She regarded the experience in the Lutheran Hospital in Germany as A TURNING POINT IN HER LIFE and issued her findings anonymously in 1851; “The Institution of Kaiserswerth on the Rhine, for the Practical Training of WORKS AND Deaconesses,” etc. was her first published APPOINTMENTS work. In 1853, She accepted the position of Superintendent at the Institute for the Care of Sick Gentlewomen (Invalid Women) in Upper Harley Street, London. She held this position until October 1854. 8  In March 1853, the Crimean War broke out between Russia and Turkey, with the British and French forces aiding Turkish armies in repelling the advances of the Russians. Soldiers began going down CRIMEAN WAR with cholera and malaria (around 8,000.00 men) Several Nurses offered help but rejected until public protest was made after a newspaper was published concerning the status of British army. 9  FLORENCE NIGHTINGALE’S MOST FAMOUS CONTRIBUTION CAME DURING THE CRIMEAN WAR, WHICH BECAME HER CENTRAL FOCUS WHEN REPORTS BEGAN TO FILTER BACK TO BRITAIN ABOUT THE HORRIFIC CONDITIONS FOR THE WOUNDED. ON 21 OCTOBER 1854, SHE AND A STAFF OF 38 WOMEN VOLUNTEER NURSES, WERE SENT (UNDER THE AUTHORIZATION OF SIDNEY HERBERT, THE SECRETARY OF WAR) ACROSS THE BLACK SEA FROM BALAKLAVA IN CRIMEA, WHERE THE MAIN BRITISH CAMP WAS BASED. 10  Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari (Modern day Uskudar in Istanbul – Present Capital of Turkey) There were no female nurses stationed at hospitals in the Crimea. 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. 11  There was no equipment to process food for the patients. Rats and insects crawled the floor and walls. Wounded soldiers still wearing their army uniform “stiff with dirt” During her first winter at Scutari, 4,077 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. 12  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. 13 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 by William Howard Russell “She is a “ministering angel” without any exaggeration in these hospitals, and as her slender from 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.” 14  “Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army” 830 page report analyzing her WORKS experience and proposing reforms for other military hospitals operating under poor condition. Establish a Royal Commission for the Health of the Army in 1857. 15  1860s published “Notes on Nursing,” outlining nursing principles. -Outlining principles of Nursing. -Served as the cornerstone of the curriculum at the Ningtingale School. WORKS Notes on Hospitals, which deals with the correlation of sanitary techniques to medical facilities. Suggestions for Thought to Searchers after Religious Truths, she argued strongly for the removal of restrictions that prevented women having careers. 16  She funded St. Thomas’ Hospital’s establishment, and within it, the Nightingale Training School for Nurses. (Now King’s College London) 1870s Nightingale mentored Linda WORKS Richards, “America’s first trained nurse,” later became a great nursing pioneer in the USA and Japan. 1880s Wrote an article for a textbook which advocate strict precautions designed, to kill the germs. 17 FIRST BATCH OF NURSING GRADUATES 18  Crimean Monument in Waterloo Place, London, was erected in her honor. King Edward VII bestows the Order of Merit; it is the first time that the Order AWARDS AND is given to a woman. HONORS Became a Fellow of the Royal Statistical Society because of her “Nightingale Rose Diagram” Honorary member of the American Statistical Association. 19 20 21  Despite being known as the heroine of the Crimean War, Florence Nightingale fell ill in DEATH August 1910. She died unexpectedly at 2 pm the following day, Saturday, August 13, at her home in London. Usually, well-known people with great contributions are offered national funerals, but Nightingale had expressed the desire that her funeral is a quiet and modest affair. Respecting her last wishes, her relatives turned down a national funeral, and the “Lady with the Lamp” was laid to rest in her family’s plot at St. Margaret’s Church, East 22 23 ENVIRONMENTAL THEORY  DEFINED NURSING “THE ACT OF UTILIZING THE ENVIRONMENT OF THE PATIENT TO ASSIST HIM IN HIS RECOVERY” 25 NIGHTINGALE’S ENVIRONMENTAL MODEL 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. 26  12 SUB-CONCEPTS 1. HEALTH OF HOUSES 2. VENTILATION & WARMING 3. LIGHT 4. NOISE 5. VARIETY 6. BED & BEDDING 7. CLEANLINESS OF ROOMS & WALLS 8. PERSONAL CLEANLINESS 9. NUTRITION & TAKING FOOD 10.CHATTERING HOPES & ADVICES 11.OBSERVATION OF THE SICK 12.PETTY MANAGEMENT 27  NIGHTINGALE BELIEVED THAT WHEN ONE OR MORE ASPECTS OF THE ENVIRONMENT ARE OUT OF BALANCE, THE CLIENT MUST USE INCREASED ENERGY TO COUNTER THE ENVIRONMENTAL STRESS. THESE STRESSES DRAIN THE CLIENT OF ENERGY NEEDED FOR HEALING. 29  1. HEALTH OF HOUSES IS CLOSELY RELATEDD 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. 30  2. VENTILATION & WARMING “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 AFFECTED THE CLIENT’S HEALTH (BEDPANS, URINAL) EMPHASIZED THE IMPORTANCE OF ROOM TEMPERATURE (NOT TOO WARM NOR TOO COLD) 31  3. 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 ENVIRONMENTAL STIMULI (EX. ISOLATION, NICU, ICU) CAN LEAD TO CONFUSION OR “INTENSIVE CARE PSYCHOSIS” RELATED TO THE LACK OF THE USUAL CYCLING OF DAY AND NIGHT. 32  4. NOISE PATIENTS SHOULD NEVER BE WAKED INTENTIONALLY OR ACCIDENTALLY DURING THE FIRST PART OF SLEEP. NOISES THAT MAY IRRITATE PATIENTS ARE JEWELRIES WORN BY NURSES, KEYS THE JINGLE, SNAPPING OF RUBBER GLOVES, THE CLANK OF THE STETHOSCOPE AGAINST METAL BED RAILS, TELEPHONES RINGING. 33  5. 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 (EX. BRIGHTLY COLORED FLOWERS OR PLANTS, ROTATE PAINTINGS & ENGRAVINGS, PRESENT DIVERSIONAL THERAPHY) ADVOCATE READING, WRITING, AND CLEANING TO RELIEVE THE SICK 34 OF BOREDOM.  6. BED & BEDDING AN ADULT EXHALES ABOUT 3 PINTS OF MOISTURE THROUGH THE LUNGS & SKIN IN A 24 HR PERIOD. THIS 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, NEATN DRY, AND TO POSITION 35 FOR MAXIMUM SUPPORT  7. CLEANLINESS OF ROOMS & WALLS THE GREATER PART OF NURSING CONSISTS IN PRESERVING CLEANLINESS REMOVAL OF DUST WITH DAMP CLOTH RATHER THAN FEATHER DUSTER FLOORS SHOULD BE EASILY CLEANED FURNITURE AND WALLS BE EASILY WASHED CLEAN ROOM IS A HEALTHY ROOM 36  8. 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 OUTH TO WASH HER HANDS VERY FREQUENTLY DURING THE DAY - NIGHTINGALE” 37  9. NUTRITION & 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 38  10. CHATTERING HOPES & ADVICES FALSE HOPES ARE DEPRESSING TO PATIENTS SICK PERSON SHOULD HEAR GOOD NEWS THAT WOULD ASSIST THEM IN BECOMING HEALTHIER 39  11. OBSERVATION OF THE SICK NURSES MUST BE TAUGHT WHAT TO OBSERVE HOW TO OBSERVE (WHAT SYMPTOMS INDICATE FOR IMPROVEMENT) WHAT IS THE REVERSE WHICH ARE OF IMPORTANCE WHICH ARE EVIDENCE OF NEGLECT 40  11. OBSERVATION OF THE SICK IT IS IMPORTANT TO OBTAIN COMPLETE & 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.” 41  12. 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. EX. NURSING ENDORSEMENT, TEACH THE PATIENT 43  12. PETTY MANAGEMENT NOTE THAT THE CLIENT, THE NURSE, AND THE MAJOR ENVIRONMENT CONCEPTS ARE IN BALANCE; THAT IS: THE NURSE CAN MANIPULATE THE ENVIRONMENT TO COMPENSATE FOR THE CLIENT’S REPONSE TO IT. THE GOAL OF THE NURSE IS TO ASSIST THE PATIENT IN STAYING IN BALANCE. IF THE ENVIRONMENT OF A CLIENT IS OUT OF BALANCE, THE CLIENT EXPENDS UNNECESSARY ENERGY. 44  MAJOR CONCEPTS METAPARADIGM 45  ENVIRONMENT ANYTHING CAN BE MANIPULATED TO PLACE A PATIENT IN THE BEST POSSIBLE CONDITION FOR NATURE TO ACT. PHYSICAL PSYCHOLOGICAL NIGHTINGALE STRESSES THE PHYSICAL ENVIRONMENT, IN WHICH ALL THAT SURROUNDS HUMAN BEINGS IS CONSIDERED CONCERNING THEIR HEALTH STATE. 46  PERSON THE ONE WHO IS RECEIVING CARE; A DYNAMIC AND COMPLEX BEING 47  HEALTH “HEALTHY 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, A REPARATIVE PROCESS. THE GOAL OF ALL NURSING ACTIVITIES SHOULD BE CLIENT’S HEALTH. 48  NURSING A SPIRITUAL CALLING; NURSES WERE TO ASSIST NATURE TO REPAIR THE PATIENT RESPONSIBLE TO PROVIDE PHYSICIANS WITH ACCURATE INFORMATION ABOUT PATIENTS DIFFERENT TYPES OF NURSING NURSING PROPER – NURSING THE SICK GENERAL NURSING – HEALTH PROMOTION MIDWIFERY NURSING 49  NURSING NURSES MUST USE THEIR POWERS OF OBSERVATION IN CARING FOR PATIENTS NURSES MUST HAVE EDUCATIONAL BACKGROUND & KNOWLEDGE THAT WERE DIFFERENT FROM THOSE OF PHYSICIANS SHE RALLIED FOR NURSING EDUCATION TO BE COMBINATION OF CLINICAL EXPERIENCE AND CLASSROOM LEARNING. 50  APPLICATION TO NURSING PRACTICE WITH THE ADVENT OF TECHNOLOGY, AND WITH IT 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 THE NURSE PRACTITIONER OF TODAY. 51  THANK YOU Prepared by: Mira Rhodora M. Kapaw-an, RN, MAN NCM-100 Theoretical Foundation In Nursing Instructor