My first assignment in Nursing As a Profession
An assignment that had me ask myself, “what introduced my passion for nursing?
Scholarly Paper
Florence Nightingale’s Environmental Theory
Hannah Polito – 0840989
Department of Nursing, Trent University
NURS 1001 – Nursing As a Profession
Dr. Rachel Galea
Tuesday, October 1
The environmental theory had originated in 1860 and was created to reform healthcare. Florence Nightingale developed the theory in England, where she established the Nightingale Training for Nurses. Florence Nightingale was born May 12, 1820 and was raised by an upper class British family. The video The Lady With The Lamp, suggests that in the nineteenth century a woman’s “purpose in life was to marry and bear children” (Kent, 2020, 8:42), however Nightingale was passionate about nursing which had started her on her study at a hospital in Germany, later to become head of nursing at a hospital in London. She used her knowledge she had gained from those experiences to begin her training for nurses. Florence Nightingale was also known for many works which include research on nursing education, cause of infection, prevention of infection, hospital planning, proper sanitation, health promotion and proper healthcare (Gilbert, 2020). During the Crimean war at seventeen years old, Nightingale was in the midst of a cholera outbreak while she had been working as a nurse and discovered that the unsanitary conditions of the environment had brought the rapid spread of disease. Nightingale had noticed the soldiers died from two causes mainly, which was from battle as well as from infection and disease (McEnroe, 2020). Nightingale’s experience with the cholera outbreak inspired her to make it her mission to improve unsanitary conditions in healthcare. Florence Nightingale then went on to eventually establish Nightingale nursing school as the first nursing school in the world (McEnroe, 2020). Florence Nightingale’s efforts in health reform has made nursing one of the most well respected professions in the world. Nightingale developed the environmental theory for certain practices such as primary care, emergency care, and other healthcare clinics. Each one uses environmental theory when keeping the clinic tidy, sterilising medical equipment, and looking after patient hygiene. The theory may not be applicable for practices that provide virtual or over the phone care because there is no designated place of care.
Florence Nightingale’s environmental theory resonates with me most because I believe keeping cleanliness is a key aspect of patient care. In high school I had the opportunity to work alongside the nurses and other healthcare professionals in an emergency department to acquire my volunteer hours as well as gaining valuable experience working in a healthcare setting. During my time as a volunteer I had been familiarised with many components that make up the environmental theory such as proper hand washing, sterilization of equipment, and the use of personal protective equipment also known as PPE. I had volunteered at my local hospital every week for six months and learned something new every shift, many times about a form of infection prevention. For example, the hospital set up an orientation to educate volunteers on virus and bacteria spread as well as hosting meetings where we went over how each of us were implementing infection prevention into our work. One thing I can recall from our orientation was when our lead had us learn how to properly put on and take off medical gloves. We learned this was important to eliminate the chances of possible bacteria on our gloves getting on our skin which could infect us. Another memory I have of the orientation was our lead telling us to put on the gloves, then add a drop of paint to our hands and rub it in thoroughly. This activity was meant to show us volunteers, all of the spots we would have missed when washing our hands and showed us why it is extremely important to be educated on proper hand hygiene. When the pandemic of Covid-19 had recently lifted their mandates our emergency department continued to have a masking rule before entry. The masking rule was not only the emergency department but many units where patients may be infected with an airborne pathogen had made it mandatory because hospitals are filled with infectious disease and masks are proven to stop or slow down spread. A hospital is an outlet for patients to seek treatment; however, if the hospital was kept unclean then the risk of spreading infection would increase. If that were the case then patients would go to the hospital to seek treatment but undergo a new disease or infection as they exit which is why the environmental theory plays an important role in healthcare. The reason I decided I want to pursue nursing as a profession is because of one person who has truly impacted my life. My entire life I have been in and out of hospitals because at birth I was diagnosed with a metabolic disorder known as Phenylketonuria or PKU. Every year since I was born I have made two visits to the Sick Kids hospital in Toronto where I go to discuss my diet with a dietician and meet with a doctor who helps me understand my condition and performs a few tests. As a kid, I used to get a lot of anxiety about getting blood drawn, but there was one nurse who was always able to help me push through those nerves. She used the reliable method of calming my nerves with princess stickers but she was also incredible at drawing blood extremely fast which definitely helped because nobody knew how long those princess stickers would distract me. I remember before each visit I had said to my parents, “I hope we get the same nurse as last visit.” My experience with this nurse is why I now have such a huge appreciation for all nurses. Nurses are able to whole-heartedly care for you in a way that has encouraged and inspired me to do the same. Little me would have said, “when I grow up I want to be the nurse who has shown me the true meaning of the nursing profession in all aspects.” I have never been more certain about a decision in my life and I am determined to become as extraordinary in this profession as she is. I chose to study environmental theory because the way care is provided is similar to how it would be provided in the profession I would like to pursue. In the future, I hope to become an intensive care unit nurse because I admire their courage and compassion. An intensive care unit also known as the ICU, benefits from the use of Florence Nightingale’s environmental theory. This theory entails cleanliness of rooms, proper ventilation/air flow, proper lighting, kept calm/quiet, personal cleanliness and a supply of food (Kilpatrick, 2024). As a future intensive care unit nurse, I will follow Florence Nightingale’s theory to make environmental observations which I can then use to make any necessary changes for optimal patient care. An example of this theory being used in practice would be re-making the beds with clean sheets after each patient is discharged. The spread of infections are common in an intensive care unit because the patients who are suffering from an infection are frequently placed there. Prevention can be done by taking precautionary steps such as keeping proper air flow throughout the unit to prevent airborne pathogens from infecting visitors, healthcare professionals, or other patients.
As the environmental theory was made available in the nineteenth century and it is now the twenty-first century, some sequences of the theory will need alteration. Personally, I would make a few critiques to the theory to meet new nursing standards. Based on our current realities of nursing, ways we have improved the environmental theory in the past was by bringing new found knowledge into the profession. Nightingale provides a basis of holistic care with a focus on environmental cleanliness to prevent infection which includes keeping a tidy environment and proper hygiene. Through the evolution of infection prevention, scientists have been able to discover antibiotics and vaccines which can be ingested or injected to attack and sometimes kill the infection. We have implemented medical advances such as antibiotics and vaccines into the environmental theory because both are reliable treatments that have been proven to diminish or weaken infection. Florence Nightingale was also unaware of the various bacterial and viral infections but knew that infections can be spread through physical contact or no contact (Gilbert, 2020). Healthcare providers are now aware of the many different bacterial and viral infections as well as the variety of strands to each and have needed a higher education to determine the infection in order to prevent or treat it. The level of education required of a nurse has evolved many times over the past decades, starting from the Nightingale training, to a college diploma, to finally a university bachelor of science in nursing degree. My grandma was a nurse for over 50 years and she always tells me how back in her day nursing school was a college program. Another cool fact is that her last year of college was the year they switched the program to be university level. Medical advances and higher education were both ways we improved the environmental theory to meet our twenty-first century nursing standards. Components of the environmental theory that in our modern society need to be changed are how Nightingale’s theory promotes good health and well-being by environmental improvement, but could have a stronger focus on hands-on patient care (Gilbert, 2020). Hands-on patient care is as important as environmental cleanliness because preventing infection is as important as treating infection. Vaccines and antibiotics are used to help treat infection but I would also critique this theory by incorporating the nursing process which includes assessment, diagnosis, planning, implementation, and evaluation. The nursing process is important in determining the infection and using that knowledge to properly treat each patient. The required higher education nurses now obtain will allow them the ability to implement the nursing process into the environmental theory. Combining the environmental theory and the nursing process would involve a plan of prevention and treatment in all aspects. Already, there are many strengths of the environmental theory including how it prioritizes environmental cleanliness which promotes good health and well-being as well as preventing further spread of infection which allows patients to heal quicker. Preventing further spread is a strength which can be applied in nursing practice by wiping down and preparing the clinical rooms for new patients. Healthcare providers can also use this theory to take precautions before entering the patient’s room by assessing the patient’s charts to see if any PPE is needed. As a first year nursing student, I will apply this theory in my day-to-day life by being cautious of how infection is spread and how to prevent it, maintaining organizational skills, and remembering the importance of cleanliness. I believe it is important for a healthcare professional to use these theories in all aspects of their lives and not only as an aspect of their career. Keeping a consistent mindset of these theories can encourage people to truly understand the workings behind them, their importance, and how they can influence others to gain the same knowledge and understanding. I will also apply this theory to my clinical placements over the next four years which will involve nursing homes, clinics, and hospitals. In different settings I will use the environmental theory in different ways, keeping the same concept. In a nursing home I might use the theory in simpler ways such as opening the curtain for natural light, making beds, and helping with personal hygiene whereas in a hospital I will need to take extra steps to sterilize medical equipment, ensure that I have proper PPE on, and change sheets more often due to more frequent discharge of patients.
Florence Nightingale’s environmental theory has a strong structure among all others and will continue to be used in the future. The structure of the environmental theory is strong because we use environmental precautions in all healthcare settings in order to maintain the safety of the patients as well as the healthcare professionals. Healthcare professionals are implementing Florence Nightingale’s environmental theory into our modern society by taking precautions to prevent infection, promoting health and well-being, and providing a holistic approach to patient centered care. Even with minor critiques to Nightingale’s theory her mark in our history of nursing will forever be acknowledged and appreciated. An abundance of inspiration is displayed through the story of Florence Nightingale and how she came upon the development of her theory. The environmental theory has inspired many healthcare professionals and other individuals in both professional and day-to-day lives and being the foundation of our nursing history will forever make it an admirable work. Florence Nightingale’s story of health reform has inspired me to want to become an advocate for proper patient care, especially when nobody else is taking action to make changes in what they believe are important aspects of nursing. Having the opportunity to learn about who Florence Nightingale is and what she has done for public health is knowledge I will be taking with me into this profession to help me navigate obstacles and make informed decisions. The environmental theory has both strengths and weaknesses but the strengths we can implement into our own practice and the weaknesses we can learn from in order to evolve.
References
Gilbert, H. (2020). Florence Nightingale’s Environmental Theory and its
influence on contemporary infection control. Collegian, 27(6), 626-633.
https://www.sciencedirect.com/science/article/pii/S1322769620301347
Kent, G. (2020). The Lady With The Lamp. The Incredible Journey. YouTube.
https://www.youtube.com/watch?v=yWs0tlYRpEc
Kilpatrick, M. (2024, May 23). Environmental theory of Florence Nightingale.
WSNA.
https://www.wsna.org/news/2024/environmental-theory-of-florence-nightingale
McEnroe, N. (2020). Celebrating Florence Nightingale’s bicentenary. PubMed
Central (PMC). The art of medicine, 395(10235), 1475-1478.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252134/