Florence Nightingales Environmental Theory

Florence Nightingale’s Environmental Theory

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The Florence Nightingale Environmental Theory (Introduction and Theory)

Nursing theories are a set of organized concepts, definitions, propositions derived from explained relationships attained within the nursing practice and patient care. They are meant to provide frameworks upon which nursing care is provided to the patients and as a rough guide to the general nursing community. There are several nursing theories all within the different field of medicine including pediatric nursing theories, perinatal nursing theories, and holistic nursing theories among several others. Other nursing theories cut across the several the medical field. These include the Watson Caring Theory and Florence Nightingale’s Environmental theory among several others.

The Environmental theory was among the first theories ever to de described. It was developed by Florence Nightingale and was initially meant for caregivers at home. However it has gradually been included wholesomely into the current medical practice because of its favorable outcomes in patient care and management. The theory is mainly based on the principle that unsanitary conditions to a patient both within the hospital or home set up, provide poor outcomes and pose a very bad prognosis to the patient’s recovery. Within the perinatal area, involving the maternity area for instance. This is a very key aspect of care. Unsanitary conditions to both the mother and child can pose a real health hazard to both which may ultimately lead to complications and death. This can be seen both within the hospital set up or assisted home deliveries. The major concepts of the theory involve the nurse offering the nursing care, the patient or the client, the environment and the provision of health.

The subcomponents of the theory include the health of the houses, ventilation and warming, light, noise, variety, bed and bedding, personal cleanliness, nutrition and food intake, hopes and advices. Nightingale expounded that a dirty house has the same effect it has to patients, it harbors sickness due to poor living circumstances which ultimately prevents eradication of diseases. For a patient to get better, he should be surrounded by fresh air free from effluvia. She believed that these worsened the patient’s condition. Also, the importance of room warming was stressed. She stated that the patient should be kept warm, always at room temperature. The theory also advocates for direct light. This provides both the warmth and the required body vitamins such as vitamin C which also has a favorable outcome for the patient. Nightingale also stressed on the avoidance of noise exposure to the patient. She also insisted that the patient should never be woken up by nursing personnel especially during the first part of their sleep.

Provision of a variety is also stated to be a good stimulant of improvement in the patient. Changes in color and form both daily and weekly have a positive outcome in the patients’ prognosis. Also, frequent changing of beddings has a good effect on the patient. This is because the human body, through the lungs and skin excrete several waste material and accumulate moisture which then can cause reinfection. It’s also stated herein that the bed should be at the lightest are of the room which enables it to receive direct sunlight and fresh air. Personal cleanliness is also an important aspect of the theory.

Also, Because of the constant secretions from the body, a nursing personnel and the caregiver should wash their hands several times during the day to prevent the transmission of effluvia from one patient to another. Because several patients’ desire different foods at different times, Nightingale advocated for the provision of small portions of different serving frequently to the patient to enable him eat different foods and get all the aspects of a balanced diet. The final aspect in this theory is that of providing false hope to the patient. The best solution to this was stated as the nursing personnel to believe and tell the patient that better days are yet to come. This gives them hope and makes them fight better.

Reason for Selection

This theory was selected because if applied to the latter, especially in my department, labor and delivery, it would lead to very good outcomes and faster discharge of patients from the hospital. Next, the theory was one of the first theories ever to be described in the history of nursing and was brought about by the “lady of the lamp” through which the entire nursing field was built upon. Her theory incorporates several aspects within the field of nursing and most of the times suits every field of medicine sufficiently and has been used from time immemorial with success.

Thirdly, all the aspects elaborated within the theory are extremely key in the management of patient within the labor and delivery set up as will be discussed in the section below. There are aspects that relate to the mother and those that relate to the infant. Several other theories belabor on either the mother alone of the neonate alone, but in this case, both are well covered. Another reason for selection is because it is one of the most well explained theories within the nursing practice. It is therefore easy to comprehend and apply at the same time.

Finally, this theory was chosen because it goes in tandem with my own beliefs of nursing care. It is my belief that patient care and support should always be at the forefront of every aspect of the management. The patient or the client is and should be the one upon which key decision are made to see to it that they get better and leave the hospital faster enough to get back to their day to day activities. This theory mainly bases its focus on the patient as the center of attention. Every aspect, concept and component discussed in the theory is made for the patient to attain the best outcome possible.

Application of the Theory to Practice

To begin with, ventilation and warming is a very key aspect of care in the maternal unit. There should be sufficient ventilation in the room to enable patients breathe in fresh air. Most of the time, these are women from different locations who have just come to deliver and therefore, one cannot tell just by observation the illness that the woman may be harboring. Therefore good ventilation protects other individuals in that department from air-borne transmissible infections. The importance of warming is especially seen when handling the newborn baby, and thus the incorporation of the resuscitaires to provide the necessary warmth to the newborn to prevent them from developing hypothermia which can rapidly lead to hypoglycemia which has dire consequences such as convulsions, comas and even death.

Constant handwashing is also very important, especially to the nurses. This prevents transmission of infections from one baby to another or from one mother to the other. This will prevent instances of gastroenteritis outbreaks within the ward which complicates patient management. Most infections can be avoided if good handwashing mechanisms are put in place within the hospital and during home deliveries as well; especially to the neonate whose immune system is not very active just following delivery and exposure to very subtle viruses or bacteria can easily lead to infection. Thirdly, the provision of variety is also a key aspect. This is especially seen with the preterm babies. At that stage in their lives, neonates can only appreciate different varieties of appealing colors and large objects drawn to them or hanging above them. This together with provision of sufficient warmth and breastmilk leads to vary favorable outcomes in the neonates. They should be breastfed frequently in portions corresponding to their weights to ensure adequate nutrition. This aspect has also been alluded to by the environmental theory.

Next, in the neonatal intensive care unit for instance, there should be no noise exposure at all. There has been an association of sensorineural hearing loss with patients and infants who were exposed to loud sounds in the neonatal period. The section should therefore be located in a place far from hospital traffic to reduce the amount of noise pollution the children are subjected to. This prevents startles and unnecessary waking of the neonates and has proven to have very good outcomes. Frequent changing of beddings is also important because it prevents accumulation of excretions from both mother and baby which can offer a brooding ground for bacteria such as staphylococcus aureus and parasites such as sarcoptes scaibie from the excoriations of the skin.

Advantages of Using a Theory to Support Clinical Practice

There are several advantages of using theories in clinical practice. First, it allows for the practice of evidence based medicine. Theories are often constructions from derived relationships and performance of things and acts that have been seen to provide good patient outcomes. The Nightingale theory for instance was developed following her observation during her management of the patients. She thus noted the factors that have good outcomes and those that have poor outcomes to help in the patient management of different individuals. Thus the good factors are upheld in clinical practice whereas the bad ones are discouraged. All these then lead to a good prognosis of the patients.

Conclusion (Part V)

In conclusion, several theories have been used to set up hospital protocols on how to manage different medical conditions and how best to take care of the patient. This allows the nurse or the clinical personnel to offer the best available care to the patient even when they are new in a given department or hospital. It is therefore very important for medical personnel to incorporate theories in patient management..

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