Nursing Paper: Florence Nightingale

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Nursing Paper- Florence Nightingale


Known as the lady with the lamp, Florence Nightingale would also become known as the founder of modern nursing and a renown theorist of her time. Nightingale would go on to give nurses what would be known as the Environmental theory and with it a guide on patient care for years to come. This paper will discuss the background of Florence Nightingale and her theory while explaining why it was chosen for this paper and finally will go over how her theory still applies to patient care today.


Florence Nightingale, known as the founder of nursing, described a way of nursing care that would later go on to be one of the most influential and most used theories in the profession. Born in 1820 it was not until 1844 that Nightingale decided to into the field of nursing (Gonzalo, 2019). During her time serving on the front lines during the Crimean War Nightingale observed numerous deaths of soldiers. Nightingale believed the deaths were the result of subpar nutrition, inadequate supplies, being overworked. After collecting evidence that pointed to unsanitary conditions as a major cause of death, Nightingale worked to improve sanitation in both the army and civilian hospitals during peacetime (Petiprin, 2016). From her observations of the field the Environmental Theory was born and put into practice.

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Florence’s Environmental Theory defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery” (Gonzalo, 2019). Health is maintained through the “nurse’s initiative to configure environmental settings appropriate for the gradual restoration the patient’s health, and that external factors associated with the patient’s surroundings affect life or biologic and physiologic processes, and his development” (Gonzalo, 2019).

The theory is further broken down into five main concepts: ventilation, warmth, light, noise, diet, and cleanliness (Alligood, 2018).

Ventilation and Warmth

Ventilation was Nightingale’s main concern. A patient that breathed his own air too many times or did not have adequate ventilation and access to fresh air would remain sick, they would possibly get sicker (Gonzalo, 2019). The nurse was to manipulate the air around the patient and the patient around the room to maintain pure and proper ventilation by using windows and positioning (Alligood, 2018). Maintaining the proper placement of the patient means allowing them proper ventilation and thus warmth. When positioning the patient palpate around the extremities to check for heat loss (Alligood, 2018). If this happens the nurse would adjust the surroundings and ventilation to allow for the most optimal outcome possible.


Light was another key factor in patient surroundings. To achieve the most beneficial effect of the light, the nurse was instructed to move the patient into direct sunlight (Alligood, 2018). Direct sunlight is the most beneficial and has the most tangible effects on the body.


The noise was detrimental to the patient and the healing process. The nurse could and should seek to maintain quiet and activities that created noise around the patient should be avoided at all cost. Nurses should never whisper about their clients or have long conversations about them. It is to be avoided. Patients need to be a part of their care and conversation. Patients should also never be awakened intentionally or accidentally during the first parts of their sleep (Gonzalo, 2019)


The nurse needs to look at the diet of the patient and assess his dietary needs and mealtimes. This goes to assess weather the food is benefiting or hindering the healing process. Patients with complex illness can be unintentionally starved to death. Intelligent nurses successful meet the needs of the patients and can manage the dietary portion of the care (Alligood, 2018). Diet can manage many short- and long-term conditions.


Cleanliness is a critical aspect of the theory. Nightingale spoke directly to the patient, the nurse, and the environment in regard to how to keep the environment in order. A dirty environment meaning linen, floors, walls was a source of infection no matter how well ventilated it was (Alligood, 2018). All waste was to be disposed of quickly and properly and that included the waste that build up on the body daily. Nightingale advocated for patients and nurses to be washed and gowned in fresh linen nightly (Alligood, 2018).

Why Theory Chosen

This theory was chosen because it is engrained in every nurse’s head and this nurse falls back on this theory every shift. Nightingale’s theory is based on explicit knowledge and is tested time and time again through many decades of nursing practice. This nurse continues to practice the items that are laid out in theory and have her patients heal. It is muscle memory to pick up clutter and debris from patients rooms during rounds and to offer baths and linen changes while seeing if they are comfortable and if they are in need of anything. This nurse works a major homeless and transient population and cleanliness and diet are major components of the environment that lead to disease that this nurse wishes she could do more about. Everything about the environment goes into the person. You cannot separate the two and thus you cannot treat the person without treating the environment.

Applied to Practice

Nightingale’s theory can be applied to clinical practice with little thought. Nightingale’s theory is fundamental to every part of nursing. It can be used for assessing and treatments during the during nursing process. For example, the nurse notices the patient running a fever and is slightly chilled. She knows she needs to see if the fever will resolve, so the nurse turns adjusts the thermostat in the room and removes the blanket from the patient leaving the sheet. This will leave the patient with some type of cover and adjusting the thermostat allows the patient to be comfortable but removing the blanket allows for some heat loss. The nursing intervention was not invasive and brought comfort to the patient.

Another proof that it is critical to the application of every day nursing is the thought that there should be no whispering at the patient’s door. A bedside report shall take place with the oncoming nurse and the patient if they so wish to participate. This way the patient feels included in their care and knows what is going on and what to expect during the shift. It is all about maintaining a quiet environment around the patient.

Supporting Clinical Practice

Nursing theory helps nurses determine what is empirical from what is theorical knowledge. Theory helps to distinguish the basis of practice by explicitly describing nursing and by having a defined body of theory in nursing one receives better patient care improved communication between nurses, and guidance for research and education (Colley, 2003). By using theory nurses have a chance to organize their thoughts into principles that will help evaluate what to do for the patient and scenario in any given situation.


Nightingale’s key concepts remain the foundation of nursing practice today. Ventilation and warmth, light, quiet, diet, and cleanliness are all integral parts to keeping disease at bay and health in good alignment inside the body. Without balance one would fall ill. Nursing in the twenty first century has not fallen away from this, instead nurses have gotten closer. Scrubs are washed more than average, hand sanitizer and bleach are out of stock on shelves, and people are staying away from people if possible. Ventilation is being made a priority, people are finally washing their hands and now nurses need to focus on diet and light and keep focusing on ventilation. Just because one problem has stopped does not mean every problem and illness has.


  1. Alligood, M. R., (2018) Nursing Theorists and Their Work, 9th ed. Missouri: Elsevier
  2. Colley, Sarah. (2003) Nursing Theory: Its Importance to Practice. Retrieved from
  3. Gonzalo, A. (2019) Florence Nightingale’s Biography and Environmental Theory: Study Guide. Retrieved from
  4. Petiprin, A. (2016). Florence Nightingale. Retrieved from


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