Florence Nightingale Nursing Theory: Key Takeaways

Do you feel more at ease when your home is clean? Or do you notice you sleep better after washing your sheets? If you said yes to either of these questions, you’re identifying with the Florence Nightingale nursing theory. She believed that the environment around us has an impact on how we feel and heal.

While some scholars are taking a more critical look at some of her ideas, few nursing leaders have made a more lasting impression than Florence Nightingale. Nurse theory related to sanitation was first introduced by Nightingale, who helped nursing evolve from a vocation to a profession.

Born in 1820, Nightingale cared for wounded soldiers during the Crimean War, then established a formal nursing school in London after the war. Her first book, Notes on Nursing, was taught in nursing schools for decades, and many schools still recite versions of the Nightingale Pledge during graduation ceremonies. Here’s what modern nurses should know about her work.

Florence Nightingale. Source: History Channel

What Is the Florence Nightingale Theory in Nursing?

The Florence Nightingale theory of nursing (sometimes called the Florence Nightingale environmental theory) posited that the environment people live in determines their health. While basic hygiene measures and infection control are standard in today’s nursing units, they weren’t during Nightingale’s time. Her ideas began a sea change in the ways that wards are maintained and kept clean, and the ways that nurses contribute to healing.

When she arrived in the wards of Crimea, the patients there were living in filth. Through cleaning up their physical environment, Nightingale helped direct their healing and provide standards for sanitation. But she also believed that the environment is more than a clean bed and a room — patients need social, spiritual, and mental support to experience the best outcomes.

Nightingale defined elements of the environment that must be optimized so that patients can heal from illness. Nurses provide holistic environmental care by ensuring cleanliness and health promotion in these areas and more:

• Ventilation
• Light
• Noise
• Cleanliness of the room and walls
• Bed and bedding
• Personal cleanliness
• Nutrition

Nightingale also introduced a different model for nursing — one where nurses were more than physician’s helpers. She believed that nurses use not only their hands, but also their hearts and minds to promote healing environments for patients.

Application of Nightingale’s Theory in Nursing Practice: Real-World Examples

Even though Nightingale’s theories were developed in the mid-19th century, today’s nurses can still find meaning in her philosophies on sanitation. For example, the public was reminded of the importance of handwashing and personal hygiene during the height of the COVID-19 pandemic. While wiping down surfaces and sanitizing objects, modern nurses are living Nightingale’s theories.

Environmental cleanliness is essential for good health outcomes, both inside and outside of the hospital. Maintaining a patient’s hygiene is one of the first barriers against hospital-associated infections, such as central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI).

Once you understand the Florence Nightingale nursing theory, you’ll likely start seeing it everywhere — environmental standards are an essential part of modern medical care. For example, most facilities have environmental health policies that include:

• Required daily baths for patients who have Foley catheters and central lines.
• Required handwashing before, during, and after patient interventions.
• Housekeeping standards in hospitals, post-acute centers, outpatient clinics, and more.
• Removing used food trays promptly after meals.
• Decontaminating medical equipment after each patient use.
• Quiet hours during specific times of the night and day.

Ways to Promote the Florence Nightingale Nurse Theory in Patient Care

What are practical ways you can apply Nightingale’s environmental theory in your next shift? You’re probably already using environmental safety and health promotion in your nursing practice. Here are a few strategies:

• Keep meds safe and sanitary: Make sure medicines are kept safe and clean by storing them properly, preparing medications in tidy areas, and giving them to patients carefully.
• Mitigate germs: Wash your hands between patient encounters, wear gloves and masks when appropriate, and follow patient-specific contact precautions to avoid spreading infectious diseases.
• Encourage expression: Ask patients how they are doing, offer to set up calls with family, and advocate for socialization when possible.
• Prevent falls: Scan patients’ rooms for potential hazards, and try to keep rooms tidy. Patients who are a risk for falls might need a bed alarm or closer monitoring.
• Promote comfort: Help patients feel at ease by keeping rooms at a good temperature, adjusting bedding and pillows, and ensuring they have enough light to see properly.
• Encourage rest and sleep: Sleep is essential for health, yet many hospital units are noisy and busy nearly 24 hours a day. Try to help patients rest by promoting a quiet, restful environment, and ensuring patients have access to ear plugs, eye masks, toothbrushes, and other necessities.

Florence Nightingale Nursing Theory: FAQs

What is the Nightingale approach in nursing?

Florence’s Nightingale’s philosophy says that nurses use their hearts, minds, and hands to help patients heal. During Nightingale’s time, nurses were subservient to physicians, and had no professional autonomy. Her approach encouraged nurses to be more active in patient care, helping to meet patient’s environmental, spiritual, and social needs.

How did Nightingale change nursing?

Nightingale was a nurse and statistician who modernized nursing by creating standards for environmental cleanliness, nursing education, and professionalism. She was an early advocate for patient-centered care, and emphasized the importance of meeting social and spiritual needs alongside physical ones. She also pioneered using data to improve care, measuring outcomes in her work to create standardized nursing practices.

Use the Florence Nightingale Nursing Theory in Your Next Role

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