Nursing Theories of Florence Nightingale

Florence Nightingale (1820-1910) was an English aristocrat who advocated for a corps of nurses to tend British troops during the Crimean War in 1856. Nightingale accompanied the corps of nurses she organized and paid almost all of their expenses herself. Not only did the nurses do an impressive job tending the wounded, but excelled in helping soldiers when a cholera epidemic broke out. When she returned to England, she started the first school for nursing at St. Thomas Hospital.

Notes on Nursing

• In her "Notes on Nursing," Florence Nightingale offered her theories of patient care. Although her points may seem old-fashioned to a modern reader, they were revolutionary for a time in history when doctors were not yet convinced that washing their hands between patients was beneficial. She takes a holistic approach to patient care, asserting that the patient's psychological and human needs are as important as the medicine they are taking.

Fresh Air

• It was generally accepted that fresh air was extremely important for recovery, and "Notes on Nursing" has a long section explaining how to assure good ventilation of the patient's room by insisting on open windows. This practice can obviously lead to a chilly room and she explains how proper bed clothing can keep the patient warm. Although ventilation may not seem like an issue in a modern hospital, it apparently was in homes with chamber pots and no indoor plumbing.

Cleanliness

• Cleanliness is crucial both for preventing disease and for helping the patient recover, according to Nightingale. She points out as health hazards the practices of keeping full chamber pots by the patients' bedsides, livestock manure piles close to buildings, and running open sewers in the streets. She also criticizes bedding that is "well slept in" as unsanitary, and advocates regular changing, washing and airing out of bedclothes.

Environment

• Nightingale insists that patients' human needs for light and an attractive room are important for recovery. Since patients are confined to bed and have the same view all day long, she suggests that they be able to look out of a window. She also suggests some variety to alleviate patient boredom, as well as attractive colors in the room and quiet, and she believed that pleasant background music (especially wind instruments, strings and the human voice) was helpful for patients' recovery, though she admits that it might be expensive to provide.

Communication

• Nightingale felt that visitors' "chattering hopes" and advice were distressing to patients. This included false assurances, ignorant medical suggestions or suggestions that the patient has nothing wrong with him. She asserts that patients do like to hear good news from outside, and asks that visitors be more sensitive and empathic about the patient's current situation.