Florence Nightingale's Nursing Leadership Theories

Florence Nightingale, born in 1820 of a prosperous English family, decided at a young age that she was called to do something special with her life. When she chose nursing, it was an unpleasant surprise for her family since nursing was then an occupation of the lower classes. Despite objections, she persevered, was trained, and nursed British soldiers during the Crimean War.

Her ideas about hygiene and prevention and the responsibilities of the trained nurse as well as her advocacy for proper training, eventually led to the founding of the Army Medical College and the Nightingale School and Home for Nurses. Her Notes on Nursing seem like common sense today, but contained ideas unheard of during her time. She was a firm believer in the importance of the nurse taking full responsibility for a patient. She died in 1910.

Focus on Prevention

• Florence Nightingale believed that much of disease was caused by bad nursing rather than the original injury or sickness. In Notes on Nursing, she wrote that nature was trying to heal the body despite the common nursing practices of the day which actually impeded healing. In her view, the nurse was responsible for devising an overall plan that created an atmosphere conducive to healing: clean air, good food, uninterrupted rest, respect for the patient and cleanliness of the surroundings.

Constant Vigilance

• Nightingale questioned some of the excuses used by nurses to explain why something went wrong with a patient. She wrote that "I was not there at the time," cannot be tolerated as an explanation. She believed that the nurse was charged with making sure the principles of good nursing were carried out at all times by establishing a routine that underlings could follow while the nurse was sleeping or doing errands.

Personal Responsibility

• In her quest for better hygiene, Nightingale believed it might be necessary for the nurse to do manual work herself if there was no one else to do it. She wrote that, while it's not desirable to see a nurse scrubbing floors or washing linens, these chores simply must be done. If no one else is available, the nurse must do them. She had a long list of tasks, including taking up carpeting, moving the patient to a fresh bed twice a day, rinsing bed pans and warming the patient with hot bricks, bottles and flannels. All fell to the nurse, she wrote, if there was no other help.

Training of All Women

• Nightingale wrote that all women must be nurses to some extent and must learn to manage their homes in an authoritative manner in order to prevent sickness. She scolded "modern" English women for having households less healthy than their grandmothers. She attributed the rise in disease to the lack of exposure to light and air among the middle classes, and the laziness of women in regard to their household help. All help must be trained, she wrote, and they must be constantly managed. She believed it was the duty of the trained nurse to communicate the basic principles of hygiene to the women who employed her for a sick family member, thus spreading the possibility of good health to a large population.

Mental Well-Being of the Patient

• Nightingale wrote hat the nurse had the responsibility for providing leadership in establishing an atmosphere of calm and healing in the household as well as the hospital. She encouraged nurses to train the family to use quiet speech, allow for uninterrupted sleep, provide cheerful conversation and brighten the sick room with live plants or cut flowers as well as a change of view. She also advocated appealing food designed around the patient's own tastes.