The Nightingale’s environmental theory

Nightingale Case Study

Nightingale’s environmental theory advocates using a patient’s environment to assist in his or her recovery. It calls for nurses to undertake the responsibility of appropriately configuring the environmental set up of any patient for the gradual restoration of their health. The theory appreciates the fact that external factors affect biological and physiological processes in patients and their physical development. The nurse is, therefore, tasked with the responsibility of balancing the environment to enable the patient to recover from his or her ailment. Nightingale believed that a suitable environment played a huge role in the recovery process of a patient, and this belief has brought about innovative results in the treatment of patients. The theory calls for the provision of factors suitable for maintaining a favorable environment to facilitate the healing and healthy living of patients. Some of these favorable factors include adequate ventilation, proper lighting, and cleanliness of the patient’s environment. The paper will thus look at the five essential components of the environmental theory and develop an appropriate care plan for Mrs Adams, who is on case management. The paper will also look at an application of Nightingale’s environmental theory in my nursing practice.

The nurse’s first assessment of Mrs Adams’ apartment established many shortcomings that constitute an unfavorable environment for the patient. Besides the apartment being located in a prevalent crime area, the room has poor ventilation, lighting, pets, and no food for Mrs Adams. Mrs Adams also has frequent complaints of pain and draining from her surgical site and an air condition. Upon this assessment, the community health nurse should ensure that room gets cleaned immediately. The patient should also get cleaned, and her clothes changed. The room should then get organized adequately by putting everything in its rightful place to ensure proper air circulation. Move the patient close to a window to enable her to receive natural light. The nurse should ensure the air conditioner gets fixed so that the patient enjoys favorable temperatures, especially during the winter and summer periods. The nurse should ensure that enough food gets purchased and well preserved in the house for the patient. Mrs. Adams’s surgical site is cleaned by the nurse and ensure that she rests in a proper position to avoid experiencing pain from her surgical area. Lastly, the pest should be moved to a safe location so that the room remains clean and tidy for the patient to be taken care of in a favorable environment.

The five essential components include the availability of fresh air for the patient. This concept requires that the room the patient gets treatment in has good air circulation so that the air the patient breaths remains pure as the air outside the room without chilling the patient. The second component revolves around good lighting for the room. The room should receive natural sunlight, which is what patients want while in-home care. The third component of the theory is cleanliness. The patient’s room must be kept clean at all times. The fourth component is adequate drainage. Ensure that the patient’s environment has proper drainage to avoid stagnant water, providing breeding grounds for mosquitoes besides generating foul smells for the patient. The fifth component entails the use of freshwater. Clean water should be used in cleaning the patients and all the things in the patient’s room. They should also drink clean water to avoid getting infected with water-borne diseases.

Nightingale’s environmental theory focuses on modifying a patient’s environment to stimulate his or her healing process. She opined that when one or more aspects of the environment were out of balance, the patient uses their energy to balance it out. Increased use of a patient’s power to balance the environment leaves little energy to support their healing process. From the initial assessment of Mrs Adams’s apartment, the best care plan for her would be addressing the identified shortcomings. The first shortcoming from the nurse’s assessment was that the apartment was disorderly with minimal airflow and light. Nightingale emphasized that the air in which a patient takes their breath should be as fresh as the external air. From this aspect of the environmental theory, the care plan must ensure that the windows of the patient’s room get opened from time to time to allow for the free circulation of air. The planners should organize for the air conditioner to be fixed to enable the patient enjoy favourable temperature especially during the summer and winter seasons. The patient’s bed should also be in a position whereby she can receive natural light from the sun.

Another concepts of Nightingale’s theory revolves around cleanliness. The nurse found the room dirty and Mrs Adams clothes appeared unchanged. Nightingale pointed out that nurses should preserve the cleanliness of a patient’s environment and as such, the care plan should ensure that Mrs Adams’ room gets cleaned immediately and that she gets a change of clothes. The theory also addresses the importance of healthy foods for patients. The health nurse noted that Mrs Adams’ lacked food in her apartment. Food plays a critical part in a patient’s recovery and therefore the care plan should ensure that the patient’s house gets stocked with all essential food components.

To ensure that the apartment remains noise free, all the pets must be moved to a safe location to allow for a favourable environment for the patient. The care plan should ensure that Mrs Adams surgical sites get regular cleaning and that she’s always under observation from a qualified nurse. The care plan must also look at the social environment of Mrs Adams. She resides in a poor neighbourhood where crime remains prevalent. Mrs Adams apartment should thus be secured from any outside interference. The care plan would be prioritized by ensuring that sufficient resources get allocated towards ensuring that Mrs Adams gets the best possible environment to receive her home care.

Nightingale’s theory include concepts necessary for creating a favourable environment for patients to aid in their healing processes. These concepts include food and nutrition, cleanliness, pure air, pure water and an effective drainage system. These concepts aim at making nurses work more efficiently within their jurisdictions. The application of this theory in my area of nursing practice will greatly benefit the health facility I work for. I work in a nursing home that specializes in taking care of the elderly. Offering a good environment for this group of patients remains a top priority for the institution. Borrowing from the environmental theory, we ensure that all our patients as well as their rooms get cleaned regularly. The rooms remain well ventilated and the windows get opened during the day to allow for the free circulation of air in the rooms. The rooms are also well positioned to allow for natural light to penetrate them.

Proper diet remains important for the elderly and as such, our patients get provided with proper diets at regular intervals for their well-being. The institution’s drainage is also well designed for the proper flow of waste water. Proper flow of such water ensures that no stagnant water remains within the patient’s rooms to form breeding grounds for mosquitos besides generating foul smells. This approach has greatly benefitted the elderly within our communities who now have a favourable environment to experience their sunset years within our facility. In their article, provide authors, conducted a controlled observational study to assess the quality of care given to elderly people in nursing homes. They noted that the quality of care given to the elderly in nursing homes remained inadequate based against all quality indicators of their study. The noted that better coordinated care was required to improve the quality of care given to the elderly in our nursing homes. The adoption of Nightingale’s environmental theory in our nursing homes will therefore play a significant role in improving the quality of care given to the elderly in our nursing homes.

In conclusion, nursing theories play a vital role in assisting healthcare workers to provide holistic care to their patients. The theories help provide important components that generate nursing knowledge besides underpinning the nursing practice. In this paper, Nightingale’s environmental theory has been used to analyse a clinical situation and come up with the best care plan for the patient. The theory advocates for the manipulation of a patient’s physical environment to stimulate his or healing process. Key concepts in the theory include cleanliness, pure air, pure water, food and nutrition and effective drainage. By altering these concepts within a patient’s environment, the nurse can assist in restoring his or her health or bringing the patient to recovery. The environmental theory, therefore provides a basis for providing holistic care to patients and it still forms part of modern day nursing practice. Nurses should familiarize themselves with concepts of this theory especially those surrounding basic environmental hygiene to provide a favourable living environment for their patients.


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