Applying Theory to improve my practice and to my patients

Nurses and Florence Nightingale

Nurses were ignorant and lacked instruction on how to attend to patients' needs in the early years, rendering them incompetent. In addition, health institutions and their surrounds were filthy. As a result, from 1820 until 1910, Florence Nightingale created the first nursing notes that served as the foundation for research and nursing practice (Selanders, 2015). Nightingale, often known as "The Lady with a Lamp," developed nursing ideas and was thus the originator of scientific and educated nursing. She "holds the lantern" of nursing, illuminating the path for young nurses to take. She went on to establish the first nursing school, which taught professional nurses. Also, she wrote the first notes of nursing that she compiled into a textbook named “Notes on Hospitals.” The book did not only focus on nursing as a profession but also taught ordinary women how to care for their families, general cleanliness and nutritious diet among others.

Environmental Theory

Florence Nightingale wrote many theories among which is the Environmental Theory that incorporates the restoration of the health status of patients into healthcare delivery. The theory states that nursing is a profession that involves utilizing the patients’ environment to aid him in his recovery (Torres, 1993). It further entails the nurse's initiative to align together environmental settings suitable for the restoration of the patient's health. Also, it says that external factors connected with the patient’s surroundings affect life and its biological and physiological processes Also, the theory emphasizes the provision of a noise-free or quiet and warm environment. Similarly, patient's nutritional needs are attended to through documentation of food intake, assessment, and evaluation of its effects on patients. It talks about the importance of patients breathing in pure fresh air and emphasizes proper drainage and waste disposal in health facilities. Besides, Nightingale in this theory pointed out the importance of space in health facilities and the value of clean running water.

Achievement from Theory

Since the Theory emphasizes the importance of pure, clean air to patients (Pirani, 2016), I hope to push for more significant buildings well fitted with big windows and ventilators. This is to allow patients in these structures to get enough fresh air in the morning when the windows are opened. As a nurse, I have to open these windows and doors and draw curtains for good air to come in and the old one to go out.

I hope to request for more wheelchairs to take bedridden patients outside so that they get to enjoy the fresh air and light out. I will also encourage patients to take walks out as opposed to staying indoors. They get enough oxygen vital for the body and also prevent conditions like bed sores among others. Even as a nurse, I will decongest my working area to create space. When a room is congested, it tends to trap dirt and bad air which is contrary to this environmental theory.

I hope to advocate for clean water. Water to be taken by patients must be boiled at the boiling point of a hundred degrees Celsius (Selanders, 2010).This prevents diseases like typhoid among others. Patients especially those with wounds have to bathe with clean water to avoid infections.

During cold seasons warmth of patients is paramount. I hope to enlighten the concerned authorities and caregivers about the importance of warmers, heavy blankets and fireplaces in hospitals. In cold seasons, I hope to give patients hot drinks, and food especially to asthmatic and those allergic to coldness.

Applying Theory to Improve Practice and Help Patients

Air is one of the essential element necessary to sustain life. For the body and mind to function maximally, the quality of air breathed in should be pure and fresh. The human body is made up of cells which divide to make tissues. A group of tissues forms organs. All these in addition to the brain all require oxygen to function correctly. Patients need to breathe pure fresh air free from contamination. During my practice, I will ensure open windows and doors and stop smokers from coming near my patients. A smoking area should be demarcated so that smoke doesn't contaminate the air. This will help patients with breathing problems and other lung diseases to recover steadily (Jacquelyn & Edward, 1980).

Fresh oxygenated air cleans the lungs and transports more oxygen to the cells. Continuous fueling of cells produces more energy in the body. When one breathes out through the lungs, airborne toxins in the body are released. Accumulation of these toxins causes diseases like fatigue, irritability, anxiety and frequent fevers among others (McQuiston & Adele, 1995). Also, serotonin levels which affect the mood of patients are directly affected by oxygen levels. If the levels are low, the patient becomes irritable, anxious, depressed and fatigued. However, increased levels of serotonin lead to elevation of mood, happiness, and other positive emotions. Therefore as a practicing nurse, I will set the mood right for patients by cleaning their rooms, providing them enough light at night, decongesting their surroundings and talking to them positively.

Selanders and Crance (2012) assert that every health facility should have proper drainage of running water and sewerage. It is widely known that stagnant water acts as a breeding ground for mosquitoes, houseflies, and other disease-causing insects. Also, stagnant water cause water-borne diseases like bilharzia, cholera, and dysentery among others. In sub-Saharan Africa, stagnant water acts as a breeding ground for mosquitoes that cause malaria. During my practice, I will make sure nearby bushes are cleared and compound grass cut to a reasonable length. If it requires me to work with cleaners to ensure a clean environment, I will do it, after all; nursing is about offering love and service.

After using sharps, I will make sure they are safely put in sharps containers which are burnt in an incinerator after they are full. It helps to avoid infections and accidents. Highly contagious materials like blood-stained gauze, cotton, and other linen should be first disinfected then washed clean. Refuse from sluice rooms and other hospital wastes should be disposed of properly to ensure proper sanitation. Also Since most people learn from examples, I will be an example of cleanliness by keeping my nails short, holding my hair in position and always wearing a clean uniform and aprons. All this avoids transmission of infections.

Hospital beddings must be appropriately washed, ironed and disinfected regularly to minimize transmission of diseases (Attewell, 1998). Furthermore, hospital equipment and tools like trays and trolleys, kidney dishes, intravenous stands, wheelchairs, and weighing scales among others should be disinfected daily. Trash cans and dustbins must be emptied daily and sanitized as well. Hospital cabins and cupboards should also be cleaned very often. As a practicing nurse, I will ensure to clean all those.


Nightingale in the environmental theory emphasized among other things provision of clean water, light and proper general sanitation of a health facility. Keeping records and adequate documentation helps to track the treatment and recovery process which is helpful for future references. Nurses even today know the importance of working in a healthy surrounding, ensuring patients take daily baths and take walks to allow intake of fresh air and as a form of exercise. Also providing a quiet and peaceful environment for patients is vital for their recovery. For instance, patients suffering from tetanus must be kept in a tranquil setting to stop seizures. Reduced seizures consequently lead to improvement while their increase worsens the condition. All these measures are practiced by nurses even today which hasten the recovery process. They know the environment plays a significant role towards the recovery of patients (Jacquelyn & Edward, 1980). A proper environment is to improving health standards what a dot is to an i.



Attewell, A. (1998). Florence Nightingale (1820–1910). Prospects, 28(1), 151-166.

Jacquelyn, H. F., & Edward, J. H. (1980). Areas of agreement in nursing theory development. Advances in Nursing Science, 3(1), 1-8.

McQuiston, Chris Metzger, and Adele A. Webb. "Foundations of Nursing Theory Contributions of 12 Key Theorists." (1995).

Pirani, S. A. (2016). Application of Nightingale’s theory in nursing practice. Annals of Nursing and Practice, 3(1), 1040.

Selanders, L. (2015). Florence Nightingale. The evolution.

Selanders, L. C. (2010). The power of environmental adaptation: Florence Nightingale’s original theory for nursing practice. Journal of Holistic Nursing, 28(1), 81-88.

Selanders, L., & Crane, P. (2012). The voice of Florence Nightingale on advocacy. Online J Issues Nurs, 17(1).

Torres, G. (1993). Florence Nightingale. George JB, organizador. Teorias de enfermagem: os fundamentos para a prática profissional. Porto Alegre (RS): Artes Médicas, 38-48.

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