Nightingale’s Environmental Conceptual Model

Florence Nightingale and the Environmentalist Theory

Florence Nightingale established and published the nursing philosophical and theoretical view of the patient's health in connection to environmental conditions, which led to the development of this theory. Metaparadigms have four components: environment, person, health, and nursing. Nightingale's conceptual paradigm related health to five environmental elements. These are as follows: clean, fresh air, efficient drainage, clean water, cleanliness, and light. Nightingale was primarily interested in the environmental elements that influence an organism's life and development. She stated that inadequate environmental variables have the potential to prevent, inhibit, or contribute to diseases and death (Kim & Kollak, 2006).

Importance of the Nurse's Role

The function of the nurse is to provide a balance in the environment so as to save the life of the patient. The nurses have to make a priority on the stimulating environmental factor that influences the health of the patient. Nightingale did believe that exposure to various environmental factors provided the difference in the patient's recovery process. This forms the underlying basis of the environmentalist theory. Therefore, Nightingale is well identified with the actions which have brought innovative outcomes to the process of the patient's treatment. A suitable environment facilitates the healing process of an individual and provides a healthy living.

The Role of the Environment in Health

The environment does play a major role in maintaining health and promotion of recovery from sickness. According to Nightingale, an environment which aids in the promotion of health permits a patient to retain their energy or "vital powers" to utilize in self-healing (Kim & Kollak, 2006). A person refers to the individual that receives treatment care, and Nightingale views a person as being a multidimensional being who includes psychological, biological, spiritual, and social components. The components of social or psychological contain feelings, self-concept, social interactions, and thought-processes. Biological component is attended to by medicine while spiritual intertwine the person's spiritual beliefs. Health is seen as a combination of results of environment, physical and psychological elements. Nightingale stipulates that "health is not only to be well but to be able to use well every power we have" (Kim & Kollak, 2006). He incorporated the 6 D's of "Dys-ease" which are dirt, drink, diet, damp, drought, and drain as the factors that influence health. Health is her last metaparadigm where she stated that nursing intertwines with the elements of the environment. The objective of nursing is strict to place the patient in a better position and to facilitate the healing process through putting the patient in a suitable environment. The roles of nursing include the provision of the necessary warmth, fresh air, cleanliness, light, and appropriate diet. Through assisting in controlling the environment does influence the nurses to maintain proper health of the patient.

Impact of Nightingale's Theory on Nursing

Nightingale's theory has formed the solid foundation of the nursing profession. Her contribution to the nursing theory includes identifying the role of the nurses in satisfying the personal needs of the patients. The recognition of the importance of the environmental factors on the influence of the care given to the sick individuals is also a key aspect in this theory. Moreover, it has been significant in the evaluation of the standards and the acceptance of the nursing profession through the development of sound principle practices in nursing education (Fawcett, 1993). Fawcett notes that the theory has had an influence on the nursing knowledge concerning the patient's care and provides a definition of clinical nursing care as a distinct and separate practice of the other medical fields.

Applicability of Nightingale's Theory in Nursing

The theory is widely applicable to nursing and quality of patient care. Currently, in the nursing field, nurses are trained on how to individualize patients care and ways of responding to a variety of symptoms of different diseases. Nightingale's belief for education continuity has proved to be a critical aspect in nursing and aims at increasing the health and quality of the patient in today's world. An example of this theoretical view's applicability is in the treatment of tinea pedis, which is a foot fungal infection. In this case, the concept of the theory is utilized so as to assist in the control of the severe growth of the fungal infection and thus, reduction in the secondary infections. The five fundamental environmental factors improve the overall health of an individual.


Fawcett, J. (1993). Analysis and evaluation of nursing theories (1st ed.). Philadelphia: F.A. Davis Co.

Kim, H. & Kollak, I. (2006). Nursing theories (1st ed.). New York, NY: Springer Pub. Co.


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