Page 83 - alligood 8th edition_Neat

64 UNIT II Nursing Philosophies

MAJOR CONCEPTS & DEFINITIONS—cont’d
that healthy surroundings were necessary for proper and disposal of bodily excretions and sewage were
nursing care and restoration/maintenance of health. required to prevent contamination of the environ-
Her theoretical work on five essential components ment. Finally, Nightingale advocated bathing patients
of environmental health (pure air, pure water, effi- on a frequent, even daily, basis at a time when this
cient drainage, cleanliness, and light) is as relevant practice was not the norm. She required that nurses
today as it was 150 years ago. also bathe daily, that their clothing be clean, and that
Proper ventilation for the patient seemed to be of they wash their hands frequently (Nightingale, 1969).
greatest concern to Nightingale; her charge to nurses This concept held special significance for individual
was to “keep the air he breathes as pure as the exter- patient care, and it was critically important in im-
nal air, without chilling him” (Nightingale, 1969, proving the health status of the poor who were living
p. 12). Nightingale’s emphasis on proper ventilation in crowded, environmentally inferior conditions with
indicates that she recognized the surroundings as inadequate sewage and limited access to pure water
a source of disease and recovery. In addition to dis- (Nightingale, 1969).
cussing ventilation in the room or home, Nightingale Nightingale included the concepts of quiet and
provided a description for measuring the patient’s diet in her theory. The nurse was required to assess
body temperature through palpation of extremities the need for quiet and to intervene as needed to
to check for heat loss (Nightingale, 1969). The nurse maintain it (Nightingale, 1969). Noise created by
was instructed to manipulate the surroundings to physical activities in the areas around a patient’s
maintain ventilation and patient warmth by using room was to be avoided because it could harm the
a good fire, opening windows, and properly posi- patient. Nightingale was also concerned about the
tioning the patient in the room. patient’s diet (Nightingale, 1969). She instructed
The concept of light was also of importance nurses to assess not only dietary intake, but also the
in Nightingale’s theory. In particular, she identified meal schedule and its effect on the patient. She
direct sunlight as a particular need of patients. She believed that patients with chronic illness could be
noted that “light has quite as real and tangible effects starved to death unintentionally, and that intelligent
upon the human body . . . Who has not observed the nurses successfully met patients’ nutritional needs.
purifying effect of light, and especially of direct sun- Another component of Nightingale’s writing was
light, upon the air of a room?” (Nightingale, 1969, a description of petty management (nursing admin-
pp. 84-85). To achieve the beneficial effects of sun- istration) (Nightingale, 1969). She pointed out that
light, nurses were instructed to move and position the nurse was in control of the environment both
patients to expose them to sunlight. physically and administratively. The nurse was to
Cleanliness is another critical component of protect the patient from receiving of upsetting news,
Nightingale’s environmental theory (Nightingale, seeing visitors who could negatively affect recovery,
1969). In this regard, she specifically addressed the and experiencing sudden disruptions of sleep. In
patient, the nurse, and the physical environment. She addition, Nightingale recognized that pet visits
noted that a dirty environment (floors, carpets, walls, (small animals) might be of comfort to the patient.
and bed linens) was a source of infection through the Nightingale believed that the nurse remained in
organic matter it contained. Even if the environment charge of the environment, even when she was
was well ventilated, the presence of organic material not physically present, because she should oversee
created a dirty area; therefore, appropriate handling others who worked in her absence.

Use of Empirical Evidence Her expertise as a statistician is evident in the reports
Nightingale’s reports describing health and sanitary that she generated throughout her lifetime on the
conditions in the Crimea and in England identify her varied subjects of health care, nursing, and social
as an outstanding scientist and empirical researcher. reform.