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68 UNIT II Nursing Philosophies

In health care facilities, the ability to control room Although some of Nightingale’s rationales have
temperature for an individual patient often is increas- been modified or disproved by medical advances and
ingly difficult. This same environment may create scientific discovery, many of her concepts have
great noise through activities and the technology endured the tests of time and technological advances.
(equipment) used to assist the patient’s reparative It is clear that much of her theory remains relevant for
process. Nurses have looked in a scholarly way at nursing today. Concepts from Nightingale’s writings,
these problems as they continue to affect patients and from political commentary to scholarly research,
the health care system (McCarthy, Ouimet, & Daun, continue to be cited in the nursing literature.
1991; McLaughlin, McLaughlin, Elliott, & Campalani, Several authors have analyzed Nightingale’s petty
1996; MNA, 1999; Pope, 1995). management concepts and actions, identifying some
Monteiro (1985) provided the American public of the timelessness and universality of her manage-
health community with a comprehensive review of ment style (Decker & Farley, 1991; Henry, Woods, &
Nightingale’s work as a sanitarian and a social re- Nagelkerk, 1990; Monteiro, 1985). More recently,
former, reminding them of the extent of her impact Lorentzon (2003) focused specifically on Nightingale’s
on health care in various settings and her concern role as a mentor to a former student in her review and
about poverty and sanitation issues. Although other analysis of letters written between her and her former
disciplines in the United States have increasingly ad- student Rachel Williams. This analysis provides a
dressed such issues, it is clear that nurses and nurs- review of mentoring approaches based on Nightingale’s
ing have an active role in providing direct patient theories; her comments on management as offered to
care and in becoming involved in the social and Rachel Williams would stimulate good discussion
political arenas to ensure healthy environments for about the needs of nurses today for mentoring and
all citizens. professional development. Lannon (2007) and Naraya-
McPhaul and Lipscomb (2005) have applied Night- nasamy and Narayanasamy (2007) based their exami-
ingale’s environmental principles to practice in occu- nations of nursing staff and leadership development
pational health nursing. These nurse specialists have on Nightingale’s statements about the essential need for
increasingly recognized current environmental health continued learning in nursing practice.
problems at local, regional, and global levels. Modern Finally, several writers have analyzed Nightingale’s
changes in travel, migration, and the physical environ- role in the suffrage movement, especially in the con-
ment are causing health problems for many. text of feminist theory development. Although she
Infectious diseases (e.g., HIV, TB, West Nile virus) has been criticized for not actively participating in
are examples of these changes. In addition, nurses this movement, Nightingale indicated in a letter to
are confronted by an epidemic of toxic substances John Stuart Mill that she could do work for women in
and nosocomial infections and the development other ways (Woodham-Smith, 1951). Her essay titled
of resistant organisms (e.g., MRSA) in their patient Cassandra (Nightingale 1852) reflects support for the
care environments; first-line prevention measures of concept that is now known as feminism. Scholars
handwashing and environmental cleanliness harken continue to assess and analyze her role in the feminist
back to Nightingale’s original environmental theory movement of this modern era (Dossey, 2000; Hektor,
and principles. Other problems created by environ- 1994; Holliday & Parker, 1997; Selanders, 2010;
mental changes and pollution might astound Night- Welch, 1990). Selanders (2010) argues powerfully that
ingale, but she would probably approach them in Nightingale was a feminist and that her beliefs as a
a typically aggressive fashion for control. As health feminist were integral to the development of modern
care systems and providers struggle to promote professional nursing.
patient safety through prevention of infection in
health care facilities, this work can be framed in these Education
words of Florence Nightingale: “It seems a strange Nightingale’s principles of nurse training (instruction
principle to enunciate, as the very first requirement, in scientific principles and practical experience for the
in a hospital that it should Do the Sick No Harm” mastery of skills) provided a universal template for early
(Vincent, 2005). nurse training schools, beginning with St. Thomas’s