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Florence Nightingale’s Environmental Theory: Impact and Relevance in Modern Nursing

Florence Nightingale's Environmental Theory: Impact and Relevance in Modern Nursing

Florence Nightingale developed the environmental theory. The gist of the theory involves external forces and factors that influence human health. A favorable environment breeds good health, and an unfavorable environment is likely to cause an illness or worsen health status. However, the model has its strengths and shortcomings.

The assumptions of Nightingale concerning her theory involved the following. Pure water, pure air, cleanliness, effective drainage, and light were key elements that facilitated good health. She believed that a healthy environment could cure an individual. Nurses must observe the patient and report the findings to the physician organizationally. In addition, Florence Nightingale described nursing as an art and medicine as a science.

Nightingale noted that nursing was an art that involved the utilization of the environment in promoting patient health. The concepts of different environments include clean water, light, noise, proper drainage, clean bed and linen, warmth, ventilation, personal cleanliness, various environments, nutrition, and social support. Any unfavorable environmental condition, like impure water, will likely cause disease. Environmental concepts influence the patient in various dimensions: psychologically, biologically and socially.

Origins of the Theory

At the time of Florence Nightingale, nursing in America and other parts of the world was poorly developed. There were no clear concepts and philosophies related to nursing. Nursing services were administered without any form of prescribed training. Nightingale and other nurses assisted the injured soldiers during the Crimean War. As wars increased, there was a profound demand for nursing services, making Nightingale insist on training nurses.

Nightingale’s religious beliefs and philosophy made her develop the environmental theory. Her experience during the Crimean War when caring for the injured soldiers was a major impetus that provided a basic foundation for her theory. She observed that soldiers’ deaths contributed to environmental factors, such as infections. This observation motivated her to spearhead the environmental theory.


The simplicity of the concept enabled the adoption and integration of the model into health care. The model is simple to understand; hence, it paves the way for practical application in nursing.

The Nightingale model facilitated disease prevention. Its principles of a clean environment, proper drainage, adequate ventilation, and personal hygiene provided valuable ways of promoting good health and preventing various diseases from dirty environments. This was one of the strengths of Nightingale’s model. The theory itself has been applied in different setups, including water, sanitation, and architectural structures erected in such a way that it can allow adequate lighting and ventilation. The theory is also useful in waste disposal, noise control, and regulating room temperatures, facilitating an environment conducive to health.

The model becomes an important factor during the nursing assessment of patients. The theory provided some basic guidelines on what to consider during the nursing assessment of patients. The nurse could assess the health status of the patient based on different environmental factors. For example, noise can impair individual sleep. If, during the assessment, the nurse finds out that the patient cannot sleep due to noise, he or she should act to minimize noise so that a favorable environment is available. Nightingale’s model guides the nursing process’s evaluation and implementation.


Nightingale’s theory is testable and has been subjected to descriptive studies. More than 50 research activities have been done based on Nightingale’s theory. These studies have supported her theory. In one of the descriptive studies, “The home environment of the children exposed to HIV”, the researchers observed that unhygienic conditions contributed to higher risks of acquiring other infectious diseases among the children exposed to HIV at birth.

Overall Evaluation

The concentration on the environment as a major influence on health outcomes is a weakness of the Nightingale theory. According to Nightingale, providing a favorable environment could free an individual from disease. The model did not consider the disease process and its pathophysiology, which could greatly influence health outcomes. Nightingale also rejected the germ theory, which explains that microbes like bacteria cause disease. Furthermore, she did not mention medical technology, which is vital in today’s nursing field.

However, the model still provides important principles of integrating environmental elements in health care for nurses to provide better health outcomes. Nightingale’s writings have played a significant role in the training of nurses and incorporating her principles into clinical practice. Nursing scholars support her work and even use her model for setting nursing standards.

The model is valid, as evident by research on the Crimean War, which showed that a healthy environment was a prerequisite for healing. The casualties were reduced from 48% to 2% when maintaining a favorable clean environment. Nurses are trained to facilitate optimal patient health; part of reaching this goal is using the environment. In addition, the environmental theory is a transcultural model; it is applied to nursing activities and learned worldwide.

Nightingale’s theory is comprehensive because it is taught in nursing schools and used as a standard model of care. This model has also provided a platform for further studies and the incorporation of good environmental measures. The model is also specified, as it accurately describes and identifies the environmental factors that affect health. Furthermore, the model is general, as it is universally accepted and applied up to date.

The theory can be used in advanced nursing practice as part of care because it gives basic guidelines for caring for the patient by considering environmental factors. For instance, maintaining a clean environment is one way to reduce infections.

In conclusion, Nightingale’s theory will remain a part of nursing, and its utilization is likely to improve patients’ health outcomes.

đź“Ž References

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