Florence Nightingale Environmental Theory: Application


Clinicians, especially nurses have used clinical theories as benchmarks and a basis for their actions and professional conduct. One of the most relevant clinical theories is the Nightingale theory that lays a special emphasis on environmental cleanliness. This paper will assess appropriate actions that a community nurse should take when attending Mrs. Adams, a 68-year-old senior who is widowed and lives with three cats and a dog. We will also review a care plan aligned with the needs of Mrs. Adams. Additionally, we will provide an assessment of Nightingale’s Environmental Theory in terms of what population would derive the maximum benefit from it from an area of nursing practice will be assessed too. 

Actions that a Nurse Should Undertake upon First Assessment of Mrs. Adams Apartment

Using the Nightingale’s theory, the management of Mrs. Adams should be carried out in the following priority list. The first step a community nurse should take in ensuring that Mrs. Adams is safe and in a healthy environment is to ensure that there is a sufficient circulation of air in Mrs. Adams apartment. The nurse should open the windows and have the air conditioner repaired. Blais & Hayes (2015) assert that opening windows and having a working fan would make the air in the apartment pure and healthy for breathing. Foul and unnecessarily warm air is unhealthy even to a healthy person as noted by Karim (2015). The second step is the opening of windows to allow sufficient flow of natural light, which is therapeutic to a suffering patient according as Wirz-Justice, Benedetti, and Berger(2005) noted. 

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The next step that the nurse should undertake is to have the effluent draining from her surgical site drained and the floor dried. This action is the equivalent of Nightingale’s action of drainage. The discharge from her surgical site forms a perfect environment for pathogens to breed as described by Blais and Hayes (2015). With the continued stay of the effluent on the floor and on other surfaces, pathogens get more chances to breed, posing a risk to the health of Mrs. Adams. Any other rubbish that is in the apartment should be disposed of procedurally to comply with the procedures outlined by Nightingale’s environmental theory. This will ensure that there are no breeding grounds for pathogens, which most probably would lead to foul smell effectively contradicting the efforts in the first component of this paper. 

The fourth component of the nurse’s plan would be to ensure cleanliness in the apartment. Nursing, as Nightingale put it, is a discipline that mostly involves observing cleanliness. Cleanliness should be done by making beds and ensuring general order in the apartment. It is at this point that the nurse should change Mrs. Adams clothes and organize how they shall be cleaned. The nurse should leave Mrs. Adams changed in clean clothes and encourage her to always change her clothes. The fifth component should be ensuring that the apartment has fresh water. Impure water that is being used for domestic purposes has the potential to harbor epidemics, which would severely affect the health of the people in that apartment. It is through this point that the nurse should look into the issue of food. The nurse should organize about how healthy and nutritious foods will be getting to Mrs. Adams. 

Plan of Care 

The plan of care will focus on three aspects that affect the health of Mrs. Adams. They include dressing, health management, provision of food and clean water, and lastly checking the environment. The nurse should prioritize the three action points in the order at which they have been listed. 

Dressing the Surgical Site and Maintaining Mrs. Adams General Health

Problem 1: Health Management

Health problem: maintain the health of Mrs. Adams who is diabetic, hypertensive and with breast cancer after a right side mastectomy.

Nursing problem: Pain management and general health management

Goal of care: Make life bearable for Mrs. Adams through improved health. 

Intervention: Wound dressing, Drug administration to manage pain, diabetes, and hypertension

Method: Drug administration and wound dressing

Evaluation: Check the progress of health by monitoring health metrics such as blood pressure. 

Problem 2: Access to Food and Water

Health problem: Poor nutrition 

Nursing problem: Lack of sufficient, portable, safe drinking water and nutritious food. 

Goal of care: Ensure that there is enough water and food for Mrs. Adams

Intervention: Organize how food and water will get to Mrs. Adams

Method: Campaigning for organizations that take up such responsibilities including the government

Evaluation: Mrs. Adams gets proper nutrition every day. 

Problem 3: Environmental Health

Health problem: Living in a hazardous environment 

Nursing problem: Inability of Mrs. Adams to live in a healthy environment

Goal of care: Reduce the threats that are posed by the unmanaged environment

Intervention: Help Mrs. Adams to clean and maintain the environment. Advise her to do the simple tasks like opening windows, and disposing of trash properly. 

Method: Home visits

Evaluation: Check how clean the environment is frequently. 

Application of Nightingale’s Environmental Theory to an Area of Nursing Practice

The passion of serving the old and sick often left with the burden of taking care of young children is an element in nursing practice that can utilize the Nightingale’s Environmental Theory. When doing home visits to old individuals, it is important to check out their environment and ensure that it is supportive of a healthy lifestyle. Nightingale opined that the majority of the diseases can simply be avoided if there is a well-kept environment that is clean and supported with all amenities like water. Blais and Hayes (2015) went further to mention that a well-ventilated environment with sufficient natural lighting is a formidable prevention against many diseases. With this understanding as a nurse, it is appropriate to ensure that there is sufficient lighting and ventilation in a patient’s house. Emphasizing the same to them so that they can be doing it on their own is also important. Additionally, it is important to ensure that the house is well kept and drained of all wetness and rubbish. 

Attending to patients who are receiving home nursing is a delicate process that attracts emotions. Learning and knowing how to handle the emotions is also part of the job. According to Rahim (2013), developing a relationship with a patient who is receiving home nursing is desirable and professional. It restores the confidence of the patient and it makes the patient look forward to the next time the nurse will visit. One way of doing this is to be tender with the patient and more so with the kids in such an establishment. Doing this leaves an emotional impact and cements the relationship between the nurse, patients, and their families. 


Blais, K. & Hayes J.S (2015). Professional nursing practice: Concepts and perspectives. Prentice Hall. New Jersey.

Rahim, S. (2013). Clinical Application of Nightingale’s Environmental Theory. i-Manager’s Journal on Nursing, 3(1), 43.

Karim, H. N. (2015). Clinical Application of Nightingale Theory. International Journal of Innovative Research and Development, 4(11).Wirz-Justice, A., Benedetti, F., Berger, M., Lam, R. W., Martiny, K., Terman, M., & Wu, J. C. (2005). Chronotherapeutics (light and wake therapy) in affective disorders. Psychological medicine, 35(7), 939-944.

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