Florence Nightingale's Theoretical Analysis of the Role of Nurses in Healthcare

Junior (College 3rd year) ・Healthcare&Medicine ・APA ・3 Sources

According to Meleis (2012), objective evaluation and critique of theories is usually complex and therefore requires simplification by breaking down the theory into various components. According to Chinn and Krammer (2004), there is a set of questions which are necessary for guiding the evaluation of theories. The questions guide the reviewer in theory description as well as in the critical reflection of the theory. The questions as per Chinn and Krammer include; What is the purpose of the theory? What are the concepts of the theory? What are the relationships in theory? What is the theory structure? And what are some of the assumptions of the theory?

Part I


Florence Nightingale's Environmental theory seeks to describe the origin of diseases in a similar context as the germ theory. The theory puts emphasis on the need to ensure that the environmental factors are taken into consideration when addressing health in nursing practice.(Medeiros, Enders, & Lira, 2015) Based on this theory, the environmental factors play a key role in health. Therefore, the nursing practice should focus on adjusting the factors in the environment to ensure that the health outcomes are improved(Medeiros, Enders, & Lira, 2015).


The first concept is that of the 13 canons or the subconcepts that should be which are key in manipulating the environment and keep the patients healthy. One such manipulation is ensuring proper ventilation. This ensures that the air which the patients breathe is clean. Other concepts outlined in this theory include light and proper personal hygiene as positive influences on the environment and subsequently better health outcomes.


In elaborating her theory, Nightingale provides definitions of various terms in order to improve the clarity of her theory. In her theory, she defines a disease as a reparative process which is not always accompanied by suffering. On the other hand, Nightingale defines the environment as the main agent acting upon the patient to produce disease. Therefore, in describing the role of nurses in healthcare, Nightingale suggests that their core mandate is to be a change agent of both the patient and the environment.


The primary relationship described by the theory is the influence of the environment on the health outcomes. Nightingale suggests that there is a direct relationship between the two concepts since disease usually arises from environmental exposure. Another relationship described in theory is that of nurses and healthcare provision within a described environment. Nurses must be conversant with environmental controls in order to be in a position to effectively control the environmental factors which affect the health outcomes.


The theory is structured into concepts which begin with the broad concepts. First, she describes the various types of environment that can lead to diseases including the physical environment, the psychological environment, and the social environment. Secondly, the theory provides a breakdown of all the 13 canons and how they can impact on health.


The theory makes various assumptions. First, nursing is achieved from environmental alteration, mankind can achieve perfection and that nursing requires a specific education base.

Part II


Florence Nightingale's environmental theory and concepts are presented in a clear manner. The theory also contains a general guideline which elaborates on the concepts of environment and how they affect one’s health.


Nightingale simplifies the theory by introducing the role of nurses in a nurse-patient relationship as manipulators of the environmental factors. In addition, the theory is based on the core mandates of nurses including caring and helping.


The primary argument in Florence Nightingale’s environmental theory is that keeping people healthy is usually dependent on the environmental control(Medeiros, Enders, & Lira, 2015). Also, the theory is grounded on the belief that nature is a great healer and can cure all diseases. Therefore, since nature is able to cure, the primary role of nurses is to put the patients in the best possible condition so that nature can effectively work on the patient. In addition, the time taken for a patient to heal is dependent on how the environment is manipulated(Medeiros, Enders, & Lira, 2015). Her theory is closely related to the germ theory. She, therefore, argues that well=maintained environment, as well as careful manipulation of the same through observing the required hygiene standards, is key to prevention or decreasing diseases. While the environment is the main acting agent in disease production, nurses are the change agents for both the environment as well as the patient.


When discussing the various aspects of the environment such as the social, physical and emotional environments, Nightingale does not split them up in her theory but chooses to discuss all of them on your own. The theory opened up new aspects of nursing which are being used even today.
The theory acts as a guide which provides a framework which should be followed by nurses in the dispensation of care. Her theory contributed to proper hygienic practices such as hand washing which reduced the effect of germs and consequently, reducing morbidity and mortality.


Chinn, P., & Kramer, M. (2004). Integrated knowledge development in nursing.
St. Louis Mosby.
Medeiros, A., Enders, B., & Lira, A. (2015). The Florence Nightingale’s Environmental Theory: A Critical Analysis. 19(3).
Meleis, A. (2012). Theoretical nursing : development and progress. Philadelphia : Wolters Kluwer Health/Lippincott Williams & Wilkins.

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