Florence Nightingale’s Theory and the Determinants of Health PDF

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Florence Nightingale’s Theory and the Determinants of Health

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Nightingale’s Theory and the Determinants of Health Environment is defined by the Merriam-Webster dictionary as "the circumstances, objects, or conditions by which one is surrounded" (n.d., Def. 1). Florence Nightingale, through her foundational Practice-Based Theory, highlighted the significance of patient environments on nursing care outcomes (Potter & Perry, 2014, p. 60). Throughout the course of life, people continuously encounter changing conditions - which can be directly influenced by the Determinants of Health (Public Health Agency of Canada, n.d.). In this paper, I will outline the ways in which social and physical environments influence aspects of nursing healthcare, and how Nightingale's theory is a fundamental component to comprehending this. It is of an undeniably great importance for the sake of personal health that individuals aim for the healthiest and safest surroundings. Florence Nightingale's Nursing Theory In 1860, Florence Nightingale's Notes on Nursing: What It Is and What It Is Not was published by D. Appleton and Company in the United States (2014). At the time, this book provided tremendous insight into what nursing care truly consisted of, and even today it is still crucially relevant to modern day nursing. There are 13 canons of nursing outlined by Nightingale (1860/2014): "ventilation and warming, health of house, petty management, noise, variety, taking food, what food, bed and bedding, light, cleanliness of rooms and walls, personal cleanliness, chattering hopes and advices, [and] observation of the sick". Seven canons specifically address the need for a safe, clean physical environment: ventilation and warming, health of house, bed and bedding, light, and cleanliness of rooms and walls" (Nightingale, 1860/2014). While (at the time of Nightingale) it was not generally comprehended by the medical community that unclean surroundings contributed to the spread of infection, Florence Nightingale logically outlines this in her writings. Moreover, she accurately

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claims that "pure air; pure water; efficient drainage; cleanliness; [and] light" are essential characteristics of creating a healthy "house," which in turn leads to an increase of individual overall health (Nightingale, 1860/2014, Chapter 2). While two other topics relate to the physical environment, they are more focused on patient experience. “Noise” mainly refers to unnecessary disruptions, which can disturb patients and impair healing (Nightingale, 1860/2014, Chapter 4). “Variety” addresses physical circumstances and the need for change, as by being stationary in the same care environment for too long, persons can easily be hindered (Nightingale, 1860/2014, Chapter 5). In addition to creating physical surroundings suitable for patient care, Nightingale also highlighted the need for stable social aspects. The remaining seven canons of nursing are more related to the psycho-social and needs aspects of nursing care. "Petty management," "chattering hopes and advices" and "observation of the sick" directly relate to the ways by which nurses must treat, manage and recognize conditions in patients. This must happen in a manner that is both respectful and productive (Nightingale, 1860/2014). "Taking food" and address the need for a respectful and informed attitude when feeding other people (Nightingale, 1860/2014, Chapter 6). Nurses must ensure proper nutrition when feeding the sick as addressed in "what food," for obvious health benefits (Nightingale, 1860/2014, Chapter and 7). Lastly, "personal cleanliness" outlines the importance of providing hygiene to those under a nurse's care (Nightingale, 1860/2014, Chapter 11). Together, all of these canons protect patients from the hazards of being neglected. As a whole, Florence Nightingale's theory of nursing describes the social, physical and psychological aspects of nursing care. It is important to take all these facets into account when caring for patients, as "an environment conducive to healing" is unique to nursing, and tremendously affects individuals in a highly positive regard (Potter & Perry, 2014, p. 60). By

F. NIGHTINGALE’S THEORY attempting to eliminate unnecessary stress on patients, nurses facilitate patient focus to be on getting better. Applying Nightingale's Nursing Theory to the Determinants of Health The Public Health Agency of Canada (PHAC) lists the Determinants of Health as 12 things: "income and social status, social support networks, education and literacy, employment/working conditions, physical environments, biological and genetic endowment, individual health practices and coping skills, healthy child development, health services, gender, culture, [and] social environments" (2013). This particular healthcare issue has constantly become more apparent in modern nations, as institutions and governments have been able to recognize the value in addressing these concerns within populations (World Health Organization [WHO], 2016). These determinants are crucial to deciphering the cause of a health issue because the "context of people's lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate" (WHO, 2016). A Canadian Federal and Provincial report found that, respectively, both men and women in the top 20% income bracket live up to six and eight years longer than those in the bottom 20% (Lord, 1994). The WHO (2016) has also stated that there was a direct proportion to income and health; being that the higher income and social status are, the better health individuals tend to have. Taking Nightingale's theory into perspective, the Determinants of Health play a crucial role in the types of environments individuals are subject to on a daily basis. People's environments directly affect their health as "badly constructed houses do for the healthy what badly constructed hospitals do for the sick" (Nightingale, 1860/2014, Chapter 2). It is very clear in a clinical sense that unhealthy surroundings will harbor various stressors such as germs or pathogens, and thus not aide in the healing process. However, it should be more known that the same poor conditions will eventually erode a “healthy” person's wellbeing.

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When individuals are at a societal disadvantage due to a circumstance such as gender inequality, cultural exclusion, or poor working conditions, this begins to construct the foundation for other determinants to take hold. Due to such preexisting factors, individuals could be in lower income brackets or social statuses than they normally would. Nurses must be able to work past such societal biases when caring for patients, in order to provide coherent and sound care. When advocating for the betterment of lower status and more at-risk people, nurses are working directly to prevent the festering of avoidable, future health issues that could potentially be further influenced by the Determinants of Health. As Nightingale (1860/2014, Chapter 13) wrote, “one duty of every nurse certainly is prevention.” Conclusion In order to gain a more complete understanding of the cause surrounding an individual’s health/concerns, nurses should incorporate Florence Nightingale’s elements of theory and the Determinants of Health, as outlined in this paper. While Nightingale’s theory was first released in 1860 and is over a century old, it is still relevant to not only the practical elements of nursing, but also the compassionate components of care. In the future, nurses can be increasingly more effective as they continue to embrace Nightingale’s 13 canons of nursing when considering the PHAC’s 12 Determinants of Health, and caring for patients. Therefore, it is paramount that current and future nursing professionals are knowledgeable and utilize Nightingale’s work.

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Braveman, P., & Gottlieb, L. (2014). The Social Determinants of Health: It's Time to Consider the Causes of the Causes. Public Health Reports, 12919-31. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863696/ Environment [Def. 1]. (n.d.). In Merriam-Webster Online, Retrieved November 1, 2016, from http://www.merriam-webster.com/dictionary/environment. Lord, C. (1994). Strategies for population health: investing in the health of Canadians. Ottawa, ON: The Committee. Retrieved from http://publications.gc.ca/collections/ collection_2016/sc-hc/H39-316-1994-eng.pdf Nightingale, F. (2014) Notes on nursing. University of Pennsylvania (Ed. & Trans.) Retrieved from http://digital.library.upenn.edu/women/ nightingale/nursing/nursing.html (Original work published 1860) Potter, P. A., Perry, A. G., Kerr-Ross, J. C., Wood, M. J., Astle, B., & Duggleby, W. (Eds.). (2014). Canadian fundamentals of nursing (5th ed.). Toronto, ON: Mosby Elsevier. Public Health Agency of Canada. "What Makes Canadians Healthy or Unhealthy?" 23 Jan. 2013. Web. 03 Nov. 2016. Retrieved from http://www.phac-aspc.gc.ca/phsp/determinants/determinants-eng.php#physenviron World Health Organization. The determinants of health. (2016). Retrieved November 03, 2016, from http://www.who.int/hia/evidence/doh/en/...