Introduction to Nursing Theory and Florence Nightingale PDF

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Week 3: Introduction to Nursing Theory Florence Nightingale Examples of theories: -

Relativity (Einstein) Germ (Pasteur) Big Bang (Hubble) Evolution (Darwin) Gravity (Newton) Psychological development (Erikson) Cognitive development (Piaget) Human motivation/hierarchy of needs (Maslow)

Functions of Theories -

Organize knowing Explain experiences Interpret observations Describe relationships Guide actions Predict outcomes Provide evidence of achievements - A theory is also testable and backed by evidence. Nursing Theory -

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Fawcett, 1989: “…a relatively specific and concrete set of concepts and propositions that purports to account for or characterize phenomena of interest to the discipline of nursing.” Nurses must know: - What they are doing - Why they are doing what they are doing - What may be the range of outcomes of what they are doing - How to measure the outcomes of actions Nursing Theory Provides - Structure for the thinking about, being, and doing of nursing - Structure for developing, evaluating, and using nursing scholarship - Venue for extending and refining nursing knowledge - Direction for all avenues of nursing practice - Credibility for designation as a “Profession” ( discipline vs. profession)

Which Nursing Theories will we be studying? - Nightingale- Environmental Theory - Benner - Ways of Knowing - Watson- Human Caring - Paterson and Zderad- Humanistic Nursing - Parse- Human Becoming How do we Evaluate and Analyze Nursing Theory -

Criteria (according to Chinn and Kramer, 2008): - Clarity – How clear is the theory? - Simplicity – How simple is the theory? - Generality – How general is the theory? - Empirical Precision – How accessible is the theory? - Derivable consequences – How important is the theory?

History of Nursing Theory -

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Nursing Theory became a major theme in the last half of the 20th century Much of what was known about nursing in the early eras was not tested or used uniformly in practice or education. Ideas were passed on through education focused on skills and functional tasks about nursing practice that seemed effective. A major goal was for the development of nursing knowledge on which to base nursing practice, improve quality of care, and gain recognition of nursing as a profession Until the proposal of nursing as a science in 1950, nursing practice was based on principles and traditions passed on from apprenticeships Curriculum Era - Addressed questions of what content nurses should study to learn how to be a nurse - Emphasis on course selection and content for nursing programs and gave way to research era - Mid 1930’s curriculum had been published, however, it was the middle of this century before most states acted upon this goal. Research Emphasis Era - Focused on the research process and long-range goal of acquiring substantive knowledge to guide nursing practice Graduate Education Era - Masters degree programs for nursing in order to meet the public need for specialized clinical nursing practice Theory Era - Natural outgrowth of the research and graduate eras into a more theoretical based nursing framework Theory Utilization Era - Emphasis shifted to theory application in nursing

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Important step for theory based nursing, evidence based practice, and future theory development

Nursing's First Theorist (Florence Nightingale) - Well known for her care of soldiers during the Crimean War - Goal of Nursing to her: - “Assisting the patient in his or her retention of “vital powers” by meeting his or her needs, and thus, putting the patient in the best possible condition for nature to act upon”( Nightingale, 1860) - Influence on Nightingale’s Theory Development - Early Life – Think “Determinants of Health” - War - Feminism - Social Justice - Spirituality\Religion - Science - Nightingale’s Assumptions - Nursing is separate from medicine - Nurses should be trained - The environment is important to health - Disease processes are not important to health - Nursing is an art and a science - Research( observation – collection of data and drawing conclusions) by the nurse is important - Both the sick and the well are governed by the same ”laws” of health - Nurses require formal education - More Nightingales ideas

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Environment the most important issue Nurses support/manipulate the environment to attain/maintain health People interact with their environment Nursing is most concerned with the relationship of the person with his/her environment - Nurses focused more on environment and how that correlated with the patient - Confidentiality should be maintained Nightingale’s Theory - Focuses on the environment (surrounding) - Ventilation - Warmth - Light - Diet - Cleanliness - Noise Definitions that help us understand nightingales theory (and other) - Paradigm - A global, general framework made up of assumptions about aspects of the discipline held by members to be essential in development of the discipline (Parker, 2005) - Models that guide scientific activity & knowledge development (Kuhn, 1970, 1977) - Meta-paradigm (Meta=beyond; above other paradigms and includes them) - Person - Environment - Health - Nursing Nurse According to Florence - Any woman who has charge of the personnel health of someone else” - Included caring for babies, children and “invalids” - All women, at one time would have to “care” for someone - Trained nurses were to learn additional scientific principles to be applied in their work Nursing According to Florence - Is an art and a science - Based in caring - Is “Service to G-d” in relief of man - Involves performance of tasks to an for the patient - Require control of the patient’s environment to enhance recovery Patient According to Florence - Is at the centre- beginning of Client Centred Care - Contains physiological, spiritual, and intellectual components - Someone needing care - No such thing as the client (not applicable in today's society) Health According to Florence - “Being well/Using all power”

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Result of : - environmental, physical and psychological factors - Environmental components essential to health - Not just the absence of disease - Prevention through environmental control (foundation for public health nursing) Environment According to Florence - Pure air/ventilation - Pure Water - Efficient Drainage - Cleanliness - Light - Noise - Food - Variety - Hurry

Nightingales Model (13 canons)

Nightingale and Today’s Environment - Health of houses: - Pure air - Fresh air from clean source

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Not too warm/cold Hospitals - Negative flow isolation rooms, N95 masks Pure water – does everyone have the same access? Efficient drainage – mold, sanitation, sewage Cleanliness Why do hospitals not have carpets? Housekeeping staff Personal, of rooms, bed and bedding Light – sunburn, overheating, windows, atriums in hosp. Noise, food, variety

Canadian Nurses association and Canadian Medical Association -

“A healthy environment is fundamental to life, and attention to the effect of the environment on human health is imperative if we are to attain the goal of health for all.” (2005)

Making Florence's perspective relevant today-Modern Nursing and the environment -

Assessing/detecting hazards Educating re toxins / environmental “wellness” Reporting serious threats Facilitating home/school/community/ workplace wellness Being involved in public policy/legislation Preventing exposure Facilitating behavior change Encouraging use of public transit/cycling Making referrals

TEXTBOOK: Alligood (2018) Ch.1, pp 1-9 -

Introduction to Nursing Theory: Its History and Significance...