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FLORENCE’S MODEL • Environment was the main focus
• 5 main interests• Pure air• Pure water• Efficient drainage• Cleanliness • Light
FLORENCE’S MODEL• Florence was gifted with math and
introduced graphs and documents to show statics and trends
PATIENT CAREFlorence Nightingale worked diligently to provide a safe and clean environment for her patients. After taking into account the alarmingly high mortality rates she began implementing the use of clean practices and adequate dietary intake.
Dietary
Diet for chronically ill patients should be monitored
Intake should be monitored Meal scheduling Meals should be edible Meals should be prepared with clean
water
Historical Evolution of the Model
THEN – 1800’S NOW - 2010
Unclean environmentNo formal education for
nurses No evidence based
practice No rounding
No respect for nursing
Formal education Sterile/clean environment
Use of empirical evidence
Recognition of nursing as a profession
METAPARADIGMSPERSON
• Florence believed a person was an individual and treated them as such. They had four components.
• Biological• Psychological
• Social• Spiritual
Metaparadigms
HEALTH Being well Use all resources Control health through environment Disease is repetitive Nutrition is vital Six D’s of diseases
Dirt- Provide a clean environment Drink- Fresh Water Diet- Proper diet Damp- Clean dry environment Drafts- Fresh air was required with minimal noise Drain- proper drainage and sewage removal
Metaparadigms
ENVIRONMENT Influenced health Vital to recovery
External and internal environment
Keep it Dry
Metaparadigms
NURSING
Nursing is a profession Responsible for environment Needs formal education Is an art and a science Distinct and separate from medicine
Unique Thoughts Started the thought process on holism
Developed the use of empirical evidence
Cleanliness Nutrition
Rounding
Health is “not only to be well, but to be able to use well every power that we have” – Florence Nightingale
How we Use This In Clinical Practice
We now have evidence based practice Standards of care Holistic medicine Hand washing Clean/sterile technique Rounding Emotional support
How We Use This in Assessment
Subjective and objective information Holistic medicine Hourly rounding The interview process Documentation
Education
Who is Flo? You know! Base our teaching on her knowledge
ADLs Diet Rounding Environment Clean technique
Current Research
Nightingale’s ideas currently still practiced Research continues to expand and evolve through
Evidence Based Practices- continually evolving, new ideas being introduced
Holistic Medicine – gaining popularity, more widely used, seen as being effective
Nurses are able to incorporate holistic nursing into their practice by understanding the principles of nursing and psychophysiological modalities
Methodologies are advancing, originating from Florence particularly in research
How research is done, why it is done, the development, conduction and implementation
Date collection and statistical analysis continues to expand
Current Research
Society Takes responsibility for the
implementation of clean and safe practices Searches for clean water and
provides sanitation Encourages staff to keep a clean
environment Contributed to a decrease in
mortality and morbidity
Current Research
Education Continually advancing
Greater public awareness Studies, research and educational tools are
available and being used today Organizations began getting involved- facilitating
further research and improving practices CURN Conduct and Utilization Research in Nursing
Strengths
Driven & Heroic- throughout the era of the Crimean War Hard working- during a time of mans work Bravery- traveled to countries riddled with illness, warranted
for cleaner environments, encouraged staff to clean barracks, provide edible food and gather supplies
Advocate- Wrote hundreds of letters to government officials informing them of the current conditions and advocating for better practices
Practiced holistic nursing- finding patients money, housing and food
Hospital administration- Maintained accurate records and relied on statistical information to help make the best decisions.
Teaching – setting up nursing schools and teaching students
Limitations Then
Although Florence Nightingale had many good ideas, women were often rejected when they attempted to become involved in medicine.
Privacy was not an issue and soldiers were kept in small areas without blankets.
Soldiers may have been unwashed and still in the same clothing they came to the hospital in as sanitation was not of large concern.
Limitations Then
Lack of knowledge may have helped spread cholera and malaria.
A women attempting to change the way a professional man practices was seen as a personal attack.
Restrictions prevented women from having careers even though their services were much needed.
Limitations Then
Few schools existed that could train and produce an educated nurse. Nursing was for working class women and not considered respectable.
KING’S COLLEGE IN LONDON
Limitations Now
The price of receiving adequate medical care has become almost unaffordable for the average working class family.
The opportunity to profit from provided medical care and much needed prescription drugs has increased.
The endless resources (internet) has provided many with inaccurate information they now base medical decisions on.
New Insights
Florence Nightingale suspected there may be germs present that could be passed from one patient to another. Today we know this to be true and use hand washing, germicides, and gloves to help prevent the spread of disease and infection (germs).
Florence Nightingale used measurement to track improvement, the same concept many of us see on a skin and wound assessment sheet.
New Insights
Florence Nightingale wrote the first textbook on nursing, today nurses teach fellow nurses through the use of classrooms and nursing textbooks.
The Nightengale in the East
Her heart it means good for no bounty she'll take, She'd lay down her life for the poor soldiers sake.
She prays for the dying, she gives peace to the brave,She feels that the soldier has a soul to be saved.The wounded they love her as it has been seen,
She's the soldier's preserver, they call her their Queen.May God give her strength, and her heart never fail,
One of heaven's best gifts is Miss Nightingale.
References Attewell, A. (2010). Florence Nightingale's relevance to nurses. Journal of
Holistic Nursing, 28(1), 101-106. doi: 10.1177/0898010109357245 Audain, C. (2010, July 2). Florence nightingale [Biographies of woman
mathematicians]. Retrieved October 14, 2010, from Agnes Scott College website: http://www.agnesscott.edu/lriddle/women/nitegale.htm
Hacking, S. (2010). Florence Nightingale-a case study in excellence. Retrieved September/ October, 2010, from http://ezinearticles.com/ ?Florence-Nightingale---A-Case-Study-in-Excellence&id=5141589
Kearney-Nunnery, R. (2008). Advancing your career: Concepts of profession nursing (4th ed.).
Philadelphia, PA: F.A. Davis Company. (Original work published 1997) Men in nursing. (2010). Retrieved October 9, 2010, from All nursing
schools database. Selanders, L. (2010). The power of environmental adaptation: Florence
Nightingale's original theory for nursing practice. Journal of Holistic Nursing, 28(1), 81-88. doi: 10.1177/0898010109360257
Stanley, D. & Sherratt, A. (2010). Lamp light on leadership: Clinical leadership and Florence Nightingale. Journal of Nursing Management, 18(1), 115-121. doi: 10.1111/j.1365-2834.2010.01051.x
Questions
1.) What do you think are some practices that may seem insignificant today but could have a profound impact on the future of patient care.
2.) Compare and contrast the use of fresh air in hospitals.
3.) Florence wrote letter to congressman often explaining to them the current situations. Explain how you could take more of an active role improving hospitals, payor sources or overall patient care.