Introduction and history of Nursing Theorist
In the first half of the twentieth century it has been realized that there is need for knowledge base to guide professional nursing practice and many theoretical work has been contributed by nurses ever since but there is no specific date and place nursing theory took place. It was during the Crimean war that the nursing spirit of Nightingale came into limelight when she use to treat and heal the soldiers injured during the war. Born in England in the year 1820 from the very beginning she believed that God had send her to be a nurse and serve humanity by providing her the power and resilience of healing and curing people. With the passage of time as the services and the scope of services provided by Nightingale began to expand she became known as ‘The Lady of the Lamp’.
It was during this time that Nightingale with the help of the data and information that she had collected over so many years of nursing decided to organize them in the form of a theory. There were four essential concepts common amongst nursing theories which are man, health, environment, and nursing. Nightingale was the first lady who expressed her firm conviction nursing knowledge is different from medical knowledge. (Sullivan, 2000)
According to her nursing is the act of fertilizing the environment of the patient to assist him in recovery. She focused on the changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act. She had a strong health promotion and maintenance focus. She identified three related concept self care, self care deficit and nursing system. According to her nursing intervention is needed when individual is unable to perform the necessary self care activity.
Development of theory
The nursing model as proposed by Nightingale is comprised upon various elements and dimensions of healthcare related to human beings. These aspects include the psychological, intellectual and spiritual components. According to the theory that has been presented by Florence accentuates upon the fact that out of all these the component of treatment is highly effective with the help of the spiritual aspect. (Laurent, 2000)
From the perspective of Nightingale Sister exercised a resident essential function. Its task was to consolidate the learning acquired in the halls and monitor the moral development of students. It is surprising that Florence Nightingale had imagined training nurses in 1860 without this feature and found it could only be filled with support of the general supervisor of nurses and doctors. Florence Nightingale also outlined her theory of learning, which focuses on the acquisition of practical skills.
Application of theory
In contemporary nursing practices and methods that are applied in the science of nursing have been pioneered by Florence Nightingale. During the many years when she served as the nurse she compiled various notes and collections of nursing information through the help of which she was able to compile and pioneer her theory on the practice of nursing which is known as the Environmental Theory.
The salient feature of the environmental theory accentuates upon the various components and the changes that can be introduced in a medial setting to improve the condition of the patient that are suffering from the disease. (Kerfoot, 2001)
The basic and fundamental features of the theory encompass upon a several of factors that can be classified and categorized as external factors, additional factors and the scientific and religious connection that can be included in the theory to enhance the effectivity of the theory that has been proposed by Nightingale.
The external factors of the theory constitute the presence of fresh air, clean water, adequate presence of clean and hygienic food, cleanliness and the presence of sufficient sunlight. Any of these factors if not provided in sufficient or proper amount will impede and halt the recovery process.
In the early 19th century when the practices related to medicine and healthcare of patients were not subjected to the rules of cleanliness. In addition to this it is also important to mention that in those times doctors and other medical proficients that were involved in surgical operations, it was a convention that doctors with the most blood stained clothes was considered the best doctor in the hospital. It was primarily because of the services of Nightingale that these conventions were rectified and proper attention towards the creation of a noise free and environmentally compatible atmosphere was provided for the healthy sustenance and nutrition of patients. (Marquis, 2009)
Moreover it was an outcome of the services of Nightingale that for the first time in the history of nursing and patient healthcare planning of a proper diet plan for patients was also designed and implemented by the caretaker staff.
Forming the PICO question
The PICO question that can be based upon the salient features of the environmental theory that was presented by Florence Nightingale can be related to the setting of the environment for bariatric patients.
Q. What conditions or setting of environment within a hospital is suitable for the accommodation of bariatric patients?
A couple of changes that need to be made in the environment for the proper accommodation of such patients which will include the following changes:
· Building Entry points: for obese persons it is necessary that entry points would be designed with comfortable ramps with hand rails instead of stairs. The width of the doors must be more than 3 and a half feet
· Treatment Rooms: beds which are specially designed for the bariatric patients are more than 40 inches wide, while the bariatric wheelchair is 38.5 inches in width. Thus, it is suggested that the doors of the treatment rooms must be wide enough that the wide wheelchairs or bariatric beds would easily pass through it.
· Rooms and Toilet: rooms required for obese persons have to be larger than the normal rooms (Hoover and Smith, 2005) in order to accommodate the large size bed, furniture and family members of the obese patient. It is recommended that the size of bariatric patients’ room is not less than 272 square feet. Like rooms, toilets also need wider space so that two caregivers also fit in. It is suggested that the width of the door must be 3 feet and 6 inches and the centerline of the toilet should be 24 inches instead of 18 inches.
By providing these people with a better and medically feasible environment the treatment of such patients as in accordance with the theory can enhance their treatment.
Apart from all the internal and external factors that have been discussed there are also evidences that Nightingale was also overwhelmingly influenced by spiritual influences and affiliations which she believed were send from God and hence manifested themselves in the form of disease fostering and spreading in the human body.
She was herself an advocate of the miasma theory and strongly believed that these types of airs and influences are send from God in the form of noxious airs.
Furthermore she also use to believe that in order to prevent ourselves from such kind of disease attacks and influences it is important that human beings at their own level must ensure that their surroundings are clean and hygienic and that also nurses must also exercise spiritual measures in order to bring an improvement in the condition of the patient through material as well as spiritual means. (Perra, 2000)