This paper presents a critique of nursing theory. A case of Florence Nightingale’s Environmental theory has been selected and the main ideas and assumptions discussed. The origin of the theory, its testability, and its usefulness in nursing practice are also tackled.
Nursing is a science that focuses on improving the health and healing of humanity through effective care. The discipline is based on diversified components of knowledge such as philosophy, science, art, and ethics. The science incorporates several theories that are based on research findings within the discipline. The main purpose of the nursing theories is to improve the art and practice of nursing. This is further driven by the need to generate better health in persons, families, and communities. The theories are, therefore, developed to promote coherent ways of viewing and approaching people’s care in their contextual environments (Parker & Smith, 2010).
Main Ideas of Florence Nightingale’s Environmental Theory
The environmental theory of nursing was propagated by Florence Nightingale and was first published in 1860. According to her, nursing incorporates the restoration of the normal health status of the patients as well as of the nurses. For this to be successfully achieved, the practice evolves around certain environmental factors that are interrelated. The theory states that the process of nursing involves utilizing the environment to assist the patients in their recovery. Nightingale reasoned that when several aspects of the environment were not balanced, patients had to use extra energy to counter the imbalance hence hindering the healing process (Meleis, 2010).
Pure and fresh air is one of these environmental factors that were perceived as significant by Nightingale. This implies that the air that people breathe should be kept as pure as the external air without chilling the patient. Pure water and effective drainage were other factors that she considered significant. For her, the use of impure water for domestic purposes and poor drainage makes humanity be at risk of epidemics. General cleanliness and light are also considered as significant factors that affect health. As a result, general cleanliness and usefulness of good and quality light must be upheld in a nursing environment (Meleis, 2010).
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In relation to these, Nightingale concluded that a clean environment that observes all these environmental factors is paramount in the nursing practice. She also emphasized the quiet and noise-free and warm environment, attending to patients’ dietary needs, effective documentation and evaluation strategies. She, therefore, observed that these factors are interrelated to the extent that any deficiency in one or more of them is likely to impair the functions of the rest (Parker & Smith, 2010).
Origin of the Theory
At the time when this theory was propagated, society, as observed by the theorist, was dominated by a number of factors that influenced the theory. These include poor sanitation in health institutions and incompetence of the health workers and nurses. As a result of this, the healthcare services were unreliable and non-satisfactory to the needs of the patients (Nightingale, 1992).
Nightingale’s personal experience, values, and orientation were influential in shaping her theoretical view. As a young woman, she often accompanied her mother to hospitals in order to visit the sick. In this process, she observed that, despite the reputation that the nurses had, the hospitals were dirty, crowded, and smelly. She, therefore, joined the profession with the view of creating change and improving the service. She also believed that nursing required special commitment as it is a call from God (Nightingale, 1992).
With a view of her approach to theoretical development, Nightingale employed an inmate with a human immunodeficiency approach. This involved the need to create an environment that allows people to recover from illness by improving sanitation conditions. She was also guided by her prior knowledge and writings about science. These are mainly documented in her work such as What is Nursing and What is Not. This gave her a clear background on the understanding of the concept and the practice of nursing as well as its goals (Parker & Smith, 2010).
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The Usefulness of the Theory
This theory has been useful in understanding the foundations of nursing practice in various settings. For instance, Nightingale and other nurses that she had trained implemented this theory during the Crimean war. In this health crisis, she effectively took care of injured soldiers by attending to their immediate needs and also curbing the spread of other communicable infections that were rampant at this period (Meleis, 2010). This theory is also significant to current nursing both in relation to practice and research. Its values, a philosophical basis, assumptions, and beliefs are fundamental in understanding the meaning, elements, and paradigms of nursing (Meleis, 2010).
Testability of the Theory
An evaluation of this theory reveals that it has testable and non-testable tenets. For instance, environmental factors such as ventilation, warmth, quietness, diet, and cleanliness are measurable and their impact on health improvement is testable. However, the universality and timelessness of other concepts such as a nurse, patient, and environmental interrelationship remain pertinent (Parker & Smith, 2010).
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Several scholarly types of research have been made on Florence Nightingale’s environmental theory. These have been done by scholars such as Slanders Louise, Flaskerud Jacquelyn, and Edward Halloran, and Dennis Karen. For instance, Dennis Karen’s research was based on these propositions: the patient is the focal point of nursing care; nurses concern themselves with disease prevention, health promotion, the physical environment, and psychosocial process (Meleis, 2010).
In the overall evaluation, Nightingale’s Environmental theory is both comprehensive and specific. It argues that the interrelationship between environments, external influences and conditions can prevent, suppress or contribute to death. The theory is also specific by pointing out certain environmental factors such as sanitation, clean water, light, and drainage that affect health.