Although she was born in 1820, Florence Nightingale’s precepts, assumptions and theories drive many expectations in nursing education and practice. Among these are her theories about the influence of the environment on health and the benefits of basic sanitation. She also taught that patients should be properly nourished. Nightingale was the first to call for formal education for nurses, which would allow them to make accurate observations of patients and document their findings.. Many of Nightingale’s ideas are intrinsic to current nursing practice: assess, diagnose, plan, implement and evaluate.
Nightingale fought constantly to improve nursing as a profession and felt that nurses should receive education specific to nursing, as well as hands-on clinical training. For example, the nurse must be able to conduct a physical examination, collect and analyze data about her patients, recognize potential problems, prioritize the information, and communicate and document her findings. Nursing students now learn all these skills in formal programs with standardized curricula. A registered nurse may have an associate degree, a nursing diploma or a bachelor's degree. The U.S. Bureau of Labor Statistics notes all nursing students complete courses in anatomy, physiology, microbiology, chemistry, nutrition and psychology, and also spend time in hands-on clinical training.
Sanitation and Health
Nightingale practiced in an era and under conditions when sanitation was limited and patients often died of infections. A September 2010 article in the "American Journal of Public Health" notes that during Nightingale's service in the Crimean War, most soldiers died from diseases such as typhus, typhoid, cholera and dysentery, not from injuries in battle. Nightingale wrote of the need for fresh air and cleanliness, discussed the need to build and manage housing to allow for proper ventilation and admonished nurses to wash their hands frequently. Many of these precepts are still used in constructing hospitals, and frequent hand washing is required not only of nurses but of all health care professionals and personnel. She also promoted public health concepts and felt nurses should not only care for the sick but also help patients maintain and improve their health.
Nutrition and Health
Good nutrition is one of the foundations of good health, according to Nightingale. She noted that patients have different nutritional needs and desires, and recommended smaller and more frequent feedings. During the Crimean War, Nightingale had food brought from England to help meet patients’ nutritional needs. Today’s nurses educate patients about nutrition and diet and the connection between diet and such problems as diabetes. A healthy diet is viewed as a way to help prevent nutritional deficiencies, promote overall health and prevent chronic diseases and disabilities.Today’s nurses have an understanding of how to manage the diets of patients with diabetes or kidney disease to help prevent complications.
Promoting Rest for Healing
In Nightingale's time, patient care was not highly technical. Medications and medical treatments were limited, and many nursing actions were directed to keeping patients comfortable so they could rest and allow the body to heal. Nightingale urged nurses to manage the patient's environment to promote rest and help them sleep. For example, if the environment is noisy, patients in pain may become irritable and require more pain medication in order to rest. Patients may also find it more difficult to rest if they have too many visitors. Since rest is essential for healing, Nightingale noted the nurse should alter the environment --speak softly, close the door or limit visitors -- to allow healing to occur.