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JMRY8 Module 1 Research and Nightingale

JMRY8 Module 1 Research and Nightingale

Nightingale Case Study

This paper will be applying Florence Nightingales five essential components of her environmental theory over information contained in a case study. A description of Nightingale’s environmental theory outline and how its application is beneficial to this particular patient’s case. The case study will include patient personal data, environmental data, and the nursing approach to providing care to this patient. Formulating the pertinent criteria for the nurse to address upon the initial nursing assessment regarding patient condition, surroundings, and abilities. The presentation of the nursing care plan for this case study will encompass the five Nightingale components. Discussion about nursing judgement for prioritizing this patient’s needs according to their care plan objectives and goals. This case study concerns a 68-year-old widow recently discharged from the hospital after a surgical procedure. She returned home to a small isolated poorly ventilated apartment. Once arriving home, she has poor self-care, nourishment, and cleanliness issues.

Suggestions of Nightingales environmental theory and how they incorporate into current nursing practice and geriatric patient populations with varied conditions reviewed. The proposed management of Nightingale’s theory in the modern-day long term care setting with current nurse caring relationships.

 Environmental Theory in Home Health Care

JMRY8 Module 1 Research and Nightingale

Upon inpatient status the case management nurse should begin interpreting patient Adams current care needs and gathering information about her income, family, and home situation. Upon recommendations from the case manager the physician ordered home health nursing care services to assist patient Adams once she returned to her home. The case manager relayed the details of the patient’s hospital stay to the home health provider for a smooth transition of care. The home health nurse is an important asset to the physician’s continuation of patient care for wound healing after the invasive surgery just five days prior to discharge. The home health nurse should “use their powers of observation in caring for patients” (Alligood, (2021 p.86) with each encounter. Upon the initial nurse visit patient Adams is experiencing pain, drainage, and lack of environmental cleanliness within her apartment. 

JMRY8 Module 1 Research and Nightingale

In the adaptation of the Nightingale environmental theory, patient Adams is a person needing care and healing of spirit. The nurse initial action is to assist patient Adams with “finding a key role in her health, and this health is a function of the interaction among patient, nurse and environment” (Smith, 2015 p. 49). The home health nurse should apply the nursing process along with Nightingale’s environmental theory and administer them together so that knowledgeable care can be provided to patient Adams.

Environmental Theory Components

Smith (2015 p.49) shares Nightingale’s five environmental components essential to a person health: clean air, pure water, efficient drainage, cleanliness and light.” The home health nurse observes Adam’s apartment is unsanitary, lacking in fresh air, or adequate lighting. Adams living environment should have an adequate air system free of odors and dirt. The home health nurse should meet the environmental challenges by cleaning light fixtures, flooring, and ridding the apartment of dirt, mold, and mildew. Attending to the storage and maintenance of patient Adams soiled clothing and disorderly apartment will ease her stress and anxiety. The patient’s “environment has a significant role in providing safe care and prompt recovery” according to (Hussain, 2020 p.1).

The Care Plan Process

The home health nurse should decide the appropriate resources to meet the goals within patient Adam’s care plan. These interventions focus on the manipulation of a patient’s environment as a core constituent of nursing care (Hussain, 2020 p. 49). The nurse can collaborate with the apartment owner for repair of the air conditioning, reach out to any family or friends of patient Adams to perform welfare check, animal cares and to delegate household chores. Contacting the local Area on Aging for resources available to the elderly for financial assistance, delivery of meals, monthly commodities and home care-based needs and transportation. Prioritizing Adams personal care needs along with her environmental needs the nurse may “seek constant adjustment between internal and external zones to maintain homeostasis” (Jobin, 2018 p. 11).

JMRY8 Module 1 Research and Nightingale

Theory in Geriatric Nursing Practice

Florence Nightingale’s theory on environmental principles and nursing concepts can also be applied to today’s patient care methods. Long term care facilities who house elderly patients should incorporate the essential environmental components of Nightingale’s theory by promoting “context of care, colors, light, music, pets, exercise, flowers as aspects to be emphasized in a favorable environment in search of healing” (Riegel, 2020 p. 2). Providing these environmental factors can influence the aging patient’s holistic health. The elderly will react positively to their environmental comforts like how they prefer furniture arranged, personal belongings stored and the absence of loud noises. Nightingale’s theory is based on the “anticipation of care and attention to patients’ needs, providing guidance for nurses to perform activities in order to meet patients’ needs (Riegel, 2020 p.3). Geriatric facilities should accentuate the value of patient to nurse connection to assist in developing policies that will promote this collaboration of patient-nurse union of care. 


Florence Nightingale’s theory can simply and easily be applied in healthcare by nurses of today. Application of the environmental theory has the same components of care as they did long ago. Nurses can embrace the five essential elements to current patient care in long term facilities, home health care and case management which all deal with the older patient population. Patients who experience trauma, surgeries, or a decline in function all require nurse to meet their spiritual and environmental needs. Safeguarding the spiritual component in nursing while addressing the environmental needs can balance patient needs while enhancing the patient to nurse relationship and trust.

JMRY8 Module 1 Research and Nightingale


Alligood, M. (2021). Nursing theory utilization and application (5th ed). College of Nursing, Library of Congress Cataloging-in-Publication Data. http://stikespanritahusada.ac.id/wp-content/uploads/2017/04/Nursing-Theory-Utilization-Application-2014-CD.pdf

Hussain, A., & Karim, K. (2020). Enhancing patient’s surrounding: Application of nightingale’s environmental theory into nursing practice. I-Manager’s Journal on Nursing, Article 10(1), 45-49. http://dx.doi.org/10.26634/jnur.10.1.16688

Jobin, P., Siva, R., Sudha, R., & Hema, V. H. (2018). Inter-sensory perception model: Integrating the sixth sense in providing nursing care. Manipal Journal of Nursing and Health Sciences (MJNHS), Article 4(1), 8-17. https://www.proquest.com/scholarly-journals/inter-sensory-perception-model-integrating-sixth/docview/2115197282/se-2?accountid=34574

Riegel, F., Crossetti, M. d. G. O., Martini, J. G., & Nes, A. A. G. (2021). Florence Nightingale’s theory and her contributions to holistic critical thinking in nursing. Revista Brasileira De Enfermagem, Article 74(2), 1-5. http://dx.doi.org/10.1590/0034-7167-2020-0139

Smith, M.C. & Parker, M.E. (2015). Nursing theories and nursing practice (4th ed.). F.A. Davis Company.

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