Florence Nightingale made a contribution that the external conditions and influences can lead to the contribution, prevention, and suppression of a disease and illness. Through her mission, she was helping in the retaining of the vitality of patients. She developed a theory that states that there exist different environments namely; physical, psychological, and social. The environments alter the patient outcomes ( Rahim & Shirin, 2013) . With that, she asserts that putting a patient in a natural condition does not necessarily mean he or she is alone. During the period that nature takes to heal, there is nursing with the intent of; alleviating pain, sleep procuring, and diet guarding.
Case Study
The case study captures the situation of Mrs. Adam who is 68 and a widow. She is referred to the management upon her hospital discharge upon the recommendations of the physicians and she is unable to independently care for herself. From the diagnosis, she is suffering from diabetes, breast cancer, and hypertension. Her apartment is located in an area that is encompassed by low-income in the city where there is a high prevalence of crime. As per the assessment that was conducted by the Community Health Nurse, her apartment was not in order and less airflow and light (Aspen University, 2018). In her apartment, she has no food, and the clothes were unchanged. Mrs. Adams considers three cats and a dog as her family after the death of married husband a while ago. She complains of pain and draining in the site of surgery and an air conditioner that is broken.
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First Assessment
The surrounding environment should undergo a process of evaluation upon the initial touch with Mrs. Adams. Her self-care and the deficits should be utilized as per the assessment initially. The components of the environment consist of the houses health, warming and associated ventilation, noise, light, the beddings, variety, the cleanliness that is personal, taking of food, and the nutrition. According to the case study, the air conditioner is not functioning, and the residents have no access to air flow ( Rahim & Shirin, 2013) . Due to the patient’s high rate of crime in the neighborhood, it a concern to have safety if really the windows are kept open and not locked. The comment of Nightingale is that "we nose the murders in the musty, unaired, unsunned room, scarlet fever which is behind the door or the fever or hospital gangrene." With that, it implicates the needs of her ventilation, air control, and a light that is good to help in the repair of wounds after the surgery. There is harboring of bacteria and infection increase due to pets that live in an environment that has less ventilation.
Importantly, her risk factors are unclean clothes and the residence disarray. The residence disarray and the inadequacy of food items is an indication that she lives alone and less support if any (Aspen University, 2018). The current status of health is a hindrance to her cleaning of the residence to a form that is unacceptable. In the aspect of residence, cleaning is a change of clothes frequency and airing of the linens. From her theory, Nightingale made a report that patients deposit their floras that are harmful on the bed and if there is no changing of the bedding, it develops to a great saturation of flora, that re-enters the body of a patient and causes an infection that is additional ( Rahim & Shirin, 2013) . With that, changing of linens needs Mrs. Adams to be assisted with the daily hygiene. In her relation, Nightingale links with the situation of unwashed skin on a patient to slow the spread of poison hence the importance of sponge baths in daily activities.
Five Essential Components of Nightingale’s Environmental Theory
In her advocating, Nightingale related the patients’ rehabilitation to be direct in a correlation with the surrounding they are taken back after being discharged from the healthcare. Mainly, it may not always be clean or optimally a healing surrounding. She advocated that there are five factors that are essential that ensures a good sanitation of abodes that are private for the improvement of the outcome of the restitution of a disease (Ackley, Betty & Ludwig, Gail, 2014) .
Air that is purely fresh . With that, it is essential for breathing as it is outside ambient air.
Pure water . With that, it evades one from the contribution of a disease.
Effective drainage . A drainage that is good is needed to ward off the epidemic disease and ill health facilitated by the home sewer systems that are contaminated,
Cleanliness . This aspect must be preserved in all situations by the practitioners. They need to maintain the cleanliness of patients and the frequency of washing their hands.
Light . The need to have light in the treatment of a disease is very paramount, in specific, the sunlight ( Wayne & Gil, 2014) .
Care Plan
Diagnosis of Nursing:
The impaired physical mobility that is related to the nerve, lymphedema, and damage of muscles, and the acute pain that is experienced by Mrs. Adams without the ability to ambulate with no help. The acute pain is in relation with the recent procedure of surgery as experienced by her and the verbal complaint of pain with the medication of pain usage (Ackley, Betty & Ludwig, Gail, 2014).
The infection risk is in relation to the condition of the lady’s wound, her history of medication, and the condition of residence with ventilation that is poor, cleanliness, and a nutrition that is poor.
Subjective Data:
There are complaints from the patient of experiences of pain and breaking of the air conditioner. She made a report that she is a widow with no help (Ackley, Betty & Ludwig, Gail, 2014).
Objective Data:
A 68-year old female widow with a past experience of diabetes, hypertension, and breast cancer. The patient is in coverage of radical right breast cancer mastectomy. The patient has a failure in the right upper arm after the procedure of surgery. There are three pets kept in the house.
Nursing Outcomes:
The goals of a patient; the resident will undergo a cleaning process and improvement of the ventilation. The lines of the bed will be changed, and receive bathing on daily basis. The patient will undergo exhibition of an increase of mobility strength by getting from bed to chair, and sit for half an hour daily. The patient will undergo verbalization of two ways for the prevention of injuries that are physical during the ambulation ( Wayne & Gil, 2014). Daily hygiene will be performed hence decreasing the infection risk.
Nursing Interventions:
The nurse assesses the daily readiness of a patient to the nursing outcomes. The nurse will assist the patient in seeking other people for the support of the patient during the process. In her care plan, the rehabilitation is important to Mrs. Adams (Aspen University, 2018). The infection is paramount as well and needs to be addressed consistently. She will improve with the assistance of health support.
Applicability of the Theory
Today, the Nightingale’s environmental theory is applicable in the area of nursing practice. It is recommendable that at the community level, individuals can be offered the required awareness that regards the basic hygiene that involves the environment through the media. At the heath care level, if the checklist that regards the factors of environment is attached in the bedside folder of a patient, it will be easy to compel by the nurses for its implementation of which it will lead to delivery of positive effects on the conditions of a patient (Ackley, Betty & Ludwig, Gail, 2014).
References
Ackley, Betty & Ludwig, Gail (2014). Nursing diagnosis handbook: An evidence-based guide to planning care. Mastectomy (10 th ed.). Maryland Heights, MO: Mosby
Aspen University (2018). Concepts and Theories in Nursing . Module 1. Assignment 1. Retrieved from https://aspenuniversity.edu/conceptsandtheoriesinnursing /assignment1/
Rahim, & Shirin (2013). Clinical application of Nightingale’s environmental theory. i-manager’s Journal on Nursing, 3 (1), 43-46, February/April 2013
Wayne, & Gil (2014). Florence Nightingale’s Environmental Theory. Nurselabs.com. Retrieved from https://nurselabs.com/florence nightingale’s environmental theory
