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Florence Nightingale’s Environmental Model

Topic Description

Florence Nightingale’s Environmental Theory is founded on the assumption that in order to successfully keep people healthy, one must assert a control over the environment (Dossey, 2010). The environment, in this case, assumes the role of the great healer with the ability to cure diseases. As such, in Nightingale’s words “nature alone cures” and, therefore, the nurse plays a crucial role in enabling the patient to be in the best position which allows nature to act. The primary idea is to have the nurse manipulate the environment in a manner that allows the best possible outcome to be achieved (Parker & Smith, 2010). If the nurse can manipulate the environment positively, then the patient will achieve a good state of health.

According to the Environmental Theory, there are thirteen canons or concepts that play a central role in a patients’ health. The basis of the Environmental Theory is the nurse’s evaluation of the environment on the basis of the effects it has on the patient (George, 2010). The outcome of the assessment should indicate whether the environment has a positive or negative effect on the patient. To ensure adequate nursing assessment of the environment, it is necessary for the nurse to have some experience to validate the observations effectively. According to Dossey (2010) the patient is an integral part of the whole Environmental Theory. As such the approach that is applied in the theory requires that the care be centered on the patient and focus on the whole person.

Origins of the theory

The Environmental Theory was developed during the Victorian age. People who lived during this era believed that the primary cause of disease were germs. Nightingale’s work was driven by her skepticism towards germs being regarded as the main cause of disease. According to Parker and Smith (2010), the prevention of diseases was anchored in the manipulation of the environment by ensuring that appropriate hygiene practices were observed. During the time when Nightingale wrote her theory, hospitals overlooked sanitation. The health workers who lived at the time lacked any knowledge of the environmental consequences on health. As such, the health workers lacked the competency for attending to patients’ needs in a comprehensive manner (Dossey, 2010). Nightingale’s motivation stemmed from her desire to see that nurses offered wholesome care for their patients.

Usefulness the Theory

The primary goal of the Environmental Theory is to ensure that nurses have a clear direction on what is required to ensure that patients have positive health changes. The purpose of the theory is well aligned with nursing as it aims at providing wholesome care for the patients, as well as an improvement in the quality of life (George, 2010). Nightingale held that hand washing was significant and therapeutic. As such, hand washing is an integral part of nursing care.

Hand washing has transformed into an important method of primary diseases prevention approaches. Nurses are required to observe hand hygiene during their care (Parker & Smith, 2010). It is necessary for nurses to ensure that their hands are washed clean before most of the procedures. During the care of nursing, it is vital that nurses ensure that their hands are clean after touching one patient before moving on to the next patient. Nursing as a profession is also active in the Environmental Theory since the nurse is portrayed as the agent who can manipulate the environment in a manner in which guarantees quality care. The theory can be said to contribute to the prediction of nursing outcomes. Dossey (2010) argues that theory clearly spells out consequences of not observing hand hygiene. The Environmental Theory, therefore, plays a vital role in nursing care.

Testability of the Theory

The Environmental Theory is testable in nursing and healthcare practice. The role of the proposed concepts can be evaluated using modern clinical methods. For example, research which has been conducted over time since the publishing of the Environmental Theory has demonstrated that contaminated hands play a dominant role in the transmission of infectious diseases. The theory can be said to generate research which revolves around the role of sanitation in patient care. Other studies that borrow from the theory revolved around the issue of nosocomial infections.

The theory has generated numerous studies in the field of nursing and especially public health nursing as well as community health nursing. Among the research on the theory is the work of Shirin (2013), which focuses on focuses on the clinical application of the Environmental Theory. The research focuses on different clinical scenarios such as ventilation, beds, and beddings as well as personal cleanliness. The study hypothesizes that the theory can have a significant input in the patient outcomes and if the clinical scenarios were manipulated as per the concepts that are discussed in the theory.

Overall Evaluation

The Environmental Theory is comprehensive and accurate. The theory specifies that the nurse an integral player who drives the manipulation of the environment. The theory is complete in that it emphasizes the need for the nurse to understand the patient and their environment. The scope of the theory is also broad and as such it can find application in several nursing domains. The Environmental Theory can be generalized. However, the theory limited since the tenets of the theory do not find use in diseases such as genetic disorders as well as other malignant diseases. Notably, the theory can help improve the quality of care in most patients.

One of the strengths of the environmental theory is that it’s concept of diseases prevention through manipulation of the environment is in line with nursing practice. The theory also emphasizes the need for nurses to have knowledge so that they can adequately interpret the environment (Dossey, 2010). The theory is also credited with fostering data collection and applying the same in patient care. In this theory, nurses are given an active role in the management of patients while at the same time encouraging the patients to participate in their wellness.

The theory is, however, weak given the fact that it fails to acknowledge other causes of disease besides the environment. Most diseases have multi-factorial causes and as such, other causes such as the genetics of an individual cannot be ignored. The theory relies on the thirteen canons which describe patient as it was during the Victorian era (Parker & Smith, 2010). The theory seems to borrow much of its context from the Crimean War when Nightingale wrote her first publication.

The theory would find application in my management of Tinea pedis among the vulnerable groups such as homeless people. Foot infections are a frequent occurrence among the homeless people. The risk emanates mainly from the living conditions which exposes them to wet conditions. The inability to take care of their hygiene, as well as access to clean shoes and socks, increases the risk of developing foot infections. In caring for these patients in the General Ward, the Environmental theory would find application given that it states that personal hygiene couple with direct sunlight is critical in guaranteeing improved health.


Dossey, B. (2010). Florence Nightingale’s vision for health and healing.Journal of Holistic Nursing, 28(4), 221-224.

George, J. (2010). Nursing Theories: The Base for Professional Nursing Practice. New Jersey: Prentice Hall.

Parker, M. & Smith, M. (2010). Nursing Theories and Nursing Practice. Philadelphia: F.A. Davis.

Shirin, R. (2013). Clinical application of Nightngale’s environmental theory. Journal of Nursing, 3(1), 43.

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ApeGrade. 2022. "Florence Nightingale’s Environmental Model." April 23, 2022. https://apegrade.com/florence-nightingales-environmental-model/.


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