Professional Documents
Culture Documents
Florence Nightingale (1820±1910), considered the founder of educated and scientific nursing and
widely known as À À
[1], wrote the first nursing notes that became the basis
of nursing practice and research. The notes, entitled
(1860), listed some of her theories that have served as foundations of nursing practice in various
settings, including the succeeding conceptual frameworks and theories in the field of nursing.[2]
Nightingale is considered the first nursing theorist. One of her theories was the ^
, which incorporated the restoration of the usual health status of the nurse's clients into
the delivery of health care²it is still practiced today.
[hide]
1 Environmental effects
2 Environmental factors affecting health
º Provision of care by environment
è See also
References
Ô
^
She stated in her nursing notes that nursing "is an act of utilizing the environment of the patient
to assist him in his recovery" (Nightingale 1860/1969),[º], that it involves the nurse's initiative to
configure environmental settings appropriate for the gradual restoration of the patient's health,
and that external factors associated with the patient's surroundings affect life or biologic and
physiologic processes, and his development.[è]
Ô
^
Adequate ventilation has also been regarded as a factor contributing to changes of the patient's
process of illness recovery
Defined in her environmental theory are the following factors present in the patient's
environment:
Any deficiency in one or more of these factors could lead to impaired functioning of life
processes or diminished health status.[6]
Ô
The factors posed great significance during Nightingale's time, when health institutions had poor
sanitation, and health workers had little education and training and were frequently incompetent
and unreliable in attending to the needs of the patients. Also emphasized in her environmental
theory is the provision of a or
and
, attending to patient's
dietary needs by assessment, documentation of time of food intake, and evaluating its effects on
the patient.[7]
Nightingale's theory was shown to be applicable during the Crimean War when she, along with
other nurses she had trained, took care of injured soldiers by attending to their immediate needs,
when communicable diseases and rapid spread of infections were rampant in this early period in
the development of disease-capable medicines. The practice of environment configuration
according to patient's health or disease condition is still applied today, in such cases as patients
infected with × (suffering from tetanus), who need minimal noise to calm them
and a quiet environment to prevent seizure-causing stimulus.
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^() (September 1, 1909, Reading, Pennsylvania ± 17 Úarch 1999) was a
nursing theorist whose seminal work
was published in 192.
For example, as the nurse listens to her client she or he develops a general impression of the
client's situation. The nurse then validates his or her inferences by checking with the client for
accuracy. The result may be experiential learning, improved coping strategies, and personal
growth for both parties.
Ô
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Hildegard Peplau was born September 1, 1909, in Reading, PA, the second daughter of
immigrants Õustav and Ottylie Peplau, and one of six children. As a child, she witnessed the
devastating flu epidemic of 1918, a personal experience that greatly influenced her
understanding of the impact of illness and death on families.
Peplau began her career in nursing in 19º1 as a graduate of the Pottstown, PA, School of
Nursing. She then worked as a staff nurse in Pennsylvania and New York City. A summer
position as nurse for the New York University summer camp led to a recommendation for Peplau
to become the school nurse at §ennington College in ermont. There she earned a bachelor¶s
degree in interpersonal psychology in 19èº. At §ennington and through field experiences at
Chestnut Àodge, a private psychiatric facility, she studied psychological issues with Erich
Fromm, Frieda FrommReichmann, and Harry Stack Sullivan. Peplau¶s life-long work was
largely focused on extending Sullivan¶s interpersonal theory for use in nursing practice.
From 19èº to 19è she served in the Army Nurse Corps and was assigned to the º12th Field
Station Hospital in England, where the American School of Úilitary Psychiatry was located.
Here she met and worked with all the leading figures in §ritish and American psychiatry. After
the war, Peplau was at the table with many of these same men as they worked to reshape the
mental health system in the United States through the passage of the National Úental Health Act
of 19è6 and so on.
Peplau held master¶s and doctoral degrees from Teachers College, Columbia University. She was
also certified in psychoanalysis at the William Alanson White Institute of New York City. In the
early 190s, Peplau developed and taught the first classes for graduate psychiatric nursing
students at Teachers College. Dr. Peplau was a member of the faculty of the College of Nursing
at Rutgers University from 19è to 197è. At Rutgers, Peplau created the first graduate level
program for the preparation of clinical specialists in psychiatric nursing. She was a prolific writer
and was equally well known for her presentations, speeches, and clinical training workshops.
Peplau vigorously advocated that nurses should become further educated so they could provide
truly therapeutic care to patients rather than the custodial care that was prevalent in the mental
hospitals of that era. During the 190s and 1960s, she conducted summer workshops for nurses
throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught
interpersonal concepts and interviewing techniques, as well as individual, family, and group
therapy. Peplau was an advisor to the World Health Organization and was a visiting professor at
universities in Africa, Àatin America, §elgium, and throughout the United States. A strong
advocate for graduate education and research in nursing, she served as a consultant to the U.S.
Surgeon Õeneral, the U.S. Air Force, and the National Institutes of Úental Health. She
participated in many government policy-making groups. After her retirement from Rutgers, she
served as a visiting professor at the University of Àeuven in §elgium in 197 and 1976. There
she helped establish the first graduate nursing program in Europe.[ ]
Ô
Peplau's model has proved of great use to later nurse theorists and clinicians in developing more
sophisticated and therapeutic nursing interventions
Ô
Peplau's Seven Nursing Roles illustrate the dynamic character roles typical to clinical nursing.
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1. Orientation Phase
2. Working Phase
-Identification Phase
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º. Termination / Resolution Phase
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is the term given to the body of knowledge that is used to define or explain
various aspects of the profession of nursing.
Ô
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[1]
Ô
Õ have the broadest scope and present general concepts and propositions.
Theories at this level may both reflect and provide insights useful for practice but are not
designed for empirical testing. This limits the use of grand nursing theories for directing,
explaining, and predicting nursing in particular situations. Theories at this level are intended to
be pertinent to all instances of nursing.
Ô
Ú are narrower in scope than grand nursing theories and offer an
effective bridge between grand nursing theories and nursing practice. They present concepts and
propositions at a lower level of abstraction and hold great promise for increasing theory-based
research and nursing practice strategies.
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have the most limited scope and level of abstraction and are developed
for use within a specific range of nursing situations. Nursing practice theories provide
frameworks for nursing interventions, and predict outcomes and the impact of nursing practice.
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Purposely omitted from this list is that most famous of all nurses, Florence Nightingale.
Nightingale never actually formulated a theory of nursing science but was posthumously
accredited with same by others who categorized her personal journaling and communications
into a theoretical framework.
Also not included are the many nurses who improved on these theorists' ideas without
developing their own theoretical vision