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Critique of Florence Nightingale’s Environmental Theory


Florence Nightingale was a nurse whose work formed the foundation of the environmental theory. The concepts of the theory emanated from her work during the Crimean War. During the war, she discovered that soldiers were not dying from injuries but from other diseases like typhoid. Nightingale altered the environment by providing proper nutrition and improving sanitation. The theory is used in modern nursing because its focuses on the effect of environment on patients. Environment is an important aspect of a patient’s recovery process. In recent years, several studies have been conducted to study the relationship between health and environment.

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Florence Nightingale developed the environmental theory that heralded modern nursing. The theory is based on the importance of environment on patient recovery and health (Selanders, 2010).


According to Nightingale’s environmental theory, environment is an important aspect of the nursing care offered to patients. Nightingale taught that nursing requires professional education and use of knowledge and skills (Alligood, 2011). The theory postulates that nurses should manipulate the environment in order to improve the health status of patients. The environment has positive and negative effects on the health of patients. The main concepts of the theory include the importance of fresh breathing air, cleanliness, food, nutrition, clean drinking water, proper lighting, variety, clean beddings, and efficient drainage (Alligood, 2011). These factors affect the health of patients in different ways.

Origins of the theory

The theory was developed after Florence Nightingale’s successful career in nursing. During the Crimean War, Nightingale offered health care services to wounded soldiers. She aimed at improving the health of wounded soldiers by providing proper nutrition, better sanitary conditions, and clean drinking water (McKenna, 2006). Nightingale reduced the mortality rate among soldiers. For that reason, she continued to provide better sanitary conditions and nutrition. After establishing the St Thomas Hospital, Nightingale started teaching what she had practiced during the war. Her teachings were consolidated into a nursing philosophy, which was referred to as the environmental nursing theory. The most important aspects of the nursing process include observation, diagnosis, planning, and implementation of nursing principles (McKenna, 2006). In order to develop the theory, Nightingale used her observation that organisms in the environment and in the organic materials that soldiers consumed were the causes of diseases (Selanders, 2010).


The theory is useful in nursing practice because it enumerates steps that nurses should take when dealing with patients (Selanders, 2010). It discusses the importance of altering an environment in order to eradicate diseases and protect individuals from infection. This theory encourages nurses to alter the environment using professional knowledge and skills (McKenna, 2006). For instance, by providing proper nutrition, nurses can help diabetic and obese individuals embrace healthy lives.


The theory is testable because different studies have been performed to validate its principles. The theory has generated numerous research studies. For instance, a study conducted to establish the relationship between hospital environment and patient recovery found out that a noisy environment slowed down recovery because it made patients stressed and anxious (Zborowsky & Kreitzer 2005). The study revealed that a noisy hospital environment can raise the blood pressure of a patient. Proposition statements used in such research undertakings aim to show how environment affects the recovery of patients. Nutrition, light, noise, and clean sanitation are important factors to consider when altering the environment in order to hasten patient recovery (Hendrich & Sorrels, 2004).

Overall evaluation

The theory is comprehensive and specific. Research studies have revealed that environment is an important aspect in fighting diseases. The theory is specific because it pinpoints explicit environmental aspects that could be altered to improve patients’ health (Selanders, 2010). For instance, the theory states that proper lighting, proper nutrition, cleanliness, sanitation, and adequate ventilation are important in nursing practices (Zborowsky & Kreitzer 2005). The theory outlines specific actions that should be taken in order to create an environment that promotes recuperation of patients. The strengths of the theory include testability, the possibility of application in nursing practice, and inclusion of actions that promote preventive measures. The theory has weaknesses that include exclusion of three nursing metaparadigms and failure to validate the germ theory. I would use this theory in my practice to prevent diseases and hasten patients’ recovery (Selanders, 2010).

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Alligood, M. (2011). Nursing Theorists and Their Work. New York: Elsevier Health Sciences.

Hendrich, A.L., & Sorrels, A.K. (2004). Effects of Acuity-Adaptable Rooms on Flow of Patients and Delivery of Care. American Journal of Critical Care, 13(1), 35-45.

McKenna, H. (2006). Nursing Theories and Models. New York: Routledge.

Selanders, L. C. (2010). The Power of Environmental Adaptation: Florence Nightingale’s Original Theory of Nursing Practice. Journal of Holistic Nursing, 28(10), 81-88.

Zborowsky, T., & Kreitzer, M. (2005). Creating Optimal Healing Environment in a Health Care Setting. Web.

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