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The Legacy of Florence Nightingale


Florence Nightingale is considered the mother of modern medicine. She was the first person to endorse a scientific and practice-based approach and developed the first medical framework that established some of the basic notions of medicine still used today (Alligood, 2017). Her influence effectively changed medicine from the art of obscure and unreliable mysticism into the realm of science. Her method was based on personal experiences, observations, and experimentations, the results of which were shown in her books and rules for the nurses and tried during the Crimean war.

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This methodology has proven to be efficient at dispatching the myths about medicine and patient care that existed at the time. Careful experimentation helped Florence Nightingale discover that, for example, ventilation played a crucial role in helping individuals recover, as opposed to the doctrine of keeping the doors and windows sealed all the time, thus allowing bacteria to condense and thrive in a stuffy, moist, and dark environment (Alligood, 2017). Same discoveries followed about sterilization, overcrowding, patient check-up and activity, and a myriad of other activities that are now considered the basics in medicine.

Since Florence Nightingale’s framework was the first of its kind, many others that were developed later used it as a basis. The fundamental value of Nightingale’s theory is in the creation of four pillars of medicine: Patient, Health, Nursing, and the Environment.

These pillars are present in all contemporary theories that followed. Although her own focus was largely on the environment in order to improve the patient’s health, it was the necessary first step towards patient-centered care. Her contribution remains relevant in the 21st century as well, as all modern nurses are required to learn and understand the framework in order to move on to the advanced material. Hospital Miramar, Florida, has based its environmental strategy inpatient care on Nightingale’s theory, providing fresh air, comfortable conditions, plenty of light, and hygienic procedures to ensure a positive effect.

For the online library search of the task, I utilized the MEDLINE and CINAHL databases. I set the publishing date to 2014-2019, in order to ensure that only the latest and most accurate academic information is delivered. The search terms contained the following keywords: nursing theory, Florence Nightingale, theoretical framework, pillars of nursing, nursing framework, patient-centered care, and environmental theory. A wide search showed over 1193 articles in MEDLINE and 704 in CINAHL.

Out of that number, roughly 118 were relevant to this week’s discussion. I picked an article that was the most appropriate to the scope of this paper, titled “Application of Nightingale’s theory in nursing practice” by Shahina Sabza Ali Pirani. The article was published in 2016 in the Annals of Nursing and Practice. It provides important information about Nightingale’s environmental theory and its application by utilizing a case study as an example. It establishes the usefulness of the theory by showing how ignorance and neglect of the patient’s environment can lead to increased chances of acquiring additional infections (Pirani, 2016).


The article helps understand the main tenets of Nightingale’s theory and provides a convincing example of the value of the environment. However, being a qualitative paper, it does not provide any statistical means and relies largely on secondary sources of information. It does not present the theory in comparison to other, more modern environmental theories, such as Henderson’s and Watson’s theories, for example. Nevertheless, it demonstrates that despite being an old and very basic framework, it can be applied to situations where even the basics are neglected, in order to establish a standard of quality care.

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Alligood, M. R. (2017). Nursing theorists and their work (9th ed.). New York, NY: Elsevier.

Pirani, S. S. A. (2016). Application of Nightingale’s theory in nursing practice. Annals of Nursing and Practice, 3(1), 1040.

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