Historical Developments, Current Nursing Perspectives, and Nursing Theorist

Describe the impacts of the historical,current nursing perspective and the nursing theorist have on
contemporary nursing practice today and discuss how these relate to current practice. Include in the
discussion the nursing model that links the theorist.
The following is the theorist we are to discuss;
Theorist: Florence Nightingale – Environmental theory model.
We are to discuss the following points in the essay.

  1. Florence Nightingale enforcers a sanitary reform at Scutari during the Crimean war. Following its
    application the infection and mortality rate dropped.
  2. Steralisation of equipment
  3. Introduction of ANNT ( Aseptic Non Touch Technique)

Historical Developments, Current Nursing Perspectives, and Nursing Theorist
There are several theories of nursing and which impact on the current nursing practice. Most
nursing theories focus on the relationship between the patient, the environment, and health and
the role of the nurse. Nightingale was the first theorist in nursing practice and developed the
Environmental Theory (Pirani, 2016, p. 1040). The following essay is a discussion of the
Nightingale’s Environmental Theory and its impact on contemporary nursing practice.
Sanitary Reform
Florence Nightingale developed the theory based on her observation that the health status of the
individual is dependent on the level of sanitation around the patient. Also, the theorist identified
other environmental factors that are responsible for the health of every individual. The factors
include; sufficient sunlight, enough food, pure water, clean air and cleanliness of the patient and
the patient. Nightingale believed that the role of the nurse was to alter the environment to
maximize the ability of the patient to achieve a healthy lifestyle. According to her observations
of the rate of mortality among the soldiers, the theorist concluded that there was an association
between soldiers and the sanitation within their environment. Nightingale initiated hand washing

Environmental Theory 2
and environmental cleanliness within the soldiers’ camps. The sanitation she introduced
prevented the contribution of the unclean environment towards reduced health status of the
individual. Currently, the scientific explanation between health and sanitation has been well
established. The contaminated environment contains pathogenic microorganism. When the skin
barrier is broken, for instance, in traumatic wounds, the pathogenic micro-organisms access the
human body and spread through the body systems, eventually causing widespread inflammation
and subsequently death if not successfully managed. The role of the nurse, therefore, in
contemporary practice, is to modify the environment within which patients live to maximize the
level of interaction between the patient and the environment. For instance, nurses ensure
adequate food intake for patients whose symptoms negatively affect the ability of the patients to
take food. In the modern community health nursing practice, nurses advocate for health
promotion and prevention of diseases, through advocating for the clean environment and
personal hygiene. Also, in the contemporary nursing practice, the nurse is responsible for
ensuring that wounds are free from infection by performing aseptic wound cleaning and dressing
(Karim, 2015, p.448).
Sterilization of Equipment
Sterilization of equipment is based on the Nightingales’ environmental theory. The theory states
that the environment determines the health of an individual. Instruments used in the assessment,
diagnosis and treatment of various conditions are considered as part of the environment that
surrounds the patient. Some of the equipment is used to perform invasive procedures, for
example, surgical sutures, forceps, orthopedic fixators, and retractors. Pathogenic
microorganisms, especially bacteria, are found inhabiting the surfaces of this equipment. The
introduction and use of the equipment in invasive procedures predispose the patient to infections,

Environmental Theory 3
thus negatively affecting the health status of the patient undertaking the procedure. Therefore,
the role of the nurses is to prevent the introduction of the disease-causing micro-organism
through the objects. According to the Nightgale’s theory and the model that requires that nurses
modify the environment to improve the health of the patient, nurses are responsible for
eliminating the microorganism on the equipment. One of the ways to free the equipment of the
micro-organisms is to sterilize them. Sterilization is the process of complete destruction of the
particles, micro-organisms and all other forms of life on the equipment. One of the ways to
achieve sterilization is through heating and irradiation. Nurses are responsible for carrying out
the sterilization of equipment and packaging the sterilized equipment. Further, in contemporary
practice, nurses are responsible for ensuring that the equipment used in invasive procedures been
sterilized. Nurses are responsible for monitoring and controlling the flow of equipment for
invasive procedures from the site of sterilization into the area of use and back for use
(Zborowsky, 2014, p.20).
Introduction of Aseptic Non-Touch Technique
The aseptic non-touch technique is another contemporary nursing practice skill. According to
Nightingale, the patient continuously interacts with the environment, which has an impact on the
health status of the patient. One of the components of the environment is made up of the people
who interact with the patient. Healthcare professionals, including nurses, interact with patents
and therefore form part of the environment surrounding the patients. Specifically, nurses provide
individualized care to the patients and therefore spent a lot of time at the patient’s bedside.
Further, nurses provide care to patients through performing procedures on the patient such as
wound cleaning and dressing, administration of drugs and vaginal examination. The procedures
highlighted above are performed as hands-on procedures. To reduce the introduction of disease-

Environmental Theory 4
causing micro-organism into the body of the patient and thus the risk of infection into the
patients’ body system, nurses should practice no touch practice. Nurses are supposed to use
protective wears such as surgical gloves, gowns and face masks to avoid contacting patients with
bare hands while performing the procedures (Alejandro, 2017, p.41).
In conclusion, Florence Nightingale developed a theory that emphasized that nurses should
improve the environment in order to impact on the health of the patients positively. The theory
remains relevant in the contemporary nursing practice in various ways.


Alejandro, J.I., 2017. Lessons learned through nursing theory. Nursing2018, 47(2), pp.41-42.
Karim, H.N., 2015. Clinical Application of Nightingale Theory. International Journal of
Innovative Research and Development, 4(11), p.448.
Pirani, S.A., 2016. Application of Nightingale’s theory in nursing practice. Annals of Nursing
and Practice, 3(1), p.1040.
Zborowsky, T., 2014. The legacy of Florence Nightingale’s environmental theory: Nursing
research focusing on the impact of healthcare environments. HERD: Health
Environments Research & Design Journal, 7(4), pp.19-34.

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