Florence Nightingale's Theory on Nursing Meta-Paradigms

This paper discusses Florence Nightingale's theory on nursing meta-paradigms, which includes the concepts of person, health, environment, and nursing. The importance of each concept in patient care is explored, along with a comparison of Nightingale's definitions to modern definitions. The paper also discusses the transformation that has occurred or needs to be modified considering the health of a patient.

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The Evolution of Theoretical Knowledge
(The Nightingale theory)
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Table of Contents
Introduction.................................................................................................................................................2
First concept: Person (my definition)..........................................................................................................2
First concept: Person (Florence Nightingale's definition)............................................................................2
Experience...................................................................................................................................................3
Second Concept: Health (my definition).....................................................................................................3
Second concept: Health (Florence Nightingale’s definition).......................................................................4
Experience...................................................................................................................................................5
Third concept: Environment (my definition)...............................................................................................5
Third concept: Environment (Florence Nightingale’s definition)................................................................6
Experience...................................................................................................................................................6
Fourth concept: Nursing (my definition).....................................................................................................7
Fourth concept: Nursing (Florence Nightingale’s definition)......................................................................7
Experience...................................................................................................................................................8
Florence Nightingale: Totality.....................................................................................................................8
Conclusion...................................................................................................................................................9
References.................................................................................................................................................10

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Introduction
The paper reflects upon the Florence Nightingale theory that describes the concepts of
Meta paradigms in the nursing practice. It will discuss the concepts of nursing Meta-paradigms
that play a vital role in the patient's recovery. Nursing comprises of for major concepts of Meta
paradigms they are Person, health, nursing, and environment. It is important understand the
desired concept o totality as it reveals the sum of the parts that becomes equal to the whole. The
primary aim is to compare the previous definitions of the concepts with todays. It will also
discuss the transformation that has occurred or needs to be modified considering the health of a
patient. For over a hundred years the nightingale's theory has been utilized and still today most of
the nursing profession finds it difficult to understand (Nightingale, 2018).
First concept: a person (my definition)
The first concept of meta-paradigm is determined to be a person or human being. A
person can be defend as a child, woman or man of the species that differs from other animals by
superior upright stance, articulate speech and mental development (Fairbrother, Chiarella &
Braithwaite, 2015). According to my definition related to a person or human being states that a
person is a concept that is based on psychological and physiological needs. As per the
description provided, the five-person variables are defined to be the body, mind, spiritual and
social. I believe that person or patient plays a vital role in the nursing practice, hence it is the
primary responsibility of the nurse to give special importance to the needs of the patient. It is
stated that to understand a patient's particular requirements; it is important to understand the
patient and to provide personalized care (Boykin & Schoenhofer, 2015).

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First concept: person (Florence Nightingale’s definition)
As per Nightingale, a person is referred to as being composed of spiritual, social,
psychological and biological concepts as well as being multidimensional. She describes this by
saying that it is impossible to build a human body as a prescription is made (Létourneau, Cara &
Goudreau, 2017). Nightingale describes the fact that even when a person is sick, still the person
comprises of a sense of autonomy. According to her, a sick person should be given full attention
at every moment whenever he is talking something related to business (Hanna, 2018). I agree
with the concept of the theory that is stated by Nightingale as it describes the fact that in the
nursing metaparadigm the most important concept is person or patient. As per Nightingale, this
should be done to provide convenience to the patient so that he or she should feel comfortable
within the environment. It is observed that at the beginning the concept of person refers to the
lifestyle of an individual while now it is transformed into the multidimensional factors (Mackey
& Bassendowski, 2017).
Moreover, Nightingale had used the term multidimensional factors to explain the concept
of a person. As I have not used the term multidimensional in my definition hence, I agree with
her definition. She has described the importance of multidimensional factors in her definition
which I have not discussed that presents the fact my definition has not gone through the actual
definition of a human being.
Experience
I strongly believe that my definition of a person is influenced by my workplace
environment. At the time of placement once I was given a chance to handle a malnourished
patient. While interacting with that patient, I come to know that the patient is suffering from this
disease due to his poor income. The patient does not get sufficient food that resulted in the

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occurrence of this disease. The socio-cultural and psychological factors have highly affected the
person. Thus, a person is governed and affected by various factors rather than physical health
issues.
Second Concept: Health (my definition)
The concept of Health is considered to be the significant component in the meta-
paradigm. The concept of health is defined by cultures, religion, beliefs, and traditions. My
philosophy of health states the fact that health is a concept which does not possess uniformity of
position. I believe that health is a major factor in patient care. By fulfilling the medical
requirements, through preparedness, cleanliness and caring nurses can substantially improve the
health of a patient (McAllister, Madsen & Holmes, 2014). Another significant factor of health is
it must be evaluated and monitored on a regular basis.
Second concept: Health (Florence Nightingale’s definition)
Nightingale in her theory defines health as the absence of comfort. She also states that the
health of a person cannot be understood completely. As per Nightingale, the principles of health
are not known, and the positive pathology of health is found to be negative. It could be positive if
the health of the patient is observed and experienced properly (Alimohammadi, Taleghani,
Mohammadi & Akbarian, 2014). She explains the fact that with the help of observing or
experiencing the health of a person it becomes quite easy for the nurse to bring back or maintain
the state of health. She believed that not only the sick patient but also the healthy person must be
given proper care (Lee, Vincent & Finnegan, 2017). I completely agree with the theory as she
relates health with six necessary components to protect the health of an individual. Whereas, as
per the theorist, it is stated that the health of an individual gets affected by various environmental
factors and it could be treated by observing and experiencing. In her theory, she is mainly

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focused upon the principles of health, whereas my definition is focused on monitoring and
evaluating the health of a patient regularly. Nightingale stated that the concept of health could
not be understood completely while I believe that it could be understood by understanding the
needs of the patient. Therefore, it can be effectively concluded that Nightingale has mentioned
some principles of health that must be followed whereas; I have not discussed any discipline in
my definition of health. I agree with the Nightingale theory that refers to health as the dynamic
process.
Elements Comments
Dust and Diet Sanitation of houses and personal hygiene
Drinking water Pure drinking water
Dietary habits Must take a balanced, fresh and healthy diet
Damping A little and dried out the warm environment
Draughts Air ventilation
Drainage system Proper sewer and drainage system
Experience
In my scenario, another issue is that I realized that all the eatables of my patient that were
placed on the bedside trolley were kept uncovered. As per the Nightingale theory, she stated that
the utilization of any of the chamber utensil without a lid must be abolished not only for the sick
but also for the healthy person. As the consumptions of this uncovered eatables could not only
prove to be risky for the sick patient but also the healthy person.

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Third concept: Environment (my definition)
Another significant component of nursing meta-paradigm is an environment. According
to my definition, an environment is regarded where an individual is involved actively and
constantly. My philosophy related to environment states that every person possesses his
environment both external and internal environment. A depth analysis reveals that the concept of
environment plays a significant role in promoting recovery and maintaining wellbeing and health
(Wesley & McHugh, 1995). An environment that promotes health permits the patient to gain
their vital powers or energy for using towards the process of self-healing.
Third concept: Environment (Florence Nightingale’s definition)
In the Nightingale theory, the concept of environment is widely discussed. A patient's
environment is a changeable thing and can change as per the need and health of the patient
(Johnson & Webber, 2015). Nightingales state that it is the priority of the nurses to keep the
environment clean for the well-being of the patient. She also describes that for the speedy
recovery of the patient it is necessary to have clean clothing, bed, as well as the room, should be
well furnished (American Psychological Assocation. 2009). Earlier the definition of environment
stated the fact that the internal or external environment could influence the patient. While
nowadays as per the theory it is demonstrated that the environment gets influenced by certain
environmental factors such as proper light, cleanliness, well-organized drainage, pure water, and
fresh air. I agree with the concept of the environment that is defined as per the Nightingale
theory as it states that to have a quick recovery it is important for the nurses to consider the
environmental factors. As in my definition, I have not mentioned the roles and responsibilities of
the nurses based on environmental factors. Whereas, similar to the theory I have also explained
the impacts of environmental factors that affect the health of the patient. Thus, I could closely

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relate my definition of an environment with Nightingale theory that focuses upon the factors of
the internal and external environment.
Experience
In my case, the windows of the ward were closed because of AC, and this is the reason
the ward was so stinking. During that time I too believe that the windows must be closed to
preserve the cooling, but Nightingale argued in her theory that the windows of the wards must be
kept open to allow the fresh air to enter into the ward. Thus, ultimately I found that the poor
condition of my patient was due to the stingy environment as I did not find any other reason for
the poor condition of the patient.
Fourth concept: Nursing (my definition)
Nursing is mainly defined as a modification of the environment of the patient to facilitate
him with convenience at the time of disease period (Kim, 2000). Meanwhile, they are related to
the consequences occurs due to poor conditions of the environmental factors. According to my
definition of nursing, it is a profession that is determined to be an academic discipline that is
studied and practiced followed by all the disciplines related to the health sciences. I strongly
believe that nursing is regarded as a moral practice where its objective is the restoration of others
not for profit or personal gain. It is determined to be a moral act where patients and nurses
interact with each other and build a kind of power, vulnerability, and trust between them.
Fourth concept: Nursing (Florence Nightingale’s definition)
In Nightingale's theory, the concept of nursing refers to the fact that the nurses must
provide the patients with a better environment. She explains that every woman in the world is
considered to be a nurse as every woman has the responsibility to look upon the health of

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somebody in the family that puts the women in the position of a nurse (Belenky, Clinchy,
Goldberger, & Tarule, 1986). She believed that most of the sufferings and symptoms of the
patients were not related directly to their ailment or disease. Nightingale also defines nursing as a
discipline that is determined to be the body of knowledge (Martin, 1994). Therefore, I agree with
this because as per nightingale theory nursing has been directed from a vocation to a discipline
which is regarded as a holistic approach. In my definition, I too have defined nursing as the
combination of various disciplines related to health sciences. I agree with this particular theory
as it states the fact that the responsibilities of the nurses involve providing necessary factors like
proper or balanced diet, cleanliness, light, warmth, and fresh air. However, where Nightingale
had given prime importance to the environmental factors that must be overlooked by the nurses.
My definition states that nursing is a moral practice where a good relationship between nurses
and patient is significant.
Experience
At the time of my placement, I was given the opportunity to handle a diabetic patient. I
found that my patient was neglected regarding the environmental factors although he was a poor
diabetic patient. The rate of diabetes disease is increasing worldwide. Therefore, it becomes
significant to provide the patients with better nursing care and environment. In my case, the
patient was not even getting the basic nursing care. There was the unavailability of the good
environment, and better nursing services were one of the significant factors for his poor
condition.
Florence Nightingale: Totality
According to Florence Nightingale, the four significant components of meta-paradigm of
nursing are a person, health, environment, and nursing where the healthcare professionals are

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required to fulfill the needs of the patients (MacDonald & Bowen, 2017). The component of
nursing is determined to be a totality because as per her definition of meta-paradigms she has
presented an image of the patient who has the right to acquire emotional, economic and social
stability (Franco, 2018). She explained the fact that managing the environmental consequences
will eventually help the nurses to maintain patient's health. It is possible for the nurses to
encounter the true ailments of the disease only after controlling the environmental consequences
(Thorne, 2014). One of the important criteria was chattering hopes and providing advice to the
patient to make them feel comfortable and develop a sense of protection among the patients. Bad
administration, bad architectural and bad sanitary arrangements make it difficult for the nurses to
provide the patients with a better environment. The objective of nursing is to concentrates on
health promotion, prevention of illness, care and cure of the sick. Also, nursing aims to
concentrate on the quality of life from the perspective of a person (Thorne, 2015).
Conclusion
The paper discussed the four concepts of Meta paradigms that are significant in the
nursing practices and these are defined by me. It is observed that the contribution of Nightingale
through her theory has significantly improved the nursing practice that helps in patient’s
recovery. The Florence Nightingale theory is entirely related to her personal experiences that she
faced at the time of providing care to the injured and the sick soldiers. In her theory, she stated
that the patient has a strong relationship with his or her health, environment and nurse. Also, it
provided with the transformation that has occurred by following the concept of the theory.

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