Nursing Theories And Nursing Practice 4th Edition By Smith – Test Bank

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Chapter 4

Statement of Intent

This chapter explores the life of Florence Nightingale and her contributions to nursing. A

biographical account is provided that addresses her education, travel, spiritual background, and

Crimean War experiences. The medical environment of the 1800s and her views of women

during that time are also presented. An overview is provided for the foundations of Nightingale’s

model of nursing and how it is interpreted today.Chapter 4

Key Terms

Spirituality

Crimean War

Moral Authority

Atmosphere

Environment

Sickness

Contagionism

Feminism

Expressions of Caring

Laws of Nursing

Laws of Health

Health of Houses

Observation

Personal Cleanliness

Petty Management

Light

Cleanliness of Rooms

Ventilation and Warming

Bed and Bedding

Taking Food

What Food?

Noise

Chattering Hopes and Advices

VarietyChapter 4

Objectives

On completion of this chapter, students will be able to:

1. 2. 3. 4. 5. 6. 7. 8. 9. Summarize significant events in Nightingale’s life that led her to nursing and influenced

the development of her model of nursing.

Discuss the influence of Nightingale’s spirituality on her practice of nursing.

Compare and contrast the medical milieu of the 1800s with the medical milieu of today.

Discuss the impact of Nightingale’s feminist view within the context of her work.

Discuss Nightingale’s conception of nursing and analyze the elements of Nightingale’s

Theory of Nursing.

Identify the expressions of caring that are essential components of Nightingale’s Theory

of Nursing.

Discuss Nightingale’s assumptions and their relevance and application to nursing today.

Identify ways to apply Nightingale’s Environmental Model to the current practice of

nursing.

Identify and discuss the application of the four major factors that influenced

Nightingale’s Model (Environmental Model) to current nursing practice.Chapter 4

Outline

Introduction the Theorist

Foundation of Nursing Practice

Call to Serve

Justice-Making

Early Life and Education

Family

Travel

Kaiserworth

Spirituality

Science and Spirituality

Truth Seeking

War

Crimean War Experience

Breaking Gender Barriers

Battle Front Innovations

Introduction to the Theory

Role of Observation

Defining Disease

The Medical Milieu

19th Century Medicine

Paradigm ShiftOrigins of Disease

The Feminist Context of Nightingale’s Caring

Respectable Profession

Moral Role

Cultural Feminism

Ideas About Nursing

Notes on Nursing: What It Is; What It Is Not

Nursing as a Science

Statistics

Nightingale’s Assumptions

Goal of Nursing

Education

Environment

Nightingale’s Legacy for 21st-Century Nursing Practice

Caring

Activism

Applications: Nightingale’s Legacy of CaringChapter 4

Questions for Classroom Discussion

1. In Nightingale’s mind a specific function of nursing was to “put the patient in the best

condition for nature to act upon him. What was the meaning of this perpsective? What can nurses

do in contemporary nursing practice to implement this function of patient care?

2. How does Nightingale’s legacy for 21st-century nursing practice create an environment for

evidence-based practice in the current hospital or community setting? Discuss nursing situations

that would validate your thoughts.

3. Discuss how Nightingale’s concepts might decrease hospital-acquired infections and the

impact on patient recovery. Develop one hypothesis statement clarifying the relationship

beween envrionmentally and hospital-acquired infections.Chapter 4

Multiple-Choice Questions

(Answers appear in bold)

1. Nightingale proposed nursing as:

A. An extension of the environment

B. An art and a science

C. Empirical science

D. Physician’s handmaiden

2. Nightingale defined a nurse as any woman who had “charge of the personal health of

somebody” whether well, as in caring for babies and children, or sick, as an “invalid”

(Nightingale, 1860/1969). It was assumed that all women:

A. One time or another in their lives, would nurse

B. Needed to know the laws of health

C. Nursing proper, or “sick” nursing, was both an art and a science and required organized,

formal education to care for those suffering from disease.

D. All of the above

3. The goal of nursing as described by Nightingale is:

A. Work collaboratively with the physician to implement the medical orders.

B. Take care of the patient’s environment by maintaining cooking, cleaning, and scrubbing the

floors.

C. Assisting the patient in his or her retention of “vital powers” by meeting his or her

needs, thus putting the patient in the best condition for nature to act upon.

D. Giving the patient medicine when the medicine is due.4. Nightingale isolated five environmental components essential to an individual’s health. Select

the correct grouping from the following:

A. Calming colors, quiet, comfortable temperature, clean air, pure water

B. Clean air, pure water, efficient drainage, cleanliness, and light

C. Light, color, sound, smell, temperature

D. Pure food, clean water, cleanliness, quiet, calming color

5. In Nightingale’s mind, the specific “scientific” activity of nursing that was the central element

in health care, without which medicine and surgery would be ineffective is which of the

following:

A. Preparing nutritious meals

B. Maintaining an aesthetic environment

C. Maintaining hygiene

D. Sustaining a quiet environment

6. In the mid-19th century , there were two competing theories regarding the nature and origin of

disease. These competing thoeries were:

A. Localization and specificity

B. Contagionism and quarantine

C. Vectorism and pollution

D. Atmosphere and environment

7. According to Nightingale, a nurse is defined as:

A. The handmaiden of the physician

B. A member of the moral majorityC. Any woman who had charge of the personal health of somebody, whether well or sick.

D. An individual who felt a calling to take charge of the sick

8. The patient is at the center of the Nightingale model and incorporates:

A. A holistic view of the person

B. Psychological, intellectual, and spiritual components

C. A unique individual filled with chttering hopes and advice

D. A & B

E. All of the above.

9. According to Nightingale, health is viewed as:

A. An additive process

B. The result of environmental, physical, and psychological factors

C. The absence of illness

D. A & B

E. All of the above

10. Cultural feminism is defined as:

A. Women are a product of the culture.

B. A belief in inherent gender differences

C. The emancipation of women as a cultural fad.

D. The corruption of women by masculine politics .Chapter 4: Florence Nightingale’s Legacy of Caring and Its Applications

Instructions: Read the case study and answer the questions that follow.

The Community Health Nurse knocked softly before entering Isabel’s bedroom. On this home

visit Isabel was holding her 3-week-old baby girl, Pearl, while 2-year-old Jerry was sitting on the

floor playing with a cat. In one corner, a full litter box sat on the floor next to the changing table.

The nurse noted two half- empty 4-oz formula bottles on the changing table, an empty box of

baby wipes, and three soiled cloth diapers. Looking into Pearl’s sleeping face, Isabel said “She’s

finally fell asleep…I am so tired…Jerry stop teasing Freckles (the cat) and come over here and

hold Pearl while I get something to drink…do you want something to drink?” The nurse quickly

scanned the room, seeing an unmade bed with a bassinet wedged against the wall. Jerry’s bed,

also unmade, was in the corner opposite the litter box. The small bedroom was stifling hot, the

ceiling fan was not on, and the windows were closed. A table in the middle of the room had

plates with partially eaten sandwiches and half-finished cans of soda.

1. Based on this case study how would the nurse practicing from Nightingale’s theory

begin her home visit? What would be the priority for the nurse in this situation?

2. How might Nightingale’s understanding of sanitation and environment guide the nurse

in her home visit?

3. How could the nurse develop a relationship with Isabel and return as a welcomed

visitor in Isabel’s “home”?

Guided Response (Answer) for Instructors:

1. Nightingale focuses on the concepts of the patient in relationship with the

environment, sanitation or hygiene, observation skills, and empirical knowledge. The priority

for the nurse would be the safety of the patient in this environment. This requires the nurse todraw upon empirical knowledge and experience to place the patient “in the best condition for

nature to act upon” (Nightingale, 1860/1969).

2. According to Nightingale, important things to consider include:

Sanitation—litter box, formula bottles, soiled diapers, food and drink left in the

open

Environment—the above with the addition of ventilation, light, pleasant

surroundings

Empirical knowledge

a. Isabel—postpartum health, hydration, nutrition and personal cleanliness, and

follow-up health care provider visits

b. Pearl—hydration, weight gain, number of diapers soiled per day, color of

skin, stool and urine. Physical evaluation for reflexes/responses

c. Jerry—general health, mental and physical development and nutrition

3. Nightingale reminds us the nurse is a guest in someone else’s environment. Consistent

with Nightingale’s assertion of nurse as guest, the community nurse might begin the visit

with a simple question such as “How may I help you?” This question opens the door for

communication and would give Isabel an opportunity to begin the visit by expressing her

needs first. Ask students to consider how Isabel might respond to this open-ended

question, what follow-up questions they might ask, and what nursing activities might be

useful from Nightingale’s perspective.