welcome everyone to today's session we'll dive into one of the most foundational Concepts in nursing the environmental theory developed by none other than Florence Nightingale in this session we'll explore how nighting Gill's principles continue to influence our practice from the layout of modern hospitals to the everyday decisions we make in patient care whether you're new to nursing or assistant professional understanding these Concepts is key to providing holistic and effective care so grab your notes and let's explore how nighting Gill's wisdom from over 160 years ago remains as relevant as ever learning objectives so after this session you will be able to First identify key environmental factors in nightingale's theory and their effects on patient recovery next app apply nighting Gill's principles to create a healing environment in nursing practice and research and lastly evaluate the nurses role in managing the environment including observation and patient comfort so who is Florence Nightingale Florence Nightingale born on May 12 1820 in Florence Italy is celebrated as the founder of modern nursing raised in a wealthy British family she defied societal Expectations by pursuing a career in nursing which was then considered a low status occupation she received formal training in nursing in Germany and France Florence Nightingale is widely acknowledged as the founder of modern nursing due to her transformative contributions to the field before her work nursing was often viewed as a low status occupation primarily performed by untrained individuals or those from lower societal or social classes and nighting Gill's efforts changed the perception by introducing formal training and establishing nursing as a respected profession nightingale's work during the Crimean War was revolutionary she emphasize the importance of Sanitation hygiene and environmental factors in patient care her systematic approach to improving Hospital conditions including ventilation cleanliness and nutrition drastically reduced the death rate among soldiers she founded the nighting Gill training school for nurses in 1860 which was the first secular nursing school in the world this institution set standards for nursing education and professional practice providing a structured and scientific approach to nursing nightingale's contributions earned her numerous accolades and honors reflecting her impact on the field of Nursing and public health just like she was awarded by Queen Victoria with the Royal Red Cross in 1883 this award or honor recognizes her exceptional contributions to the nursing profession and her role in improving military Healthcare during the Crimean War next award was given in 18 1907 which is the order of Merit this prestigious award given by King Edward iith was one of the highest honors in the United Kingdom acknowledging her outstanding achievements and contributions to nursing and Health Care celebrated on May 12th is the uh nighting Gill's birthday which is the International Nurses Day this day honors her Legacy and recognizes the contributions of nurses worldwide it serves as a reminder of the importance of ongoing need um for excellence in patient care of our nursing profession n Gill's pioneering work not only elevated the status of nursing but also laid the groundwork for contemporary Health Care practices emphasizing the critical role of a well-managed environment in patient recovery and health Florence nightingale's education and major work played a pivotal role in shaping modern nursing Nightingale received a formal nursing training at is um at several prominent institutions at the Lutheran Hospital in Berlin she gained hands-on experience in patient care and Hospital management she also trained at The Institute of St Vincent deul in Paris um where she learned about advanced nursing practices and the importance of hygiene this education equipped her with the skills and knowledge necessary to revolutionize nursing care her most notable contribution came during the cran War which um occurred in 1853 to 1856 when she arrived at the British Military Hospital in scutari Turkey she found unsanitary conditions that led to the high mortality rate among wounded soldiers by implementing rigorous hygiene practices improving ventilation and ensuring adequate food and supplies she drastically reduced death rates from 42% to 2% her work during the war not only saved countless lives but also established nursing as a critical and respected profession these achievements underscored nill's lasting impact on nursing particularly through her emphasis on sanitation and environment um in the patient care as you can see in the the photo um that's a visual representation of how Nightingale um became known especially during creian war and uh as you can see Nightingale is providing care to the wounded and eel soldiers during the creman war um as I have mentioned she gained her International recognition during this war um where she was sent with the team of nurses to improve conditions the British military hospital um and of course horrified by the unsanitary conditions as um overcrowding and lack of basic supplies as I have mentioned um nil implemented strict hygiene practices um which also improved uh which she also improved the ventilation uh ensured PR uh proper nutrition within um her Turf of work now after the war Nightingale continued to advocate for healthcare reform now she established the nighting training school for nurses in 1860 uh in which it lays on the foundation of or foundation for nursing education being it as a professional work now that work of hers um led her to making or to publish her book known as notes on nursing what it is and what it is not which remains a seminal text in nursing Theory nighting Gill's approach to nursing the focus of Nursing in this model is to alter the patient environment in order to affect change in his or her health the environmental factors that affect Health as identified in this Theory are fresh air pure water sufficient Food Supplies efficient drainage cleanliness of the patient and environment and light particularly direct sunlight if any of these areas is lacking the patient may experience diminished Health a nurse's role in a patient's recovery is to alter the environment in order to gradually create the optimal conditions for the patient's body to heal itself in some cases this would mean minimal noise and in other cases could mean a specific diet all of these areas can be manipulated to help the patient meet his or her health goals and get healthy environmental Theory so let's talk about her Theory environmental Theory defines nursing as the act of utilizing the environment of the patient to assist him in his or her recovery this Theory emphasizes that nurses should should actively manage and adjust the patient surroundings to promote healing and support body's natural recovery processes Nightingale believed that external environmental factors significantly impact biological and psychological functions and overall development now Nightingale elaborated on her theory in um her seminal work notes on nursing what it is and what it is not um this book outlines her approach to nursing and highlights The crucial role of environmental conditions in patient care now as the first nursing theorist nighting gay laid the groundwork for modern nursing practices establishing principles that continue to guide the profession today her focus on creating optimal environments for patient recovery remains a fundamental aspect of nursing now the book um also into how the or um how to organize and manipulate the environment to support patient healing now manipulation of the environment Nightingale explores uh how various environmental factors such as ventilation lighting and cleanliness can be strategically adjusted to create an optimal healing environment now this involves understanding how these factors influence patient health and making deliberate changes to enhance the condition in which patient receives um care enhancing the healing process in doing so 19 Gil's discussion is thought-provoking in that it challenges caregivers to consider how their actions and the environment they control impact patient outcomes by focusing on the organization and management of the environment the book emphasizes the importance of creating conditions that support the body's natural healing processes and improve overall patient care now in summary uh notes on nursing serves as both a practical guide for caregivers and a conceptual exploration on how environmental factors can be managed to enhance patient recovery nightingale's work underscores the integral role of the environment in nursing care and provides foundational principles for creating effect Ive healing spaces Florence nightingale's perspective on environmental balance highlights a crucial aspect of patient care Nightingale posited that a balanced environment is essential for Optimal Health and Recovery when aspects of the environment such as cleanliness ventilation lightened noise are out of balance patients are focused to um expand X or to spend more energy to cope with these stress stressors now these additional energy expenditure detracts from the body's natural healing resources instead of focusing all their energy on recovering from illness or injury patients must divert some of it to managing the adverse effects of an unfavorable environment so for example if a patient is exposed to excessive noise or poor air quality their body has to work harder to overcome these stresses which can slow down the healing process nighting Gill's Theory underscores the importance of creating an optimal healing environment to minimize these additional demands on patients by ensuring that environmental factors are carefully managed such as maintaining cleanliness proper ventilation adequate lighting and minimizing unnecessary noise nurses can help patients conserve their energy for recovery and improve overall health outcomes in essence 19 gills Theory advocates for the pro U ProActive Management of environmental conditions to support the body's natural healing um healing abilities and enhance patient recovery notes on nursing Florence nightingale's book is a crucial resource for individuals who are responsible for the health and well-being of others with a particular focus on women in nursing notes the book provides um actionable guidelines that offers clear practical advice on various aspects of patient care including hygiene nutrition and um management of Hospital um environments now these guidelines are designed to help caregivers Implement effective practices that can directly impact patient um recovery and well-being as I have mentioned um most of um the writings in this book is um addressed especially among women because nursing back then is considered a women's um work no the the the very essence of nursing um just like nursing or breastfeeding is usually done by women so that's why although it sound um sexist but in today's modern society nursing becomes more Dynamic of which men can perform the nursing roles uh of which the uh women back then um were you know um stereotypically performs the the nursing roles of course now when we talk about the U empowerment and training nighting gilds insights aim to empower caregivers with the knowledge and skills needed to Exel in their roles Now by providing strategies um the book serves as a valuable training tool for those involved in nursing care helping them to uh perform their duties more effectively and professionally now referring to the quote written there um Florence nting Gill's quote underscores the importance of combining everyday um sanitary practices with nursing care she believed that effective nursing involves more than just medical treatment it includes maintaining cleanliness and hygiene to prevent disease and promote Health by um applying basic sanitary know knowledge um nurses help create no you know the environments um that support both the prevention of ill illness and the recovery from it um Nightingale emphasized the good nursing care uh that good nursing care uh ensures the body remains in a healthy state or recovers more quickly from illness this holistic approach integrates sanitary practices into patient care recognizing that a clean environment is crucial for both preventing diseases and aiding in healing now she identified five key um environmental factors crucial for promoting health and recovery so uh first is pure fresh air Nightingale emphasized the importance of ensuring that patients breathe air as clean as the external environment without causing them to feel cold um fresh air helps prevent the buildup of State contaminated air sorry stale um contaminated air that can contribute to respiratory issues like pneumonia and hinder recovery next is pure water nting Gil highlighted the critical role of clean water in preventing illnesses um because unclean water or clean or water that is unsanitary or um filled with bacteria or microorganisms in general can cause gastrointestin problems um just like um am amasis or um intestinal diarrhea now she noted that impure water can lead to the spread of diseases especially during epidemics um ensuring access to pure water is essential for both maintaining health and supporting recovery next is effective drainage um you know proper drainage is vital to avoid the accumulation of waste and prevent it from becoming a source of disease so let's say there is a stagnant um drainage uh here in the Philippines we all know that uh it is endemic in the Philippines the uh the what do you call this the Deni uh fever of which if there is a stagnant drainage or a stagnant water it is a breeding ground for mosquitoes and if these mosquitoes are infected um by 0s egyp um uh mosquitoes um uh I mean ads Egypt mosquito is the the vector of den virus uh and once it uh you know bites a person of course the person could be infected with the Dena fever or the denu virus itself now so that's why she really emphasized um there should be proper drainage uh which is very much applicable specifically in third world country where there are problem I mean it's a national problem uh when it comes to uh you know um drainage no even the household drainage uh is um a very basic problem that we should address especially when we uh go to the Comm Community uh then we have cleanliness Nightingale believed that maintaining cleanliness was a found fundamental aspect of nursing care she argued that much of nursing involves ensuring that the environment and the patient surroundings are kept clean to prevent infection and promote healing so it is very imperative to to us humans um to really clean our environment we need to sweep the the the floor um to dust off the floor um so that we will not be um we will not be health problems later on um for example allergies okay next light especially direct sunlight now light particularly um plays an important role in treating diseases Nightingale recognized that adequate lighting including exposure to Natural Light um can have beneficial effects on health and Recovery by improving mood and overall well-being and we all know when we talk about direct sunlight it is a good source of vitamin D um of which that's uh very pretty much basic um knowledge now the factors post great significance during during nightingale's time when Health institutions you know um what you call this had poor sanitation and health workers had little Education and Training and were frequently incompetent and unreliable in attending to the patients needs uh also uh emphasized in her environmental theory is providing a quiet or Noise free and warm environment um attending to patients dietary needs by assessment documentation of time of food intake and evaluating its effect on the patient now deficiencies in these five uh sorry uh six factor sorry five factors rather uh produce illness or lack of Health but the body could repair itself with a nurturing environment nightingale's environmental theory is built upon um several core assumptions um these guides how the environment is managed to achieve the health goals and support healing number one natural loss nting Gale believed that health is um important and healing are governed by natural laws these include principles of hygiene cleanliness and Environmental Management that when applied correctly can significantly influence Health outcomes adhering to these natural laws help create conditions that support the body's natural ability to recover next mankind can achieve Perfection this assumption reflects the belief that human beings have the potential to achieve Optimal Health and well-being Nightingale was optimistic that through proper care and Environmental Management individuals could reach a state of health that approaches perfection minimizing the incidence of disease and enhancing recovery third nursing is a calling Nightingale viewed nursing as a vocation that requires dedication and a deep sense of responsibility she saw nursing not just as a profession but as a calling emphasizing the importance of a personal commitment to Patient Care and the well-being of others fourth nursing is an arts and a science Nightingale recognized that nursing combines both artistic and scientific elements the art of nursing involves compassionate and empathetic care while the science involves applying knowledge and principles of health and hygiene these dual nature allows nurses to provide effective and holistic care fifth nursing is achieved through environmental alter alterations alteration according to 19 Gale U effective nursing care involves altering and managing the patient's environment to enhance healing these includes optimizing factors like ventilation cleanliness and light to create conditions that support the patient recovery sixth is nursing uh requires a specific educational base Nightingale emphasized that nursing is a specialized field that requires for Education and Training this educational base provides nurses with the Knowledge and Skills necessary to effectively manage the environment and deliver high quality Care lastly nursing is distinct and separate from medicine Nightingale argued that nursing should be recognized as a distinct discipline from medicine while medicine focuses on diagnosing and treating diseases nursing concentrates on creating a support environment that facilitates healing and promotes overall health these um these distinction highlights the unique role of Nursing in the Health Care system now these assumptions collectively underscore the importance of Environmental Management in nursing and affirm the role of nursing as both a science and an art grounded in education and a commitment to Patient Care major Concepts now the environmental theory of 19 Gil is a patient care theory that is it focuses on care of the patient rather than the nursing process the relationship between patient and nurse or the individual nurse and in this way the model must be adapted to fit the needs of individual patients and the environmental factors may affect different patients um unique to the situation and illnesses and the nurse must address these factors on a Case by case basis in order to make sure that the factors are altered in a way that best cares for an individual patient and uh his or her needs now the conceptual framework shown um specifically on the environmental Theory you have to take note that that the client is in the center and the nurse is out outside of the circle of the client but there is an interaction between the client and the nurse now um the major environmental concepts are imbalance as you notice there are two um arrows going to the patient of from the patient to the nurse or from the nurse to the patient so that's the interaction or the arrow represents the interaction of the client and the nurse and then the surrounding the client is the environment of which we can modify for um the patients based on his or her unique needs now the goal of the the nurse is to assist the patient in staying in Balance if the environment of the client is out of balance the client expends unnecessary energy now according to nighting Gale nursing is separate from medicine um the goal of nursing is to put the patient in the best possible condition in order for nature to act nursing is the activities that promote Health which occur in any caregiving situation and health is not only to well um patients but to be able to use well um well every Power we have n gills Theory addresses disease on literal level explaining it as the absence of comfort so from the major Concepts let's talk um individually of these subconcepts first is the ventilation and warming Nightingale emphasized the importance of fresh air and warm for patient recovery in nursing practice this translates to ensuring that patient rooms are well ventilated and comfortably heated um proper ventilation helps prevent the buildup of harmful pathogens and um stale air while appropriate warmth maintains patient comfort and supports the body's healing processes for patients um these aspect directly affects their recovery by creating a more comfortable and hygienic environment now for nurses um it involves routinely monitoring and adjusting environmental conditions to meet patients needs thereby fostering a healing atmosphere health and houses Nightingale believ that the environment where patients reside must be clean well drained and sanitary this means that nursing practice must include rigorous standards for cleanly cleanliness rather um and effective drainage in patient care areas ensuring a clean and well-maintained environment reduces the risk of the infe ction and supports overall health for patients a hygienic environment minimizes exposure to contaminants and promotes faster recovery nurses are responsible for upholding these standards and Performing regular inspections to maintain a safe and healthy space noise Nightingale identified that need for the need for a quiet environment to Aid recovery in practice of nursing this means minimizing unnecessary noise in patient areas to promote rest and relaxation now if you notice in um hospitals uh we do um limit the visitations on to our patient much specifically to our Intensive Care Unit patients or ICU patients of which we really minimize the the unnecessary noise even the un um unnecessary um distractions for our patient um of course for patient the quieter setting enhances the ability to rest which is crucial for healing because of course uh when we talk about Hospital setup and our patient is is admitted um the the thing that we need them to do is to rest and recuperate for nurses um creating a calm environment requires attention to noise levels and implementing strategies to reduce disruptions thereby improving the overall quality of care variety to prevent monotony and enhance a mental health Nightingale recommended incorporating Variety in patients environment such as through changes in color and form in nursing practice this involves introducing elements that provide Visual and sensory stimulation to keep patients engaged and uplifted um for example if your patient is suffering from pain we can um Implement strategies like um diversional activities uh for example reading magazines or watching tele uh watching television or playing games in this in the phone or listening to the radio or drawing these are some of the things that we can put into when it comes to variety now for our patients these variety can alleviate feelings of boredom and improve mental well-being while for us nurses it involves creativity um or no creatively adopting the environment to support both emotional and physical recovery of our patients nutrition 19 highlighted the critical role of nutrition in recovery advocating for diet stord for the patients needs so for example if your patient is um injured um and needs um tissue repair of course your the diet should be high in protein because um protein is uh I mean the responsibility of protein is to promote um healing process in our body through um the the the utilization of amino acids now this involves assessing the um assessing and providing appropriate food types the the amount of food and even the timing um to support the healing of our patient now in nursing practice this means coordinating with the dietary services or to the nutritionist and dietitian um so that they can create um a well balanced uh of of a variety and an adequate food that is high in nutrient um density okay now also um for proper nutrition uh impacting the patient um of course that will um help improve the the strength and recovery of um our patient now while for us nurses when we talk about nutrition for our patient we must ensure that dietary needs are met and adjusted as necessary because for example if you notice that our patient is malnourished of course we have to Advocate um nutritional um a proper nutritional intake so again to to to improve the quality of nutriture of our patient so when I say nutriture it's the nutritional status again the patient is malnourished or let's say undernourished so we have to provide um enough or high nutrient dense um food um so that the patient will um gain weight um of course if uh the patient has a um sorry if the patient suffers from malnutrition of course the patient um is very or pretty much um susceptible to any diseases okay next is light um access to Natural Light particularly direct sunlight was seen by Nightingale as vital for health now nursing practice should ensure that patients have exposure to natural light when possible which can positively affect mood and recovery of course um exposure to direct sunlight benefits patients by boosting vitamin D production which support supports bone um health health and immune function it also regulates um circadian rhythms uh improving Sleep Quality and Mood by increasing serotonin levels additionally sunlight can enhance immune responses reduce inflammation and potentially alleviate pain contributing to overall physical and mental well-being now for patients natural light can enhance the well-being and circadian rhythms um while nurses need to manage light exposure in patient areas to support these benefits now there are hospitals um um as I can remember um one of my classmates during Masters um she shared that in Saudi Arabia um most hospitals there the bed the hospital beds are facing directly on the or towards the window so that patients can um really see uh the the sunlight uh especially when there is daylight this actually the study they conducted a study about it and it really has um an improvement on the overall well-being of their patients now the study conducted was directly uh among geriatric patients um to improve their sense of time also that improveed their sleep pattern um yeah so that's why uh the the the light is included by night n Gil now cleanliness according to nting Gil she really emphasized that maintaining cleanliness both the environment and of the patient body is crucial for preventing infections and promoting healing in nursing this means adhering to strict hygiene protocols and ensuring that both patient care areas and patients themselves are kept clean um in many hospitals now um we we have uh uh what do you call the is uh infection uh infection prevention and control um program um which uh this program do give standards or um set standards to nurses and other healthc Care Professionals and um how do you call this um anciliary workers to um practice the cleaning uh within the area that's why when you go to hospitals um it's very common that they smell bleach um or um chlorine because this uh helps in killing the bacteria that is surrounding the hospital and of course hospital is a dirty environment or a dirty place um that's why some patients can um contract virus bacteria or other microorganisms um which we call nosocomial infection or Hospital acquired infection that is why it's important to have um cleanliness and apart from this for example uh if you have um food waste and that is um thrown in the floor um near the patient's bed of course this is a an opportunity for infestations like rats or um house fly to thrive and this can cause I mean these um animals and insects can become vectors of diseases that's why clean cleanliness is a must in hospitals now of course this will prevent infections and supports faster recovery uh with nurses playing a key role in upholding Clinic standards next bed and bedding um Nightingale stressed that beds and bedding must be clean dry and comfortable nursing practice involves regularly changing and maintaining bedding to ensure patient comfort and prevent issues such as bed Source that's why for example um in the ICU we really impose the every twoh hour turning of our patients because we want to prevent bed Source or the cuitus ERS um that is why we con we also constantly change the beddings of our patient for example our patient is incontinent and has wet the bed so we have to change that because a wet bed can cause again bed sore or redness leading to bed sores now for our patients a clean and comfortable bed supports rest uh restful sleep and Recovery while nurses must ensure the that these standards s are consistently met chattering hopes and advices um tonight inale um of course she advised um against giving false hope or engaging in superficial conversations that could distress patient so for example if the patient requests about this and then you will um um you will respond by providing false hope or false reassurance there is a non- therapeutic communication um in nursing practice this means providing honest supportive communication while avoiding unrealistic promises um the topic on therapeutic communication will be further discussed to you on the pre-finals or much to the fundamentals in nursing now for our patients um truthful and empathetic communication Fosters trust and emotional support while Nur nures need to balance honesty and compassion in their interactions because um nurses are expected to establish Rapport when you go on your um fundamentals in nursing um subject you will be discussing about different Pro nursing procedures and the first step of each procedure is to establish Rapport why it is important because we want to build trust to all our patients or to our patient um since there is trust uh of course we have uh we have to gain that um so that they will cooperate and participate in most of our nursing interventions imagine if your patient is um mistrusting you of course even if there is a doctor's order of for example inserting a catheter a urinary catheter to your patient of course the patient will decline or will refuse the management because um the patient felt um you are not worthy of his or her trust so because you committed uh for example giving a false hope or false advises so one thing is for sure we have to practice our therapeutic Communication in order for us to work harmoniously with our patients next OBS lastly is the observation of the seek uh 19 Gil considered observation a critical nursing skill for assessing patient condition and Care Effectiveness this involves closely monitoring patients to detect changes and adjust care as needed now for our patients careful observation ensures timely interventions and appropriate care while nurses must develop Keen observational skills to provide effective and responsive care so when we talk about observational skills this means that you have to use your five senses more particularly on the sense of sight sense of touch and sense of hearing because um when we talk about clinical eye uh we can see that there um whatever is happening in our patient we can address that um for exam for instance the the Grimace of our patient may indicate that the patient is experiencing pain although the verbalization of the patient says that he or she is okay but again when we talk about the Grims of the patient it indicates that the patient may be suffering from the pain um or for instance if you do have the clinical eye when you turn your patient on to side you notice redness and of course redness is a warning sign that there could be an impending bed sore so since you have the clinical eye you can address that so you report it to the doctor or take a picture of it so that this will become your basis so um and also when we talk about observation of the seek we have to use our assessment skills so when we talk about assessment skills you have to do the subjective data Gathering and objective data Gathering when we talk about subjective data Gathering we interview the patient we interview the family members about their health history about their social history family history um and other relevant data important to the condition of the patient whereas when we talk about um objective um data Gathering uh we gather data based on again our five senses from what we have observed um and of course these observation skill um will be the basis of how we perform our nursing process now the nursing process is your nursing assessment nursing diagnosis planning and outcome identification implementation of the intervention uh nursing interventions and lastly the evaluation of the process next um is the metap Paradigm of Florence Nightingale now the major concepts of Florence Nightingale is um first on nursing uh and she meant nursing is both an art and a science focused on managing the environment to support the natural healing process Nightingale believed that nursing's primary role is to place the patient in the best condition for nature to heal them what nursing has to do is to put the patient in the best condition for nature to act upon him and this was mentioned by Nightingale um around 19 1859 um also Nightingale stated that nursing is ought to signify the proper use of fresh air light warmth cleanliness quiet and the proper selection of administration of diet all at the least expense of vital power to the patient she reflected the art of Nursing in her statement that the art of nursing as now practiced seems to be expressly constituted to unmake what God had made diseases to be um and this is more on the reparative process now nursing is um she also wrote in her book that nursing is an art and it is to be made an art it requires an exclusive um devotion as hard as a preparation as any painters or sculptor work for what it is the or for what is the having to do with dead canvas or cold marble compared with having to do with the living body the Temple of God's spirit it is one of the Fine Arts and she emphasized the finest of Fine Arts so that's a good quote from Nightingale again she me she she quoted nursing as the uh finest of Fine Arts I like that one for the person nighting Gale viewed the person holistically considering the physical mental and spiritual Dimensions she believed that patients are individuals with unique needs um this deserving of of respect dignity and personalized care they are defined in relation to the uh to their environment and the impact of the environment upon them now the needs of the patient are not only um based on the needs to be considered but also uh she recognized the spiritual dimension of the person the greater part of the nursing consists of preserving cleanliness and uh which is the first Canon of which is to keep the air he breathes as pure as external um air without chilling him she quoted now when you talk about environment of which uh this is the the the focus no of her Theory the environment is the key factor in healing and health Nightingale emphasized the need to control environmental factors such as cleanliness ventilation warmth diet what else noise and so on to really create conditions conducive to recovery now she also stressed that physical environment in her writing um reflect a community health model in which all that surrounds human beings is considered concerning their health State now to quote her what nursing has to do is to put the patient the best condition for nature to act upon him now this includes sound light air cleanliness again the diet uh what else um alleviation of distressing or unnecessary noise lastly health health according to Nightingale is not merely the absence of disease but the ability to use all one's Powers fully um she saw Health as a state of well-being that allows individuals to perform to their fullest potential now she stated we know nothing of Health the positive of which pathology is Nega negative um ex except for the observation and experience given her definition that the art of nursing is to unmake what God had made thisas then the goal of all nursing activities should be client health she added I quotee health is not only to be well but to be able to use well every Power we have to use now Theory analysis first um contemporary environmental challenges modern issues like global warming nuclear threats uh what else um humade um calamities or anthropogenic in um um anthropogenic climate change and let's say pollution are present uh environmental conditions far from the natural and nurturing ideals that Nightingale invisioned next is the ventilation concept uh nightingale's emphasis on fresh air is challenged today by industrialization additionally natural air may carry impurities that can harm um patients with open wounds such as burn V uh burned V victims now since I mentioned about industrialization um back then um in England uh because of the you know advancement in industrialization steam engine happened and it come to a point that um the entire city um was played with smoke so of course the air is contaminated that's why they passed the um the Clean Air Act of which the Philippines uh uh followed it with the Clean Air Act of um oh recall this the Republic act 8749 which is a comprehensive law aimed at improving air quality and protecting Public Health um addition Al um you know natural air may carry impurities that can harm patients um for example they can develop pneumonia no as um um difficulty in breathing um what else um um fume poisoning no next is light concept uh the sun's Rays once considered healing are now potentially harmful due to the weakened ozone layer now continuous exposure to direct sunlight may do more harm than good for patients of course we uh because of certain studies uh and we all know of the damage to the ozone layer um especially the direct um exposure to ultraviolet race Alpha and beta can cause um skin cancer that's why it's pretty much considered nowadays when we talk about exposure to sunlight that's why um doctors prescribe most patients um or nurses are instructed to expose their patients um early morning or late afternoon since the kind of direct sunlight um is not much of the exposure to ultraviolet race next is the healthy environment no while night Gill's assertion that a healthy environment promotes um healing remains true maintaining such an environment is difficult amid modern technological and Industrial advancements now uh as we have experienced the pandemic it really had a t on the Health Care System specifically on third world countries like the Philippines of which um most of our healthc care Technologies are not that much Advanced compared to other others um leading to multiple deaths or casualties um so even if there are technology and even there are Advanced Technologies similar to The Western countries um environmental problems like for example the covid-19 really affects the way we um the way we address the problem the the way we address our medical concerns uh of course given the fact that um it's a new problem and we need to study more about it um that's why it took two years for us to develop vaccines to develop um certain guidelines um to to address the the pandemic issue okay next the need uh for theory development of course some of n Gill's Concepts may not be feasible in today's context um highlighting the need for theory development to address current environmental Realties NE uh lastly is uh enduring significance uh or value now despite the challenges nightingale's environmental Theory remains a foundational starting point for nursing practice and continues to influence the profession's growth and Evolution Now application to practice ensuring clean air as I have mentioned there was a Clean Air Act passed um um which is your Republic act um what do you call this 8749 um and then of course we have to maintain proper ventilation in patient areas to promote fresh air and reduce exposure to pollutants and pathogens uh we also have to apply it by providing pure water no ensuring access to clean safe drinking and portable water uh maintain hygienic standards for water use in patient care um for example not necessarily drinking but also those patients uh dialysis patients who need um Safe Water um for the utilization of their dialysis or in the utilization rather of their dialyses next is the implementation of effective drainage uh of course it's important to design and maintain proper drainage system to prevent waste buildup and contamination in patient environment next maintain cleanliness regularly clean and sanitize patient areas equipment and um Linens to prevent infections and promote a hygienic environment um in this ma in this way we have uh of course we will be taught about handwashing and its importance and significance in our practice um what are the five moments in doing hand hygiene um of again the emphasis is uh hand washing is the single most um intervention that can prevent cross-contamination okay uh and and together with the cleanliness of the surroundings of our patient and of the hospital in General next optim imizing light um utilize natural light and appropriate artificial lighting to enhance mood reduce stress and support overall well-being manage noise levels uh of course you have to minimize unnecessary noise in patient areas to create a peaceful environment conducive to rest and Recovery next control temperature and humidity adjust room temperature and humidity to comfortable levels to prevent discomfort and support the body's natural functions you also have to educate and train staff uh in doing so you have to provide ongoing education on Environmental Management and its impact on patient Health to ensure staff can effectively apply nting Gil's principles and of course this is uh although this is very basic no um hospitals are training or orienting rather their staff specifically the um those who are involved in the direct patient contact like your nurses other Healthcare professionals including anciliary workers like uh the janitorial services to practice proper waste disposal uh just one of the Environmental Management because it is um what do you call this uh a real problem in hospital that waste are being mixed or or in short wastes are not segregated properly so that becomes a problem to the hospital and not NE not only the the patient wastes no there are also equipments or materials we use that can also be um a hazard um to to other people for example with the use of our syringe of course the syringe has a um needle and nurses nurses who do not practice proper disposal of needles um Can Dam can of course um cause Hazard to others for instance they throw their needles to the trash to let's say to the biodegradable trash bin and once it is um you know um C uh cleaned by the janitorial service they may be pricked by the needle then what if you use that needle to to patients with sensitive cases like HIV so the janitor could contract the HIV or let's say hepatitis so it's very important for healthc Care Professionals and even those in the anciliary work um to be knowledgeable about Environmental Management okay next um the application of research study uh environmental impacts now you have to also investigate how factors like air quality water Purity and lighting affect patient outcomes you could also assess hygiene practices by conducting research on the effectiveness of cleanliness protocols and their impact on infection rates next evaluation on the noise and comfort you can examine how noise levels and environmental Comfort like your temperature and humidity influence patient recovery and satisfaction next analysation of your educational interventions so you can explore on the impact of training Health Care staff on Environmental Management and Patient Care Quality then test modifications if you can do that um you can conduct studies on how specific changes in the environment like your improved ventilation or lighting affect patient health and Recovery now of course by focusing on these areas um research can help validate and refine n Gils Theory and improve health care [Applause] practices now lady with a lamp um of course Florence nightingale's voice and signature reflect her enduring Legacy in healthcare they peret the [Applause] my dear old comade of Sal laa and [Applause] such a delicate voice you know um of course known as the lady with the lamp um she earned this title from her compassionate night time rounds caring for soldiers during the Crimean War her dedication and visibility during those dark hours made her a symbol of Hope and comfort uh Nill is also celebrated as the mother of modern nursing her groundbreaking work in establishing nursing as a respected profession which I pretty much emphasized during the first um uh first uh interaction uh and discussion of this topic um has her focus on creating optimal healing environments set to the foundation for complimentary nursing practices now as we have heard of her voice and her signature uh which is presented to you um in this U particular slide um are more than just historical artifacts they symbolize her profound impact on nursing and the care we provide today so let's continue to honor her Legacy by applying her principles to our practice so thank you for following along and I leave you with the quote the very first requirement in hospital is that it should do to the sick no harm thank you for listening again and see you in the next video