Personal Nursing Philosophy and Nightingale’s Enduring Influence

I had always thought of philosophy as an obscure term, that did not apply to my life, until I took a philosophy course in college. Philosophy is a searching for wisdom based on what you believe about yourself and the world in which you live. It is a constant state of questioning. It is searching to help define what you know to be true by examining not only yourself, but your experiences, and your evaluation of those experiences. A philosophy gives your soul a path and acts as your guiding light; a reflection of your reality in order to clarify how you want to live your life going forward. This clarification, of what we think and why, helps us flourish in life and our nursing practice.

In nursing we are faced with many decisions daily, and we want to rely on our philosophy to keep us grounded. For me, my nursing philosophy is evolving as I gain more knowledge, but it is formed based on my values, or core beliefs. I believe everyone is entitled to the best possible health care, and as a nurse I play a role in that care. Nursing is about human connection, caring and always inquiring as to why something is done, in order to provide the best possible care for our patients. My philosophy includes striving to do what I believe is right and to seek answers to improve decision-making skills. It is ultimately about how I live, in work and in play. “Philosophy conveys a way of life. It develops the human spirit and what is good in human life and practice gradually over time.” I see my nursing philosophy further developing, but continually holding on to the fundamental principles of compassionate and holistic patient centered care to promote health and well-being. It involves examining not just the patient, but all the factors surrounding that patient that may contribute to their healing. This dynamic state constantly requires learning and reflecting to improve the care of my patients. “Nurses embody their philosophy in their actions when they enact their knowledge, ethics, and whole being in the care of others.”

There is not a nurse today who is not familiar with Florence Nightingale. She was truly remarkable in taking nursing from an almost disregarded, disrespected profession, to one of respect and formality, making it a noble profession requiring education and dedication. Prior to Nightingale, nursing care was viewed as menial work and provided mostly by servants, prisoners or prostitutes, “Who had little or no training and even less enthusiasm for the job.” It was her philosophy on life that led the transformation of the way nursing was practiced around the globe. She was a seeker of knowledge, consistently analyzing and observing, to see how different factors impacted her patients.

Although Nightingale was born into a family of wealth and privilege, she had an innate perspective that helped propel her ideas into realities. She recognized that people who were of lesser means were treated unfairly, especially when ill, and felt that all were entitled to the same care and comfort. Her Christianity, spirituality, and belief that egalitarian and competent care were basic human rights for all, was her motivator. She felt all religions should be respected to create unity and was concerned with the lack of equality arising from cultural intolerance. Nightingale used her status to connect with people of influence, to be heard by powerful men in government, and to bring about dramatic changes in healthcare. Her fierce embracing of justice for her patients made her a formidable advocate for them. “It was her desire to diminish the suffering of the helpless; to provide care to whomever was in need irrespective of their socioeconomic status.”

Nightingale’s leadership skills and commitment to change helped make her goals a reality. As a transformational leader, she recognized many challenges in the world of healthcare and motivated others to unite for a common purpose of bringing about change. She recognized there was power in numbers, and inspired women to become nurses. She had faith in any woman who wanted to become a nurse, that they too, would achieve leadership competence with time, dedication and education.

Nursing theories were first developed by Nightingale. Specifically, her environmental theories paved the way for massive improvements in hospitals, home care and overall patient well-being. She strongly believed that nursing involved more than just the treatment of the patient. She used her critical thinking to examine environmental factors she felt played a pivotal role in a patient’s health. Her theory consisted of controlling environmental elements, including ventilation and warming, sunlight, noise, health of the house, bed and bedding, efficient drainage, fresh water, personal cleanliness, and good nutrition. Through practice and observation, she put her theory to the test and made a significant impact in reducing incidence of disease, increasing recovery of her patients, and dramatically decreasing mortality rates of British soldiers in Crimea.

Nightingale embraced her holistic philosophy of cleanliness and disease prevention, and impacted health and patient care throughout the world. She educated other nurses and doctors, publishing articles and books on these concepts, as well as opening schools and hospitals. She elevated and formalized the profession providing instruction and training. She believed that whether you were sick or well, the environment should be the same in that it was always promoting wellness.

Several key components of Nightingale’s philosophy resonate with me. She honed her observational skills and always looked beyond her patient to see what else may be affecting their health. She looked at the community to see what could be changed to influence well-being. I, like Nightingale, believe that disease prevention and taking care of oneself and one’s environment contribute significantly to overall health. Nightingale’s philosophy on wellness stated that, “The work of nurses should not be limited to caring for people during illness.” My background in dietetics and fitness lends itself to a wellness metaparadigm. Teaching patients how to adapt healthier habits empowers them to take control of their health. Nightingale was a transformational leader who believed education of her nurses and her patients was an invaluable tool. “Oh teach health, teach health, teach health, to rich and poor, to educate and if there be any uneducated, oh teach it all, the more, to women especially.”

Nightingale’s influence on the world of nursing and healthcare was global. Her recognition, commitment and determination to change the landscape of how a patient was treated was based on her holistic philosophy of caring for not only the person, in sickness and health, but in facilitating a healing environment that promoted wellness. Nightingale’s philosophy of egalitarianism was essential, and she proved to be a formidable advocate for her patients and for communities, thus creating long lasting changes. Treating all patients equally and without bias is central to caring and compassionate nursing care, and something that is consistently reinforced in nursing school.

Nightingale’s ability to keep an open mind created community, unity, and thus healing beyond just her patients. This concept was pivotal to her work and her example should be motivating to all nurses. Without Nightingale’s grounded philosophy, her strength of leadership, and motivation to educate other nurses, the profession may have not been transformed and respected to the degree that it is today. Her devotion to improving the profession and the lives of her patients motivates me to keep learning, to treat all patients with dignity and to care for them to the best of my ability. “A good nurse will test her nursing and learn something to the last day of her nursing life. Nursing takes a whole life to learn.”

References

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• Bruce, A., Rietze, L., Lim, A., (2014). Understanding philosophy in a nurse’s world: What, where and why?, Nursing and Health, 2(3):65-71.
• de Almeida Medeiros, A. B., Cruz Enders, B., & De Carvalho Lira, A. L. B. (2015). The Florence Nightingale’s Environmental Theory: A Critical Analysis. Anna Nery School Journal of Nursing / Escola Anna Nery Revista de Enfermagem, 19(3), 518–524. https://doi-org.proxy.library.stonybrook.edu/10.5935/1414-8145.20150069
• Dossey, Barbara M. PhD, RN; Rosa, William E. MS, RN; Beck, Deva-Marie PhD, RN Nursing and the Sustainable Development Goals: From Nightingale to Now, AJN, American Journal of Nursing: May 2019 - Volume 119 - Issue 5 - p 44-49. doi:10.1097/01.NAJ.0000557912.35398.8f
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• Ulrich, B. (2020). From the Editor-in-Chief. Year of the Nurse: Celebrating the 200th Anniversary of the Birth of Florence Nightingale. Nephrology Nursing Journal, 47(2), 109–111. doi-org.proxy.library.stonybrook.edu/10.37526/1526-744X.2020.47.2.109