THEORY ANALYSIS PAPER 1
Theory Analysis Paper
Vicki L. Thompson
NURS 502: Nursing Theory and Advanced Practice
Liberty University
Author Note
Vicki Thompson
I have no known conflicts of interest to disclose.
Correspondence concerning this article should be addressed to Vicki Thompson, Liberty
University, Dept. of Nursing, 1971 University Blvd, Lynchburg, VA 24515, United States.
Email: vthompson42@liberty.edu
THEORY ANALYSIS PAPER 2
Theory Analysis Paper
According to McEwen & Wills (2019), nursing theories were developed by nursing
scholars from the 1950s through 1970s in order to set apart the differences between nursing and
medicine. The theory that will be analyzed is Florence Nightingale’s Nursing of What It Is and
What It Is Not. Peggy Chinn and Maeona Kramer (Jacobs) state that a theory description has six
elements. They consist of: Purpose, concepts, definitions, relationships, structure, and
assumptions (McEwen & Wills, 2019). Critical reflection will also be addressed following the
description of Florence Nightingales’ theory. The purpose of this paper is to do a deep dive into
the theory using Chinn and Kramer’s method of theory and critical reflection.
Theory Description
Purpose
The purpose of Florence Nightingale’s Nursing: What It Is and What It Is Not, which
was written in 1860, was to examine and address how certain factors affected the care and
recovery of her patients. Nightingale’s model of nursing changed nursing and health care. She
concluded that, “cleanliness, fresh air, sanitation, comfort and socialization were necessary to
healing” (McEwen & Wills, 2019, p. 132). According to this theory, “the role of the nurse is to
use the patient’s environment to help him or her recover and get back to the usual environment”
(Petiprin, 2020, para. 2). Environment is important as it contributes to their health in either a
positive or negative way (Petiprin, 2020).
THEORY ANALYSIS PAPER 3
Concepts and Definition
Florence Nightingale addressed the metaparadigm concepts of human, environment,
health, and nursing in her writings. Through all of her studies, Florence Nightingale really
focused on a healthy environment, as she believed was essential for her patients to heal
(McEwen & Wills, 2019). She concluded that there were many factors that were not only
harmful, but also impeded the healing of her patients. Noise was one of her examples. She
believed noise interfered with a patient’s need for rest, and what noises to avoid, including:
“caregivers talking with the hearing of the individual, the rustle of the wide skirts, fidgeting,
asking unnecessary question, and a heavy tread while walking” (McEwen & Wills, 2019, p. 134).
Social contact, nutritious food, proper bedding and cleanliness were also essential. (McEwen &
Wills, 2019).
Relationships
Florence Nightingale believed that in order to achieve the wellbeing and healing of her
patients, there were five points that were essential: “pure air, pure water, efficient drainage,
cleanliness, and light” (McEwen & Wills, 2019, p. 134). Florence Nightingale wrote numerous
letters and detailed notes of all her work. She believed the environment played a major part with
her patients. Florence Nightingale put focus on lighting in homes, buildings, etc., as well as
there being fresh air through those homes. In her notes, she homed in once again regarding the
environment of patients and how this aids in their healing, to include the homes they lived in.
She believed that maintaining a clean home and nursing care would make a difference in the
patients healing, as well as those around them or ones they were in contact with (McEwen &
Wills, 2019).
THEORY ANALYSIS PAPER 4
Structure
She believed there should be a relationship between the nurses and the physicians. The
nurse was to observe and then report the findings to the physician in an “orderly manner”
(McEwen & Wills, 2019, p. 135). She expressed that: “nurses should think critically about the
care of the patient and do what was appropriate and necessary to assist the patient to heal”
(McEwen & Wills, 2019, p. 135). Nightingale drew up the plans of care for her nurses to
complete on the sick patients. Many are still being used today. Her work has been the
foundation of nursing and many colleges and universities use her theories as their foundation for
nursing as well (McEwen & Wills, 2019).
Assumptions
Florence Nightingale made focus on the environment around individuals in which she
cared for. There were several assumptions made in her theory that focused on caring for
individual’s environment to reach goals and assist in their healing (Petiprin, 2020). “These
assumptions are: natural laws, mankind can achieve perfection, nursing is a calling, nursing is an
art and a science, nursing is achieved through environmental alteration, nursing requires a
specific educational base, and nursing is distinct and separate from medicine” (Petiprin, 2020,
para. 2).
Exemplar
My Encounter with J.E.
Working in the orthopedic unit of a large city hospital, we typically had these patients for
mostly 4 to 7 days post-op, along with the regular orthopedic routine care patients. This one
gentleman was a patient of mine, whom I referred to as J.E. He had been a surgical post-op
THEORY ANALYSIS PAPER 5
patient of mine just 3 weeks prior. He never had any visitors during his stay then and was picked
up by his daughter. Now 3 weeks later, he was my patient again with a massive infection from
the surgical site at his right shoulder. I looked at my assessment from his last visit, and he had
stated he felt safe at home, had running water, and heat/air. The evening of this second
admission, I sat on the side of his bed and asked J.E. how he was and what had happened that
brought him back. After some back and forth question and answering, he admitted to me that he
had no one at home to care for him, he was using rain water from a large barrel on the side of his
home, and his power had been turned off during his last stay with us.
This does, in fact, go right along with Florence Nightingale’s theory of how a patient’s
environment does in fact have an impact on a patient’s current illness and the outcome of their
recovery. Due to J.E. not having care to help with dressing changes, clean water to rinse and
clean the wound with and having no electricity to warm up water, or even bathe, was a hindrance
to his recovery. All of these factors together put him at increased risk for infection, which is
what brought him back to our unit.
Urgent Care Nursing
Currently working in the urgent care setting, part of our assessment is the social history.
In this part of our assessment, we use the same information gathering and assessment of their
surroundings as Florence Nightingale did with her patients. We assess their environment by
asking questions such as: 1) Do they have pets; (2) Do they have city or well water; (3) Do they
have heat and air; (4) Their occupation; (5) If they are an infant or adolescent, who do they live
with; and (6) Are they exposed to second hand smoke. All of these questions have a direct
impact on a patient’s care, as well as, what could be contributing to the cause of what brought
them to us.
THEORY ANALYSIS PAPER 6
Critical Reflection
Sematic Clarity and Consistency
Florence Nightingale’s multiple concepts of human, environment, health and nursing
were well defined in her theory. “Nightingale’s focus on the environment is important for nurses
to consider when developing interventions for population health” (McEwen & Wills, 2019, p.
135). Each of her concepts deliver meaning, as well as examples of how nursing then is being
used as a foundation to nursing now.
Structural Clarity and Consistency
Nightingale’s concepts are clearly defined in her theory. She has tied environmental
factors to the healing of the ill and how each concept of the human, the environment, their health,
and nursing encompass all aspects of care (McEwen & Wills, 2019).
Complexity
The theory of Florence Nightingale is simple. She states what the theory is, includes the
concepts that are needed to fulfill this theory, then adds on the sub concepts of what is needed to
complete the overall goal of healing the patient. Her detailed examples are made clear in her
theory.
Generality
Nightingale is known throughout the nursing profession. Educators, to this day, continue
to use her teaching and ideals throughout the profession as they teach other nurses (McEwen &
Wills, 2019). Considered to be the first nursing theorists, the model of nursing developed from
Nightingale, “contains elements that have not changed since the establishment of the modern
THEORY ANALYSIS PAPER 7
nursing profession. Though this theory was pioneering at the time it was created, the principles
it applies are timeless” (Petiprin, 2020, para. 1).
Accessibility
The concepts used in Florence Nightingale’s theory are well defined. Her theory is easily
accessible as the principles and foundation continue to be studied and used to date.
“Nightingale’s work has influenced the nursing profession and nursing education for nearly 160
years” (McEwen & Wills, 2019, p. 134).
Importance
Nightingale’s theory holds strong value today as it did then. “Nightingale’s legacy
continues to be important to nursing scholars, and her vast contributions continue to enlighten
nursing science” (McEwen & Wills, 2019, p. 136). Her work as a nurse reformed nursing and
health care, as well as setting guidelines for nurses (McEwen & Wills, 2019).
Conclusion
Chinn and Kramer’s process were used in this paper where the theory of Nursing: What
It Is and What It Is Not was analyzed. The theory description identified important concepts
involved in Nightingale’s theory, which has become the foundation for nursing today. The
critical reflection section focused on the structure and complexity of the concepts. After
analyzing the theory, it was found that Florence Nightingale has set the standard and foundation
for nursing as it is practiced today. This reminds me of a verse in the King James Bible,
available online, that states in Matthew 10:8: “Heal the sick, cleanse the lepers, raise the dead,
cast out devils: freely ye have received, freely give” (King James Bible, 1769/2017).
THEORY ANALYSIS PAPER 8
References
King James Bible. (2017). King James Bible Online. https://www.kingjamesbibleonline.org/
(Original work published 1769)
McEwen, M., & Wills, E. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.
Petiprin, A. (2020). Biography of Florence Nightingale. Nursing-Theory.org. Retrieved
February 6, 2021, from https://nursing-theory.org/nursing-theorists/Florence-Nightingale.php
Petiprin, A. (2020). Nightingale’s Environment Theory. Nursing-Theory.org. Retrieved
February 6, 2021, from https://nursing-theory.org/nursing-theorists/Florence-Nightingale.php
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