Personal Philosophy

Patricia Morton

Bon Secours Memorial College of Nursing

Transition to Baccalaureate Nursing

NUR 3240

Gardner

March 5, 2017

Honor Code I pledge..

 Florence Nightingale is said to be one of the founders of modern day nursing (Jan 2012)

and many of her theories and practices are still in use today. Her philosophies on science based

nursing, treating the person as a whole and the recording of data pertaining to care are just a few

of the examples of how she has shaped the nursing profession into the people we are today. One

of the theories she had pertaining to environment has always resounded with me and I continue

to share in her philosophy and let it dictate my practice.

Florence felt that the three main problems when trying to care for a sick soldier were

"dirt, diet and drains." During her time spent in the Crimean war, she took on the challenges of

reducing one military hospitals mortality rate by initiating hygiene standards and insisting on

having basic necessities such as soap, clean linen and towels. It was not enough to have

medications when lice, bugs and infection were overtaking the soldiers. Florence believed that

"patients are to be put in the best condition for nature to act on them, it is the responsibility of

nurses to reduce noise, to relieve patients anxieties, and to help them sleep" therefore she felt it

was her responsibility to watch over the soldiers at night so they would not have to worry and

could rest properly. That is how she earned the nickname "the lady with the lamp" due to her

roaming the wards at night with a lamp to check on her patients.

I too feel that environment plays a critical role in a patients health and outcome. I

believe that skin infections are less likely to spread if washed immediately after the initial insult,

and then again daily to reduce growing bacteria. I agree that changing linen daily reduces the

opportunities for skin infections, bacterial growth or skin breakdown from contact with soiled
linen along with the opportunities for infection related to modern day central lines and

contamination from the patient's own flora. Custodians, physician, nurses and all hospital team

members are responsible for keeping a clean and tidy room for the patient. (Nursing Journal

2007). Nosocomial infections are on the rise while we are constantly looking for ways to cut the

budget but cutting corners is not the answer. I find it unnerving to enter into a patients room

only to find several meal trays that have not been picked up, leftover food sitting on a windowsill

or to learn that the patient has not been bathed in several days. I realize there are situations that

might prohibit a full bath or shower on occasion but hygiene is not only necessary, it is critical to

the outcome of any person who has a compromised immune system or is a post-operative

infection risk.

As a nurse, it is not enough to address the physical environment in which your patient

currently resides: the OR, the ED or the medical surgical unit. A nurse must ask the probing

questions about the physical environment that the patient has come from or will be returning to.

If a patient lives in a lice or flea infested home and is treated for several days for a skin infection

only to be discharged back to the same environment, we have not done our due diligence. We

must ask the questions and explore options that will best suit the patient for optimum recovery.

The same holds true for other concerns such as ability to perform ones own ADL's, access to

nutritious and healthy meals, etc. This is where collaboration and communication with other

departments becomes crucial so that concerns can be expressed and avenues explored for patient

and family needs. (AHRQ 2017)

References:

Nightingale F. Florence Nightingale: Measuring Hospital Care Outcomes: Excerpts From the

Books Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the

British Army Founded Chiefly on the Experience of the Late War, and Notes on Hospitals.

Oakbrook Terrace, Ill: Joint Commission on Accreditation of Healthcare Organizations;

1999:4145. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920984/

Pellowe, Carol M. EdD, MA, BA, RN, RNT. November 2007. Standard principles: hospital

environmental hygiene and hand hygiene. Retrieved from:

https://www.nursingtimes.net/clinical-subjects/infection-control/standard-principles-hospital-

environmental-hygiene-and-hand-hygiene/291499.fullarticle

Preventing readmission through comprehensive discharge planning. March 2013.

Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23241896

Discharge planning checklist. Retrieved from:

https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilie

s/strategy4/Strat4_Tool_1_IDEAL_chklst_508.pdf