Nightingale Case Study

Nightingale Case Study

Florence Nightingale, the forerunner of modern nursing, is one of the earliest nursing theorists. One of her theories, environmental theory, is essential in nursing practice today since it has shaped practice by guiding contemporary infection control.

The theory emphasizes creating a safe environment to promote healing, well-being, good health, and appropriate patient outcomes (Gilbert, 2020). It also maintains that the health of houses is the most important aspect of providing the right environment for patient healing, care, and comfort. This essay presents the application of Florence Nightingale’s environmental theory to a case study.

The case study involves a 68-year-old lady, Mrs. Adams, who has just been discharged from the hospital. Mrs. Adams was diagnosed with diabetes, hypertension, and breast cancer. The community health nurse goes to assess her home environment and discovers that she lives in a poorly ventilated low-income apartment with three cats and a small dog, which she considers family. The house is also in disorder and has a minimal flow of light. Despite being 5 days post operation from right mastectomy, she complains of pain and draining from the surgical site.

Environmental Theory’s Application and the Five Essential Components

Based on the first assessment, there are several steps that the nurse would take after the first assessment. To begin with, the community health nurse should advise the lady on moving into another house. The current house does not provide the required environment that promotes healing.

Nightingale’s environmental theory maintains that an environment that promotes healing, well-being, and health should have a good flow of light, air, clean water, sanitation, and a certain level of cleanliness. Thus, advising the lady to get another house that promotes a healing environment should be the first action taken by the nurse.

Additionally, the nurse should encourage the lady to try and get some time to take walks during the day and get help tidying up the house to ensure the flow of clean air, or at least get some clean air. Cleanliness would help deal with bacteria and other microorganisms that cause infections and re-infections, especially on the surgical site. There are two cats and a small dog which also require a clean environment to avoid spreading infections to Mrs. Adams.

More so, taking walks to get some clean air would help with psychological and physical healing since it would help relieve stress. Educating the lady on nutrition and the importance of nutrition on healing and well-being is also vital. From the assessment, the community health nurse found that Mrs. Adams’ house lacked food, which shows that she might not be taking her nutrition and feeding seriously.

Furthermore, patient education on taking the initiative to care for one’s health is also necessary for the nurse to consider taking. The nurse noted that Mrs. Adams’s clothes had been unchanged since she was discharged. The house was also not in order. Despite being elderly, Mrs. Adams should take the initiative and care for herself. She should reach out to other family members for help.

The five essential components of Nightingale’s environmental theory include basic sanitation, cleanliness, clean air and water, and light. According to Riegel et al. (2021), these five elements provide the right environment to promote healing and well-being. More so, noise and unnecessary disturbance harm the patient and other individuals. Nightingale also recommends appropriate beds, bedding, personal hygiene for individuals, and nutritious food.

Care Plan and Care Plan Prioritization

A care plan is essential for Mrs. Adams, especially given that she has been diagnosed with hypertension, diabetes, and breast cancer. The care plan should include managing the three conditions and, most importantly, consider other personal aspects such as psychological wellness. The specific elements of the care plan include pain management, medications, food, physical activity, nutrition, blood sugar regulation, rehabilitation after surgery, concern, openness, availability for the patient, and the provision of comfort and relaxation measures.

The American Diabetes Association (2021) recommends that individualized care plans be developed, especially for patients with comorbid diabetes and other conditions. The most essential care plan elements for a diabetes patient are blood sugar level regulation, physical activity, and food and nutrition.

The plan of care for Mrs. Adams should include patient education on regulating her blood sugar levels, the importance of physical activity in diabetes management, and lifestyle modification to accommodate healthy food and meet the nutritional requirements of a diabetic patient.

Additionally, the care plan should include rehabilitation after surgery, emotional support, mainly due to the cancer diagnosis, and the fact that Mrs. Adams is 5 days post-operation from a right-sided mastectomy. Rehabilitation after surgery should be prioritized since it is meant to meet the patient’s physical, social and emotional needs, thus helping them cope and get back to their normal life after surgery.

Emotional support would include openness, concern, and availability of the care team to Mrs. Adams. Due to the three diagnoses, she might have feelings of anticipated loss and other concerns. The care team should provide support by being available and open to address the concerns and encourage her along the care journey. More so, emotional support should be a priority for Mrs. Adams, mostly because she is elderly and living alone, and therefore at a higher risk of negative emotional effects that would further affect her health and well-being.

Application of Nightingales Environmental Theory into Practice

One of the areas in nursing practice where Nightingale’s environmental theory would be applied is preventive care. Preventive care is routine healthcare that includes patient counseling, screenings, and checkups to help prevent or detect serious medical problems or health conditions before they occur or become serious. Research shows that the environment mainly influences various respiratory diseases, cancers, and heart conditions (Gilbert, 2020).

Thus, Nightingale’s environmental model can be used to prevent these conditions from being serious or even occurring. The nurses are responsible for participating in health prevention campaigns focusing on the environment. In these campaigns, people should be taught the importance of different environmental factors influencing health, including sanitation, water, clean air, and personal hygiene.

The specific patient population that would benefit from the approach is diabetes patients living in low-resource settings. According to Sher and Akhtar (2018), environmental modification to make diabetes patients comfortable. For instance, personal hygiene and cleanliness can help prevent further infections.

More so, the nurse should put diabetes patients in the best environmental condition so that nature can act upon them. Nightingale believed that, given the right environment, diseases heal naturally. Thus, providing patient education on the importance of the environment on health and well-being would help prevent diabetes and diabetes complications.


Nightingale’s environmental theory has been considerably instrumental in shaping nursing practice. The theory’s basic components include basic sanitation, cleanliness, clean air and water, and light. The theorist maintains that the correct environment to promote healing and well-being must include clean air, basic sanitation, light, cleanliness, and water. The theory can be applied in preventive health, as discussed above.


American Diabetes Association. (2021). Standards of medical care in diabetes—2021 abridged for primary care providers. Clinical diabetes: a publication of the American Diabetes Association39(1), 14.

Gilbert, H. A. (2020). Florence Nightingale’s Environmental Theory and its influence on contemporary infection control. Collegian27(6), 626-633.

Riegel, F., Crossetti, M. D. G. O., Martini, J. G., & Nes, A. A. G. (2021). Florence Nightingale’s theory and her contributions to holistic critical thinking in nursing. Brazilian Journal of Nursing74.

Sher, A. N. A., & Akhtar, A. (2018). Clinical application of Nightingale’s theory. Journal of Clinical Research and Bioethics9(4), 1-3.

Nightingale Case Study

Assignment Description:

Nightingale Case Study

Write a 1000-1500-word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) outside sources and the textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Case Study: Mrs. Adams, a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently. Her diagnosis is diabetes, hypertension, and breast cancer. She is 5 days’ post-op from a right sided mastectomy.  Mrs. Adams apartment is located in a low-income area of the city where crime is prevalent. Upon assessment by the Community Health Nurse, Mrs. Adams apartment was in disorder with minimal airflow or light. Her clothes appeared unchanged and she had no food in the apartment. The small apartment also housed 3 cats and a small dog who Mrs. Adams considers family since the death of her husband 1 year ago. Mrs. Adams complains of pain and draining from her surgical site and a broken air conditioner.

  • Using Nightingale’s Environmental Theory, what actions would the nurse take upon the first assessment? What are the five essential components?
  • What would be an appropriate plan of care be for Mrs. Adams? How would you prioritize the care plan?
  • Apply Nightingale’s Environmental Theory to an area of your nursing practice? What patient-population would benefit from this approach? Support this practice change with at least one evidenced-based article.