Journal of Holistic Nursing

The purpose of this qualitative, historical field study was to identify the nature and attributes of caring relationships as depicted in the writings of Florence Nightingale. Latent content analysis was the methodology used for the discovery and analysis of words, ideas, and themes from selected Nightingale works. Five themes were identified that represented a caring relationship: attend to, attention to, nurture, competent, and genuine. These themes are congruent with Nightingale’s threefold concept of nursing. Watson’s carative factors were used to cross-validate the results. The findings of this study indicate that the phenomenon of caring relationships in nursing has been a part of our professional language since Victorian times. Historical research provides a sense of connectedness to nursing’s past and contributes to the ongoing education of nurses and further development of the nursing profession.

This article is a tribute to Florence Nightingale whose book Notes on Nursing was published 150 years ago in 1860. Nightingale was a proponent of rounding on patients to ensure their environment contributed to healing. Patients and their families experience greater satisfaction when a registered nurse rounds on them. The liaison nurse provides the connection between a surgical patient and the family in the waiting room. This activity promotes communication and spiritual support for family members who will participate in patient care both during hospitalization and after the patient returns home. Nursing theorists support the interconnectedness that takes place during rounding. Story theory directs the nurse to connect with the patient’s story so that holistic care, recognizing body, mind, and spirit, can take place. High-touch/low-tech as practiced in Asia includes nurse—family interaction, integrating knowledge about the patient’s history and preferences with nursing assessment, planning, interventions, and evaluation of care. Nursing diagnoses support critical thinking for the nurse during rounding and interaction with family members. Hospice care includes family stories, humor, and the comfort of presence of loved ones.

Vulnerable populations, specifically migrant farm workers and persons experiencing homelessness, are often at an increased risk for foot infections. This risk is related to their working and living conditions, socioeconomic status, limited access to health care, frequent exposure to wet environments, limited access to clean and dry socks and shoes, bathing or laundry facilities, and daily routines that requires them to be on their feet for long periods of time. After years of caring for these populations and hundreds of clinical encounters, an evidence-based, effective method of foot care that incorporates intentional comfort touch has been developed. This article describes methods for mitigating the severity of fungal growth, decreasing the risk of secondary infections, and improving skin integrity by manipulating the micro-environment of the patients’ feet. This includes fundamental aspects of hygiene as described by Florence Nightingale’s Environmental Theory that suggests that direct sunlight, fresh air, and cleanliness improves health.

Purpose: To build on current knowledge and definitions of healing to further analyze and clarify the concepts as it relates to nursing practice and care of the conscious adult patient. Methods: Literature surrounding previous concept analyses and definitions of healing were reviewed. Using the process outlined by Walker and Avant, model, borderline, related, and contrary patient case examples with brief rationale are presented. Findings: Theoretical definition: Healing is as a positive, subjective, unpredictable process involving transformation to new sense of wholeness, spiritual transcendence, and reinterpretation of life. Operational Definition: Healing is the personal experience of transcending suffering and transforming to wholeness. Conclusions: Nurses, through transpersonal caring, and patients, through beliefs and their innate healing abilities/nature/God, may mediate the healing process. As nurses focus on the International Year of the Nurse and global health, it is paramount that healing, a major tenet of nursing, be explored and analyzed to increase understanding for both nurses and patients.

Whether it is adhering to the latest regulatory requirements, measuring performance, evaluating the patient’s experience of care, or preventing pressure ulcers, nothing is more vital to the success of any initiative than the requisite skill and observations of a professional nurse. Yet, for many nurses, getting through the day can be a struggle. Feeling overwhelmed, disconnected, and scattered, reshaping the identity and passion once recognized as an individual’s “calling” to professional nursing leads to poor outcomes for nurses and patients alike. Nursing was not intended to be such a struggle, and many “new” performance indicators contain elements that have been recognized as proper nursing practice throughout the history of the profession. Nurses must be reminded of their rich history and the teachings of Florence Nightingale. This article summarizes one hospital’s experience with a newly developed tool used during nursing orientation. While connecting past and present, both standards and expectations for nursing practice are communicated, leaving nurses feeling supported, validated, and energized.

Health care is in crisis at the global, national, and local levels, with hundreds of millions living without basic care, or with insufficient care. Current health care models seem to have ignored, muted, or excluded the voices of the people they were intended to serve, resulting in health systems and care delivery models that do not respond to the needs of the people. This article describes a values-based approach to health and health care services in which the voices of the people are heard and listened to, and in which individuals and communities are informed participants in their own care. We draw parallels between contemporary concerns for decency in care giving to Florence Nightingale’s path-breaking work, first with the British military medical system and then Great Britain as a whole.

Florence Nightingale has been the subject of numerous biographies and topical studies since she became a public figure during the Crimean War of 1854-1856. However, both the biographical and the topical literature have given little emphasis to the fourteen months of Nightingale’s superintendency at The Establishment for Gentlewomen During Illness located on Harley Street, London. Thematic analysis of primary documents including Nightingale’s Quarterly Reports to the Governors of her Nursing Home and the recently identified found Minutes of the Ladies’ Committee of the Establishment of Gentlewomen During Illness were utilized to identify specific themes considered essential to Nightingale’s professional and philosophical development. Harley Street proved to be the catalyst of opportunity that later launched her into the public view as a visionary through which she was to develop nursing as a profession and promote nursing as a legitimate route for women’s education and employment.

Florence Nightingale lived and worked in response to her times—yet also ahead of her time. She insisted on pursuing a career even though her wealthy family could have provided her with a lifetime of leisure. Because she was a woman, this choice to work outside her home was all the more unusual. Nightingale was also a vanguard woman because she chose nursing, a role that was considered the work of desperate, impoverished women who lived on the street like prostitutes. In addition to these unusual choices, Nightingale’s career was unique beyond anyone in her time. She was one of the most prolific authors of the 19th century. In addition to being an early role model for nursing, Nightingale was also a leader in several other fields emerging in her time, including social work, statistical analysis, and print journalism. As a global thinker, Nightingale would have loved 21st century. She noted cultural, social, and economic concerns, particularly in relation to health and to the discipline of nursing. She urged nurses to progress in their practice and to think outside their official domains. She responded to the culture of the 19th century by envisioning what could be changed. Working with her talents and available resources, she evolved the health care culture of the 20th century and beyond. She called all of this work “Health-Nursing.” As we remember and further study the extraordinary panorama that is our Nightingale legacy, we are creating and shaping our relevant, emerging 21st century nursing practice.

In 1893, Chicago hosted the Columbian Exposition. This event showcased America’s social, cultural, and scientific advances and its growing cultural parity with Western Europe. This was the first major exposition in which women played a prominent role. Integral to the fair was a series of Congresses that provided an international platform for discussion of social issues. The Congress on Hospitals, Dispensaries, and Nursing, a section of the International Congress of Charities, Correction, and Philanthropy, particularly focused on health care issues. Nursing leaders from Europe and North America participated. Although Florence Nightingale provided a major paper that was read at the Congress, she was unable to attend the event. The intent of this article is to examine the issues and themes debated at the 1893 Congress and identify how the influence of Nightingale effected these discussions and the development of Western nursing for the next half-century.

Today’s global health problems may seem insurmountable. Antibiotic-resistant microbes are increasing, and more economic, environmental, and social factors are affecting health. Health care costs keep rising. Hot politics and the chronic global nursing shortages all threaten the future of health care delivery. Also, diseases in many war-torn regions clearly place all humanity’s health at risk. How can nurses possibly address these larger “global” challenges? To consider this question—and what nurses might do to contribute solutions—this article looks at the wider horizon of health care problems and how Florence Nightingale faced similar bigger health issues in her time. The health problems of today require renewed vision and the participation of committed citizens who take an active role in the promotion of human health—both locally and globally. By learning more about Nightingale’s legacy, nurses actually attain a significant breadth and depth of knowledge and skill to share in these endeavors. Based on a review of Nightingale’s responses and insights, seven recommendations are shared for consideration. While continuing the practices we have established, nurses can also create new, innovative, and relevant practice arenas, becoming—like she did in her time—global change agents for the sake of human health. From her broader viewpoint, Nightingale passed her global vision to us in order to extend our own horizons of possibility: remembering who we are, considering what we can do, who we care for, and why.

Florence Nightingale brought nursing from a disreputable and immoral vocation into the honest and ethical profession that is enjoyed today by emphasizing strict morals in the personal and work lives of her nursing students. In modern day, ethical principles guide the nursing profession and have many relevant connections to Nightingale’s morals. Just as the high moral character of Nightingale’s nurses helped nursing rise to a profession in her day, teaching and following ethical principles is crucial in furthering the nursing profession in our day.