Florence Nightingale is one of the pioneers of modern nursing practice and was instrumental in the development of Environmental Theory, a concept which signifies that positive health and wellbeing is in part supported by good hygiene and cleanliness, fresh air, and sunlight, among other principles (Gurler, 2014). Nightingale’s belief in a sound and protective surrounding environment was driven by the poor conditions that were evident in hospitals and which fueled her passion to improve the environment and create a climate of healing for all patients (Gurler, 2014). Florence Nightingale sought to provide each patient with greater attention and focus in a timely manner to promote healing and recovery more quickly, which is one of the key principles of the nursing profession as it exists today (Gurler, 2014). Nightingale also advocated for sanitary conditions and promoted the concepts of improved hygiene and infection control to promote healing, which had not existed until this era (Gurler, 2014).
Use of Theory and Application to Nursing Practice
Florence Nightingale’s belief “that nature alone heals” is a founding principle of Environmental Theory and supports the need to improve the surrounding environment to support greater healing for patients (Jarrin, 2012). Another principle supported by Nightingale was to treat all patients equally, regardless of background, status, race, and disability; this enabled her to identify the plight of “common people” and to strengthen nursing care and treatment towards equality for all patients (Jarrin, 2012). This concept applies today since patients who are ill and require emergency care, for example, are accepted regardless of financial need and can obtain the treatment that is necessary to promote recovery (Jarrin, 2012).

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Florence Nightingale’s Theoretical Approach to Healing
Florence Nightingale consistently focused on the patient and not the disease, which strengthens the ability of modern nurses to deliver care and treatment that is based upon the patient’s individual needs rather than theories or concepts (Jarrin, 2012). Nightingale also believed that all patients deserved compassion, solace, and understanding from their nurses as they suffered through illness or disease, and that this requires a strong human touch and perspective that encouraged comfort and strength among patients (Jarrin, 2012). Nightingale’s theory established a framework for today’s modern nursing practice with a significant emphasis on the nursing work environment, whereby nurses can promote healing and provide exemplary care to patients in a timely manner to improve their health (Jarrin, 2012). Furthermore, the nurse is responsible for creating an environment in which healing can occur with supportive actions and decisions which will have a positive impact on health over time (Jarrin, 2012).

Student Application of Theory to Nursing Practice
21st Century nursing students have an obligation to study and implement the concepts related to Florence Nightingale’s Environmental Theory because they serve as the underlying driving force in advancing successful outcomes for patients and in strengthening their resolve. Student nurses should not only be taught the theory, but conceptualize the theory and apply it to modern patient care in different ways, from how direct care is delivered to patients, the compassion and support that is required, and the necessity for optimal hygiene to prevent infection. Therefore, student nurses should promote a culture of safety and to provide a positive and meaningful healing environment which reduces the surrounding noise, which is conveyed as “that which damages the patient” (Mazer, 2012, p. 350). In this context, nurses have the responsibility to be proactive in their efforts to provide patients with an environment with fewer outside distractions so that healing can occur in a timely manner (Mazer, 2012). Furthermore, patients can experience a dynamic in which they experience lower levels of agitation, pain, and other distractions which take away from healing (Mazer, 2012). Nightingale envisioned a healthcare environment which could promote healing and patient safety without significant noise and where nurses provided the necessary care and treatment in a professional, timely, and supportive manner (Mazer, 2012).

Student’s Five-Year Perspective
For nursing students, there is a critical need to evaluate what a nurse stands for and how he or she wishes to practice going forward. Student nurses who are forward-thinking will examine how their practice will look five years from now, for example, and how their actions will impact patients in different ways. For instance, the care and treatment of vulnerable populations is a critical aspect of this process and requires nurses to emulate Florence Nightingale’s strength and courage in working with these individuals to provide supportive care and treatment without delays (Howett, Connor, & Downes, 2010). From this perspective, compassionate comfort and touch are essential to promote healing and the key principles of hygiene and infection control are critical to patient health (Howlett et al., 2010). Throughout the nursing profession, there has been an evolution of theories and guidance from historical experts such as Florence Nightingale, and these experiences are critical in addressing some of the key elements of change and idealism which are necessary to move the profession going forward (Hegge, 2011). In this capacity, nursing students must look ahead to what is on the horizon and recognize that the challenges of the profession will continue to evolve and require nurses to examine new types of problems, along with understanding how these ideals impact decision-making and the treatment of all patients (Hegge, 2011). Nurses must continue to evolve and create opportunities to improve the nursing profession and the practice setting, using Nightingale’s theory and ideals as a guide. In addition, nurses must establish a greater emphasis on understanding the dynamics of the profession and in recognizing the needs of their patients in different ways, using the tools and resources that are available to them to improve care and treatment. In this capacity, nurses must have the tools that are necessary to inspire healing and to support a caring and nurturing environment, particularly when patients are highly fearful of hospitalization and disease (Roque & Carraro, 2015). It is expected that nurses will apply Nightingale’s concepts to the practice setting on a continuous basis and apply their knowledge to promote healing and recovery in a timely manner (Roque & Carraro, 2015).

Conclusion
Florence Nightingale is a historical and highly respected figure in the nursing profession and the principles behind Environmental Theory remain significant in 21st Century nursing practice. Nightingale supported the plight of vulnerable members of society and sought to address their needs because she recognized that they did not have an advocate in the profession from whom they could gain strength and support. She sought to reverse that trend and to enable vulnerable children and adults to gain access to care and treatment that were necessary to improve their health on a regular basis. Patients must be provided with a caring and nurturing environment in which to heal, and this includes not only the physical surroundings, but also nurses’ perspectives and approaches to the practice setting which drive their objectives and the principles of excellence in nursing care. As the founder of modern nursing practice, Florence Nightingale serves as a reminder to all students and practicing nurses that the focus on the patient and on providing a supportive and hygienic surrounding environment is of critical importance in advancing the key principles and objectives of the practice setting on a regular basis. Furthermore, it provides a system under which nurses can exercise their knowledge and skills effectively to provide encouragement to patients and to promote healing as best as possible.

    References
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