Nightingalean assumptions in hospital practices: grants for nursing

Objective: to know the conception that the nurses of a public hospital and of teaching have on the environmental assumptions of Florence Nightingale. Method: a descriptive, exploratory, qualitative approach study with eight nurse assistants. The data were collected from a semi-structured individual interview and analyzed by the Content Analysis Technique. Results: nurses consider the conditions of hygiene, food, accommodation and air quality offered to patients and professional staff in their work, corresponding to Nightingalean environmental assumptions, even though they do not have a solid knowledge of Nightingalean theory and its usefulness to professional practice. Conclusion: a permanent educational process is necessary to overcome this lack of knowledge. Descriptors: Nursing; Environment; Health; Nursing Care. RESUMO Objetivo: conhecer a concepção que os enfermeiros de uma instituição hospitalar pública e de ensino têm sobre os pressupostos ambientais de Florence Nightingale. Método: estudo descritivo, exploratório, de abordagem qualitativa, com oito enfermeiros assistenciais. Os dados foram coletados a partir de entrevista individual semiestruturada e analisadas pela Técnica de Análise de Conteúdo. Resultados: os enfermeiros consideram as condições de higiene, alimentação, acomodação e qualidade do ar oferecidas aos pacientes e equipe profissional em seu atuar correspondentes aos pressupostos ambientais nightingaleanos, mesmo não tendo um conhecimento sólido da teoria nightingaleana e de sua utilidade para a prática profissional. Conclusão: faz-se necessário um processo educativo permanente para suprir essa lacuna de desconhecimento. Descritores: Enfermagem; Meio Ambiente; Saúde; Cuidados de Enfermagem. RESUMEN Objetivo: Conocer la concepción que los enfermeros de un hospital escuela público tienen sobre los presupuestos ambientales de Florence Nightingale. Método: Estudio descriptivo, exploratorio de abordaje cualitativo, con ocho enfermeras asistenciales. Los datos fueron recolectados a partir de entrevistas individuales semiestructuradas y analizadas por la técnica de análisis de contenido. Resultados: los enfermeros consideran las condiciones de higiene, la alimentación, el alojamiento y la calidad del aire ofrecido a los pacientes y el personal profesional en su trabajo, correspondes a los presupuestos ambientales Nightingalean, mismo no teniendo un conocimiento sólido de la teoría Nightengalean y su utilidad para la práctica profesional. Conclusión: Se hace necesario un proceso educativo permanente para cumplir con esta brecha de desconocimiento. Descriptores: Enfermería; Medio Ambiente; Salud; Cuidados de Enfermería. Nurse, Master in Health Sciences and Environment, Antônio Pedro University Hospital, Fluminense Federal University/UFF. Niterói (RJ), Brazil. E-mail: josehelder@predialnet.com. br ORIGINAL ARTICLE Aragão JHA. Nightingalean assumptions in hospital practices. English/Portuguese J Nurs UFPE on line. , Recife, 11(Suppl. 4):1625-33, Apr, 2017 1626 ISSN: 1981-8963 DOI: 10.5205/reuol.10438-93070-1-RV.1104sup201703 Florence Nightingale's environmental theory (1820-1910) marks the beginning of modern Nursing. The environmental assumptions of Florence Nightingale theory were firmly established in the second half of the nineteenth century as the very foundations of scientific Nursing. They duly emphasize the environment as a force capable of promoting and recovering the health of the human being, indicating that a balance between them must exist to revitalize health. The word theory has its origin in Greek, theoria meaning a "vision". Theory is defined as a body of systematized concepts that allows us to know a given domain of reality. The theory provides means to know this reality. The means are the concepts, which, systematized, form the theory. The observation of practice and reflection led to the consensus that the central concepts of Nursing were human beings, the environment, health and Nursing itself. Nursing theories began to be constructed relating these concepts. The importance of the use of theories is emphasized in that they aim to direct the nurses' thinking, their observation and their interpretation of reality. The nurse must be able to go through different Nursing theories. Theories reflect the thinking that underlies the development of knowledge oriented to professional practice. Knowing well theories of Nursing means the first condition for nurses to take on the different perspectives of care. Nowadays, due to the increasing complexity of actions and the context of health care, professionals should guide their practices based on more than one theory of Nursing. Florence Nightingale advocated the centrality of the physical environment as a determinant of health and the cure of illness in people. In its conception, the concept of the environment encompassed the psychological and social environments. Human health depended on the interaction of environmental factors. Florence emphasized in her environmental theory, as it is considered today by the doctrine, the important elements in maintaining a healthy environment: ventilation, provision of fresh and pure air; lighting, brightness and direct sunlight; heat, related to avoiding the cooling of the patients; cleaning, reference to infection prevention; the noise, the need for observance of silence; odors and food. The variety of objects, forms and colors offered to the sick, plus a conversation about good things, are also cited as contributing to their mental, and physical recovery. Florence Nightingale focused on hygiene prioritization and highlighted five essential components of the ideal cure: clean air, pure water, sanitation, cleanliness and light. These nightingalean thinking assumptions are of vital importance at present, given, the issue of hospital infection. Increasingly common, deadly, and resistant, hospital infections emerge as the greatest worldwide threat. The increase in technology and the development of medicine have altered the roles and responsibilities of Nursing, causing changes that, for many, hamper patient care. However, despite improved treatment and health care, the key aspects of Nursing care, first established by Florence Nightingale, remain vitally important to global health. There is a lack of resumption of the Nightingalean assumptions and the solidification of the discussion on the healthenvironment interface in in-service education and lifelong education. Florence's environmental theory has fundamental importance for the discussion of many aspects related to our socio-environmental responsibility. Nightingalean thinking helps us to confront the environmental problem, a complex event that has an important impact on the health-disease process, and which requires individual and collective efforts for its resolubility. The reality shows a scenario in which environmental elements are not yet fully considered by health workers. It is urgent to change this perception, especially in the hospital scenario, marked by influences that contribute to the segregation between health and the environment. Education is fundamental for the re-evaluation of visions, positions and actions. The implementation of a process of permanent education allows the expansion of the health concept in order to incorporate other dimensions, as recommended in the various international events on health promotion. Knowing the assumptions of Florence Nightingale's Theory of Environmentalism is essential for the foundation of professional practice, a basic requirement of actions and health care. The search for and acquisition of this knowledge is therefore a real professional challenge of our day, which, overdue, will allow a more conscious and informed environmental action in the context of Nursing hospital practice. From these reflections, the objective was: INTRODUCTION Aragão JHA. Nightingalean assumptions in hospital practices. English/Portuguese J Nurs UFPE on line. , Recife, 11(Suppl. 4):1625-33, Apr, 2017 1627 ISSN: 1981-8963 DOI: 10.5205/reuol.10438-93070-1-RV.1104sup201703 ● To know the conception that the nurses of a public hospital and teaching institution have about the environmental assumptions of Florence Nightingale. Exploratory, descriptive and qualitative approach. The research site was the Antônio Pedro University Hospital of the Fluminense Federal University (HUAP / UFF) in Niterói, Rio de Janeiro. This study included eight nurses who met the following inclusion criteria: being a statutory employee for more than one year in the institution, providing direct patient care and volunteering to participate. In choosing the subjects to be interviewed, care was taken to elect nurses from seven different care areas, keeping proportionality, as far as possible, between the different sectors. The ability of a sample to reflect multiple dimensions of a totality is the criterion of selection of subjects for the study in the qualitative approach, not the numerical criterion. The sample should contain a certain number of recidivism of information, without neglecting those odd, whose explanatory potential must be taken into account. The set of informants must be diversified enough to allow the apprehension of similarities and differences, enriching the research. Data were collected through semistructured individual interviews in the months of February and March 2014. The interviewees were invited by the researcher to participate and, informally, clarified about the purpose of the study, the ethical issues involved, the approximate duration of the interview, the use of recording and prior scheduling. At the time of the interview, all the information was reprinted and started only after reading and signing the Informed Consent Term. The interviews took place during the interviewee's working hours, in a reserved place in the hospital, and had an average duration of 30 minutes. The subjects were identified with the letter E, of nurse, f