The “Florence Nightingale” Approach To Patient Care

Most, if not all of us, have experienced some kind of care as a patient. And whether you’ve been on the receiving end of an invested, caring physician versus a hurried, indifferent physician, you may have also felt that there’s a connection between a positive health outlook and good, compassionate care.

Florence Nightingale, also known as the “Lady with the Lamp,” revolutionized nursing and patient care in the 1800s. She was a beacon of light traveling down hospital hallways as she cared for wounded soldiers during the Crimean War. Her mission was to lower the death rate in hospitals by administering proper patient care. In fact, she actually accomplished her mission by lowering the hospital’s death rate by two-thirds. Nightingale foresaw the importance of personal connection for patient care. She carried with her endless compassion and a spirit of service.

“The amount of relief and comfort experienced by the sick after the skin has been carefully washed and dried, is one of the commonest observations made at a sick bed.” – Florence Nightingale

Isn’t that something? “Carefully washing” a patient can seem less significant than administering medications, but Nightingale praised it as the most comforting. It could be that these small, seemingly insignificant actions can be even more healing than the strongest medication. Building a positive rapport with patients can ensure that the journey to recovery is quick and emotionally uplifting.

Analyzing human physiology, scientists see the relationship between psychological, neuroendocrine, immunological, and other physiological processes. Psychoneuroimmunology (PNI), the study of the physiological connection between mind and body, was coined in 1981 by researcher Dr. Robert Ader.

“People say the effect is only on the mind. It is no such thing. The effect is on the body, too. Little as we know about the way in which we are affected by form, by color, and light, we do know this, that they have an actual physical effect. Variety of form and brilliancy of color in the objects presented to patients, are actual means of recovery.” – Florence Nightingale

How our thoughts affect our functions

As part of the endocrine system, the pituitary and adrenal glands are vital in relaying information from the hypothalamus (the control center of endocrine function) to the rest of the body by the secretion of hormones. The hypothalamus is affected by emotional and cognitive states. The brain is stimulated by signals from inside the body such as organs and outside the body by cranial and peripheral nerves indicating smell, hearing, sight, or taste. The stimuli are processed in the brain that leads to thoughts and emotions.

The hypothalamus is key to mediating these physiological activities. This forms the basis for understanding how interventions affect sensory stimulation and different body processes. It also enlightens us on how interventions that affect our thoughts and emotions can lead to changes in physiological functions.

Stress reduction for recovery

I think we can safely say that we all have experienced some level of stress in our lives. Have you ever wondered how stress affects your body? Studies have shown that chronic stress is associated with immunological suppression.

It’s been shown that PNI is a bidirectional communication between neuroendocrine and immune systems. This supports the concept of a holistic approach to patient care. This type of integrated therapy has been seen to benefit patients with cancer. Stress reduction is key to a patient’s recovery.

Sensory therapy

The therapeutic value of sensory interventions in patient care is unprecedented. Sight is part of the senses and is vital to our everyday activities. The sense of sight stimulates the optic nerve affecting the way a person feels emotionally.

Florence Nightingale in her documents, Notes on Nursing, saw the value of colors, natural light, and aesthetic surroundings in a patient’s recovery process.

“It is the unqualified result of all my experience with the sick that, second only to their need of fresh air, is their need of light; that, after a close room, what hurts them most is a dark room and that it is not only light but direct sunlight they want.” – Florence Nightingale

Research supports that there are benefits from hospital rooms with windows and views of the outdoors. Recently, contractors have put a higher priority on location and ambiance of patient rooms and treatment areas. Hospital rooms without windows are rarely seen except in cases where radiation therapy is used. We have all seen rooms with wall murals or paintings. It adds a different emotion other than negative apprehension. This gives patients and families a different perception of the environment leading to a positive psychological response.

This is only one type of intervention that can be beneficial to patients. PNI gives us the scientific foundation for the many integrative therapies. These mind-body therapies are categorized into four mechanisms: sensory, cognitive, expressive, and physical. PNI is a biomedical framework that supports the use of many of these integrative therapies for patients with cancer.

Whenever you visit a family member who is admitted to a hospital make sure their room is well- lit. Bring a positive environment to their bedside. You could be the key to a quick recovery by influencing their immunological function.



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Raeann Leal

Raeann is a graduate student at Loma Linda University School of Public Health pursuing her MPH in Lifestyle Medicine. In her free time, Raeann likes to cook unique and healthy dishes, read relevant and recent research articles related to diseases and their cures, and experience the outdoors.

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