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Nursing is growing and transforming in scientific developments including research, theory, and professional practice. It has a rich history that goes beyond the time of Florence Nightingale to the most recent nurse theorists, clinicians, and researchers. Practicing involves the knowledge of integration through model conceptualizations and adoption. Florence Nightingale and Sister Callista Roy are some of the prominent nursing theorists. The two developed personal philosophies of nursing that have impacted practice and research. This essay will compare and contrast both theorists, including their work and professional contributions to clinical practice.
Brief Overview of the Two Theorists
Florence Nightingale is known as the founder of modern-day nursing. She was born in Florence, Italy, in 1820 as a second daughter whose parents wanted her to marry a rich man (Smith & Parker, 2015). However, she did not want to let anything kill her dream of serving people to the level that she refused to fulfill her parent's wishes. In 1844, she decided to work as a nurse, and her parents were unhappy because of this decision. This is contrary to Roy, who had her mother as a role model. She was a vocational nurse who impacted her daughter with the necessary values to become the best selfless professional (Smith & Parker, 2015). Nightingale went to Kaiserwerth College in Germany where she acquired her education in 1851 and by 1883, she was given an opportunity to reorganize a small hospital in Harvey of England, where she did an outstanding job (Alligood, 2010). This landed her an opportunity to serve in the military, an exposure that resulted in the development of her Environment Theory that currently impacts practice. She found the military hospitals being dirty with many soldiers dying from preventable diseases. It inspired her to improve hospital hygiene and other environmental factors (Smith & Parker, 2015). She believed in training nurses; therefore, she became the first person to train nurses in school at St. Thomas Hospital before her death.
Conversely, Callista Roy is an outstanding nurse theorist, researcher, and instructor, who has immense contributions to all aspects of the nursing profession. She received her nursing bachelor’s degree in 1963 from the renowned Mount Saint Mary’s College before attending the University of California in Los Angeles for a master's degree in nursing pediatrics, and a doctorate degree in sociology in 1966, 1975, and 1977 respectively (Roy, 2013). Roy then completed a post-doctoral program in neuroscience at the University of California as a clinical nurse scholar. Therefore, she is more educated that her senior colleague, Nightingale. The idea for her Adaptation Model is accredited to her professional and educational experience, family and cultural values, and most importantly, her teachers and colleagues. She proposed her model when studying for the master’s degree after being challenged by Dorothy Johnson to develop a nursing conceptual model (Harnegie, 2015). Furthermore, she had some experience in pediatric nursing where she noted how children had the ability to adapt to environmental changes, which brought the concept of environmental adaptation.
Theoretical Contribution to the Nursing Profession
Nightingale came up with the Environmental Theory of nursing in which she gathered her life and professional experience to develop it. In her theory, she considers nurses, patients or clients, and environment as concepts that are in equilibrium, and the role of a nurse is to manipulate the environment and to make it assist the client’s recovery (Smith & Parker, 2015). Such a thing means that nurses are responsible for maintaining the equilibrium by helping a person respond effectively. In case the balance is altered, the patient expends unnecessary energy. For instance, in the presence of the disease, the nurse observes the client’s response or reaction before intervening to mitigate the causative nuisance to reduce unnecessary energy expenditure. Nightingale views physical environment manipulation as a critical component of care in which she identified nutrition, bed and bedding, noise, warmth, light, variety, cleanliness, and ventilation and warmth, as major environmental areas for nurses to control.
Roy, just like Nightingale, insists the role of the environment and the response a person displays in maintaining or achieving health. However, Roy believes that nurses should assist the patient to cope and adapt to the environment. According to Alligood (2010), Roy explains that nurses should help a patient incorporate coping skills and strategies by assessing the needs, identifying the levels of adaptation and helping the patient to adapt effectively. The three levels of adaptation are compromised, compensatory, and integrated (Harnegie, 2015). Unlike, Nightingale's theory, Roy insists on nurses helping the client to adapt rather than manipulating the environment. This makes her theory more diverse because nurses can help their patients in all aspects including spiritual, physical, and psychological needs to improve adaptation instead of dwelling on the physical environment alone.
The two theorists also define and explain the metaparadigms of nursing philosophy. Roy defines a person as a human adaptive system that is regarded as a whole with parts functioning as a unit for a specific purpose (Smith & Parker, 2015). The person includes people, and communities. She then defined health as the state of being and becoming integrated as a whole that reflects mutuality between the environment and the individual. The environment refers to all the conditions, circumstances, and influences that affect the behavior and development of clients as adaptive systems (Smith & Parker, 2015). The goal of nursing is to promote adaptation in the four modes that include physiological, self-concept, interdependence and role function.
Contrarily, Nightingale failed to define various concepts the way Roy did. She instead defined the human beings in relationship to the environment and its impact on them (Harnegie, 2015). Also, she did not define health but referred to it as the opposite to disease or pathology. Nightingale explains that the environment is all factors that surround the person and are considered in relation to the state of health. Surprisingly, she defines a nurse as a woman in charge of providing or caring for individuals in need (Smith & Parker, 2015). The goal of nursing is to help a patient to be in the best condition for the environment to act upon, which differs from that of Roy.
Relationship to Clinical Practice
The two theorists have a positive implication for nursing practice. Nightingale’s theory forms the framework of the nursing process because it entails the assessment of the patient and the prevailing situation, identifying needs to fulfill, implementing a care plan, evaluating the implementation progress, and finally changing the plan to sever the patient in an effective manner (Alligood, 2010). The theorist also emphasizes the concept of critical thinking that is necessary for practice when delivering care and carrying out various stages of the nursing process. Her contribution in practice has enlightened nurses on what should be manipulated in the environment to ensure the patient gets well. Her role has transformed nursing practice because she introduced formal training that has caused nursing to be a profession of informed and educated individuals (Alligood, 2014). Roy’s contribution targets the environment and the role of nurses in helping the individual to adapt well. The theory helps nurses assess the needs of patients, namely physiological, biopsychosocial, and psychological (Smith & Parker, 2015). Nurses utilize her theory to identify the three adaptation levels and the modes of coping (Roy, 2013). Just like Nightingale, Roy clearly explains the role of nursing, which has shaped the scope of professional practice.
Conclusion
Although Roy and Nightingale differ in their personality and theories, similarities exist. Nightingale was self-motivated to become a nurse and develop her theory while Roy had a supporting family and teachers who motivated her to develop the Roy’s Adaptation Model. Through her Environment Theory, Nightingale insists on the role of the physical environment on a patient and how the nurse should help to respond effectively. On the other hand, Roy dwells much upon the adaptation of the individual due to environmental changes and a nursing as a profession that helps patients adapt. All the two have four concepts of metaparadigm of nursing despite the variations in their definition. These two theories have an enormous positive impact on nursing practice.
References
Alligood, M. R. (2010). Nursing theory: Utilization & application (4th Ed.). St. Louis, MO: Mosby Elsevier.
Alligood, M. R. (2014). Nursing theorists and their work. Mosby: Elsevier Health Sciences.
Harnegie, M. P. (2015). Generating middle range theory: from evidence to practice by Sister Callista Roy with the Roy adaptation association. Journal of Hospital Librarianship, 15(3), 342-343.
Roy, C. (2013). Generating middle range theory: from evidence to practice. New York: Springer Publishing Company.
Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. Philadelphia: FA Davis.
