If Florence Nightingale were to arrive mysteriously on our nursing unit, we would be compelled to show her the ways in which nursing and health management have changed and improved since her Victorian Age. But Florence would be compelled to demonstrate how they haven’t.
Again, women, and the best women, are woefully deficient in sanitary knowledge; although it is to women that we must look, first and last, for its application, as far as sanitary knowledge is concerned. Is all this premature suffering and death necessary? Or did Nature intend mothers to be always accompanied by doctors? Or is it better to learn the piano-forte than to learn the laws which subserve the preservation of our offspring?
Assessment
We must remember that Florence considered women who took care well of children to also be nurses. She unveiled sanitation blunders in even the wealthiest of homes, as well as the hospitals, and saw them as very threatening even to the well. She pointed out the lack of education and scientific knowledge in the nursing care of children and patients. Just as she unabashedly revealed the flaws and ignorance that plagued public health nursing management in her time, she would not hesitate to question the detrimental psychosocial errors of our day, especially those which retard the progress and wellness of children. Florence would see that a great number of children are figuratively orphaned and become incensed about the common threats to the contemporary child:
- Fatherlessness
- Economic strain related to single parenthood
- Absence of a parent in the home as he/she needs to be away generating income
- The absence and distance of grandparents with intergenerational benefits lacking
- A society which screams that love and acceptance are conditional and must constantly be earned
- Schools where the milieu and norms resemble no other institution in society except prisons
Florence would support her argument by demonstrating that these threats are evidenced by the widespread incivility and inconsideration of our youth as they “progress” in their development. Florence would see that our child masses are transported as herds on buses where behaviors are often worse than within the schools walls. The fifth grader who believes in Santa Claus this year might very well be witnessing sex acts the following September on the bus in addition to the violence and bullying found there. They join a larger collective herd once they reach the school where students might be able to learn classroom content if they can get past all the social stressors. If Florence would happen to witness the outbreak of a fight, she would see that the event becomes a spectacle for the rest to be entertained by, complete with cheers and agitators. Florence would study the children, the statistics and the data on school violence including violence, murder, suicide, and bullying and regard them as symptoms of other grave social trends and epidemics plaguing our modern society. She would trace these trends back to some of their root causes:
- Inescapable trend of mothers having to be bread-w
inners
- Longing of children for individual nurturing and solace in their homes
- Lack of knowledge of and reverence for God with prayer missing from the schools
- Erosion of marriages and the family unit
Diagnosis
Parent and Child Readiness for Enhanced Self-Care
Planning
Florence would not only expose these root causes, but she would attempt to rectify them by planning and generating educational campaigns against them. Florence would be very pleased to learn Maslow’s hierarchy of needs and adopt it immediately as a concept for all of her nurses to use in planning their improvement strategies. She would insist that nurses start at the bottom of the triangle and work their way up. She would also praise the recipe nurses have adopted for their work called the “Nursing Process” and require her nurses to use it routinely in every facet of their work: Assessment, Diagnosis, Planning, Implementation, and Evaluation.
Florence would first educate her nurses and then enlist them to go out and touch the masses, via an infrastructure already in place: the churches. This is the philosophy of Faith Community (Parish) Nursing. She would direct her nurses to organize and lead at the church tier, and then encourage the parish nurses and volunteers to reach one family and one patient at a time. Single parents and struggling families could be encouraged, aided and supported by church congregations starting at the lowest levels of Maslow and working upward. This is actually a Biblical directive. The Bible gives clear mandates on caring for the widows and orphans. Single parent families are likened to the widow and the orphan so often mentioned in the Bible.They are especially vulnerable in the bitter society and economy we are currently experiencing. The parish goal: To assist the widow, the orphan, the struggling parent, and the fatherless with a hand up (not a hand out) while respecting their dignity and maximizing independence and pride in their achievements.
Implementation
Once the Faith Community Nurse and the parish have planned their work, they are ready to work their plan. The implementation phase is simply the “doing”.
Evaluation
We would anticipate that all kinds of good fruit would result from a program such as this. As the congregation works their plan, we would anticipate that new needs would be uncovered and identified, calling for continuous reassessment and readjustments of the nursing management. The plan would be tweaked and modified as needs would dictate. The Nursing Process would prove yet again that it is an effective method at both the individual and collective levels.
There are churches who take this concept to the next level by adopting an entire public school. They are having fantastic results and the tide is reversing. The program is expanding across the country. For more information, visit The National Church Adoptive School Initiative.
- Nightingale, F. (1969). Notes on Nursing: What it is, and what it is not. Mineola, NY:Dover Publications, 7
