Florence Nightingale: Legado, presente y perspectivas en tiempos de pandemia de COVID-19

Breigeiron, Márcia Koja; Vaccari, Alessandra; Ribeiro, Sofia Panato

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Revista Brasileira de Enfermagem

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REFLECTION • Rev. Bras. Enferm. 74 (Suppl 1) • 2021 • https://doi.org/10.1590/0034-7167-2020-1306 copiar

Florence Nightingale: Legado, presente y perspectivas en tiempos de pandemia de COVID-19

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Reflejar acerca de la influencia de las enseñanzas de Florence Nightingale para el enfrentamiento de la pandemia de COVID-19 y sus repercusiones al futuro de la profesión.

Métodos:

Estudio descriptivo del tipo reflexivo, realizado entre mayo y julio de 2020, por medio de revisión narrativa acerca de la temática y debates entre las autoras.

Resultados:

Los hallados están divididos en dos capítulos, a saber: la Teoría Ambientalista y las enseñanzas de Florence Nightingale frente a la pandemia de COVID-19; y Florence Nightingale: legado, presente y perspectivas.

Consideraciones finales:

Aún los estudios de Florence Nightingale con la Teoría Ambientalista y sus enseñanzas como enfermera son válidos, mismo después de casi dos siglos desde su preludio, y deben continuar sirviendo como base para la consolidación de la profesión de enfermería.

Descriptores:
Historia de la Enfermería; Rol de la Enfermera; Pandemia; Coronavirus; COVID-19

Florence Nightingale Legacy	Present (COVID-19)	Perspectives (Future)
Hygiene and cleaning Florence Nightingale's main messages about essential factors in disease prevention: washing hands with soap and water; cleanliness of the environment; air circulation; lighting; hygiene of the sick and professionals; and house hygiene⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾-⁽²2 Frello AT, Carraro TE. Florence Nightingale's contributions: an integrative review of the literature. Esc Anna Nery. 2013;17(3):573-9. https://doi.org/10.1590/S1414-81452013000300024 https://doi.org/10.1590/S1414-8145201300... ⁾⁾.	Hygiene and cleaning of hands, surfaces, clothes, shoes, and alcohol gel are guidelines that have never been more important and disseminated by all professionals. However, although basic, these principles showed a series of situations of global fragility.	Hygiene practices have helped to transform public health concepts and must be maintained by professionals and the population in general. Basic hygiene procedures are an indispensable way to combat microorganisms and must be respected, reducing the spread of various diseases.
Physical and mental health Florence Nightingale valued the importance of beneficial environments for mental and physical health, as she believed that patients were less likely to improve if they became depressed or desperate. In Army hospitals, she encouraged soldiers to read, write letters and talk⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾-⁽³3 Nightingale F. Notas sobre enfermagem: o que é e o que não é. São Paulo: Cortez; 1989.⁾⁾.	Maintaining physical and mental health provides awareness and sensitivity to deal with the situation in a calm manner. Therefore, reading, interacting with others and practicing physical exercises are important to preserve physical and mental health in days of social detachment and work overload.	Thoughts, feelings, and behaviors have a major impact on the state of physical health. On the other hand, the state of physical health has a considerable influence on well-being and mental health. Thus, it is important to know this link between mental and physical health for disease prevention. We must work more effectively on emotional/mental health with the members of our team, adding professionals with knowledge and experience in this area.
Work Organization Nightingale instituted the definition of tasks, service protocols and organization of professional practice as a work model. With the implementation of the technical division of nursing work, he developed the first model of nursing care through the systematization of work, in addition to having contributed to the development of public health⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾-⁽²2 Frello AT, Carraro TE. Florence Nightingale's contributions: an integrative review of the literature. Esc Anna Nery. 2013;17(3):573-9. https://doi.org/10.1590/S1414-81452013000300024 https://doi.org/10.1590/S1414-8145201300... ⁾⁾.	Protocols are fundamental in the organization of the care team, with many nurses being on the front line as responsible for the development of managerial and care protocols to combat the pandemic. Thus, protocols gain greater importance in the work of everyone, including other health professions.	The work based on protocols adds qualified and equitable assistance to patients and provides greater security not only for them, but also for professionals. However, as health professionals, we must always respect the individuality of those we are caring for and, even working with protocols, always remember that we deal with people.
Social distancing Florence Nightingale, in a period of social isolation due to an infection (brucellosis), produced a 900-page report on failures in care during the Crimean War (1853-1856) and a book on hospital design⁽⁽³3 Nightingale F. Notas sobre enfermagem: o que é e o que não é. São Paulo: Cortez; 1989.⁾⁾.	Around the world, social distancing initiatives have been instituted to combat the spread of the new coronavirus.	The social distancing carried out in an organized way is necessary to reduce the transmissibility of highly contagious microorganisms, making us rethink our social coexistence habits. This is a time when many health professionals take the opportunity to study about new perspectives of care, such as call centers, monitoring and health consultancy, which should have their use improved in the near future.
Research, theory and practice Florence Nightingale aligned the observations of her work with the teachings received, testing her ideas and perceptions in practice. In addition, she created the Rose Diagram⁽⁹⁾, to visualize data on contamination, considered a revolutionary method for those times⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾⁾.	The monitoring of statistical data used in public health has an influence coming from another great contribution of Florence Nightingale: the use of graphs to improve data interpretation.	Professional practice combined with scientific evidence supports health policies that save lives.
Training of professionals Nightingale defended nursing as a science that requires training and professional knowledge⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾⁾.	Remote training for the use of clinical protocols aimed at the care of patients and professionals, within the scope of health promotion, disease prevention, treatment, and rehabilitation, is being essential. During the pandemic, online teaching technologies were perfected and new technologies were developed, such as: videos, podcasts, blogs, infographics, serious games, virtual meetings and tele-simulation.	Systematic training supports quality care and brings financial returns to institutions that invest in their professionals. The new technologies for training and teaching will be better consolidated based on the correlation with innovative/active pedagogical methodologies and the constant technological development in education.
Teaching In a society in which only the voices of men were heard, Florence Nightingale devoted herself to scientific research and invested in education. In care, she defended the importance of well-trained nursing through quality teaching⁽⁽²2 Frello AT, Carraro TE. Florence Nightingale's contributions: an integrative review of the literature. Esc Anna Nery. 2013;17(3):573-9. https://doi.org/10.1590/S1414-81452013000300024 https://doi.org/10.1590/S1414-8145201300... ⁾⁾.	Governments need to invest massively in nursing education, creating jobs, and promoting the leadership of these professionals to ensure that there are enough of them with the right skills for effective, equitable and sustainable health systems.	The reflection on the nurse's training process, regarding the theoretical and practical articulation, should support the reorientation of doing and knowing. This reflection needs to be a priority so that changes can be made in nursing education and that these are consistent with the needs of the contemporary world.
Profession and innovation Florence instituted nursing as a profession, giving visibility to professionals. Likewise, it innovated when it gave priority to caring for people and not just the health-disease process⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾⁾.	The concepts of health and quality of life are constantly transformed as innovation and human complexity change. Nursing teams around the world have been innovating for evidence-based care and scientific knowledge, seeking greater therapeutic benefit for people with COVID-19.	Florence Nightingale's teachings configure the bases of nursing care, reinterpreted in the concepts of person/environment, nursing/professional and health/disease; and they must continue to support our profession as well as helping innovation and entrepreneurship in nursing.
Profession and leadership Florence Nightingale encouraged clinical, care and administrative leadership; and used statistical data for hospital reform⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾-⁽²2 Frello AT, Carraro TE. Florence Nightingale's contributions: an integrative review of the literature. Esc Anna Nery. 2013;17(3):573-9. https://doi.org/10.1590/S1414-81452013000300024 https://doi.org/10.1590/S1414-8145201300... ⁾⁾.	Nursing is playing a fundamental role in the actions of protection and assistance to individuals, considering the social determinants that are involved in the issue of transmission and increase in the number of cases of COVID 19.	Ability to communicate, resolve conflicts and take initiative are essential leadership attributes for the nursing profession, which contribute to care.
Ethics Nightingale stood out for the ethical conduct of his achievements as a nurse⁽⁽¹1 Costa R, Padilha MI, Amante LN, Costa E, Bock LF. O legado de Florence Nightingale: uma viagem no tempo. Texto Contexto Enferm. 2009;18(4):661-9. https://doi.org/10.1590/S0104-07072009000400007 https://doi.org/10.1590/S0104-0707200900... ⁾⁾.	Always care for the person we care for and the ethics of the profession.	Provide ethical, scientific, safe and quality assistance.

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[1] Corresponding author: Márcia Koja Breigeiron E-mail: mbreigeiron@gmail.com