When one thinks about clinical nursing practice in general terms, the patient’s well-being is of paramount concern.  Focus is placed on both physiological and psychological parameters with emphasis on meeting Maslow’s hierarchy of needs not withstanding environmental and social-demographic variables.  And yet, the majority of nurses in clinical nursing practice have relatively little training in the key science area of Nutrition.  In historical terms, Florence Nightingale led the visionary pathway to recognize the importance of diet, observation and individual well-being.   Ms. Nightingale’s emphasis on the importance of “cookery” in nursing the sick led the pathway for recognition of the importance of food and nutrition in nursing practice (Hertzler, 2004). While nurses include dietary observations in their daily clinical practice, there should be a renewed focus and emphasis on strengthening their framework of nutrition.

Importance of Nutrition as a Physiological Need

Without the continued input of food and water containing essential nutrients, all of us would suffer the effects of malnutrition leading to coma and death.  Nutrition is more than dietary observation. It is important for nurses to have a thorough understanding of nutrient needs (essential and non-essential) in order to be able to assess, implement and evaluate outcomes for patients.  Nutritional factors include autoimmune, allergic responses, dietary-medication interactions and metabolic/digestive ailments that may alter typical responses during the digestive absorptive process.

Importance of Nutrition as a Psychological Need

And while most individuals focus on nutrition as a physiological need, there is ample research to suggest that nutrition (foods choice selections and eating patterns) are affected and/or mediated by not only a physiological response but rather a physiological stimulus. Thus, food and body and mind are connected in neural pathways that may present in various ways.  Individual reactions to foods are mediated by the combination of each person’s unique body system.  Harkening back to Florence Nightingale, she realized this fact that an individual’s response should dictate the dietary approach to be taken with a patient.

Combining Clinical Practice and Nutrition

So, what would Florence Nightingale think about the current state of “clinical practice and nutrition”? First and foremost, the basic elements that she addressed are as timely and significant today as they were in the past.  Concern for the patient remains a holistic approach with ample attention given to achieving the delicate balance of health.  In terms of where to begin as a prelude to research, start at the beginning – go back to Notes on nursing and read the chapters on “Taking food” and “What food?”  And then, proceed forward towards collecting new knowledge by participating in interdisciplinary teams and collaborating with dieticians in clinical practice.  Work on developing a strong network of evidence based practice and applying it to your clinical practice.  Ms. Nightingale used the term, “nutrition” 4 times and mentioned “food” 62 times in her classic volume, Notes on nursing.  The importance of nursing observations: assessments, planning, implementation and evaluation are essential parts of assisting patients to maintain adequate nutrition and hydration and are part of each nurse’s responsibility (Bloomfield & Pegram, 2012). As nurses, we must remain committed to including nutrition management as an essential part of our clinical practice.

References

Bloomfield, J. & Pegram, A. (2012). Improving nutrition and hydration in hospital: the nurse’s responsibility. Nursing Standard, 26(34), 52-56.

Hertzler, A.A. (2004). Florence Nightingale’s influence on civil war nutrition. Nutrition Today, 39(4), 157-160.

Nightingale, F. (1860). Notes on nursing: what it is, and what it is not (London: Harrison, [1860]). MU Special Collections, Rare Book collection, TR51, N68.   Food Revolutions. Science and Nutrition, 1700-1950. Retrieved from: https://library.missouri.edu/exhibits/food/nightingale.html

About the Author

Daryle Wane, PhD, ARNP, FNP-BC has 37 years’ experience in the professional discipline of nursing and 25 years’ experience in higher education and is currently the BSN Program Director of the Bachelor of Science in Nursing Program at Pasco-Hernando State College in New Port Richey, Florida.  Dr. Wane has taught nursing classes across the curriculum and designed nursing programs functioning as a subject matter expert and participant member of Instructional Technology Design team.  Dr. Wane has also authored several publications in nursing and nutrition, and serves as a Peer Reviewer for several journals/organizations as well as being an Academic Editor for Medicine and on the Editorial Board of Annals of Public Health and Research Journal. Dr. Wane has given a keynote address at 2016 2nd  Florida Nursing Association (FNA) Nursing Research & Evidenced Based Practice Nursing Conference and will also be giving a keynote address at the 2nd National Nursing World (NCW) Conference in Las Vegas to be held in October 2017.