NUR 600 M2 Nursing Reflection Assignment
NUR 600 M2 Nursing Reflection Assignment
Florence Nightingale’s legacy in nursing continues to inspire reflection on how the environment shapes health outcomes. According to Prasetyo and Rofi’i (2025), Nightingale’s vision emphasized the importance of surroundings in patient recovery, a perspective that remains relevant as modern healthcare confronts complex challenges. Nurses today navigate evolving systems where environmental factors, policy decisions, and interdisciplinary collaboration intersect to influence patient well-being. Revisiting Nightingale’s ideas provides an opportunity to connect historical foundations to contemporary practice, encouraging critical reflection on how theory informs action. In academic and clinical settings alike, such reflection strengthens professional identity and guides evidence‑based care. This discussion explores Nightingale’s Environmental Theory, its application to the 2023 Wildfire Smoke Crisis, interdisciplinary perspectives, stakeholder involvement, and measurable outcomes in nursing practice.
Nightingale’s Theory
Nightingale’s Environmental Theory established nursing as a discipline deeply connected to the conditions in which patients are cared for. She emphasized that recovery was not dependent solely on medical interventions but on the quality of air, water, light, cleanliness, and nutrition available to individuals. Nurses were expected to observe these factors carefully and adjust them to promote healing. This framework shifted nursing from a task‑based occupation to one rooted in scientific reasoning and environmental stewardship. The theory underscored prevention, dignity, and holistic care, positioning nurses as advocates for healthier surroundings. As Hegge (2013) highlights, Nightingale’s insights redefined nursing practice by linking patient outcomes directly to environmental management, thereby laying the foundation for modern approaches to public health and evidence‑based nursing care.
Health, healing, and nursing care are profoundly shaped by environmental conditions that either support or hinder recovery. Patients exposed to clean air, pure water, adequate warmth, and quiet surroundings experience greater comfort and resilience, while those in neglected environments face delayed healing and increased complications (Hegge, 2023). Nurses respond by ensuring safe clinical spaces, monitoring for hazards, and educating patients on how to minimize risks in their communities. These responsibilities extend beyond bedside care to include advocacy for healthier policies and environments. Nightingale envisioned nurses as agents of change, responsible for aligning external conditions with the body’s natural reparative processes. This perspective remains vital today, guiding nursing practice in infection control, community health, and environmental health promotion.
Current Environmental Problem: 2023 Wildfire Smoke Crisis
In June 2023, smoke from extensive Canadian wildfires blanketed large portions of the United States, driving air quality indices into hazardous ranges. The American Lung Association reported that this event caused record spikes in particle pollution (PM2.5), with millions exposed to unhealthy air (American Lung Association, 2026). Environmental factors such as prolonged drought, extreme heat, and dense forest fuel loads intensified the fires, while atmospheric patterns carried smoke across state lines. This crisis illustrated how environmental conditions — climate change, land management practices, and weather variability — directly contributed to deteriorating air quality. The event highlighted the fragility of environmental systems and demonstrated the profound influence of ecological forces on public health.
The health consequences of the wildfire smoke crisis were immediate and widespread. Vulnerable populations, including children, older adults, and outdoor workers, experienced the greatest harm. McArdle (2023) documented increases in emergency department visits for asthma during Canadian wildfire smoke episodes, demonstrating the direct respiratory consequences of prolonged exposure to smoke. Communities faced school closures, canceled outdoor activities, and disruptions to daily life. Hospitals reported surges in admissions, straining resources and staff capacity. Beyond acute illness, prolonged exposure raised concerns about long-term respiratory damage and psychological stress from living under persistent environmental threats. This event underscored how environmental degradation translates into tangible health inequities, disproportionately affecting marginalized populations with limited access to protective measures.
The wildfire smoke crisis prompted significant political and legal responses. In 2024, the Environmental Protection Agency [EPA] issued updated Clean Air Act guidance on wildfire smoke events, emphasizing state responsibilities for emergency air quality management (EPA, 2024). Federal and state governments declared public health emergencies, distributing masks and issuing advisories. Policy debates intensified over climate change mitigation, forest management, and cross-border accountability amid Canadian wildfires that directly affected US air quality. Legal challenges also emerged over emission standards, with industry groups contesting stricter regulations aimed at reducing greenhouse gas emissions. These developments illustrate how environmental health crises reflect natural forces, political priorities, regulatory frameworks, and legal disputes shaping the scope of protective action.
Compare Nursing with Another Discipline: Public Health
Public health professionals approached the 2023 wildfire smoke crisis with a focus on population-level strategies, emphasizing surveillance, prevention, and policy coordination. Agencies monitored air quality indices, issued advisories, and collaborated with environmental scientists to track smoke dispersion. Educational campaigns informed communities about protective measures, including limiting outdoor activity and remaining indoors when air quality deteriorated. These measures also included improving indoor air filtration and using properly fitted N95 masks to reduce exposure to harmful smoke. This discipline framed the crisis as a systemic challenge requiring coordinated responses across government, healthcare, and community sectors, ensuring that interventions reached entire populations rather than individual patients (Vargo et al., 2023).
Nursing, in contrast, addressed the crisis through direct patient care, education, and advocacy. Nurses managed symptoms in clinical settings, treating asthma exacerbations, respiratory distress, and cardiovascular complications associated with smoke exposure. They educated patients about practical protective strategies, including using indoor air purifiers, limiting outdoor exposure, and adhering to medication regimens. Nurses also advocated for healthier environments. During the 2023 crisis, they played a frontline role in triaging patients, coordinating care, and effectively supporting overwhelmed emergency departments. Their patient-centered approach complemented public health’s population-level strategies, demonstrating that an effective response required both disciplines to work in tandem to bridge systemic protections and individualized care (Quary & Slota, 2024).
Stakeholders and Resources
Stakeholders in the 2023 wildfire smoke crisis included federal agencies, state governments, healthcare providers, and community organizations. The Environmental Protection Agency coordinated air quality monitoring and issued advisories, while state health departments declared emergencies and distributed protective equipment. Hospitals and nursing staff managed surges in respiratory cases, ensuring continuity of care despite strained resources. Community organizations played a vital role in reaching vulnerable populations by providing filtered-air shelters and distributing masks. Collaboration among these stakeholders was essential to mitigate exposure risks and protect public health. Chen et al. (2023) note that the crisis demonstrated that environmental health emergencies demand coordinated, multi‑sector responses. Each group contributed distinct expertise, underscoring the need for policy, healthcare, and community support to converge to safeguard populations during environmental disasters.
Resources mobilized during the crisis included emergency funding, protective equipment, and public health infrastructure. Federal and state governments allocated funds for air quality monitoring, hospital surge capacity, and community outreach. The Centers for Disease Control and Prevention provided technical guidance on protective measures, while local agencies distributed N95 masks and established clean air shelters (Public Health Agency of Canada, 2024). Nursing resources were particularly critical, as staff adapted clinical protocols to manage smoke-related illnesses and educated patients on self-care strategies. Legal frameworks under the Clean Air Act supported resource allocation by mandating emergency responses to hazardous air quality events. These resources highlighted the importance of preparedness, ensuring that healthcare systems and communities could respond effectively to environmental health threats while minimizing inequities in access to care.
Measurable Outcomes in Nursing Practice
Proposed nursing interventions during the wildfire smoke crisis include implementing standardized respiratory triage protocols, expanding patient education on protective behaviors, and coordinating with public health agencies to establish clean air shelters. Evaluation would rely on measurable indicators such as reductions in emergency department wait times, decreased hospital readmissions for asthma exacerbations, and improved patient adherence to inhaler regimens. Surveys could assess patient knowledge of smoke‑related risks before and after nursing education sessions, while hospital data would track changes in acute respiratory admissions. According to Sandova (2025), outcome evaluation must integrate both clinical metrics and patient-reported measures, ensuring that interventions are medically effective and empower communities to adopt sustainable protective practices during environmental health emergencies.
Additional solutions include distributing N95 masks through nursing‑led outreach, integrating telehealth consultations for vulnerable populations, and advocating for policy changes that strengthen emergency preparedness. Evaluation would focus on quantifiable outcomes: mask distribution rates, shelter utilization statistics, and telehealth appointment completion rates. Patient satisfaction surveys would measure perceived accessibility and effectiveness of nursing interventions, while community health reports would document reductions in respiratory complications among populations receiving targeted support. Outcome indicators must capture both equity and efficacy to ensure that marginalized groups benefit from interventions. Success would be demonstrated through measurable declines in smoke‑related hospitalizations, increased patient engagement in protective behaviors, and enhanced resilience of healthcare systems to withstand future environmental crises.
Conclusion
Nightingale’s perspective continues to remind nursing professionals that meaningful care begins with understanding the broader conditions that influence health and recovery. The 2023 wildfire smoke crisis brings this principle into sharp focus, revealing how environmental threats can simultaneously affect individuals, communities, and healthcare systems. Such challenges require nurses to look beyond immediate symptoms and recognize the value of prevention, education, advocacy, and collaboration. Working alongside public health professionals, government agencies, and community partners allows nursing practice to become more responsive, equitable, and prepared for emerging threats. When measurable outcomes and thoughtful reflection guide these efforts, nurses can strengthen both patient care and community protection. This responsibility ultimately sustains nursing’s enduring commitment to promoting health wherever people live.
References
American Lung Association. (2026). Wildfire smoke is now a nationwide health threat. American Lung Association. https://www.lung.org/blog/wildfire-smoke-nationwide
Chen, K., Ma, Y., Bell, M. L., & Yang, W. (2023). Canadian wildfire smoke and asthma syndrome emergency department visits in New York City. Jama, 330(14), 1385-1387. https://doi.org/10.1001/jama.2023.18768
Hegge, M. (2013). Nightingale’s environmental theory. Nursing Science Quarterly, 26(3), 211–219. https://doi.org/10.1177/0894318413489255
McArdle, C. E. (2023). Asthma-associated emergency department visits during the Canadian wildfire smoke episodes—United States, April–August 2023. MMWR. Morbidity and Mortality Weekly Report, 72. http://dx.doi.org/10.15585/mmwr.mm7234a5
Prasetyo, Y. A., & Rofi’i, A. Y. A. B. (2025). Carrying the torch of Nightingale’s legacy into health reform: A nursing perspective. Journal of Holistic Nursing Science, 12(2), 333–340. https://doi.org/10.31603/jhns.v12i2.1419
Public Health Agency of Canada. (2024). Wildfires in Canada: Toolkit for Public Health Authorities [Internet].
Quarry, C., & Slota, M. (2024). Critical Care Nursing Response to the Maui Wildfire Disaster: Narrative Review and Case Study. AACN Advanced Critical Care, 35(4), 334–342. https://doi.org/10.4037/aacnacc2024456
Sandoval, S., Bui, J., & Hopfer, S. (2025). Wildfire and smoke risk communication: A systematic literature review from a health equity focus. International Journal of Environmental Research and Public Health, 22(3), 368. https://doi.org/10.3390/ijerph22030368
US Environmental Protection Agency. (2024). EPA finalizes stronger standards for harmful soot pollution, significantly increasing health protections. US Environmental Protection Agency. https://www.epa.gov/newsreleases/epa-finalizes-stronger-standards-harmful-soot-pollution-significantly-increasing
Vargo, J., Lappe, B., Mirabelli, M. C., & Conlon, K. C. (2023). Social vulnerability in US communities affected by wildfire smoke, 2011-2021. American Journal of Public Health, 113(7), 759–767. https://doi.org/10.2105/AJPH.2023.307286
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Directions:
Florence Nightingale was a leader in nursing whose writings led to the foundation of many of our current nursing philosophies and theoretical models. Although there have been significant changes in our society and health care since her era, one can identify evidence of her writings and practice in current nursing practice. For this assignment, read “Nightingale’s Environmental Theory” published by Margaret Hegge in Nursing Science Quarterly, 26(3), 211–219. The article can be accessed on the D’Youville Library website, and a PDF copy of this article can be found in the Library Resource section of the NUR 600 course. In this article, Dr. Hegge describes the environmental theory from Nightingale’s experiences.
In your writing, please address the following topics:
Introduction to the main topic of the paper
Describe Nightingale’s Theory
Explain the current (actual or potential) environmental problem faced by patients or communities. Be sure that the problem is within the past 5 years and show the impact of the environment on the health problem. Discuss political influences, policy issues, and legal influences on the problem. Examples of current environmental problems include: COVID-19, the Flint Water Crisis, air pollution, etc.
Compare and contrast one other discipline (e.g., PT, OT, Pharmacy, Social Work, Nutrition, etc.) with nursing in examining the problem
Discuss stakeholders and resources involved in examining the problem
Discuss outcomes. How will you measure the success of the solutions you propose?
General directions for submitting the assignment:
Use subheadings for each topic following the grading rubric
The paper should be detailed with evidence
APA format should be used including a title page and references. You will lose credit if you do not follow APA format
The assignment should be submitted electronically as a Word document to the Canvas site
Before you begin writing, please review the grading rubric for this assignment. Be sure to proofread your work and confirm that you are meeting the grading criteria. Have someone proofread for you if you feel you need assistance with writing
Assignment is due on Sunday of Week 2 by 11:59pm EST
The D’Youville Librarians are available if you have difficulty accessing the article. You can contact a D’Youville Librarian