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Elements of Care: Nursing Environmental Theory in Historical Context

Libster, Martha M. PhD, RN

doi: 10.1097/01.HNP.0000318025.37904.6c

The natural elements ether, fire, air, water, and earth foundational to many healing traditions are also present in nursing history. Regulation of these elements can be traced to 19th-century nurses' “sickroom management.” Nightingale's Notes on Nursing and Coskery's Advices Concerning the Sick provide examples of holistic application of the elements of care.

School of Nursing, East Carolina University, Greenville, North Carolina.

Corresponding Author: Martha M. Libster, PhD, RN, School of Nursing, East Carolina University, Health Sciences Bldg 3185H, Greenville, NC 27858 (

© 2008 Lippincott Williams & Wilkins, Inc.