The Nightingale-KOMI Care Theory

My 30years with Nightingale’s thoughts, Hitoe Kanai, 1997

It was in 1970, just after I graduated from a nursing school, when I encountered these words of Florence Nightingale:

Nurse’s work means downright work, in a cheery, happy, hopeful, friendly, spirit. An earnest, bright, cheerful woman, without that notion of “making sacrifices,” etc., perpetually occurring to her mind, is the real nurse.

(Addresses to Probationers and Nurses of the Nightingale school at St. Thomas’s Hospital, 1875)

When I read it, something inspired me and the idea struck that she was a ‘true’ nurse. I felt something was urging me on to know ‘real’ Nightingale (not Nightingale as the lady with the lamp) and to truly understand the legacy she left to the nurses to come. Since then I have been studying Nightingale’s thoughts in depth, and it’s been nearly 30 years, more than half of my life. I cannot help thinking that time flies when I see the new century waiting for us just around the corner.               

Last 30 years, I have been trying to find a way to connect Nightingale’s ideas to our country’s nursing practice, by looking into her life, reading most of her writings again and again, visiting her birth place to feel her existence, and reflecting on all I learnt. Now my efforts seem to have blossomed and I have a clear idea of the principals of nursing, which was vague in my younger days. As a nurse it is a pure joy to consolidate such an idea and I feel wholly contented with my past researches on Nightingale.

I do love the profession of nursing. I hope that the real meaning of nursing is widely understood and put into practice. In order to achieve it, I believe that nurses themselves should actively comprehend the true aim of their profession, and strive to reflect the idea into their daily works.

However, it seems that most Japanese nurses have not yet understood the principles of nursing.Many words are told and many books are published to explain about the profession, but practitioners are still uncertain and keep asking questions like ‘what is nursing?’ or ‘am I doing a right thing?’ It is a great pity that we do neglect the quintessence of nursing, which Nightingale suggested and tried to pass on to our generations.

I therefore decided to play a part as a reformer and a missionary of Nightingale’s thoughts in order to pass her ideas on to Japanese nurses, and to define the theoretical bases that reflect Nightingale’s thoughts for our country’s nursing care practice. Luckily enough, last 20 years I have constantly and eagerly asked by the Japanese nursing world to give lectures on the subject. By responding to Japanese nurses’ keen interests, my understandings on Nightingale’s thoughts deepened. In that sense, it was the Japanese nursing world that has supported and allowed me to pursue my study and research. Many people, both academics and practitioners, also guided me to achieve the aim I set. Had it not been for their kind help, I would not have been able to complete this task. I believe my deep appreciation should be most effectively shown by sincerely pursuing my work in the future.

During last 25years, our country has become an aging society, and the structure of diseases in the society has changed. Such a change is causing the shortage of family care givers and has become one of the serious issues in our country. This issue urges the reformation of the healthcare and the social welfare systems, and we now need a new structure to solve the problem we are facing.

Our country’s welfare system, especially the part directly related to our growing aging society, has been rapidly changing during last decade, and I have been acting as a bridge between ‘the hospital nursing world (=healthcare system)’ and ‘the home & community caring world (=social welfare system)’ by providing theoretical suggestions through my study on Nightingale’s philosophy. I believe that reformation of the systems should not be very difficult, as, in fact, they were treated as connected issues in England in the 19th Century by Nightingale.

By considering our country’s unique needs, I further developed my understandings of Nightingale’s ideas on nursing, and eventually established my own nursing care theory. It is now called ‘The Nightingale KOMI Care Theory’.

The Term KOMI is derived from my married surname, Kominami, and I playfully think that KOMI also stands for Kanai’s Original Modern Innovation. It has been my (Kanai’s) dream and lifework to establish my own nursing care theory that fully reflects Nightingale’s thoughts, and so perhaps the Japanese nursing world would not mind even if they realise that the name includes my tiny ‘ego’.
We hold seminars to introduce this theory throughout the year, and are happy that a lot of people from the related professions willingly attend it every year.

The KOMI Care Theory has its own recording system called the KOMI Care System, which in practice supports to connect the hospital nursing and the home & community care. The theory, together with the system, is expected to develop and grow as the theoretical foundation to lead nursing care practice in Japan in the coming century. I hope that the seminars’ graduates who have fully comprehended the true aim of their profession will strive to reflect what they understood into their daily works. Their small actions will eventually make a huge impact on our nursing care world and force it to change. Through putting the KOMI Care Theory into practice, I believe that we are creating the society that Nightingale imagined here in Japan in the 21st century.

(C) F.N.A. All rights reserved.