Florence Nightingale\'s Notes on Nursing

Florence Nightingale's Notes On Nursing

Florence Nightingale begins with her beliefs: that disease is the reparative process of Nature (p. 8). Disease is the natural processes of a human being hindered by lack of knowledge or neglect, the need for fresh air, light, warmth, quiet or cleanliness. Disease, she says, may also be due to lack of punctuality and care in administering the patient's diet, or a combination of some of each of these.

Therefore the nurse's job is to administer not only medicines or "poultices," but to provide all of the above necessary elements for a healthy life at the least expense of the patient's energy. Nightingale also says that pain and suffering is usually a symptom of the absence of good environmental surroundings, including the care given by the nurse. She puts little emphasis on remedies and medicine, though she asks that the nurse carefully administer them in helping the patient repair to natural health.

Nursing, according to Nightingale, is also extended to the well, providing clean, healthy surroundings for children (of whom half died before they were five years old, in her day). Accordingly, she specifies that the following be provided to both families and to sick patients in hospitals:

Ventilation and Warmth: Nightingale is an advocate of fresh air in every room at all times, along with warmth when one goes to bed with the windows open. Breathing one's own "putrefying" air is unhealthy, she says. She recommends testing the air and exchanging it so that it will not be foul. Keeping the patient's body warm and away from "night air" with warm bedclothes, a fire in the fireplace and hot drinks is vital to health. The smoke must not enter, the bedclothes should be aired and the chamber pot (toilet) smells should be contained. It is up to the nurse to clean utensils, close lids, open windows or clean a room for a patient.

Health of Houses: Nightingale said that houses must have:

Pure air

Pure water

Efficient drainage

Cleanliness, and Light.

The concept of houses built to allow light and air into every corner seems to be in favor these days, as Nightingale recommended. To raise children in this environment, she says, one would save money on doctor's bills. She believed that if one kept children in a clean place with proper diet and ventilation, that they would not even catch the measles.

Petty Management. Nightingale says that one's efforts, household items and even houses should be efficient, well-organized and clear to everyone, because the nurse may not always be with the patient and others will deal with the patient when she is not there. Nightingale talks about how the nurse's responsibility, as she is "in charge" is supremely important, and that means knowing what everything and everyone is doing and keeping everything about the house in order and functioning as it should.

Noise is the bane of a patient's existence and unnecessary noise is never to be allowed. People should whisper and the noises of a woman's dress rustling might be the thing that disturbs the patient and creates more illness. A hurried care with noises is most annoying. A punctual, calm, firm attitude on the part of the nurse may create a more healing atmosphere. Nightingale even tells the nurse how to read!

Variety: Nightingale says that colors and beautiful things about the patient, as well as the view, make a great deal of difference in the patient's ability to recover. Nurses should show the patients pictures and entertain them this way. Care, to Nightingale, means thinking of the patient's needs and desires for things to do and to be entertained.

Taking Food: The nurse must supply a patient's every need, including the food that brings recovery to the body. She is in favor of hot tea and something to eat every three hours. But she advises never to leave food by the patient and to not let the patient see others' food. Eating is to be done to the exclusion of business talk or things that might discourage digestion.

What Food: Hearty food, of course, should be given to the patient: meat, eggs, tea, milk, butter, bread and jelly. One should not give a patient cocoa.

Bed and Bedding: If the bedding is not correct, the patient will be feverish. Bedding should be cleaned often, airing the dirty sheets, one should use iron spring bedsteads and the bed should not be too wide or high. She also attributes scrofula, bed sores and soreness to improper bedding.

Light: Again, Nightingale extols the great benefit of light to ward off and cure illness.

Cleanliness of the rooms and walls are crucial, and one should remove dust, rather than "dusting" which throws it around. Carpets should also be cleaned.

Personal Cleanliness: "Poisoning by the skin" is attributed to lack of bathing, clean air and ventilation, so one should steam and rub the skin that is being bathed, as one gives the patient the equivalent of a sponge bath.

Chattering hopes and advices: She discourages friends of the ill to air their hopes for the patient in an attempt to cheer the sick. This puts false hopes in the heads of and annoys the patient if they are sensible.

Observation of the sick: When people inquire about the condition of the patient, the nurse should keep her opinion to herself, as there is no good answer to the question "is he better?" Under this heading, Nightingale addresses starvation, diarrhea, vomiting and fidgeting. These are observations by the nurse and do not tell her how well the patient is.