Notes on Nursing

Nonfiction | Book | Adult | Published in 1860

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Summary

Chapter Summaries & Analyses

Preface-Chapter 4

Chapters 5-7

Chapters 8-10

Chapters 11-13

Conclusion and Supplementary

Key Figures

Themes

Index of Terms

Important Quotes

Essay Topics

Tools

Beta

Discussion Questions

Chapters 8-10Chapter Summaries & Analyses

Chapter 8 Summary: “Bed and Bedding”

While a fever is often considered the result of an illness, it’s most often the result of improper bedding. The patient can’t be left to sleep in a bed that’s unclean, damp, too cold, or too warm. The sick bed should be built to properly serve both patient and nurse: just the right height and width for the patient to be properly elevated off the floor but not so wide that the nurse can’t reach across it. The bed shouldn’t be in a place that’s damp or dark and should always be properly prepared. While many would consider the bed care outside the nurse’s responsibility, the nurse’s duty is to ensure that the bed is made up correctly and provides the proper support for the patient (who will spend most of the time convalescing in bed).

Chapter 9 Summary: “Light”

Second in importance only to the need for fresh air is the need for sunlight. Being in the dark is detrimental to one’s health; light has a purifying effect on the environment. When possible, the bedroom and sick room should be different rooms so that each can be inundated with fresh air and sunlight by moving the patient from one room to the other. During the day, the sick room can be bathed in as much light as circumstances allow—and during the night, making the bedroom as dark as possible helps the patient sleep.

Chapter 10 Summary: “Cleanliness of Rooms and Walls”

While the importance of light and fresh air can’t be overstated, their effectiveness is minimal if the room isn’t kept to an impeccably high standard of cleanliness. Removing dust is crucial—not simply moving it from one part of the room to another. The only dusting that can be truly called cleaning removes dirt and dust altogether using wet rags and proper cleaning supplies. Covering up dirt and dust isn’t a substitute for removing it.

The worst culprit for unsanitary sick rooms is carpet, which retains dirt, dust, filth, and excreta that should be removed—and could be if the floors were of a hard substance: “[A] dirty carpet literally infects the room” (65), and when it becomes damp, it’s even more unhygienic and dangerous to the patient. Like carpet, wallpaper attracts and retains dust and similar particles.

Chapters 8-10 Analysis

Returning to environmental factors, Nightingale discusses the importance of proper care of proper bedding, proper levels of light (especially natural light), and proper cleanliness for patients who are convalescing. While many in her era were principally concerned that the patient not catch cold while in bed, Nightingale warns that patients often develop fever if their bed is insufficiently made up. Many factors affect the proper care of a patient in bed: It must not be too warm or too cold, it must not be unclean, and it must not be at all damp. The bed must provide conditions ideal for the individual circumstances and, above all, must be clean and dry.

Additionally, the bed must be ideally suited for the nurse’s caretaking convenience. A bed that’s too wide, for instance, can prevent convenient access to the patient and is thus unsuitable for sustained care. Nightingale’s promotes mutual support that maximizes both the patient’s ability to heal properly and the nurse’s ability to assist in the healing process. Convenience in this instance isn’t to give the lazy and incompetent an easy path; rather, it’s to facilitate efficient and effective care and, in turn, support patient comfort and recovery.

Almost as important as fresh air and pure water is light, which has both physical and mental benefits on healing. The physical benefits of light are simple: Sunlight is a natural disinfectant and greatly assists in purifying the patient’s room and the environmental elements in it. The mental benefits of light (especially natural light) are practically incalculable and exponentially assist in a sick patient’s recovery. The presence of light, however, can’t make up for a filthy room; no amount of sunlight can eliminate the negative effects of layers of dust and the presence of damp or filth in a sick room.

Again proving herself ahead of her time, Nightingale anticipates the discovery of microbes and entities like dust mites that can harmful well and sick people alike. While not addressing germ theory, which was only discovered and promulgated in the decades after this text was published (the causes of tuberculosis and cholera, for instance, were only discovered at the end of the 19th century), Nightingale nevertheless warns against the harmful effects of dust and filth. Railing against the day’s common thinking, she elaborates on the dangers of wallpaper and carpeting as vectors of contamination and illness due to their natural tendency to retain infection and disease. A sterile environment helps patients, while the lack of proper hygiene is necessarily harmful.