The life of Florence Nightingale

by Sarah A. Tooley

Her first published work after her return home was a statistical account of her distribution of the “Voluntary Contributions,” placed at her disposal for the sick soldiers, which has already been dealt with. In the following year (1858) she issued her Notes on Matters affecting the Health, Efficiency, and Hospital Administration of the British Army, which was of great value to the Commission on the War, then sitting, and led to the institution of many reforms.

In 1859 Miss Nightingale published her Notes on Hospitals, the basis of which was a paper she prepared for the Social Science Association. “It may seem a strange principle,” she writes with grim humour, “to enunciate as the very first requirement in a hospital that it should do the sick no harm. It is quite necessary, nevertheless, to lay down such a principle, because the actual mortality in hospitals, especially in those of large crowded cities, is very much higher than any calculation founded on the mortality of the same class of diseases among patients treated out of hospital would lead us to expect.”

It was the knowledge of this unsatisfactory fact which led Miss Nightingale to thoroughly investigate the influence which hospital construction exercised on the death-rate of patients received into the wards. The result was her Notes on Hospitals, which in the enlarged edition, published in 1863, became a standard work on the subject. It is technical in character, and, in addition to recommendations on the conduct and arrangements of hospitals, gives plans for hospital construction. It covers the whole field from floors and walls to hospital furniture.

In the following year of 1860 came that ever popular book, Notes on Nursing: What it Is, and What it is Not, of which more than one hundred thousand copies have been sold. In it Miss Nightingale gives such homely advice as can be put into practice by every girl and woman in the land. The subject is always topical, and I cannot do better than cull some of the words of wisdom from the Queen of Nurses.

The Notes, she explains, are not intended as a manual for nurses but simply to give hints for thought to women who have personal charge of the health of others, and almost every woman in England has some time or other the charge of the health of another. “Every woman is a nurse.” Then she proceeds with piquant saying and homely illustration to give simple rules for the amateur nurse. “No need to discuss,” she says, “whether the top of Mont Blanc will ever be inhabited—it will be thousands of years before we have reached the bottom of Mont Blanc in making the earth healthy. Nursing has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, quiet, and proper selection and administration of diet.”

She goes on to refer to the “coxcombries” of education, by which the elements of astronomy are taught to every schoolgirl while the future wives and mothers are not instructed in those laws which God has assigned to the relations of our bodies with the world in which He has put them. It is no use to blame the climate, which we cannot control, for sickness. “What can we do with the east wind?” people ask.

“Who is it who knows when the wind is in the east?” returns Miss Nightingale. “Not the Highland drover, certainly exposed to the east wind, but the young lady who is worn out with the want of exposure to fresh air, to sunlight. Put the latter under as good sanitary condition as the former, and she too will not know when the wind is in the east.”

Miss Nightingale groups young ladies and soldiers together as the most frequent victims of consumption, owing to foul air and exposure to chills. “Young ladies, like soldiers, go out in all weathers, the one to parties, the other to sentry duty; both enter foul air, the one in ball-rooms, the other in guard-rooms; both go home in damp night air after skin and lungs are oppressed in their functions by overcrowding.” She implores young ladies to open their windows and bedcurtains at night, and not be afraid of spoiling their complexions. This was written, it must be remembered, more than forty years ago, when girls were more afraid of fresh air than they are to-day, now that cycling, hockey, and golf have inured them even to east winds.

After dealing with household hygiene in chapters on “Ventilating and Warming,” and “Health of Houses,” she proceeds to consider the bad results of “Petty Management,” under which heading the want of relays of nurses is dealt with both in institutions and in private homes. A tired, jaded nurse is almost worse than no nurse at all. The nurse must have needed rest; still, the patient should not be left alone. “I once heard a neglectful official rebuked,” says Miss Nightingale, “in the words, ‘Patients, sir, will not stop dying while we are in church.’”

The subject of “Noise” gives Miss Nightingale the occasion to speak plainly on the dress of the amateur nurse. She wrote in the days of crinolines, but her strictures would equally apply to the woman who in modern times gets her long skirts entangled in the furniture, and creates as much noise and upset in the sick chamber as did the nurse of the olden days with her crinoline. Miss Nightingale endorses Lord Melbourne’s sentiments when he said: “I would rather have men about me when I am ill. I think it requires very strong health to put up with women.” It was “the fidget of silk and crinoline, the crackling of starched petticoats, the creaking of stays and shoes,” which led Lord Melbourne to make this ungallant observation.