Miss Nightingale advises the private woman called upon to nurse in her own family to copy the neat, trim style of dressing adopted by the professional nurse. Her manner should be as motionless as possible. “Never gesticulate when speaking to the sick,” cultivate conciseness and calmness, and avoid an irresolute manner.
The chapter on “Variety” deals in a beautiful and sympathetic spirit with the effect of colour and variety of objects on the sick person. “The effect in sickness,” she writes, “of beautiful objects, of variety of objects, and especially of brilliancy of colour, is hardly at all appreciated. Such cravings are not fancies.... Variety of form and brilliancy of colour in the objects presented to patients are actual means of recovery,” and she recalls her own case, already quoted, when a nosegay of wild-flowers brought to her hut on the heights of Balaclava, where she lay with fever, seemed to put new life into her. “Form and colour,” she says, “will free your patient from his painful ideas better than any argument.” People say it is the effect on the patient’s mind. It is no such thing; the effect is on the body too. While variety in objects is necessary, “it must be a slow variety; don’t show a patient ten or twelve engravings successively.” One fresh picture a day hung on his wall or brought to his bedside will be more appreciated.
The Queen of Nurses combats the frequently accepted idea that cut flowers and growing plants are unhealthy in a sick-room, even at night. “The carbonic acid they give off at nights,” she writes, “would not poison a fly. Nay, in overcrowded rooms they actually absorb carbonic acid and give off oxygen. Cut flowers also decompose water and produce oxygen gas.” The nurse should observe what colours are most pleasing to her patient. “Some sick persons feel stimulus from looking at scarlet flowers, others exhaustion from looking at deep blue.”
This reminds me of an incident which occurred while the present writer was going over Netley Hospital when it was filled with wounded from the battlefields of South Africa. The convalescent soldiers were doing fancy woolwork, and a sister came into a ward bearing a parcel of wool sent by a benevolent lady. When opened, the wool was found to be all in khaki colour. The men turned their heads in disgust. “Didn’t we see enough of khaki in South Africa, sister?” they exclaimed. “Why don’t these kind ladies send us bright colours which will drive the thought of khaki out of our minds.” A moment’s intelligent reflection on the colours most likely to please the brave fellows at Netley would have prevented such a foolish mistake. Miss Nightingale’s words of wisdom, written forty years ago, are not obsolete yet.
The subject of “Taking Food” is next dealt with, and Miss Nightingale vigorously attacks the accepted traditions. It is a common error “that beef tea is the most nutritious of all articles. Now just try and boil down a pound of beef into beef tea, evaporate your beef tea, and see what is left of your beef—barely a tablespoonful of solid nourishment to half a pint of water in beef tea.” Still, Miss Nightingale admits that there is a certain reparative quality in beef tea, as in ordinary tea. She denounces that favourite article with the friends of the sick, jelly, which usually contains no nourishment at all.
Miss Nightingale is constantly called the “soldier’s friend” and one may add that she is above all the patient’s friend. “Attend,” she writes, “to the intelligent cravings of the sick. Patients crave for things laid down in no sick dietary. It often happens that the patient’s stomach is right and the book wrong. You can’t diet a patient from a book.”
How many weary invalids will thank the Queen of Nurses for granting them the too often condemned cup of tea. “A great deal too much against tea is said by wise people,” she writes. “When you see the natural and almost universal craving in English sick for their ‘tea,’ you cannot but feel that Nature knows what she is about. I should be very glad if any of the abusers of tea would point out what to give to an English patient after a sleepless night, instead of tea. It is the almost universal testimony of English men and women who have undergone great fatigue, such as riding long journeys without stopping, or sitting up for several nights in succession, that they could do it best upon an occasional cup of tea—and nothing else. Let experience, not theory, decide upon this as upon all other things.” Cocoa increases fat, but has no restorative power, and it is “pure mockery to offer it as a substitute for tea—you might,” adds Miss Nightingale, “as well offer patients chestnuts instead of tea.” She gives the warning, however, that too much tea is given to the sick by foolish people, and that as a rule neither tea nor coffee should be given to invalids after five o’clock.
The remarks on “Beds and Bedding” are not as relevant now as when they were written in the days of the much be-curtained four-post bedstead and luxurious feather beds. Most people now acknowledge the superiority of the iron bedstead with spring mattress. The bed coverings should be light as well as warm and “a true nurse,” says Miss Nightingale, “always makes her patient’s bed and does not leave it to the housemaid.” She recommends that the bed should always be in the lightest place in the room, and the patient able to see out of window. “A fashionable physician,” she writes, “has been saying that he turns his patients’ faces from the light. Yes, but Nature is stronger than fashionable physicians, and depend upon it, she turns the faces back and towards such light as she can get.” Observation of the sick shows that patients do not turn their faces to the wall.
Miss Nightingale, in illustration of the craving of the sick to see out of window, relates a beautiful story of a nurse’s self-sacrifice. A poor man in one of the hospitals was suffering from spinal accident and expressed an intense longing just to have one look out of the window. The nurse, moved with compassion for the poor fellow’s craving, raised him on her back so that he might take his coveted look at the outside world once again. His joy was great, but the effort cost the nurse a long and serious illness.
Under the heading of “Chattering Hopes and Advices,” Miss Nightingale evidently speaks out of the fulness of her own experience. “‘Chattering Hopes,’” she says, “may seem an odd heading. But I really believe there is scarcely a greater worry which invalids have to endure than the incurable hopes of their friends. There is no one practice against which I can speak more strongly from actual experience, wide and long, of its effects during sickness, observed both upon others and upon myself. I would appeal most seriously to all friends, visitors, and attendants of the sick to leave off this practice of attempting to ‘cheer’ the sick by making light of their danger and by exaggerating their probabilities of recovery.... The fact is that the patient is not ‘cheered’ at all by these well-meaning, most tiresome friends.” The advice or opinion of the experienced does not of course come under the head of “Chattering Hopes,” but it is the advice of “inexperience to bitter experience” which Miss Nightingale condemns, and which amounts to nothing more than this, “that you think I shall recover from consumption, because somebody knows somebody, somewhere, who has recovered from fever.” Nurses should protect their patients from visitors of the class indicated.