Notes on Nursing: What It Is, and What It Is Not

Summary

Notes on Nursing is a short practical book that Florence Nightingale published in 1859, three years after returning from the Crimean War. It was not written as a textbook for professional nurses. Its preface says the notes are meant to give hints for thought to women who have charge of the health of others, because, as Nightingale observes, almost every woman at some time nurses a child or an invalid. Nightingale's starting point is that disease is a reparative process, and that much of the suffering blamed on illness actually comes from the lack of fresh air, light, warmth, quiet, cleanliness or proper diet. Nursing, she argues, should mean putting the patient in the best condition for nature to act upon him, at the least expense of his vital power. The first rule, and the subject of her first chapter, is to keep the air the patient breathes as pure as the air outside without chilling him. The chapters that follow deal with the health of houses, where she lists five essentials: pure air, pure water, efficient drainage, cleanliness and light. She writes on petty management, by which she means arranging things so that care continues when the nurse is absent; on noise, especially the harm of whispering and sudden interruptions; on variety for the sick mind; on food, beds, light and the cleanliness of rooms and persons. A chapter on 'chattering hopes and advices' warns visitors against cheerful but thoughtless encouragement. The longest chapter, on observation of the sick, insists that a nurse must learn what to observe and how, and must report facts, not opinions. The book is sharp, witty and often impatient with carelessness. Some of its science, such as Nightingale's doubts about contagion, was overtaken by the germ theory, but its emphasis on hygiene, observation and attention to the whole patient shaped modern nursing.

Top Lessons

• Small things matter

  Nightingale shows that fresh air, quiet and clean sheets can decide whether a patient recovers. Faithfulness in small things is a theme of her book.

• Observation and facts

  Nightingale demands that nurses observe carefully and report facts rather than impressions. Her statistical work in the Crimea grew from the same habit.

• Seeing the whole person

  She attends to the patient's mind as well as body: boredom, worry and false cheerfulness all harm the sick.

• For the Christian reader

  Nightingale believed God had called her to serve, and she saw nursing as a vocation rather than a menial task. Her book shows how love for the sick is expressed in disciplined attention to their needs.

Verified Quotes

Medical Lens

A founding text of modern nursing, emphasizing environment, hygiene and observation.

• I. Ventilation and Warming

  Pure air as the first principle of nursing.

• XIII. Observation of the Sick

  Training nurses to observe and report.