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

by Florence Nightingale

INDEX.

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Disease is a reparative process	7
Of the sufferings of disease; disease not always the cause	7
What nursing ought to do	8
Nursing the sick little understood	8
Nursing ought to assist the reparative process	8
Nursing the well little understood	9
Curious deductions from an excessive death rate	9
First rule of nursing to keep the air within as pure as the air without	11
Why are uninhabited rooms shut up?	11
Without chill	12
Open windows	13
What kind of warmth desirable	13
Bedrooms almost universally foul	13
An air-test of essential consequence	14
When warmth must be carefully looked to	14
Cold air not ventilation, nor fresh air a method of chill	15
Night air. Air from outside. Open your windows, shut your doors	16
Smoke. Airing damp things in a patient's room. Effluvia from exereta	17
Chamber utensils without lids	18
Don't make your sick room into a sewer	18
Abolish slop pails. Fumigations. Health of houses—five points essential. Health of carriages	19
Pure air, pure water	20
Drainage. Sinks	21
Cleanliness. Light	22
Three common errors in managing the health of houses	22
Head in charge must see to house hygiene, not do it herself	23
Does God think of these things so seriously?	23
How does he carry out his laws?	24
How does he teach his laws?	24
Servants' rooms	24
Physical degeneration in families; its causes. Don't make your sick room into a ventilating shaft for the whole house. Infection. Diseases are not individuals arranged in classes, like cats and dogs, but conditions growing out of one another	25
Why must children have measles, &c.? Petty management	27
Illustrations of the want of it	28
Strangers coming into sick room	28
Sick room airing the whole house	28
Uninhabited room fouling the whole house. Lingering smell of paint a want of care	28
Delivery and non-delivery of letters and messages	29
Partial messages such as "being always in the way" yourself, increase instead of saving the patient's anxiety, because they must be only partial. Why let your patient ever be surprised?	29
What is the cause of half the accidents which happen?	30
Petty management better understood in institutions than in private houses. What institutions are the exception? Nursing in regimental hospitals	31
What it is to be "in charge"	32
Why hired nurses give so much trouble. Unnecessary noise. Never let a patient be waked out of his first sleep.	34
Noise which excites expectation	35
Whispered conversation in the room, or just outside the door	35, 36
Noise of female dress. Patient's repulsion to nurses who rustle	36
Burning of the crinolines	37
Indecency of the crinolines	37
Hurry peculiarly hurtful to the sick	37
How to visit the sick, and not hurt them. These things not fancy	38
Interruption damaging to sick and to well	38, 39
Keeping a patient standing. Patients dread surprise. Never speak to a patient in the art of moving	39
Effects of over-exertion of sick	40
Careless observation of the results of careless visits	40
Difference between real and fancy patients	41
Conciseness necessary with sick	41
Irresolution most painful to them	42
What a patient must not have to see to. Reading aloud	42
Read aloud slowly, distinctly, and steadily to the sick	43
Never read aloud by fits and starts to the sick. The sick would rather be told a thing than have it read to them	43
People overheard. Music	44
Variety a means of recovery	44
Color and form means of recovery; this is no fancy. Flowers	45
Effects of body and mind	46
Sick suffer to excess from mental as well as bodily pain. Help the sick to vary their thoughts	46
Desperate desire in the sick to "see out of window." Supply to the sick the defect of manual labor	47
Physical effect of color. Want of attention to hours of taking food	49
Patients often starved to death in chronic cases. Food never to be left by the patient's side. Patient had better not see more food than his own.	50

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You cannot be too careful as to quality in sick diet	51
Nurse must have some rule of thought about her patient's diet. Nurse must have some rule of time about the patient's diet	52
Keep your patient's cup dry underneath. Common errors in diet. Beef tea. Eggs. Meat without vegetables	53
Arrowroot. Milk, butter, cream, &c. Intelligent cravings of particular sick for particular articles of diet	54
Sweet things. Jelly	55
Beef tea. Observation, not chemistry, must decide sick diet	56
Home-made bread. Sound observation has scarcely yet been brought to bear on sick diet	57
Tea and coffee. Cocoa	58, 59
Bulk. Feverishness a symptom of bedding. Uncleanliness of ordinary bedding. Nurses often do not think the sick room any business of theirs, but only the sick	60
Air your dirty sheets, not only your clean ones	61
Iron spring bedsteads the best. Comfort and cleanliness of two beds. Bed not to be too wide	62
Bed not to be too high, nor in a dark place, nor a four-poster with curtains. Scrofula often a result of disposition of bed clothes. Bed sores. Heavy and impervious bed clothes	63
Light essential to both health and recovery	64
Aspect, view, and sunlight, matters of first importance to the sick	65
Without sunlight, we degenerate body and mind. Almost all patients lie with their faces to the light. Cleanliness of carpets and furniture	66
Dust never removed now. How a room is dusted	67
Floors. Papered, plastered, oil-painted walls. Atmosphere in painted and papered rooms quite distinguishable. Best kind of wall for a sick room. How to keep your wall clean at the expense of your clothes	68
Dirty air from without. Best kind of wall for a house. Dirty air from within. Dirty air from the carpet. Remedies	69
Poisoning by the skin	70
Ventilation and skin-cleanliness equally essential	71
Steaming and rubbing the skin. Advising the sick	72
Chattering hopes the bane of the sick	73
Patient does not want to talk of himself. Absurd statistical comparisons made in common, conversation by the most sensible people for the benefit of the sick. Absurd consolations put forth for the benefit of the sick	74
Wonderful presumption of the advisers of the sick. Advisers the same now as two hundred years ago. Mockery of the advice given to sick	76
Means of giving pleasure to the sick	77
Two new classes of patients peculiar to this generation. What is the use of the question, Is he better?	79
Leading questions useless or misleading	81
Means of obtaining inaccurate information	82
As to food patient takes or does not take	83
As to diarrhœa. More important to spare the patient thought than physical exertion. Means of cultivating sound and ready observation	83, 84
Sound and ready observation essential in a nurse	85
English women have great capacity of, but little practice in, close observation	86
Difference of excitable and accumulative temperaments. Superstition the fruit of bad observation. Physiognomy of disease little shown by the face	87
Peculiarities of patients. Nurse must observe for herself increase of patient's weakness; patient will not tell her. Accidents arising from the nurse's want of observation	89
Is the faculty of observing on the decline? Observation of general conditions. Approach of death; paleness by no means an invariable effect, as we find in novels	90
"Average rate of mortality" tells us only that so many per cent, will die. Observation must tell us which in the hundred they will be who will die	93
What observation is for. What a confidential nurse should be	94
Observation is for practical purposes. Sanitary nursing as essential in surgical as in medical cases, but not to supersede surgical nursing	95
Children: their greater susceptibility to the same things	96
Summary. Reckless amateur physicking by women. Real knowledge of the laws of health alone can check this. Danger of physicking by amateur females	98
What pathology teaches. What observation alone teaches. What medicine does. What nature alone does	l00