Nightingale’s Notes on Nursing

One book which I was delighted, and a bit surprised, to discover on our shelves while doing shelf-reading, is Florence Nightingale’s Notes on Nursing: What it is and What it is Not. Notes on Nursing was published in 1859, after Nightingale had become a celebrity for her nursing reforms during the Crimean War. (If anyone watched the first episode of the new PBS series “Mercy Street” last Sunday you’ll remember the rather strident nurse who had served under Nightingale). Our first edition is in a study, practical cover.

Florence Nightingale, Notes on Nursing. London: Harrison, [1860?]. EL3. N687n. Collection of the Rosenbach.

Although Nightingale would become famous for promoting nursing as a profession, and one suitable for women, she claimed in her preface that Notes on Nursing was not intended for professionals, but for the many women who needed to nurse at home:

The following notes are by no means intended as a rule of thought by
which nurses can teach themselves to nurse, still less as a manual to
teach nurses to nurse. They are meant simply to give hints for thought
to women who have personal charge of the health of others. Every woman,
or at least almost every woman, in England has, at one time or another
of her life, charge of the personal health of somebody, whether child or
invalid,–in other words, every woman is a nurse. Every day sanitary
knowledge, or the knowledge of nursing, or in other words, of how to put
the constitution in such a state as that it will have no disease, or
that it can recover from disease, takes a higher place. It is
recognized as the knowledge which every one ought to have–distinct from
medical knowledge, which only a profession can have.

Florence Nightingale, Notes on Nursing. London: Harrison, [1860?]. EL3. N687n. Collection of the Rosenbach.

Nonetheless, the book was used at the Nightingale School of Nursing, founded in 1860, and within the text itself Nightingale includes statistics on the number of  servant and non-servant nurses in Britain and her plea for nursing as an art (found in the conclusion) specifically references nurses in hospital wards:

(3.) It seems a commonly received idea among men and even among women
themselves that it requires nothing but a disappointment in love, the
want of an object, a general disgust, or incapacity for other things, to
turn a woman into a good nurse.
This reminds one of the parish where a stupid old man was set to be
schoolmaster because he was “past keeping the pigs.”
Apply the above receipt for making a good nurse to making a good
servant. And the receipt will be found to fail. Yet popular novelists of recent days have invented ladies disappointed
in love or fresh out of the drawing-room turning into the war-hospitals
to find their wounded lovers, and when found, forthwith abandoning their
sick-ward for their lover, as might be expected. Yet in the estimation
of the authors, these ladies were none the worse for that, but on the
contrary were heroines of nursing.
What cruel mistakes are sometimes made by benevolent men and women in
matters of business about which they can know nothing and think they
know a great deal.
The everyday management of a large ward, let alone of a hospital—the
knowing what are the laws of life and death for men, and what the laws
of health for wards—(and wards are healthy or unhealthy, mainly
according to the knowledge or ignorance of the nurse)—are not these
matters of sufficient importance and difficulty to require learning by
experience and careful inquiry, just as much as any other art? They do
not come by inspiration to the lady disappointed in love, nor to the
poor workhouse drudge hard up for a livelihood.
Nightingale’s primary focus was hygiene: cleanliness and fresh air. At the time she wrote Notes on Nursing, she did not yet embrace the germ theory of disease, believing, like many Victorians, that miasmas from filth caused disease, but her instructions on creating sanitary conditions would have been of practical benefit nonetheless. She also offered many other types of advice, from introducing variety (flowers, changing prints) into the sickroom to prevent the invalid from going stir-crazy to directions about rest and food.

As someone interested in food history, one passage I found interesting was where she argued against the common idea that beef tea and gelatin were the most nutritive food for the sick, asking her reader to evaporate the water out of  beef tea to see how little nutriment it actually contained and to consider that gelatin was mostly water and that bulk doesn’t equal nourishment. It turns out that Nightingale still thought beef tea was still useful in the sickroom because it had a certain”certain reparative quality” that she couldn’t explain, but gelatin was right out, since it “has a tendency to produce diarrhoea,–and to trust to it to repair the
waste of a diseased constitution is simply to starve the sick under the
guise of feeding them.”

An earlier owner of our copy (possibly the J. D. Ridout who wrote her(?) name on the inside of the cover) made light pencil marks next to some of the suggestions that she presumably found significant, such as managing a patient’s cup and what kinds of foods to prepare.

Florence Nightingale, Notes on Nursing. London: Harrison, [1860?]. EL3. N687n. Collection of the Rosenbach.
Florence Nightingale, Notes on Nursing. London: Harrison, [1860?]. EL3. N687n. Collection of the Rosenbach.

So while Notes on Nursing might not be what one would first expect to find in our British Literature collection, I’ve certainly enjoyed exploring our copy.

Kathy Haas is the Associate Curator at the Rosenbach and the primary poster at the Rosen-Blog.