Notes on Nursing

In this section, Nightingale emphasizes that in addition to the presence of fresh air, pure water, and peaceful surroundings, patients recovering from illness benefit from experiencing “variety” in their environment. This variety takes many forms and isn’t just variety for its own sake. As usual, Nightingale pierces through to the core of the patient experience: She shows that part of it is the basic human desire for exploration, discovery, and knowledge—which at least at a fundamental level responds to the introduction of variety into a patient’s daily life. Variety of food, location, surroundings, and opportunities all provide healthy distraction that help keep the mind occupied and aid recovery by promoting psychological wellbeing.

Far ahead of her time, Nightingale highlights the reality that mental health is vitally important to the body’s health. Monotony and boredom can be extremely painful for a patient yet unfortunately are extremely common because recovery from illness requires spending a lot of time resting and in bed. Nightingale insists that this can take a toll on mental health that’s often detrimental to physical recovery—so much so that catering to patients’ mental health is just as important as catering to their physical health.

Related to variety and mental health is the subject of food and consumption of nourishment, which often relates to the patient’s mental and emotional state. The nurse must remain observant—a fundamental trait of a good nurse, as Nightingale later emphasizes—and must take care to carefully watch what patients eat, when they eat, and how much they eat, and what they eat more or less of. Nourishment is crucial to the patient’s recovery, and the intake of food is a vital part of the nurse’s duty.

As before, Nightingale appeals to the popular thinking of the day, inquiring whether certain foods thought to be nutritious are in fact so for a body in recovery and whether certain foods have been overlooked that could contribute greatly to health and recovery. In fact, Nightingale insists that in many cases patients themselves are the best barometer of what kind of sustenance is necessary, a claim that wouldn’t have been taken seriously by many in the medical community of her day (or even by many today). Patients, she argues, best know what kind of food they can consume and how much, which is a direct result of their physical state; the body decides what it can and cannot consume, and the caretakers should thus heed patients in discussing what to offer, how much of it, and when. Nightingale holds that the patient’s lived experience is sacrosanct and elevates the dignity of the patient—beyond what many would consider reasonable. As elsewhere, Nightingale is ahead of her time in recommending treatment of each patient as an autonomous individual whose experience must be a vital part of determining the details of care.