Reading through Nightingale’s Notes on Nursing, first published in 1859, after her service at Scutari, and after she had time to reflect and assimilate her experience. By then her reputation and authority had been well-established.
That she can still speak to us in a way that is meaningful and relevant is remarkable. Some of her thoughts seem incredibly elemental to modern nurses, yet sometimes elemental practice is the most efficacious. And how often do we seriously consider simple patient comfort as central to practice, rather than a bonus or extra?
Her insight here: the importance of alleviating incidental suffering as a crucial element in halting and reversing the disease process. This is what nurses do, no?
In watching diseases, both in private houses and in public hospitals, the thing which strikes the experienced observer most forcibly is this, that the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different–of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness, or of punctuality and care in the administration of diet, of each or of all of these. And this quite as much in private as in hospital nursing.
The reparative process which Nature has instituted and which we call disease, has been hindered by some want of knowledge or attention, in one or in all of these things, and pain, suffering, or interruption of the whole process sets in.
If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease, but of the nursing.