Nightingale minisode #8 Cleaning and Chattering

Michelle: Welcome back to the Florence Nightingale Miniseries. This is minisode number eight, Cleaning and Chattering, where Florence discusses cleanliness both of a home or hospital room and of a person. She also tells us about the chattering of hopes and advices. Sounds mysterious. Let's get into it. Florence talked a little bit about the cleaning of beds in minisode number seven, bed and bedding, as well as the cleanliness of Victorian houses in minisode number two, the Five Essentials for Health. But in this chapter, Florence goes into a lot of detail about how to properly clean a room, which I will not go into. But she starts by saying, "with the current system of dusting, no room can ever be kept clean because all we do is just move the dust around." And I just found this so fascinating that there's still a lot of similarities between mid-19th century England and today. I imagine that feather dusters were used in mid-19th century England. And I agree with Florence here. Basically, you're just sending a lot of dust airborne to settle back down on top of everything. Again, she says, the only way I know how to remove dust is to wipe everything with a damp cloth. Moving on to the floors, she says the Berlin Laquered floor is the only truly clean floor because it is wet and dry rubbed every morning and evening for dust. That sounds like a lot of hard work. And who is doing it? The nurses? She is against having carpet in hospital rooms and I wholeheartedly agree, it's just gross. She says a dirty carpet, literally infects the room. Yes, back when we still had some carpeted rooms where I worked and I would just almost gag when I would see visitors kids crawling all over the floor. She's against wallpaper, but she says if you have it, it needs to be glazed paper, which I imagine had some kind of sealant on it so it could wipe down. So she summarizes the cause of dirty rooms and hospital wards down to three causes. One, dirty air coming in from without. And these could be from sewer emanations the evaporation from dirty streets, smoke, bits of unburned fuel, bits of straw, and bits of horse dung. Two, dirty air coming from within from the dust, which you often displace but never remove. And three, dirty air coming from the carpet. These are things, I think, that as nurses, we take for granted today, because in hospitals we have environmental teams that keep things very clean and sanitized at all times. But Florence experienced a lot of frustration trying to keep the wards clean. She knew that cleanliness would only help the patient. At the end of her talk on the cleanliness of hospital wards, she says "the well have a curious habit of forgetting what is to them but a trifling inconvenience to patiently be put up with but is to the sick a source of suffering delaying recovery if not actually hastening death. The well are scarcely ever more than 8 hours at most in the same room. Some change they can always make, if only for a few minutes. But the sick man who never leaves his bed, who cannot change by any movement of his own, his air or his light or his warmth, who cannot obtain quiet or get out of the smoke or the smell or the dust, he is really poisoned or depressed by what is to you the merest trifle."  And I absolutely love what she says next. "What can't be cured must be endured is the very worst and most dangerous maximum for a nurse which ever was made. Patience and resignation in her are but other words for carelessness or indifference, contemptible if in regard to herself, culpable if in regard to her sick." I think here she's saying, remember, we are well, we're independent and we can change our environment if need be, whereas our patients are sick and wholly dependent on us to control their environment. So let's do everything we can to make their environment the best it can be so they can heal and recover. By now you all know that I see the world through my NICU-colored glasses. And what Florence said has never been more apparent than in this environment. The infants we care for are 100% dependent on their parents and on us as caregivers to control their environment through providing skin-to-skin for bonding, proper positioning for comfort and energy conservation, sound levels for healthy brain growth, and positive feeding experiences so that they can develop and thrive. Florence emphasizes a great deal about how patients are to be cleaned, and she feels very strongly that it's so important. It just aids in their recovery. And then she goes on to talk about how nurses should clean themselves. She says, "every nurse ought to be careful to wash her hands very frequently during the day. If her face too, so much the better." And then she goes on to talk about different ways you could wash cold water without soap. Cold water with soap and hot water with soap. And she prefers hot water with soap as the best way to claim she finishes it with, "it is quite nonsense to say that anybody need be dirty." And I mean, how much evidence is there on hot water and soap for washing? Now Florence, what is this you say about Chattering hopes and advices? Florence says herself, "chattering hopes may seem an odd heading but I really believe there is scarcely a greater worry which invalids have to endure than the incurable hopes of their friends. There is no one practice against which I can speak more strongly from actual personal experience wide and long of its effects during sickness observed both upon others and upon myself. I would appeal most seriously to all friends, visitors, and attendants of the sick to leave off this practice of attempting to cheer the sick by making light of their danger and by exaggerating their probabilities of recovery." Remember, Florence had brucellosis and was bed-bound for quite a while, so she knew what it felt like to be a patient and she was also just a realist. I think she would be one of those people that if faced with an incurable illness, would probably say something like, "just give it to me straight, tell me how long I have, and let's just get on with it."  She was very protective of her patients and had an intuition about what she knew would help their recovery and what would hinder their recovery and for sure, friends, family, et cetera. Minimizing the seriousness of their disease would probably piss her off. Florence Nightingale has been identified as the first nurse researcher and I'm going to link a PubMed article in the show notes that catalogs her contributions to research. The next paragraph just really says it all and I think what Florence is saying here is essentially a Google search. So here goes. "I have heard a doctor condemned whose patient did not allows recover because another doctor's patient of a different sex, of a different age, recovered from a different disease in a different place. Yes, this is really true. If people who make these comparisons did but know the care and preciseness with which such comparisons are required to be made in order to be at any value whatever they would spare their tongues. In comparing the deaths of one hospital with those of another, any statistics are just considered absolutely valueless, which do not give the ages, the sexes, and the diseases of all the cases. It does not seem necessary to mention this. It does not seem necessary to say there can be no comparison between old men with dropsies and young women with consumption. Yet the cleverest men and the cleverest women are often heard making such comparisons, ignoring entirely sex, age, disease, and place. In fact, all the conditions essential to the question. It is the merest gossip." I love it. Don't talk about what you don't know about. Florence is obviously very frustrated by people who don't understand research or know research and who think they're trying to help but are actually causing harm. Well, that's all about Cleanliness and Chatter. Join me next time for the last minisode, number nine, when Florence gives us tips and tricks for the observation of a patient and leaves us with the conclusion to her book Notes on Nursing. Please visit my Instagram page for details on the final giveaway of the fancy Lippincott edition of Florence's book Notes on Nursing, What it Is and What it Is Not. Thank you and I will see you soon!