Episode 11 - Personal Cleanliness - Notes on Nursing - Florence Nightingale

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Episode Transcript

(00:00):
Section eleven personal cleanliness. In almostall diseases, the function of the skin
is more or less disordered, andin many most important diseases, nature relieves
herself almost entirely by the skin.This is particularly the case with children.

(00:22):
But the excretion which comes from theskin is left there and less removed by
washing or by the clothes. Everynurse should keep this fact constantly in mind,
for if she allow her sick toremain unwashed or their clothing to remain
on them after being saturated with perspirationor other excretion, she is interfering injuriously

(00:44):
with the natural processes of health,just as effectually as if she were to
give the patient a dose of slowpoison by the mouth. Poisoning by the
skin is no less certain than poisoningby the mouth, only it is slower
in its operation. The amount ofrelief and comfort experienced by sick after the

(01:06):
skin has been carefully washed and driedis one of the commonest observations made at
a sick bed. But it mustnot be forgotten that the comfort and relief
so obtained are not all. Theyare, in fact, nothing more than
a sign that the vital powers havebeen relieved by removing something that was oppressing
them. The nurse therefore must neverput off attending to the personal cleanliness of

(01:30):
her patient, under the plea thatall that is to be gained is a
little relief, which can be quiteas well given later. In all well
regulated hospitals this ought to be andgenerally is attended to, but it is
very generally neglected with private sick Justas it is necessary to renew the air

(01:51):
round a sick person frequently to carryoff morbid effluvia from the lungs and skin
by maintaining free ventilation, so isit necessary to keep the pores of the
skin free from all obstructing excretions.The object both of ventilation and of skin
cleanliness is pretty much the same,to wit, removing noxious matter from the

(02:14):
system as rapidly as possible. Careshould be taken in all these operations of
sponging, washing and cleansing the skinnot to expose too great a surface at
once, so as to check theperspiration which would renew the evil in another
form. The various ways of washingthe sick need not here be specified,

(02:37):
the less so as the doctors oughtto say which is to be used in
several forms of diarrhea, dysentery,etc. Where the skin is hard and
harsh, the relief afforded by washingwith a great deal of soft soap is
incalculable. In other cases, spongingwith tepid soap and water, then with

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tepid water and drying with a hottowel will be ordered. Every nurse ought
to be careful to wash her handsvery frequently during the day. If her
face too, so much the better. One word as to cleanliness, merely
as cleanliness, Compare the dirtiness ofthe water in which you have washed.

(03:22):
When it is cold without soap,cold with soap, hot with soap.
You will find the first has hardlyremoved any dirt at all, the second
a little more, the third agreat deal more. But hold your hand
over a cup of hot water fora minute or two, and then by
merely rubbing with the finger, youwill bring off flakes of dirt or dirty

(03:45):
skin. After a vapor bath,you may peel your whole self clean.
In this way. What I meanis that by simply washing or sponging with
water, you do not really cleanyour skin. Take a rough towel,
dip one corner in very hot water. If little spirit be added to it,
it will be more effectual. Andthen rub as if you were rubbing

(04:09):
the towel into your skin with yourfingers. The black flakes which will come
off will convince you that you werenot clean before. However, much soap
and water you have used, theseflakes are what require removing. And you
can really keep yourself cleaner with atumbler of hot water and a rough towel

(04:29):
and rubbing than with a whole apparatusof bath and soap and sponge without rubbing.
It is quite nonsense to say thatanybody need be dirty. Patients have
been kept clean by these means ona long voyage when a basin full of
water could not be afforded, andwhen they could not be moved out of
their berths, as if all theappurtenances of home had been at hand.

(04:55):
Washing, however, with a largequantity of water, has quite other effects
than those of mere cleanliness. Theskin absorbs the water and becomes softer and
more perspirable to wash with soap andsoft water. Is therefore desirable from other
points of view than that of clennliness. End of Section eleven.