Health of Houses

2 Health of Houses


The comfort of home extends beyond its familiarity and amenities. It is, for those assailed by illness or injury, a source of strength and security in a time when both are difficult to retain. But the use of the home as a venue for providing care requires preparation. There are adaptations and additions to the normal home environment that will help make it conducive to the work of the caregiver, and to providing benefits for the patient. The advice offered by Florence Nightingale on the basic steps to making a home a congenial space for caregiving remain applicable today. As with every subsequent chapter in this modern edition, this one begins with an excerpt from the text of the original.




imageNotes on Nursing – Florence Nightingale


There are five essential points in securing the health of houses. Without these, no house can be healthy. And it will be unhealthy just in proportion as they are deficient.



Pure air.


Badly constructed houses do for the healthy what badly constructed hospitals do for the sick. Once insure that the air in a house is stagnant, and sickness is certain to follow.



Pure water.


Pure water is more generally introduced into houses than it used to be, thanks to the exertions of the sanitary reformers. This has happily been remedied. But, in many parts of the country, well water of a very impure kind is used for domestic purposes. And when epidemic disease shows itself, persons using such water are almost sure to suffer.



Efficient drainage.


No house with any untrapped drain pipe communicating immediately with a sewer, whether it be from water closet, sink, or gully-grate, can ever be healthy. An untrapped sink may at any time spread fever or pyaemia among the inmates of a palace.



Cleanliness.


Without cleanliness, within and without your house, ventilation is comparatively useless. You cannot have the air of the house pure with dung-heaps under the windows. There are other ways of having filth inside a house besides having dirt in heaps. Old papered walls of years’ standing, dirty carpets, uncleansed furniture, are just as ready sources of impurity to the air as if there were a dung-heap in the basement.



Light essential to both health and recovery.


A dark house is always an unhealthy house, always an ill-aired house, always a dirty house. People lose their health in a dark house, and if they get ill they cannot get well again in it.


It is the unqualified result of all my experience with the sick, that second only to their need of fresh air is their need of light; that, after a close room, what hurts them most is a dark room. And that it is not only light but direct sun-light they want. I had rather have the power of carrying my patient about after the sun, according to the aspect of the rooms, if circumstances permit, than let him linger in a room when the sun is off. People think the effect is upon the spirits only. This is by no means the case. The sun is not only a painter but a sculptor. Without going into any scientific exposition we must admit that light has quite as real and tangible effects upon the human body. But this is not all. Who has not observed the purifying effect of light, and especially of direct sunlight, upon the air of a room? The cheerfulness of a room, the usefulness of light in treating disease is all-important.



Aspect, view and sunlight matters of first importance to the sick.


To a sleeper in health it does not signify what the view is from his bed. He ought never to be in it excepting when asleep, and at night. But the case is exactly reversed with the sick, even should they be as many hours out of their beds as you are in yours, which probably they are not. Therefore, that they should be able, without raising themselves or turning in bed, to see out of window from their beds, to see sky and sun-light at least, if you can show them nothing else, I assert to be, if not of the very first importance for recovery, at least something very near it. And you should therefore look to the position of the beds of your sick one of the very first things. If they can see out of two windows instead of one, so much the better. Again, the morning sun and the mid-day sun – the hours when they are quite certain not to be up, are of more importance to them, if a choice must be made, than the afternoon sun. Perhaps you can take them out of bed in the afternoon and set them by the window, where they can see the sun. But the best rule is, if possible, to give them direct sunlight from the moment he rises till the moment he sets.


Another great difference between the bed-room and the sick-room is, that the sleeper has a very large balance of fresh air to begin with, when he begins the night, if his room has been open all day as it ought to be; the sick man has not, because all day he has been breathing the air in the same room, and dirtying it by the emanations from himself. Far more care is therefore necessary to keep up a constant change of air in the sick room.



Infection.


We must not forget what, in ordinary language, is called “Infection;” – a thing of which people are generally so afraid that they frequently follow the very practice in regard to it which they ought to avoid. Nothing used to be considered so infectious or contagious as small-pox; and people not very long ago used to cover up patients with heavy bed clothes, while they kept up large fires and shut the windows. Small-pox, of course, under this regime, is very “infectious.” People are somewhat wiser now in their management of this disease. They have ventured to cover the patients lightly and to keep the windows open; and we hear much less of the “infection” of small-pox than we used to do. But do people in our days act with more wisdom on the subject of “infection” in fevers – scarlet fever, measles, &c. – than their forefathers did with small-pox? Does not the popular idea of “infection” involve that people should take greater care of themselves than of the patient? that, for instance, it is safer not to be too much with the patient, not to attend too much to his wants?


True nursing ignores infection, except to prevent it. Cleanliness and fresh air from open windows, with unremitting attention to the patient, are the only defence a true nurse either asks or needs. Wise and humane management of the patient is the best safeguard against infection.



Bedrooms almost universally foul.


During sleep, the human body, even when in health, is far more injured by the influence of foul air than when awake.


Why can’t you keep the air all night, then, as pure as the air without in the rooms you sleep in? But for this, you must have sufficient outlet for the impure air you make yourselves to go out; sufficient inlet for the pure air from without to come in. You must have open chimneys, open windows, or ventilators; no close curtains round your beds; no shutters or curtains to your windows, none of the contrivances by which you undermine your own health or destroy the chances of recovery of your sick.


Always air your room, then, from the outside air, if possible. Windows are made to open; doors are made to shut – a truth which seems extremely difficult of apprehension. I have seen a careful nurse airing her patient’s room through the door, near to which were two gaslights, (each of which consumes as much air as eleven men,) a kitchen, a corridor, the composition of the atmosphere in which consisted of gas, paint, foul air, never changed, full of effluvia, including a current of sewer air from an ill-placed sink, ascending in a continual stream by a well-staircase, and discharging themselves constantly into the patient’s room. The window of the said room, if opened, was all that was desirable to air it. Every room must be aired from without – every passage from without.

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Dec 3, 2016 | Posted by in NURSING | Comments Off on Health of Houses

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