Florence Nightingale at Home by Paul Crawford & Anna Greenwood & Richard Bates & Jonathan Memel

Author:Paul Crawford & Anna Greenwood & Richard Bates & Jonathan Memel
Language: eng
Format: epub
ISBN: 9783030465346
Publisher: Springer International Publishing

Her conclusion was that no patient should be allowed to stay in the house for longer than two months, ‘unless there be prospect either of improvement or of death’. If this rule were not implemented—she argued in her report of February 1854—‘this will become not a hospital for the sick, but a hospital for incompatible tempers and for hysterical fancies … A hospital is good for the seriously ill alone – otherwise it becomes a lodging house where the nervous become more nervous, the foolish more foolish, the idle and selfish more selfish and idle’.79 Over the following three months, she discharged three patients labelled ‘hysterical, no improvement’, and four more ‘cured of complaints which never existed’.80 In other cases, she intervened to find her patients long-term places in other institutions.81 ‘There have been admitted many cases which proved to be unworthy of the charity’, she argued in her May report.82

There was probably a part of Nightingale that felt that she had not left country house life and her nervously hypochondriac sister behind merely to spend the rest of her days ministering to the over-dramatised complaints of underemployed gentlewomen. But she was also seeking to draw a distinction: a hospital was not a home, and should not be treated as such. The problem was that it was not clear which category—hospital or home—Harley Street fitted into. It had hospital-like elements, with some patients admitted for short-term surgical or medical procedures. Nightingale wanted the Establishment to prioritise this aspect—she attended every operation that took place there—to assist her in establishing a nursing training institute.83 Many of the patients (or their families), however, saw the Establishment as a residential care home. Thus, a significant proportion of its residents were women who were not in need of hospital care, but ‘who have wearied out their families, or been wearied out by them’, or simply those ‘who have no families at all’.84 Nightingale seems to have wanted the Establishment to cease catering to such women.

A third category were those who were undergoing extended recovery from surgery or illness and ‘anxious to return to their families and save them expense’.85 These too did not belong in a hospital environment, Nightingale felt. By the time she came to write Notes on Hospitals (1859), she had identified a need for a new kind of institution—convalescent homes—to solve this problem. Starting from the principle that ‘no patient ought ever to stay a day longer in hospital than is absolutely essential for medical or surgical treatment’, Nightingale declared that ‘every hospital should have its convalescent branch, and every county its convalescent home’.86 This would benefit patients as well as hospitals, since ‘as long as they are hospital inmates, they feel as hospital inmates, they think as hospital inmates, they act as hospital inmates, not as people recovering’. Convalescent houses could be decorated in a more homely way than hospitals, and patients could move around more, take on odd jobs, or do gardening. Moving to a convalescent home would ‘get

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