The World Health Organization declared 2020 as the Year of the Nurse and Midwife in celebration of Florence Nightingale's 200th birthday on May 12, 1820. I shared my experiences when I attended two services at the National Cathedral in Washington, DC, commemorating Florence Nightingale (Harris, 2002, 2010). The cathedral has a Florence Nightingale stained-glass window in the north transept that was installed in 1938 and depicts six outstanding scenes from her life including one that portrays her writing Notes on Nursing. Each time I view the window and reflect on her words of wisdom, I am in awe that she addressed so many healthcare and nursing issues facing nursing in the 21st Century. I share several of the issues she addressed 161 years ago.
Confidentiality (Health Information Portability and Accountability Act, HIPAA in 2020)
"...And remember every nurse should be one who is to be depended upon, in other words, capable of being a 'confidential' nurse. She does not know how soon she may find herself placed in such a situation; she must be no gossip, no vain talker, she should never answer questions about her sick except to those who have a right to ask them..." (p. 70).
Infection Control
"...Every nurse ought to be careful to wash her hands very frequently during the day. If her face too, so much the better. One word as to cleanliness merely as cleanliness. Compare the dirtiness' of the water in which you have washed when it is cold without soap, cold with soap, hot with soap. You will find the first has hardly removed any dirt at all, the second a little more, the third a great deal more... (p. 53).
...True nursing ignores infection, except to prevent it" (p. 20).
Noise (Inappropriate Conversation)
"I have often been surprised at the thoughtlessness, (resulting in cruelty, quite unintentionally) of friends or of doctors who will hold a long conversation just in the room or passage adjoining to the room of the patient, who is either every moment expecting them to come in, or who has just seen them, and knows they are talking about him. If he is an amiable patient, he will try to occupy his attention elsewhere and not to listen - and this makes matters worse- for the strain upon his attention and the effort he makes are so great that it is well if he is not worse for hours after. If it is a whispered conversation in the same room, then it is absolutely cruel; for it is impossible that the patient's attention should not be involuntarily strained to hear..." (p. 26).
Safety
"...This brings us to another caution. Never speak to an invalid from behind, nor from the door, nor from any distance from him, nor when he is doing anything" (p. 28).
In summary, I share several recommendations:
1. Read and reread the original and commemorative editions of Notes on Nursing: What It Is, and What It Is Not (1859, 1992).
2. Take the time to visit the Washington National Cathedral to view the Nightingale Window when in the DC area.
3. Pass wisdom and knowledge from one nurse to another.
4. Celebrate our heritage and the diversity of nurses and the types of care nurses provide.
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