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Care, to Nightingale, means thinking of the patient's needs and desires for things to do and to be entertained.
Taking Food: The nurse must supply a patient's every need, including the food that brings recovery to the body. She is in favor of hot tea and something to eat every three hours. But she advises never to leave food by the patient and to not let the patient see others' food. Eating is to be done to the exclusion of business talk or things that might discourage digestion.
What Food: Hearty food, of course, should be given to the patient: meat, eggs, tea, milk, butter, bread and jelly. One should not give a patient cocoa.
Bed and Bedding: If the bedding is not correct, the patient will be feverish. Bedding should be cleaned often, airing the dirty sheets, one should use iron spring bedsteads and the bed should not be too wide or high. She also attributes scrofula, bed sores and soreness to improper bedding.
Light: Again, Nightingale extols the great benefit of light to ward off and cure illness.
Cleanliness of the rooms and walls are crucial, and one should remove dust, rather than "dusting" which throws it around. Carpets should also be cleaned.
Personal Cleanliness: "Poisoning by the skin" is attributed to lack of bathing, clean air and ventilation, so one should steam and rub the skin that is being bathed, as one gives the patient the equivalent of a sponge bath.
Chattering hopes and advices: She discourages friends of the ill to air their hopes for the patient in an attempt to cheer the sick. This puts false hopes in the heads...
These are observations by the nurse and do not tell her how well the patient is.
In summary, Nightingale addresses the environment and problems that the nurse has in tending to the ill and the things over which the nurse has charge and can affect. As the nurse can do nothing to know or cure the illness that the patient suffers (which the doctor has charge of), all she can do is manage the things around the patient that she can control. These things are the environment, who sees the patient, what the patient eats and sleeps on, as well as what the patient sees and does with his or her time. Beyond these things the nurse is discouraged from acting.
But what the nurse can control, cleanliness, orderliness, the environment of the sick room and the noises the patient hears, these things are of utmost importance to the nurse. These are her or his responsibility, and in today's world this remains the same. The nurse has charge of the patient's well-being outside of medications and the illness the patient suffers from. The things that the nurse can control are of utmost importance and sometimes mean the life or death of the patient.
References
Nightingale, Florence, (1860). Notes on Nursing: What it is, and what it is not. New York: D. Appleton & Co.
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