VIII. Bed and Bedding (SLEEP HYGIENE)

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Florence Nightingale, 1860

🧠 MNEMONIC: CLEAN BED

Clean bedding prevents fever
Let air reach mattress — iron bedsteads best
Every day air all bedding
Air your dirty sheets, not just clean
No vallance, no curtains — let air flow

Bed-sores are nursing fault
Exhalations go into bedding — must be aired
Damp bedding re-introduces disease

VIII. Bed and Bedding

📌 SHOCKING FACT

"Feverishness is generally supposed to be a symptom of fever — in nine cases out of ten it is a symptom of bedding."

The patient has re-introduced into the body the emanations from himself saturating his unaired bedding.

🎯 EXAM FOCUS: What's Wrong with Ordinary Beds

Wooden bedstead — impermeable
Two or three mattresses piled — never dry or air thoroughly
Vallance attached — prevents air circulation
Patient alternates between cold damp (after bed made) and warm damp (before) — both saturated with organic matter

📌 THE QUANTITY OF MOISTURE

Adult in health exhales by lungs and skin in 24 hours: three pints at least of moisture, loaded with organic matter ready for putrefaction.

In sickness, quantity often greatly increased, quality more noxious.

Where does it go? Chiefly into bedding. And stays there.

🛏️ THE IDEAL BED (MEMORIZE)

Iron bedstead with rheocline springs (permeable)
Thin hair mattress
No vallance
Not above 3 1/2 feet wide
Two bedsteads for patients entirely confined — 12 hours in each, bedding hung to air for intermediate 12 hours
Never carry sheets with patient

⚡ PREJUDICE ABOUT WIDE BEDS

Prejudice: In favour of wide bed
Truth: Refreshment of moving patient from one side to other better achieved by fresh bed. Ill patient doesn't stray far in bed.

Never put tray on bed. Patient should eat from bedside table. Bed should never be higher than sofa — otherwise patient feels "out of humanity's reach."

💡 Memory Tip: Remember "IRON" bed rules — Iron frame, Rheocline springs, Open to air, No vallance. For two beds: ROTATE — Really air, One patient, Twelve hours, Always change, Total hygiene, Ends fever.

📝 Key Takeaways for NCLEX

Fever is often caused by bedding, not disease
Iron bedsteads with permeable springs are best
Never put tray on bed; bed should be sofa height

🧠 Mnemonic Summary

IRON: Iron frame, Rheocline springs, Open to air, No vallance

Source: Notes on Nursing: What It Is and What It Is Not, Florence Nightingale, 1860. First American Edition.