XI. Personal Cleanliness (SKIN)
Florence Nightingale, 1860Skin excretes waste — must be washed
Keeping unwashed = slow poisoning
In sickness, skin function disordered
Nature relieves herself through skin
Poisoning by skin as certain as by mouth
Object: remove noxious matter rapidly
In relief and comfort, washing is vital
Steaming and rubbing removes what water can't
Observe — don't put off personal cleanliness
Nurse must wash hands frequently
XI. Personal Cleanliness
📌 KEY CONCEPT
"Poisoning by the skin is no less certain than poisoning by the mouth — only it is slower in its operation."
In almost all diseases, the function of the skin is more or less disordered. In many diseases, nature relieves herself almost entirely by the skin — particularly in children.
🎯 EXAM FOCUS: The Principle
If a nurse allows her sick to remain unwashed, or their clothing to remain on them saturated with perspiration or other excretion, she is interfering injuriously with natural processes of health — as effectually as giving a dose of slow poison by mouth.
📌 VENTILATION AND SKIN-CLEANLINESS EQUALLY ESSENTIAL
Just as necessary to renew the air frequently to carry off morbid effluvia from lungs and skin, so is it necessary to keep the pores of the skin free from obstructing excretions.
The object of both is the same: removing noxious matter from the system as rapidly as possible.
🧼 THE RIGHT WAY TO WASH
Experiment: Compare dirtiness of water when washed:
- Cold without soap → hardly removed any dirt
- Cold with soap → a little more
- Hot with soap → a great deal more
Method: Rough towel, dip corner in very hot water (add a little spirit), rub as if rubbing towel into skin. Black flakes will convince you weren't clean before.
⚡ KEY RULES
- Don't expose too great surface at once when sponging — may check perspiration
- In diarrhoea, dysentery with hard harsh skin — washing with soft soap gives incalculable relief
- Nurse should wash her hands very frequently during the day
📝 Key Takeaways for NCLEX
- Poisoning by skin is as certain as poisoning by mouth
- Wash with hot water and soap to remove skin excretions
- Nurses must wash hands frequently
🧠 Mnemonic Summary
- WASH SKIN: Waste through pores, Allow removal, Steam opens pores, Hot water best, Skin absorbs, Keep clean, In sickness, Nurse's hands too
Source: Notes on Nursing: What It Is and What It Is Not, Florence Nightingale, 1860. First American Edition.