Healthcare in Sense and Sensibility and Notes on Nursing.

Introduction

Considering the theme of healthcare in Jane Austen’s Sense and Sensibility and Florence

Nightingale’s Notes on Nursing offers great insight on the state of healthcare in their societies

during the writing of these two written works. A deep analysis of these works offer background

on how the people dealt with health issues during the time of their writing. The Covid-19

pandemic has exposed some of the weaknesses of the global healthcare system. It is therefore

clear that the world has continued to suffer during health disasters over the years. During the

times of Florence Nightingale, we see her addressing various issues that affect healthcare in

England. The issue of sanitation has been well covered in Notes on Nursing. It is therefore clear

that public sanitation and health are central to the quality of health in society. This is something

that has during the current pandemic affecting the whole world.

In Jane Austen’s Sense and Sensibility, we see Marianne Dashwood falling sick and several

people taking care of her including Colonel Brandon, her sister Elinor and Mr. Harris. However,

the quality of healthcare is extremely questionable in this context. Considering healthcare in

these two works and comparing to the current global situation, there are weaknesses in

healthcare that need to be addressed. In this paper, I will be considering the different aspects of

the healthcare situations during these periods and identify the different obstacles healthcare

workers faced during these periods. Further, I will evaluate the character of the various

caregivers and how these characters compare to each other. I will be considering John

Willoughby, Colonel Brandon and Elinor Dashwood in Sense and Sensibility and Florence

Nightingale in Notes and Nursing.

Notes on Nursing

Florence Nightingale in Notes on Nursing describes the state of healthcare in England in the

1800’s. Notes on Nursing offers an analysis of the state of healthcare. In this book, Nightingale

describes the role of nurses in medical care. In this work, she expresses the role of public

sanitation in maintaining the health of a nation. She selflessly outlines how nurses like herself

should serve the sick in the society.

Nightingale addresses the role of people in fighting disease in society. She contends that the most

visible symptoms of disease are not always from the disease itself but rather from the more basic

human needs such as fresh air, basic sanitation among others. “If a patient is cold, if a patient is

feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the

fault not of the disease, but of the nursing.” (Nightingale). This clearly shows that the role of

healthcare should not only be to administer medication to the patient but also to ensure that the

patient is comfortable enough to get cured. She opens up the definition of nursing and further

describes the role of nurses as caregivers in society. She argues that nursing should include the

management of the environment that patients are situated in. Further, she describes the ideal

environment that patients’ best survive in. “I use the word nursing for want of a better. It has

been limited to signify little more than the administration of medicines and the application of

poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the

proper selection and administration of diet–all at the least expense of vital power to the patient”

(Nightingale).
In Notes on Nursing, Nightingale mostly analyzes the different elementary factors in the patient

ecosystem. She defines each of them and then explains from her own experiences how to best

manage them. It is clear from her explanations that the state of health in England is deplorable.

She offers insights on how these environment should be improved in order to effectively improve

patient care. “Bad sanitary, bad architectural, and bad administrative arrangements often make

it impossible to nurse” (Nightingale). Poor nursing according to her is a leading cause of death in

hospitals. It is therefore important not to only focus on medication but also on creating a

conducive environment for patients to recover in. She highlights this in the case of cholera.

“Another and the commonest exclamation which will be instantly made is–Would you do

nothing, then, in cholera, fever, &c.?–so deep-rooted and universal is the conviction that to give

medicine is to be doing something, or rather everything; to give air, warmth, cleanliness, &c., is

to do nothing. The reply is, that in these and many other similar diseases the exact value of

particular remedies and modes of treatment is by no means ascertained, while there is universal

experience as to the extreme importance of careful nursing in determining the issue of disease.”

(Nightingale). In her opinion, the five key elements of a healthy environment are light, pure air,

pure water, cleanliness and efficient drainage. In her opinion, these elements must be managed in

the homes of the healthy as wells as hospital rooms. Therefore, she condemns nurses and doctors

who deny patients these elements and equates them to murderers for their gross negligence.

Sense and Sensibility

In Jane Austen’s Sense and Sensibility, there are two instances of healthcare that show the state

of healthcare in England at the time. These two instances involve the same patient, Marianne

Dashwood. The first instance involves John Willoughby and Marianne. In chapter 9 of Sense and

Sensibility we see Marianne and her sister Margaret going for a run in the fields when is
suddenly starts to rain. This leads to Marianne falling down and injuring her foot. It is when John

Willoughby meets Marianne and helps her home. “A gentleman carrying a gun, with two

pointers playing round him, was passing up the hill and within a few yards of Marianne, when

her accident happened. He put down his gun and ran to her assistance. She had raised herself

from the ground, but her foot had been twisted in her fall, and she was scarcely able to stand.

The gentleman offered his services; and perceiving that her modesty declined what her situation

rendered necessary, took her up in his arms without farther delay, and carried her down the hill.

Then passing through the garden, the gate of which had been left open by Margaret, he bore her

directly into the house, whither Margaret was just arrived, and quitted not his hold till he had

seated her in a chair in the parlour.” (Austen).

From this incidence, it is clear that there are no clear emergency services to deal with the kind of

injury that Marianne has gotten. The Good Samaritan in this instance does not have the necessary

first aid equipment or even the necessary transportation to a place where she can get the help that

she needs. He has therefore to abandon his luggage and carry the poor injured Marianne on his

hands. This is the nature of a good caregiver, selflessness. It is raining yet Willoughby selflessly

denies himself the joy of going home to shelter himself from the elements to carry an injured

person to safety. During the implementation of this selfless act he lacks the necessary equipment

and supplies that would have made his work way easier.

The second incident happens when Marianne wanders into the fields while nursing a heartbreak

after Willoughby’s marriage. At these instance, Marianne is distraught and feeling very sad. She

has lost a man that she really loved. She gets sick due to a level of negligence. As explained by

Austen, “Two delightful twilight walks on the third and fourth evenings of her being there, not

merely on the dry gravel of the shrubbery, but all over the grounds, and especially in the most
distant parts of them, where there was something more of wildness than in the rest, where the

trees were the oldest, and the grass was the longest and wettest, had—assisted by the still

greater imprudence of sitting in her wet shoes and stockings—given Marianne a cold so violent

as, though for a day or two trifled with or denied, would force itself by increasing ailments on

the concern of everybody, and the notice of herself. Prescriptions poured in from all quarters,

and as usual, were all declined. Though heavy and feverish, with a pain in her limbs, and a

cough, and a sore throat, a good night's rest was to cure her entirely; and it was with difficulty

that Elinor prevailed on her, when she went to bed, to try one or two of the simplest of the

remedies” (Austen).

This was a more serious ailment that lead to Marianne being forced to be in bedrest. Further, she

needed the services of Mr. Harris, her sister Elinor and Colonel Brandon in order for her to feel

better. It is clear that this situation is graver than the first instance. At the bedside, Elinor seats

patiently and takes care of her sister. Mr. Harris attends to Elinor daily while Colonel Brandon is

seen being always available to offer any help needed. “Elinor perceived with alarm that she was

not quite herself, and, while attempting to soothe her, eagerly felt her pulse. It was lower and

quicker than ever! and Marianne, still talking wildly of mama, her alarm increased so rapidly,

as to determine her on sending instantly for Mr. Harris, and dispatching a messenger to Barton

for her mother.” (Austen).

It is clear that Elinor was conversant with the needs of her sister and the kind of care she needed

and took every effort to make sure she got that help. These individuals show a lot of selflessness

during the moment Marianne’s illness. During all these time, they are always at her service

making sure she gets all that she needs at all times. However, they lack the requisite medical
equipment and infrastructure needed for the healthcare. They have to go use the services of an

apothecary in order to get the help needed.

Similarities with the Covid-19 Pandemic Experience

Since the Covid-19 pandemic was declared, there have been various obstacles that have been

encountered by healthcare professionals. From lack of enough personal protective equipment,

inadequate testing kits, lack of enough hospital beds, poor sanitation and lack of drugs to treat

the disease. It has been clear that the world has encountered a medical crisis of huge proportions.

In the last one year, over one million people have succumbed to the virus while more than 64

million have contracted the virus. In Victoria, we see a lot of deaths attributed to the cholera

outbreak. A careful analysis of Notes on Nursing also opens up the discussion on the number of

people who died due to poor healthcare in England.

Further the lack of enough and proper healthcare infrastructure has been highlighted in both

Sense and Sensibility and Notes on Nursing. This inadequacy has made the condition of patients

more critical and has often lead to avoidable deaths. This has also been the case during the

Covid-19 pandemic. Many individuals have lost their lives especially healthcare workers due to

lack of necessary protective equipment.

We can therefore draw several comparisons between the nature of healthcare during the writing

of these works and the current pandemic. Even with major progress in healthcare reform and

technological advancements, there are several inadequacies that need to be addressed in order to

achieve an efficient healthcare for the people.

References

Austen, Jane. Sense and Sensibility. 1811.

Nightingale, Florence. Notes on Nursing. Jones and Bartlett Publishers, 1860.