Nightingale and the Great British Cup of Tea, Part Two

As I was saying before having my cuppa (see previous post), we can find the same principle at work when we look at that beverage. (To refresh your memory, the principle to which I’m referring is that a remedy under one set of circumstances might not apply under other circumstances.) A case in point can be found in the Project Gutenberg online version of Florence Nightingale’s Notes on Nursing (1860). Here is the quote in question: “… it is however certain that there is nothing yet discovered which is a substitute to the English patient for his cup of tea; he can take it when he can take nothing else, and he often can’t take anything else if he has it not.”

The key point here is not the wonderful effect of tea per se, but the effect Nightingale notices in terms of, specifically, English patients. To interpret this, we need more information. Nightingale wrote this in 1859, and it was published in 1860. During the previous decade, she had ample firsthand nursing experience with English and non-English patients. She wrote Notes on Nursing for English people. She did not anticipate foreign translations, of which there have been more than 10. Evidence for this is that, in correspondence with her publisher, no mention is made of translations. By saying “the English patient,” Nightingale is clearly implying that, during illness, people of other nationalities do not find tea to be such an important drink. My point here is not to analyze in detail specific properties of tea, but rather to observe that British people react to tea differently than other nationalities, something Nightingale clearly understood.

Tea has been used as a “rescue” drink by British people for generations. Nightingale thought its powers were a bit exaggerated. These are her words: “When you see the natural and almost universal craving in English sick for their ‘tea,’ you cannot but feel that nature knows what she is about. But a little tea or coffee restores them quite as much as a great deal, and a great deal of tea and especially of coffee impairs the little power of digestion they have.”

If you are British, tea is something you understand naturally. There are, broadly, two sorts of tea drunk in England: builder’s tea and fine—or “posh”—teas, such as Earl Grey. Both are essentially black tea. The former, orangey in color, is cheaper and is drunk invariably with milk and sugar. When the Normandy landings took place in World War II, the British, after fighting on the beaches, stopped to brew tea. The American response was a sense of shock at British eccentricity, as if the Brits were stopping to drink posh tea at 5 p.m., rather than continue fighting. I think it would be obvious to any Brit that Tommy Smith would be drinking builder’s tea out of a sense of sheer bloody necessity, and I believe this is essentially what Florence Nightingale was talking about.

Tea remains something of an in joke in British culture to this day, to the extent that it was featured in the cult comedy-horror film “Shaun of the Dead,” which made it into Quentin Tarantino’s list of top 10 films of the ’90s. In this film, the protagonist’s stepfather is turning into a zombie, so his family’s response is to go home and have a cup of tea.

I have come across many personal anecdotes of nurses giving tea to patients in moments of crisis. In the public domain, my favorite, from the Victoria Wood’s 2013 BBC documentary “A Nice Cup of Tea” (second of the two), is an interview with a World War II volunteer nurse. Incidentally, Wood noted with some nostalgia that the younger generation of British people rarely has time to fit tea drinking into their day, so perhaps that great and honorable tradition is finally dying off. Now would be a good time, therefore, to understand what tea means to patients, before the tea-drinking tradition finally vanishes—in England, at least.

In summary, the case I am making is not so much about tea, specifically. The point is, there are some things that work for certain groups of patients and not others. I would have expected Nightingale to pick up on something so culturally significant for my home country as tea. And she did. What we can learn from this is that an understanding of cultures and diversity can provide nurses with a key to better patient care.

Who would imagine how much an Argentine patient, sick in hospital abroad, would be lifted by being offered a cup of hierba mate? On the other hand, when I worked at the Florence Nightingale Museum in the London borough of Lambeth, I was aware that 147 languages, apart from English, were spoken there. I would be challenged to name a quarter of them, despite the fact that I am a historian and linguist. Cultural diversity must also be an immense challenge for nursing. Tea is an interesting starting point for this important discussion.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.