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Florence Nightingale, OM,
RRC (12 May 1820 – 13 August
1910), who came to be known as
The Lady with the Lamp, was a
pioneer of modern nursing and a
noted statistician.
 Early
life
Florence
Nightingale was born into
a middle class, lavish,
well-connected British
family at the Villa
Colombaia, Florence,
Italy, and was named after
the city of her birth.
Her parents were William Edward
Nightingale (1794–1875) and
Frances Fanny Nightingale née
Smith (1789–1880). William
Nightingale was born William
Edward Shore. His mother Mary
née Evans was the niece of one
Peter Nightingale, under the
terms of whose will William
Shore not only inherited his
estate Lea Hurst in Derbyshire,
but also assumed the name and
arms of Nightingale. Fanny's
father (Florence's maternal
grandfather) was the
abolitionist Will Smith.
Embley Park, now a school, was
the family home of Florence
Nightingale
Inspired by what she took as a
Christian divine calling,
experienced first in 1837 at
Embley Park and later
throughout her life,
Nightingale committed herself
to nursing. This demonstrated a
passion on her part, and also a
rebellion against the expected
role for a woman of her status,
which was to become a wife and
mother. In those days, nursing
was a career with a poor
reputation, filled mostly by
poorer women, "hangers-on" who
followed the armies. In fact,
nurses were equally likely to
function as cooks. Nightingale
announced her decision to enter
nursing in 1845 evoking intense
anger and distress from her
family particularly her
mother.
She cared for poor and indigent
people. In December 1844, in
response to a pauper's death in
a workhouse infirmary in London
that became a public scandal,
she became the leading advocate
for improved medical care in
the infirmaries and immediately
engaged the support of Charles
Villiers, then president of the
Poor Law Board. This led to her
active role in the reform of
the Poor Laws, extending far
beyond the provision of medical
care. She was later
instrumental in mentoring and
then sending Agnes Elizabeth
Jones and other Nightingale
Probationers to Liverpool
Workhouse Infirmary.
In 1846 she visited
Kaiserswerth, Germany, and
learned more of its pioneering
hospital established by Theodor
Fliedner and managed by an
order of Lutheran deaconesses.
She was profoundly impressed by
the quality of care and by the
commitment and practices of the
deaconesses.
Nightingale was courted by
politician and poet Richard
Monckton Milnes, 1st Baron
Houghton, but she rejected him,
convinced that marriage would
interfere with her ability to
follow her calling to nursing.
When in Rome in 1847,
recovering from a mental
breakdown precipitated by a
continuing crisis of her
relationship with Milnes, she
met Sidney Herbert, a brilliant
politician who had been
Secretary at War (1845–1846), a
position he would hold again
during the Crimean War. Herbert
was already married, but he and
Nightingale were immediately
attracted to each other and
they became lifelong close
friends. Herbert was
instrumental in facilitating
her pioneering work in Crimea
and in the field of nursing,
and she became a key advisor to
him in his political career. In
1851 she rejected Milnes'
marriage proposal against her
mother's wishes.
Nightingale also had strong and
intimate relations with
Benjamin Jowett, particularly
about the time that she was
considering leaving money in
her will to establish a Chair
in Applied Statistics at the
University of Oxford.
Nightingale's career in nursing
began in 1851, when she
received four months training
in Germany as a deaconess of
Kaiserswerth. She undertook the
training over strenuous family
objections concerning the risks
and social implications of such
activity, and the Roman
Catholic foundations of the
hospital. While at Kaiserswerth
she reported having her most
important and intense
experience of her divine
calling.
On August 22, 1853, Nightingale
took a post of superintendent
at the Institute for the Care
of Sick Gentlewomen in Upper
Harley Street, London, a
position she held until October
1854. Her father had given her
an annual income of £500
(roughly US$50,000/£25,000 in
present terms), which allowed
her to live comfortably and to
pursue her career. James Joseph
Sylvester was her mentor.
Crimean
War
Florence Nightingale's most
famous contribution came during
the Crimean War, which became
her central focus when reports
began to filter back to Britain
about the horrific conditions
for the wounded. On October 21,
1854, she and a staff of 38
women volunteer nurses, trained
by Nightingale and including
her aunt Mai Smith, were sent
(under the authorization of
Sidney Herbert) to Turkey, some
545 km across the Black Sea
from Balaklava in the Crimea,
where the main British camp was
based.
Nightingale arrived early in
November 1854 at Selimiye
Barracks in Scutari (modern-day
Üsküdar in Istanbul). She and
her nurses found wounded
soldiers being badly cared for
by overworked medical staff in
the face of official
indifference. Medicines were in
short supply, hygiene was being
neglected, and mass infections
were common, many of them
fatal. There was no equipment
to process food for the
patients.
Nightingale and her compatriots
began by thoroughly cleaning
the hospital and equipment and
reorganizing patient care.
However, during her time at
Scutari, the death rate did not
drop; on the contrary, it began
to rise. The death count would
be highest of all other
hospitals in the region. During
her first winter at Scutari,
4077 soldiers died there. Ten
times more soldiers died from
illnesses such as typhus,
typhoid, cholera and dysentery
than from battle wounds.
Conditions at the temporary
barracks hospital were so fatal
to the patients because of
overcrowding and the hospital's
defective sewers and lack of
ventilation. A sanitary
commission had to be sent out
by the British government to
Scutari in March 1855, almost
six months after Florence
Nightingale had arrived, which
flushed out the sewers and
improved ventilation. Death
rates were sharply reduced.
Nightingale continued believing
the death rates were due to
poor nutrition and supplies and
overworking of the soldiers. It
was not until after she
returned to Britain and began
collecting evidence before the
Royal Commission on the Health
of the Army, that she came to
believe that most of the
soldiers at the hospital were
killed by poor living
conditions. This experience
would influence her later
career, when she advocated
sanitary living conditions as
of great importance.
Consequently, she reduced
deaths in the Army during
peacetime and turned attention
to the sanitary design of
hospitals.
Return
home
Florence Nightingale returned
to Britain a heroine on August
7, 1857, and, according to the
BBC, was arguably the most
famous Victorian after Queen
Victoria herself. Nightingale
moved from her family home in
Middle Claydon,
Buckinghamshire, to the
Burlington Hotel in Piccadilly.
However, she was stricken by a
fever, probably due to a
chronic form of Brucellosis
("Crimean fever") that she
contracted during the Crimean
war, possibly combined with
chronic fatigue syndrome. She
barred her mother and sister
from her room and rarely left
it.
In response to an invitation
from Queen Victoria – and
despite the limitations of
confinement to her room –
Nightingale played the central
role in the establishment of
the Royal Commission on the
Health of the Army, of which
Sidney Herbert became chairman.
As a woman, Nightingale could
not be appointed to the Royal
Commission, but she wrote the
Commission's 1,000-plus page
report that included detailed
statistical reports, and she
was instrumental in the
implementation of its
recommendations. The report of
the Royal Commission led to a
major overhaul of army military
care, and to the establishment
of an Army Medical School and
of a comprehensive system of
army medical records.
Later
career
While she was still in Turkey,
on November 29, 1855, a public
meeting to give recognition to
Florence Nightingale for her
work in the war led to the
establishment of the
Nightingale Fund for the
training of nurses. There was
an outpouring of generous
donations. Sidney Herbert
served as honorary secretary of
the fund, and the Duke of
Cambridge was chairman.
Nightingale was also considered
a pioneer in the concept of
medical tourism as well based
on her letters from 1856 in
which she would write to spas
in Turkey detailing the health
conditions, physical
descriptions, dietary
information, and other vitally
important details of patients
whom she directed there (which
was significantly less
expensive than Switzerland).
She was obviously directing
patients of meagre means to
affordable treatment.
By 1859 Nightingale had £45,000
at her disposal from the
Nightingale Fund to set up the
Nightingale Training School at
St. Thomas' Hospital on July 9,
1860. (It is now called the
Florence Nightingale School of
Nursing and Midwifery and is
part of King's College London.)
The first trained Nightingale
nurses began work on May 16 at
the Liverpool Workhouse
Infirmary. She also campaigned
and raised funds for the Royal
Buckinghamshire Hospital in
Aylesbury, near her family
home.
Nightingale wrote Notes on
Nursing, which was published in
1860, a slim 136 page book that
served as the cornerstone of
the curriculum at the
Nightingale School and other
nursing schools established.
Notes on Nursing also sold well
to the general reading public
and is considered a classic
introduction to nursing.
Nightingale would spend the
rest of her life promoting the
establishment and development
of the nursing profession and
organizing it into its modern
form.
Nightingale's work served as an
inspiration for nurses in the
American Civil War. The Union
government approached her for
advice in organizing field
medicine. Although her ideas
met official resistance, they
inspired the volunteer body of
United States Sanitary
Commission.
In 1869 Nightingale and
Elizabeth Blackwell opened the
Women's Medical College.
In the 1870s, Nightingale
mentored Linda Richards,
"America's first trained
nurse", and enabled her to to
return to the USA with adequate
training and knowledge to
establish quality nursing
schools. Linda Richards went on
to become a great nursing
pioneer in the USA and
Japan.
By 1882 Nightingale nurses had
a growing and influential
presence in the embryonic
nursing profession. Some had
become matrons at several
leading hospitals, including,
in London, St Mary's Hospital,
Westminster Hospital, St
Marylebone Workhouse Infirmary
and the Hospital for Incurables
at Putney; and throughout
Britain, e.g. Royal Victoria
Hospital, Netley; Edinburgh
Royal Infirmary; Cumberland
Infirmary; Liverpool Royal
Infirmary as well as at Sydney
Hospital, in New South Wales,
Australia.
In 1883 Nightingale was awarded
the Royal Red Cross by Queen
Victoria. In 1907 she became
the first woman to be awarded
the Order of Merit. In 1908 she
was given the Honorary Freedom
of the City of London.
By 1896, Florence Nightingale
was bedridden. She may have had
what is now known as chronic
fatigue syndrome and her
birthday is now celebrated as
the International CFS Awareness
Day. During her bedridden
years, she also made pioneering
work in the field of hospital
planning, and her work
propagated quickly across
England and the world.
She died on August 13, 1910.
The offer of burial in
Westminster Abbey was declined
by her relatives, and she is
buried in the graveyard at St.
Margaret Church in East Wellow,
Hampshire.
Contributions
to statistics
Florence Nightingale had
exhibited a gift for
mathematics from an early age
and excelled in the subject
under the tutorship of her
father. She had a special
interest in statistics, a field
in which her father, a pioneer
in the nascent field of
epidemiology, was an expert.
She made extensive use of
statistical analysis in the
compilation, analysis and
presentation of statistics on
medical care and public
health.
Nightingale was a pioneer in
the visual presentation of
information. Among other things
she used the pie chart, which
had first been developed by
William Playfair in 1801. After
the Crimean War, Nightingale
used the polar area chart,
equivalent to a modern circular
histogram or rose diagram, to
illustrate seasonal sources of
patient mortality in the
military field hospital she
managed. Nightingale called a
compilation of such diagrams a
"coxcomb", but later that term
has frequently been used for
the individual diagrams. She
made extensive use of coxcombs
to present reports on the
nature and magnitude of the
conditions of medical care in
the Crimean War to Members of
Parliament and civil servants
who would have been unlikely to
read or understand traditional
statistical reports.
In her later life Nightingale
made a comprehensive
statistical study of sanitation
in Indian rural life and was
the leading figure in the
introduction of improved
medical care and public health
service in India.
In 1858 Nightingale was elected
the first female member of the
Royal Statistical Society and
she later became an honorary
member of the American
Statistical Association.
Contributions
to literature and the
women's
movement
While better known for her
contributions in the medical
and mathematical fields,
Nightingale is also an
important link in the study of
English feminism. During 1850
and 1852, she was struggling
with her self-definition and
the expectations of an
upper-class marriage from her
family. As she sorted out her
thoughts, she wrote Suggestions
for Thought to Searchers after
Religious Truth. The
three-volume book has never
been printed in its entirety,
but a section, called
Cassandra, was published by Ray
Strachey in 1928. Strachey
included it in The Cause, a
history of the women's
movement. Apparently, the
writing served the original
purpose of sorting out
thoughts; Nightingale left soon
after to train at the Institute
for deaconesses at
Kaiserwerth.
Cassandra protests the
over-feminization of women into
near helplessness, such as
Nightingale saw in her mother
and older sister's lethargic
lifestyle, despite their
education. She rejected their
life of thoughtless comfort for
the world of social service.
The work also reflects her fear
of her ideas being ineffective,
as were Cassandra's. Cassandra
is a virgin-priestess of Apollo
who receives a
divinely-inspired prophecy, but
her prophetic warnings go
unheeded. Elaine Showalter
called Nightingale's writing "a
major text of English feminism,
a link between Wollstonecraft
and Woolf."
Legacy
and memory
Florence Nightingale's lasting
contribution has been her role
in founding the modern nursing
profession. She set a shining
example for nurses everywhere
of compassion, commitment to
patient care, and diligent and
thoughtful hospital
administration.
The work of the Nightingale
School of Nursing continues
today. There is a Florence
Nightingale Museum in London
and another museum devoted to
her at her family home, Claydon
House. The Nightingale building
in the School of Nursing and
Midwifery at the University of
Southampton is named after her.
International Nurses Day is
celebrated on her birthday each
year.
The Florence Nightingale
Declaration Campaign,
established by nursing leaders
throughout the world through
the Nightigale Initiative for
Global Health (NIGH), aims to
build a global grassroots
movement to achieve two United
Nations Resolutions for
adoption by the UN General
Assembly of 2008 which will
declare: The International Year
of the Nurse–2010 (the
centennial of Nightingale's
death); The UN Decade for a
Healthy World–2011 to 2020 (the
bicentennial of Nightingale's
birth). NIGH also works to
rekindle awareness about the
important issues highlighted by
Florence Nightingale, such as
preventive medicine and
holistic health.
Several churches in the
Anglican Communion commemorate
Nightingale with a feast day on
their liturgical calendars. So
does the Evangelical Lutheran
Church in America, which
commemorates her as a renewer
of society with Clara Maass on
13 August.
The airline KLM has named one
of their MD-11 airliners in her
memory.
Three hospitals in Istanbul are
named after Nightingale: F. N.
Hastanesi in Şişli (the biggest
private hospital in Turkey),
Metropolitan F.N. Hastanesi in
Gayrettepe, and Avrupa F.N.
Hastanesi in Mecidiyeköy, all
belonging to the Turkish
Cardiology Foundation.
During the Vietnam War,
Nightingale inspired many US
Army nurses, sparking a renewal
of interest in her life and
work. Her admirers include
Country Joe of Country Joe and
the Fish, who has assembled an
extensive website in her
honour.
The Agostino Gemelli Medical
Center in Rome, the first
university-based hospital in
Italy and one of its most
respected medical centres,
honoured Nightingale's
contribution to the nursing
profession by giving the name
"Bedside Florence" to a
wireless computer system it
developed to assist
nursing.
Nightingale Corona, on the
surface of Venus is named after
her.
There are many foundations
named after Florence
Nightingale. Most are nursing
foundations, but there is also
Nightingale Research Foundation
in Canada, dedicated to the
study and treatment of chronic
fatigue syndrome which
Nightingale is believed to have
had.
There is a psychological effect
known as the "Florence
Nightingale Effect" whereby
nurses and doctors fall in love
with their patients.
The United States Air Force
maintains a fleet of 20
McDonnell Douglas C-9A
"Nightingale" aeromedical
evacuation aircraft.
The northmost tower of the
Selimiye Barracks building is
today a museum, and in several
of its rooms, relics and
reproductions relevant to
Florence Nightingale and her
nurses are on exhibition.
A bronze plaque, attached to
the plinth of the Crimean
Memorial in the Haydarpaşa
Cemetery, Istanbul and unveiled
on Empire Day, 1954 to
celebrate the 100th anniversary
of her nursing service in this
region, bears the
inscription:
"To Florence Nightingale, whose
work near this Cemetery a
century ago relieved much human
suffering and laid the
foundations for the nursing
profession."
Source : Some
of the information on this page
came from a Wikipedia
article and is
licensed under the GNU
Documentation License.
©2008
www.geneticmatrix.com.
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