Florence Nightingale Summary
Florence Nightingale was a guiding force in the field of nursing. She was born May 12, 1820, to William “WEN” and Frances “Fanny” Nightingale in Florence, Italy. Her parents named her after the city she was born in; just over two years earlier they had named her sister—Frances Parthenope “Parthe”—after Parthenopolis, a Greek settlement now part of Naples, Italy. William Nightingale was the son of a Sheffield, England, banker and had changed his surname to Nightingale from Shore in order to inherit the estate of a great uncle, a mining magnate in Lea, Derbyshire, England. In 1817, William married Frances “Fanny” Smith, the daughter of William Smith, an abolitionist Whig member of Parliament. They embarked on an extended tour of the Mediterranean for their honeymoon, returning to England in 1821 with their two daughters.
Florence Nightingale’s Early Life
The Nightingales lived at Lea Hall from 1821 to 1825, until their new home, Lea Hurst was completed. However, Fanny deemed Lea Hurst inadequate almost immediately, with “only 15 bedrooms” and located too far from London. It became their summer home. William purchased Embley Park, a large estate in Hampshire, which became their permanent residence.
It was at Embley Park in February 1837 that Florence received a calling from God; she wrote “God has spoke to me and called me to His service.” Though she did not know what that service would be, she knew that the society life her parents and sister enjoyed so much was not going to be enough for her. She had begun a courtship with Richard Monckton Milnes, a childhood friend, and began spending time visiting the poor and sick. She asked to stay on at Lea Hurst after the rest of the family returned to Embley in 1843, but Fanny would not allow it. In the fall of 1845, the village of Wellow was hit with an influenza epidemic, and Florence nursed several people on their deathbed.
Florence knew what her calling was by this time, but the rest of her family, her mother in particular, thought she had chosen an occupation at odds with her position in society. At the time, nurses were stereotyped as coming from the lower classes with social standing little better than prostitutes, but Florence was determined to change that. In 1849, after a long courtship, she finally refused marriage to Milnes, who went on to marry Annabella Hungerford Crewe. He and his wife continued to be staunch supporters and friends of Florence.
Florence Nightingale: The Nurse
After Florence nursed her great-aunt Elizabeth Evans through her final illness, Fanny considered turning her aunt’s home, Cromford Bridge House, into a nursing home in an attempt to placate Florence, but this was not enough. Florence began studying nursing in earnest, reading everything that had been written about the vocation, volunteering at hospitals, and visiting a nursing institution in Germany for training several times. She began to notice that many of the popular treatments available—blood letting, administering infusions of arsenic, mercury, and opiates—were actually killing more patients than they saved. She believed and began proving she could save more patients from death by caring for their basic needs—keeping them warm, clean, rested, and well-fed.
In 1853, in the face of continued opposition and strong objections from her family, Florence was appointed Superintendent of Nurses at the Institution for the Care of Sick Gentlewomen in Distressed Circumstances in London. She agreed to take the position only on the condition that the institution begin accepting patients of all religions, not just members of the Church of England. At the facility, Florence was able to demonstrate her administrative and nursing skills, cutting the cost of patient care while improving the standard of care. She did not receive pay for this position and was responsible for her own expenses.
Florence Nightingale In The Crimean War
In March 1854, the Crimean War began when Britain and France declared war on Russia after the latter invaded autonomous areas of the Turkish Ottoman Empire. Much of the fighting occurred in the Crimea, on the Black Sea. The British wounded were transported 300 miles across the sea to Scutari (now Üsküdar), just outside of what is now Istanbul, Turkey. Florence had already planned to travel to the Crimea when, in October, the Secretary of War, Sir Sidney Herbert, asked her to gather a group of nurses to nurse the wounded at the military hospital in Scutari. On November 4, 1854, she arrived with 37 other nurses at the Barracks Hospital, a huge, quadrangular building with sides nearly a quarter mile long. Approximately 18,000 wounded and dying men lay in rooms and lined the corridors. The conditions in the hospital were deplorable: there were miles of corridors stuffed with wounded and dying men; bandages were rags that were clotted with blood; food consisted of watery soup; and sanitary conditions were such that cholera and lice were rampant.
During the next 21 months, Florence worked to improve conditions in the hospital. She and her nurses bathed the soldiers, washed their linens, and fed them more substantial food. She eventually established a separate kitchen with her own money to prepare easily digested food for patients. She secured a source of clean drinking water and improved overall sanitary conditions. She set up a system for receiving patients, the basis of modern triage. The mortality rate declined 2% because of her efforts. She personally attended to countless men, many on their deathbeds. She made so many endless rounds, carrying a lamp with her in the late hours of the night, that she became known as the “Lady with the Lamp,” a nickname that was published in an account of her work in The London Times.
Support for Florence’s efforts to improve conditions for the war wounded spilled over into her efforts to establish nursing as a vocation for women. On November 29, 1855, a public meeting was held in London to formally recognize her efforts, resulting in the creation of the Nightingale Fund—the only recognition Florence would accept. She used this fund after the war to help establish the Nightingale Training School at St. Thomas’s Hospital in London in 1860, the first official nursing school in England.
Florence traveled to Balaclava in May 1855 to visit hospitals in and around the city. She became ill with “Crimean fever”—probably brucellosis, a bacterial infection that became chronic. She was acutely ill for 12 days, and although she recovered enough to return to Scutari and her duties there, she periodically became chronically ill at least through the 1870s.
The Crimean War ended in February 1856 and in March, Florence returned to Balaclava, staying there until the hospitals closed. She returned privately to England, arriving at Lea Hurst in August. In September, she met with Queen Victoria and Prince Albert at Balmoral to discuss improvements that should be made to the military hospital system.
From 1857 onward, Florence was periodically bedridden as the result of Crimean fever; however, she continued to work—writing, advising, and mentoring. In 1857, she issued a confidential report on the army medical department during the Crimean War. The next year, she published Notes on Matters affecting the Health, Efficiency and Hospital Administration of the British Army. In both works, she used statistics to prove her point and was a pioneer in the graphical representation of statistics—the polar area diagram was also known as the Nightingale rose diagram.
A Pioneer In Nursing
Her reports and testimony before a commission on the sanitary conditions of the army led to numerous improvements and the opening of an army medical college in 1861, a year after the Nightingale Training School was established. Florence also advised the army on sanitary conditions in India during and after the India Mutiny of 1857, which led to the establishment of a Sanitary Department within the Indian government. In 1859, Florence published Notes on Nursing. She intended the book to help in the practice of nursing, not to be a comprehensive guide—it continues to be used as an introduction to nursing today.
During the American Civil War (1861–1865) and the Franco-Prussian War (1870–1871), Florence was asked for advice by various countries and independently by doctors and nurses. In the 1870s, she mentored Linda Richards, the first professionally trained American nurse, who established nurse training programs in the U.S. and Japan.
Florence helped establish numerous nursing organizations throughout the remainder of her life and received numerous awards for her work, including the German order of the Cross of Merit and the French gold medal of Secours aux Blessés Militaires. Queen Victoria awarded her the Royal Red Cross in 1883. She was appointed a Lady of Grace of the Order of St John in 1904 and became the first woman to be awarded the Order of Merit in 1907. She was given the Honorary Freedom of the City of London in 1908. On May 10, 1910 she was presented with the badge of honor of the Norwegian Red Cross Society. On August 13 of that same year, Florence died peacefully at her home in London. An offer was extended for burial at Westminster Abbey but her family refused, burying her in the graveyard at St. Margaret Church in East Wellow, Hampshire, close to Embley Park.
The Lady With The Lamp
By Deborah Pulliam
Florence Nightingale was distinctly not the romantic, retiring Victorian gentlewoman most of us imagine. She was a bright, tough, driven professional, a brilliant organizer and statistician, and one of the most influential women in 19th-century England.
The best-known aspect of her life–nursing wounded soldiers at Scutari Hospital in Turkey during the Crimean War–comprised, in fact, a very small part of her 50-year career, but provided the springboard from which it all began.
Looking through a rough reproduction window at the London museum that bears her name is a little like peering over Nightingale’s shoulder in the Crimea and confronting the intimate details of life there–including her hand-drawn plan of the nurses’ quarters in the Barrack Hospital at Scutari, her personal seal and wax for letters, some of her books and her dispatch case, as well as an original letter written from the hospital and her famous lamp.
The museum’s permanent exhibit documents not only the war years, but also follows Nightingale throughout her extraordinary but largely overlooked life. A brief introductory film emphasizes her wealthy Victorian upbringing and expectations of a brilliant social career.
In fact, Florence Nightingale accomplished so much during her full life that it is intriguing to wonder how she might be remembered had the public not become so fixated on the romantic image of her night-time rounds by candlelight at Scutari. This small museum highlights all of her many accomplishments: introducing sanitary science to nursing and the British Army; raising the image of the British soldier from a brawling lowlife to a heroic working man; transforming nursing from an occupation which previously had been considered fit only for prostitutes to a respectable profession; establishing a nursing school at St. Thomas’s Hospital; laying out the principles of nursing in print in 1860; and revolutionizing the public health system of India without leaving England.
Ironically, during much of her long and accomplished life (she died in 1910, at the age of 90) the general public assumed she was already dead. Nightingale actually encouraged this misinformation. She returned from the Crimea under an assumed name and walked the last few miles to her parents’ home from the train station. Uninterested in her celebrity status, she wanted only to continue her work in peace and quiet. She refused photographs and interviews, and avoided anything not directly related to her work for a Royal Commission investigating health in the British Army. Although she was undoubtedly the driving force behind the work, she almost never appeared in public.
Her thoughts and work were with the army. In a private note, written at the end of 1856, she wrote:
Oh my poor men who endured so patiently. I feel I have been such a bad mother to you to come home and leave you lying in your Crimean grave. Seventy-three percent in eight regiments during six months from disease alone–who thinks of that now? But if I could carry any one point which would prevent any part of the recurrence of this our colossal calamity then I should have been true to the cause of those brave dead.
In the post-war period, Nightingale began studying new designs for modern hospitals all over Europe, in order to help the army reform its health and sanitary systems. In Paris she found a revolutionary design in which separate units, or pavilions, made up one large hospital. By making each pavilion a light and airy self-contained unit, the hospital minimized the spread of infections. She later succeeded in promoting this design in England.
Her research culminated in Notes on Hospitals, published in 1859, which combined two papers presented the year before at the Social Science Congress. Her words had a profound effect. She addressed every aspect of hospital management, from the purchase of iron bedsteads to replace the wooden ones, to switching to glass cups instead of tin.
The 108-page book went on into three editions and established Nightingale once more as an international authority. Her advice and approval were sought for hospitals all over Europe, from Holland to Portugal and even far-off India.
In particular, the governors of St. Thomas’s Hospital in London consulted with her on a matter key to the hospital’s future. The ancient hospital in Southwark was situated on land needed by railroads for a new line. The hospital’s governors had to decide whether they should sell the entire property and build a new facility in a better location, or allow the railroad to buy only part of the land and rebuild the hospital on the remainder. Some governors felt the hospital should stay where it had been for hundreds of years, serving the same community.
When they asked Nightingale for her opinion, rather than simply accepting the notion that the hospital was in fact serving patients in the area, she drew up and analyzed statistics on the origin of St. Thomas’s patients and proved that most did not come from the immediate neighbourhood as the governors had assumed.
She also compiled a convincing body of statistics to prove that moving the hospital to a healthier site would improve the patients’ chances of recovery. After completing her analysis, in a telling display of political acumen, she sent it not to the body of governors as a whole, but to one particular governor: the Prince Consort.
In the end, the governors decided to move St. Thomas’s to its present location in Lambeth. At the time, Nightingale deemed the site to be unhealthy; nevertheless, the hospital was constructed with the pavilions she endorsed, and was finally completed in 1871. If you look carefully from Westminster Bridge, you can see the remaining pavilions wedged in between more contemporary parts of the hospital that have since engulfed the original. Ask for directions in the museum, and you can walk through the new parts of the hospital to Nightingale’s original entrance hall.
Success piled on success. In 1860, after five years of gruelling work, she completed a voluminous report that resulted in the development of an Army Medical School in addition to greatly improved army barracks, hospitals, and living conditions for soldiers.
Also in 1860 she founded the Nightingale Training School for nurses at St. Thomas’s Hospital. Far more than merely giving her name to the school, Nightingale personally advised on all matters of instruction, admissions supervision, and discipline. Her involvement extended beyond her professional duties; she often invited graduates to tea and kept in touch with them long after they had launched their careers.
Nightingale also published a 75-page booklet, Notes on Nursing: What It Is, and What It Is Not. A popular book, its initial reception still did not foretell of its lasting importance. The book is still in print today in a facsimilie of the first edition and in a reprint of the second enlarged edition. In fact, it is the best-selling item in the museum’s small shop. “I think if you’re only going to buy one thing from our shop, it’s going to be Notes on Nursing,” says Alex Attewell, curator of the museum.
While medical knowledge has significantly increased since Nightingale’s time, her common sense and wisdom still forms a solid basis for caring for people. She believed, first and foremost, in hygiene (fresh air, cleanliness, clean water, proper drainage, and plenty of light), and constant consideration for the patient’s feelings. In one particularly empathetic passage, she addresses the importance of a quiet environment:
Unnecessary noise, or noise that creates an expectation in the mind, is that which hurts a patient. It is rarely the loudness of the noise, the effect upon the organ of the ear itself, which appears to affect the sick. How well a patient will generally bear, e.g., the putting up of a scaffolding close to the house, when he cannot bear the talking, still less the whispering, especially if it be a familiar voice, outside his door.
Nightingale’s common-sense approach to health is a main theme throughout the museum’s exhibits. “We’re interested in exploring what of her writing is still relevant today,” Attewell says.
Because of her work on army medical reform, she was asked to contribute to a study of the problems of health in India. British troops on the subcontinent had the highest mortality rates of all–in 1859 the death rate was 69 per thousand, as opposed to 17 per thousand in England. Through statistics and endless study, (compiled, amazingly, without ever visiting India) she discovered what no one else had noticed: that the English way of life could simply not be transferred to a hot climate.
Her 23-page treatise on conditions in India (as compared with the government’s 2,028 pages of small print) was printed at her own expense and sent to anyone with influence, including Queen Victoria. Once again, Nightingale revealed what no one even wanted to consider: that terrible living and working conditions were killing British troops as they had in the Crimea.
Yet again she emphasized that improving the health of British troops would require improving sanitary standards as a whole. For four years Nightingale worked daily on the meticulous paperwork and statistics required to reform life in India. Her influence went beyond paperwork. Newly assigned viceroys to India visited her home for briefings before setting out for their new post.
In 1896, Nightingale “retired to her bed”, but, far from slowing down, she continued working on home health visiting, as the English call public health. “Her writing is extraordinarily relevant to today’s health visiting,” Attewell says.
In an attempt to find out just how pertinent her writing is to the health profession today, the museum sent out questionnaires to 700 public health supervisors around the country. More than half came back almost immediately. “Usually you’d think a 10 per cent response would be good,” Attewell says. “I think the interest we’ve got in the questionnaire shows there’s still extraordinary interest in her writing.” Yet more evidence of the timeless value in the work and wisdom of this remarkable woman.
“Florence Nightingale is most remembered as a pioneer of nursing and a reformer of hospital sanitation methods. For most of her ninety years Nightingale pushed for reform of the British military health- care system and with that the profession of nursing started to gain the respect it deserved. Unknown to many, however, was her use of new techniques of statistical analysis, such as during the Crimean War when she plotted the incidence of preventable deaths in the military. She developed the “polar-area diagram” to dramatize the needless deaths caused by unsanitary conditions and the need for reform. ”.
Florence Nightingale was born in Italy on May 123, 1820 and was named Florence after the city where she was born. Her parents, William Edward and Frances Nightingale were a wealthy couple who had toured Europe for two years on their honeymoon. During their travels their fist daughter, Parthenope, was born in Naples (Parthenope being the Greek name for the ancient city), followed one year later by Florence. On returning to England the Nightingales divided their time between two homes. In the summer months they lived at Lea Hurst in Derbyshire, moving to Embley in Hampshire for the winter. Lea Hurst is now a retirement home and Embley as a School.
Florence and Parthenope were taught at home by their Cambridge University educated father. Florence was an academic child while her sister excelled at painting and needlework. Florence grew up to be a lively and attractive young woman, admired in the family’s social circle and she was expected to make a good marriage, but Florence had other concerns. In 1837, whilst in the gardens at Embley, Florence had what she described as her ‘calling’. Florence heard the voice of God calling her to do his work but at this time she had no idea what that work would be.
Florence developed an interest in the social questions of the day, made visits to the homes of the sick in the local villages and began to investigate hospitals and nursing. Her parents refused to allow her to become a nurse as in the mid-nineteenth century it was not considered a suitable profession for a well educated woman. While the family conflicts over Florence’s future remained unresolved it was decided that Florence would tour Europe with some family friends, Charles and Sehna Bracebridge. The three travelled to Italy, Egypt and Greece, returning in July 1850 through Germany where they visited Pastor Theodor Fliedner’s hospital and school for deaconesses Kaiserswerth, near Dusseldorf. The following year Florence Nightingale retuned to Kasiserswerth and undertook three months nursing training which enabled her to take a vacancy as Superintendent of the Establishment for Gentlewomen during illness at No. 1 Harley Street, London in 1853.
In March 1854 Britain, France and Turkey declared war on Russia. The allies defeated the Russians at the battle of the Alma in September but reports in the Times criticized the British medical facilities for the wounded. In response, Sidney Herbert, the Minister at War, who knew Florence Nightingale socially and through her work at Harley Street, appointed her to oversee the introduction of female nurses into the military hospitals in Turkey. On 4 November 1854, Florence Nightingale arrived at the Barrack Hospital in Scutari, a suburb on the Asian side of Constantinople, with the party of 38 nurses. Initially the doctors did not want the nurses there and did not ask for their help but within ten days fresh casualties arrived from the battle of Inkermann and the nurses were fully stretched.
The ‘Lady-in-Chief’, as Florence was called, wrote home on behalf of the soldiers. She acted as a banker, sending the men’s wages home to their families, and introduced reading rooms to the hospital./ in return she gained the undying respect of outstanding success and to show the nations’ gratitude for Florence Nightingale’s hard work a public subscription was organised in November 1855. The money collected was to enable Florence Nightingale to continue her reform of nursing in the civil hospitals of Britain.
When Florence Nightingale returned from the Crimean War in August 1856, four months after the peace treaty was signed, she hid herself away from the public’s attention. In November 1856 Miss Nightingale took a hotel room in London which became the centre for the campaign for a Royal Commission to investigate the health of the British Army. When Sidney Herbert was appointed Chairman, she continued as a driving force behind the scenes.
For her contribution to Army statistics and comparative hospital statistics in 1860 Florence Nightingale became the first woman to be elected a fellow of the Statistical Society. In 1865, she settled at 10 South Street, Mayfair, in the West End of London and apart from occasional visits to Embley, Lea Hurst and to her sister at Claydon House she lived there until her death.
Florence Nightingale’s greatest achievement was to raise nursing to the level of a respectable profession for women. In 1860, with the public subscriptions of the Nightingale fund, she established the Florence Nightingale Training School for nurses at St. Thomas’ Hospital. Mrs. Sarah Wardroper, Matorn at St. Thomas’, became the head of the new school. The probationer nurses received a year’s training which included some lectures but was mainly practical ward work under the supervision of the ward sister. “Miss Nightingale “, as she was always called by the nurses, scrutinized the probationers’ ward diaries and reports.
From 1872 Florence Nightingale devoted closer attention to the organisation of the School and almost annually for the next thirty years she wrote an open letter to the nurses and probationers giving advice and encouragement. On completion of training Florence Nightingale gave the nurses books and invited them to tea. Once trained the nurses were sent to staff hospitals in Britain and abroad and to establish nursing training schools on the Nightingale model. In 1860 her best known work, Notes on Nursing, was published. It laid down the principles of nursing, careful observation and sensitivity to the patient’s needs. Notes on Nursing were translated into eleven foreign languages and is still in print today.
Florence Nightingale’s writings on hospital planning and organisation had a profound effect in England and across the world. Miss Nightingale was the principal advocate of the ‘pavilion’ plan for hospitals in Britain.
Like her friend, the public health reformer Edwin Chadwick, Florence Nightingale believed that infection arose spontaneously in dirty and poorly ventilated places. This mistaken belief nevertheless led to improvements in hygiene and healthier living and working environments. Florence Nightingale also advised and supported William Rathbone in the development of district nursing in Liverpool many Nightingale trained nurses became pioneers in this field.
Although Florence Nightingale was bedridden for many years, she campaigned tirelessly to improve health standard, publishing 200 books, reports and pamphlets. In recognition of her hard work Queen Victoria awarded Miss Nightingale the Royal Red Cross in 1883. In her old age she received many honours, including the Order of Merit (1907) becoming the first woman to receive it. Florence Nightingale died at home at the age of 90 on 13 August 1910 and according to her wishes she was buried at St. Margaret’s, East Wellow, near her parent’s home, Embley Park in Hampshire. Karl Pearson acknowledge Nightingale as a “prophetess” in the development of applied statistics.