Florence Nightingale

Florence Nightingale (12 May 1820 – 13 August 1910) was an English social reformer and statistician. She is also known as the founder of modern nursing. Her name is followed by the letters OM, RRC and DStJ.

Nightingale became well known while she was a manager and trainer of nurses during the Crimean War. She organised care for wounded soldiers at Constantinople. She greatly reduced death rates by improving cleanliness and living conditions. She became an icon of Victorian culture, especially as "The Lady with the Lamp", who made ward rounds for wounded soldiers at night. Some recent commentators have said that the media at the time exaggerated her Crimean War achievements. Critics still agree on how important her later work was in making nursing a professional job for women.

In 1860, she started professional nursing by opening her nursing school at St Thomas' Hospital in London. It was the first secular nursing school in the world, and it is now part of King's College London. Several honours were named after her, including the Nightingale Pledge that new nurses take and the Florence Nightingale Medal, which is the highest international award a nurse can receive. The annual International Nurses Day is celebrated on her birthday. Her social reforms included improving healthcare for all parts of British society, supporting better hunger relief in India, and helping to abolish prostitution laws that were harsh on women. She also helped expand the kinds of work women were allowed to do.

Nightingale was an innovator in statistics. She presented her analysis in graphs to make it easier to draw conclusions from data. She is famous for the polar area diagram, also called the Nightingale rose diagram, which is similar to a modern circular histogram or pie chart. This diagram is still regularly used in data visualisation. Nightingale was also a prolific and versatile writer. During her lifetime, much of her published work spread medical knowledge. Some of her booklets were written in simple English so that people with poor reading skills could understand them. Much of her writing, including her extensive work on religion and mysticism, was only published after her death. Other pages about her include The Lady with a Lamp, a 1951 film, Miss Nightingale at Scutari, 1854, an 1891 painting, and Florence Nightingale (disambiguation).

Early life

Florence Nightingale was born on 12 May 1820 at Villa Colombaia, near the Porta Romana in Florence. Her parents, William Edward Nightingale and Frances "Fanny" (née Smith), were travelling in Europe at the time. Like her older sister Frances Parthenope, she was named after the place where she was born. The family returned to England in 1821, and Lea Hurst in Derbyshire became one of her early homes. From 1825, after her father bought Embley Park in Hampshire, the family spent most of its time there and at Lea Hurst, with some time in London.

Her father was born William Edward Shore and took the Nightingale name after inheriting the Lea estate. Her mother was the daughter of the abolitionist and Unitarian William Smith. Her father held advanced views for his time about educating women, and he taught the girls much of their lessons himself. They studied subjects such as French, German, Latin, Greek, mathematics and music. Her Latin later helped her talk with abbots and monks she met while travelling. In 1838, during another European tour, Nightingale met the English-born Parisian hostess Mary Clarke. Clarke treated Florence as an intellectual equal, and her independence showed Nightingale a world where women could take part in intellectual life alongside men.

Nursing vocation and training

At the age of sixteen, in 1837, Nightingale felt what she later described as the first of several calls from God to serve, though the call did not say what kind of service. It took several years for her to focus on nursing, and her mother and sister, Parthenope, opposed her plans. She turned away from the expected role for a woman of her position, which was to become a wife and mother, and she taught herself the art and science of nursing. Her most persistent suitor was the politician and poet Richard Monckton Milnes, but after a nine-year courtship she refused him, believing marriage would get in the way of her calling. In Rome in 1847 she met Sidney Herbert, a politician who had been Secretary at War (1845–1846). They became lifelong close friends. During the Crimean War, when Herbert was Secretary of War again, he and his wife helped her nursing work there. She became his key adviser, and some people accused her of hastening his death from Bright's disease in 1861. Later she had strong relations with academic Benjamin Jowett, who may have wanted to marry her. She continued her travels with Charles and Selina Bracebridge as far as Greece and Egypt. In Athens she rescued a young little owl from children who were tormenting it, and she named it Athena. She often carried the owl in her pocket until it died, shortly before she left for Crimea.

Her writings on Egypt show her learning, literary skill, and philosophy of life. In January 1850, sailing up the Nile as far as the Abu Simbel temples, she wrote about their spiritual grandeur. Later that year she visited the Lutheran religious community at Kaiserswerth-am-Rhein in Germany, where she watched Pastor Theodor Fliedner, Friederike Fliedner, and the deaconesses caring for the sick and the poor. She regarded this experience as a turning point and published her findings anonymously in 1851. On 22 August 1853 she became superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London, a post she held until October 1854. Her father gave her an annual income of £500, which allowed her to live comfortably and pursue her career.

Crimean War

Florence Nightingale's most famous work came during the Crimean War. Reports reached Britain about terrible conditions for wounded soldiers at a military hospital at Scutari, on the Asiatic side of the Bosporus, opposite Constantinople. Scutari is now Üsküdar in Istanbul. In October 1854, Nightingale and a group of women volunteer nurses, including head nurse Eliza Roberts and her aunt Mai Smith, were sent to the Ottoman Empire. Fifteen Catholic nuns, mobilised by Henry Edward Manning, also went. Mary Clarke, a friend of Nightingale, had helped her on the journey through Paris. The volunteers worked about 295 nautical miles from the main British camp at Balaklava, in the Crimea, across the Black Sea. When Nightingale arrived at Selimiye Barracks in early November 1854, she found poor care, few medicines, neglected hygiene, and many deadly infections. After Nightingale wrote to The Times, the government asked Isambard Kingdom Brunel to design a prefabricated hospital. It was shipped to the Dardanelles and became Renkioi Hospital, which had a much lower death rate under Edmund Alexander Parkes. Stephen Paget wrote in the Dictionary of National Biography that Nightingale cut the death rate from 42% to 2%, through better hygiene and by calling for the Sanitary Commission. She also introduced handwashing.

During her first winter at Scutari, 4,077 British soldiers died there. Ten times more soldiers died from illnesses such as typhus, typhoid, cholera, and dysentery than from battle wounds. Overcrowding, broken sewers, and poor air led the British government to send the Sanitary Commission in March 1855. It cleaned the sewers and improved ventilation, and death rates fell sharply. Nightingale never claimed credit for this. Her own illness in May 1855 was cared for by Eliza Roberts. Nightingale later believed that poor living conditions had caused most of the soldiers' deaths, and this shaped her later work on Statistics and Sanitary Reform. Her relationship with Mary Seacole, who ran a hotel and hospital for officers in the Crimea, was described as frosty by some secondary sources. The BBC and other outlets have criticised Nightingale's wartime work, though scholar Lynn McDonald has called these criticisms "often preposterous." During the war, the French writer Lucien Baudens praised her care for the sick of three armies. Nightingale was also known as "The Lady with the Lamp," after a The Times report and Henry Wadsworth Longfellow's 1857 poem.

Later career

On 29 November 1855, the Nightingale Fund was set up at a public meeting in the Crimea to recognise her work in the war, and many people gave generous donations. Sidney Herbert was honorary secretary, and the Duke of Cambridge was chairman. In 1856 she wrote about spas in the Ottoman Empire, noting that treatment there cost much less than in Switzerland. With £45,000 from the fund, she opened the first nursing school, the Nightingale Training School, at St Thomas' Hospital on 9 July 1860. The first trained Nightingale nurses began work at the Liverpool Workhouse Infirmary on 16 May 1865. The school is now called the Florence Nightingale Faculty of Nursing and Midwifery and is part of King's College London. In 1866 she called the Royal Buckinghamshire Hospital in Aylesbury, near her sister's home at Claydon House, "the most beautiful hospital in England". She wrote Notes on Nursing in 1859, which became a core text for nursing schools and a classic introduction to nursing. As Mark Bostridge has shown, she helped bring trained nurses into the workhouse system in Britain, so sick paupers were no longer cared for by other paupers. Before this, nurses were often former servants or widows with no other work. Charles Dickens mocked poor nursing in Martin Chuzzlewit through the character Sarah Gamp.

A 2008 biography says Nightingale opposed contagionism, an early idea that diseases spread only by touch, rather than rejecting the idea of infection altogether. Her work inspired nurses in the American Civil War. The Union government asked her for advice, and her ideas inspired the United States Sanitary Commission. She believed matrons should control their nursing staff, which led to the Guy's Hospital dispute of 1879–1880 with matron Margaret Burt, and Eva Luckes faced similar problems. In the 1870s she mentored Linda Richards, "America's first trained nurse". In 1873, Elizabeth Christophers Hobson co-founded the Bellevue Training School for Nurses in New York. By 1882, Nightingale nurses were matrons at St Mary's Hospital, the Hospital for Incurables at Putney, the Royal Victoria Hospital at Netley, the Edinburgh Royal Infirmary, and Sydney Hospital in New South Wales, Australia. In 1883 she became the first recipient of the Royal Red Cross. In 1904 she was made a Lady of Grace of the Order of St John (LGStJ), and in 1907 she became the first woman to receive the Order of Merit. In 1908 she was given the Honorary Freedom of the City of London. From 1857 she was often bedridden and suffered from depression. Her birthday is now International May 12th Awareness Day for long-term illnesses, as she may have had myalgic encephalomyelitis/chronic fatigue syndrome, although a recent biography suggests brucellosis and spondylitis. From home she bought flannel by mail order, a new way of shopping set up by Welsh businessman Pryce Pryce-Jones, who used her name in his advertising. In her last decade she wrote very little because of blindness and declining mental abilities, though she still followed current affairs.

Relationships

Nightingale's work helped women in many places, but she believed that women wanted sympathy and were not as capable as men. She criticised early women's rights activists for complaining about a lack of careers for women, even though well-paid medical jobs, under her supervision and that of others, stayed empty. She preferred the friendship of powerful men, who she said had done more than women to help her reach her goals. She wrote: "I have never found one woman who has altered her life by one iota for me or my opinions." She often called herself "a man of action" and "a man of business".

Still, she had several important and lasting friendships with women. Later in life, she kept up a long exchange of letters with Irish nun Mary Clare Moore, who had worked with her in Crimea. Her most beloved close friend was Mary Clarke, an Englishwoman she met in Paris in 1837 and stayed in touch with for her whole life. She was also friends with pioneering computer programmer Ada Lovelace. When Lovelace died of cancer at 36 in 1852, after several months of pain, Nightingale wrote, "They said she could not possibly have lived so long, were it not for the tremendous vitality of the brain, that would not die". Some scholars of Nightingale's life believe she stayed chaste for her whole life, perhaps because she felt a religious calling to her career.

Death

Florence Nightingale died peacefully in her sleep in her room at 10 South Street, Mayfair, London, on 13 August 1910, at the age of 90. Her relatives declined the offer of burial in Westminster Abbey. She was buried in the churchyard of St Margaret's Church in East Wellow, Hampshire, near Embley Park, with a memorial showing only her initials and dates of birth and death.

She left a large body of work, including several hundred notes that had not been published before. In 1913, Francis William Sargant created a monument to Nightingale in Carrara marble. It was placed in the cloister of the Basilica of Santa Croce, in Florence, Italy.

Contributions

Florence Nightingale was very good at mathematics from a young age, and her father taught her. She became a pioneer in showing information visually through statistical graphics, using methods such as the pie chart, which William Playfair had first developed in 1801. She is especially known for the polar area diagram, sometimes called the Nightingale rose diagram, which is like a modern circular histogram. She called a set of these diagrams a "coxcomb". She used them to show the causes of death in the military hospital she managed and to report on medical care in the Crimean War to Members of Parliament and civil servants. In 1859 she became the first female member of the Royal Statistical Society, and in 1874 she became an honorary member of the American Statistical Association. Her work on the health of the British Army in India showed that bad drainage, dirty water, overcrowding and poor ventilation caused many deaths. Her cousin, the artist Hilary Bonham Carter, with whom she had lived, made drawings for a report on India. Nightingale campaigned for better sanitation across the country, and by 1873 she reported that deaths among soldiers in India had fallen from 69 to 18 per 1,000. She also pushed the minister James Stansfeld to strengthen public health laws, and worked with Edwin Chadwick to have local authorities enforce them. Historians believe these reforms helped raise average life expectancy in Britain by 20 years between 1871 and the mid-1930s.

Nightingale was also an important figure in writing and the women's movement. The historian I. Bernard Cohen noted that her achievements were impressive, since women of her class in Victorian England were not expected to attend university or have careers, and her father believed women should be educated. Lytton Strachey praised her in his book Eminent Victorians (1918), which made her an icon for English feminism in the 1920s and 1930s. She wrote about 200 books, pamphlets and articles. Her essay "Cassandra" was published in 1928 by Ray Strachey in a history of the women's movement. It is named after Cassandra, a princess of Troy who was given the gift of prophecy by Apollo during the Trojan War. Her large work Suggestions for Thought was published in full in 2008 by Wilfrid Laurier University. Nightingale trained at the institute for deaconesses at Kaiserswerth after writing it. The writer Elaine Showalter called her work "a major text of English feminism, a link between Wollstonecraft and Woolf". Nightingale was at first reluctant to join the Suffrage Society when John Stuart Mill asked her, but Josephine Butler convinced her that women's voting rights were essential for progress. In 1972 the poet Eleanor Ross Taylor wrote a poem in Nightingale's voice, which the poet Adrienne Rich praised.

Nightingale remained a member of the Church of England all her life, though with unusual views. She was influenced from an early age by the Wesleyan tradition and believed real religion should show in caring for others. She wrote Suggestions for Thought, her own theodicy, which develops her heterodox ideas. She questioned a God who would condemn souls to hell and believed in universal reconciliation, the idea that everyone will eventually reach heaven. She opposed discrimination against Christians of different churches and against people of other religions. She was often critical of organised religion, especially how the Church of England sometimes made the suffering of the poor worse. She also argued that secular hospitals usually gave better care than religious ones.

Legacy

Nightingale's lasting contribution is her role in founding the modern nursing profession. Her Nightingale School for Nurses opened in 1860 as the first official nurses' training programme. It is now called the Florence Nightingale Faculty of Nursing and Midwifery at King's College London. The International Committee of the Red Cross created the Florence Nightingale Medal in 1912, and it is the highest international distinction a nurse can achieve. International Nurses Day has been celebrated on her birthday since 1965. The Nightingale Pledge, a modified version of the Hippocratic Oath, was created in 1893 and named after her. Her image also appeared on £10 banknotes issued by the Bank of England from 1975 until 1994.

Many places remember her today. The Florence Nightingale Museum at St Thomas' Hospital in London reopened in May 2010. Four hospitals in Istanbul are named after her, and during the COVID-19 pandemic, several temporary NHS Nightingale Hospitals were set up in England. Her voice was preserved in a phonograph recording from 1890, kept in the British Library Sound Archive. She has also appeared in films and on television, and she has been honoured on stamps and coins around the world.

Works

Florence Nightingale wrote many books. Her best-known work, Notes on Nursing, was first published in London in 1859. Some of her other writings, including notes on spiritual topics, letters and essays, were later collected in a series called the Collected Works of Florence Nightingale.