Florence Nightingale ("The Lady with the Lamp")

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

Florence Nightingale, OM, RRC; 12 May 1820 – 13 August 1910) was a celebrated English nurse, writer and statistician. A Christian universalist, Nightingale believed that God had called her to be a nurse. She came to prominence for her pioneering work in nursing during the Crimean War, where she tended to wounded soldiers. She was dubbed "The Lady with the Lamp" after her habit of making rounds at night.

Nightingale laid the foundation of professional nursing with the establishment, in 1860, of her nursing school at St Thomas' Hospital in London, the first secular nursing school in the world. The Nightingale Pledge taken by new nurses was named in her honor, and the annual International Nurses Day is celebrated around the world on her birthday.

Florence Nightingale's two greatest life achievements--pioneering of nursing and the reform of hospitals--were amazing considering that most Victorian women of her age group did not attend universities or pursue professional careers.

Florence Nightingale was brought up at Lea Hall; in 1825 the family moved to Lea Hurst which Nightingale had just built. In 1826 he also bought Embley Park, in Hampshire and in1828 he became High Sheriff of the county. The family invariably spent the summer at Lea Hurst and the winter at Embley Park, occasionally visiting London.

It was her father, William Nightingale, who believed women, especially his children, should get an education. So Nightingale and her sister learned Italian, Latin, Greek, history, and mathematics. She in particular received excellent early preparation in mathematics from her father and aunt, and was also tutored in mathematics by James Sylvester.

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. With her analysis, Florence Nightingale revolutionized the idea that social phenomena could be objectively measured and subjected to mathematical analysis. She was an innovator in the collection, tabulation, interpretation, and graphical display of descriptive statistics.

Florence Nightingale had a broad education and came to dislike the lack of opportunity for females in her social circle. She began to visit the poor but became very interested in looking after those who were ill. She visited hospitals in London and around the country to investigate possible occupations for women there. Nursing was seen as employment that needed neither study nor intelligence.

Nightingale's hospital visits began in 1844 and continued for eleven years. She spent the winter and spring of 1849-50 in Egypt with family friends; on the journey from Paris she met two St. Vincent de Paul sisters who gave her an introduction to their convent at Alexandria. Nightingale saw that the disciplined and well-organised Sisters made better nurses than women in England. Between 31 July to 13 August 1850, Nightingale made her first visit to the Institute of Protestant Deaconesses at Kaiserswerth. The institute had been founded for the care of the destitute in 1833 and had grown into a training school for women teachers and nurses. Her visit convinced Nightingale of the possibilities of making nursing a vocation for ladies. In 1851 she spent four months at Kaiserswerth, training as a sick nurse. When she returned home, she undertook more visits to London hospitals; in the autumn of 1852 she inspected hospitals in Edinburgh and Dublin. In 1853 she accepted her first (unpaid) administrative post when she became superintendent of the Hospital for Invalid Gentlewomen.

In 1854 the Secretary of War, Sidney Herbert, recruited Nightingale and 38 nurses for service in Scutari during the Crimean War.

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 21 October 1854, she and a staff of 38 women volunteer nurses, trained by Nightingale and including her aunt Mai Smith, were sent (under the authorisation of Sidney Herbert) to the Ottoman Empire, about 295 nautical miles (546 km; 339 mi) 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.

At the beginning of the 20th century, it was asserted that Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene herself or by calling for the Sanitary Commission. The 1911 first edition of the Dictionary of National Biography made this claim, but the second edition in 2001 did not. However, death rates did not drop: they began to rise. The death count was the highest of all hospitals in the region. During her first winter at Scutari, 4,077 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, and effected flushing out the sewers and improvements to ventilation. Death rates were sharply reduced. During the war she did not recognise hygiene as the predominant cause of death, and she never claimed credit for helping to reduce the death rate.

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 influenced 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.

For her contribution to Army statistics and comparative hospital statistics in 1860 Florence became the first woman to be elected a fellow of the Statistical Society.Florence Nightingale

Florence established the Nightingale Training School for Nurses at St Thomas’ Hospital, London. Florence’s best known work Notes on Nursing was published – this is still available today and has been translated into eleven languages. In total Florence published 200 books, reports and pamphlets during her lifetime.

1872

Florence devotes closer attention to the organisation of the Nightingale Training School and almost annually for the next 30 years she wrote a letter to the students giving advice and encouragement. On completion of their training, Florence gave them nurses books and invited them to tea.

Nightingale responded to the British war office's request for advice on army medical care in Canada and was also a consultant to the United States government on army health during the American Civil War.

1883 - In recognition of Florence’s hard work, she received the Royal Red Cross from Queen Victoria.

1907 - Florence receives the Order of Merit – becoming the first woman to receive it

1908 - Florence was awarded the Freedom of the City of London.

She had already received the German order of the Cross of Merit and the French gold medal of Secours aux Blessés Militaires.

10 May 1910 she was presented with the badge of honour of the Norwegian Red Cross Society.

Florence died aged 90 at her home at 10 South Street, Mayfair, in the West End of London and was buried in the family plot at St Margaret’s East Wellow, near her parent’s home, Embley Park in Hampshire. An offer of burial in Westminster Abbey was refused by her relatives. Memorial services took place in St. Paul's Cathedral and Liverpool Cathedral, among many other places.

Cromford and Florence Nightingale.

Florence Nightingale was from the Nightingale family of the nearby village of Lea. Her great great uncle Peter Nightingale was a wealthy landowner, his lands including the manor of Cromford which he sold to Richard Arkwright. His business ventures included a cotton factory at Lea, now John Smedley's, and lead smelting.

Peter Nightingale had no legitimate children and at his death in 1803 his estate and fortune went to his sister's grandson, William Edward Shore. When William came into his inheritance at the age of 21 in 1815, he changed his name to Nightingale.

William Nightingale married Fanny Smith, the daughter of an MP and wealthy businessman, of Parndon Hall in Essex. The Nightingale daughters were born abroad, Parthenope in Naples in 1819 and on 12 May 1820, Florence was born and named after her birthplace.

Lea Hall, the Nightingale family home, was not big enough for Fanny, so William built Lea Hurst in the neighbouring village of Holloway. The house was completed in 1825, but in spite of having fifteen bedrooms was still not to Fanny's liking. She wanted to move nearer her family so William bought Embley House in Hampshire. Henceforth the family spent the winters at Embley and the summers at Lea Hurst, with frequent visits to London.

As Florence grew up she became discontented with her life and felt that she had a call from God to help others. She studied hygiene, sanitation and medical matters, gaining some experience from helping the poor and sick in Holloway, and visiting hospitals in Germany and France. All this against the fierce opposition of her mother and sister.

Towards the end of 1852 Florence was in London when she heard that her great aunt Elizabeth Evans had been taken ill. Florence travelled to her aunt's home at Cromford Bridge House to nurse her through her last illness.

After her aunt's death Florence was planning to go to Paris to work in the hospitals of the Council of the Sisters of Charity. In an attempt to stop her going, her mother Fanny offered her the now empty Cromford Bridge House to turn into a hospital. Everything would be provided - money, furniture, equipment. Florence declined, and went to Paris to continue her training as a nurse.

Florence Nightingale was to become a national celebrity as a result of her work among the wounded soldiers in the Crimea, and the work she did for many years to reform medical services in the army and in the training of nurses. She wrote many books and pamphlets on matters of hygiene. Florence Nightingale died 13 August 1910 at her home in South Street, London.

The Lady with the Lamp

During the Crimean war, Florence Nightingale gained the nickname "The Lady with the Lamp", deriving from a phrase in a report in The Times:

She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.

The phrase was further popularised by Henry Wadsworth Longfellow's 1857 poem "Santa Filomena":

Lo! in that house of misery

A lady with a lamp I see

Pass through the glimmering gloom,

And flit from room to room.

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Relationships

Although much of Nightingale's work improved the lot of women everywhere, she had little respect for women in general preferring the friendship of powerful men. She often referred to herself in the masculine, as for example "a man of action" and "a man of business".

She did, however, have several important and passionate friendships with women. As a young woman she adored both an aunt and a female cousin. Later in life she kept up a prolonged correspondence with an Irish nun, Sister Mary Clare Moore, with whom she had worked in Crimea. Her most beloved confidante was Mary Clarke, an Englishwoman she met in 1837 and kept in touch with throughout her life.

In spite of these deep emotional attachments to women, some scholars of Nightingale's life believe that she remained chaste for her entire life; perhaps because she felt an almost religious calling to her career, or because she lived in the time of Victorian sexual morality.

Death

On 13 August 1910, at the age of 90, she died peacefully in her sleep in her room at 10 South Street, Park Lane. 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

Statistics and sanitary reform

Florence Nightingale had exhibited a gift for mathematics from an early age and excelled in the subject under the tutorship of her father. Later, Nightingale became a pioneer in the visual presentation of information and statistical graphics. Among other things she used the pie chart, which had first been developed by William Playfair in 1801. While taken for granted now, it was at the time a relatively novel method of presenting data.

Indeed, Nightingale is described as "a true pioneer in the graphical representation of statistics", and is credited with developing a form of the pie chart now known as the polar area diagram, or occasionally the Nightingale rose diagram, equivalent to a modern circular histogram, in order 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 and 1859 she successfully lobbied for the establishment of a Royal Commission into the Indian situation. Two years later she provided a report to the commission, which completed its own study in 1863. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000".

In 1859 Nightingale was elected the first female member of the Royal Statistical Society and she later became an honorary member of the American Statistical Association.

Literature and the women's movement

Nightingale's achievements are all the more impressive when they are considered against the background of social restraints on women in Victorian England. Her father, William Edward Nightingale, was an extremely wealthy landowner, and the family moved in the highest circles of English society. In those days, women of Nightingale's class did not attend universities and did not pursue professional careers; their purpose in life was to marry and bear children. Nightingale was fortunate. Her father believed women should be educated, and he personally taught her Italian, Latin, Greek, philosophy, history and - most unusual of all for women of the time - writing and mathematics.

But while better known for her contributions in the nursing 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. This was an 829 page, three-volume work, which Nightingale had printed privately in 1860, but which until recently was never published in its entirety. An effort to correct this was made with a 2008 publication by Wilfrid Laurier University, as volume 11 of a 16 volume project, the Collected Works of Florence Nightingale. The best known of these essays, called Cassandra, was previously published by Ray Strachey in 1928. Strachey included it in The Cause, a history of the women's movement. Apparently, the writing served its original purpose of sorting out thoughts; Nightingale left soon after to train at the Institute for deaconesses at Kaiserswerth.

Cassandra protests the over-feminization of women into near helplessness, such as Nightingale saw in her mother's 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 was a princess of Troy who served as a priestess in the temple of Apollo during the Trojan War. The god gave her the gift of prophecy but when she refused his advances he cursed her so that her prophetic warnings would go unheeded. Elaine Showalter called Nightingale's writing "a major text of English feminism, a link between Wollstonecraft and Woolf."

Theology

Despite being named as a Unitarian in many older sources, Nightingale's own rare references to conventional Unitarianism are mildly negative, and she remained in the Church of England throughout her life, albeit with unorthodox views. Suggestions for Thought is also Nightingale's work of theology, her own theodicy, which develops her heterodox ideas. Nightingale questioned the goodness of a God who would condemn souls to hell, showing sympathy for the idea of universal reconciliation.

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