THE NIGHTINGALE INFLUENCE

In the latter half of the 18th century, one woman dramatically changed the form and direction of nursing and succeeded in establishing it as a respected field of endeavor. This outstanding woman was Florence Nightingale. Born on May 12, 1820, the second daughter of a wealthy family, she was named after the city in which she was born—Florence, Italy. Because of her family’s high social and economic standing, she was cultured, well traveled, and educated. By the age of 17, as the result of tutorage from her father, she had mastered several languages and mathematics and was extremely well read. Through the influential people she met, she was expected to select a desirable mate, marry, and assume her place in society. Florence Nightingale had other ideas, however. She wanted to become a nurse, but this aspiration was unthinkable to her family because of the conditions that surrounded nursing. She continued to travel with her family and their friends and, in the course of these travels, met Sidney Herbert and his wife, who were becoming interested in hospital reform. She began collecting information on public health and hospitals and soon became recognized as an important authority on the subject. Through friends she learned about Pastor Fliedner’s institute at Kaiserwerth and visited it in 1850. Because it was a religious institution under the auspices of the church, her parents would permit her to go there, although she could not go to English hospitals. In 1851, she spent 3 months studying at Kaiserwerth, never returning home to live. In 1853, she began working with a committee that supervised an “Establishment for Gentlewomen During Illness.” She eventually was appointed superintendent of the establishment, a position she held from August 1853 to October 1854. As her knowledge of hospitals and nursing reform grew, she was consulted by reformers and by physicians who were beginning to see the need for “trained” nurses.
After the Crimean War began in March, 1854, war correspondents wrote about the abominable manner in which the British Army cared for the sick and wounded soldiers. Florence Nightingale, by then a recognized authority on hospital care, wrote to her friend Sir Sidney Herbert, who was then Secretary of War, and offered to take a group of 38 nurses to the Crimea. (At the same time, he had written a letter proposing that she assume direction of all nursing operations at the war front. Their letters crossed in the mail.) Her tireless efforts resulted in greatly reduced mortality rates among the sick and wounded. When the war ended in 1856, Florence Nightingale returned to England as a national heroine but with her health broken. Much has been written of her “illness,” some suggesting that it was brucellosis; others stating that it was, to a large degree, a neurosis; and more recently some declaring that it was posttraumatic stress disorder. She retreated to her bedroom, and for the next 43 years conducted her business from her secluded apartment. Throughout her lifetime, Florence Nightingale wrote extensively about hospitals, sanitation, health, and health statistics, and especially about nursing and nursing education. Among the most popular books is “Notes on Nursing,” published in 1859. She crusaded for and
brought about great reform in nursing education. In 1860, she devoted her efforts to the creation of a school of nursing at St. Thomas’ Hospital in London, financed by the Nightingale Fund. The basic principles on which Miss Nightingale established her school included the following:
• Nurses would be trained in teaching hospitals associated with medical schools and organized for that purpose.
• Nurses would be selected carefully and would reside in nurses’ houses designed to
encourage discipline and form character.
• The school matron would have final authority over the curriculum, living arrangements,
and all other aspects of the school.
• The curriculum would include both theoretic material and practical experience.
• Teachers would be paid for their instruction.
• Records would be kept on the students, who would be required to attend lectures, take quizzes, write papers, and keep diaries.
In many other ways, Florence Nightingale advanced nursing as a profession. She believed that nurses should spend their time caring for patients, not cleaning; that nurses must continue learning throughout their lifetime and not become “stagnant”; that nurses should be intelligent and should use that intelligence to improve conditions for the patient; and that nursing leaders should have social standing. She had a vision of what nursing could and should be. For further discussion of Florence Nightingale’s definition of nursing. Florence Nightingale received many honors from foreign governments, and in 1907 she was recognized by the Queen of England, who awarded her the British Order of Merit. It was the first time it was given to a woman. Florence Nightingale died in her sleep at the age of 90 on August 13, 1910. The week during which she was born is now honored as National Nurses Week. The enthusiastic student is encouraged to learn more about this fascinating woman in Cecil Woodham-Smith’s book Florence Nightingale, or by pursuing the topic of Florence Nightingale through the Internet.