Florence Nightingale
Florence Nightingale was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War, in which she organised care for wounded soldiers at Constantinople. She significantly reduced death rates by improving hygiene and living standards. Nightingale gave nursing a favourable reputation and became an icon of Victorian culture, especially in the persona of "The Lady with the Lamp" making rounds of wounded soldiers at night.
Recent commentators have asserted that Nightingale's Crimean War achievements were exaggerated by the media at the time, but critics agree on the importance of her later work in professionalising nursing roles for women. In 1860, she laid the foundation of professional nursing with the establishment of her nursing school at St Thomas' Hospital in London. It was the first secular nursing school in the world and is now part of King's College London. In recognition of her pioneering work in nursing, the Nightingale Pledge taken by new nurses, and the Florence Nightingale Medal, the highest international distinction a nurse can achieve, were named in her honour, and the annual International Nurses Day is celebrated on her birthday. Her social reforms included improving healthcare for all sections of British society, advocating better hunger relief in India, helping to abolish prostitution laws that were harsh for women, and expanding the acceptable forms of female participation in the workforce.
Nightingale was an innovator in statistics; she represented her analysis in graphical forms to ease drawing conclusions and actionables from data. She is famous for usage of the polar area diagram, also called the Nightingale rose diagram, which is equivalent to a modern circular histogram or pie chart. This diagram is still regularly used in data visualisation.
Nightingale was a prodigious and versatile writer. In her lifetime, much of her published work was concerned with spreading medical knowledge. Some of her tracts were written in simple English so that they could easily be understood by those with poor literary skills. Much of her writing, including her extensive work on religion and mysticism, has only been published posthumously.
Early life
Florence Nightingale was born on 12 May 1820 into a wealthy and well-connected British family at the Villa Colombaia, in Florence, Tuscany, Italy, and was named after the city of her birth. Florence's older sister Frances Parthenope had similarly been named after her place of birth, Parthenope, a Greek settlement now part of the city of Naples. The family moved back to England in 1821, with Nightingale being brought up in the family's homes at Embley, Hampshire, and Lea Hurst, Derbyshire.Florence inherited a liberal-humanitarian outlook from both sides of her family. Her parents were William Edward Nightingale, born William Edward Shore and Frances Nightingale. William's mother Mary was the niece of Peter Nightingale, under the terms of whose will William inherited his estate at Lea Hurst, and assumed the name and arms of Nightingale. Fanny's father was the abolitionist and Unitarian William Smith. Nightingale's father educated her.
A BBC documentary reported that:
"Florence and her older sister Parthenope benefited from their father's advanced ideas about women's education. They studied history, mathematics, Italian, classical literature, and philosophy, and from an early age Florence, who was the more academic of the two girls, displayed an extraordinary ability for collecting and analysing data which she would use to great effect in later life."In 1838, her father took the family on a tour in Europe where she was introduced to the English-born Parisian hostess Mary Clarke, with whom Florence bonded. She recorded that "Clarkey" was a stimulating hostess who did not care for her appearance, and that while her ideas did not always agree with those of her guests, "she was incapable of boring anyone." Her behaviour was said to be exasperating and eccentric and she had little respect for upper-class British women, whom she regarded generally as inconsequential. She said that if given the choice between being a woman or a galley slave, then she would choose the freedom of the galleys. She generally rejected female company and spent her time with male intellectuals. Clarke made an exception, however, in the case of the Nightingale family and Florence in particular. She and Florence remained close friends for 40 years despite their 27-year age difference. Clarke demonstrated that women could be equal to men, an idea that Florence had not learned from her mother.
Nightingale underwent the first of several experiences that she believed were calls from God in February 1837 while at Embley Park, prompting a strong desire to devote her life to the service of others. In her youth she was respectful of her family's opposition to her working as a nurse, only announcing her decision to enter the field in 1844. Despite the anger and distress of her mother and sister, she rejected the expected role for a woman of her status to become a wife and mother. Nightingale worked hard to educate herself in the art and science of nursing, in the face of opposition from her family and the restrictive social code for affluent young English women.
As a young woman, Nightingale was described as attractive, slender, and graceful. While her demeanour was often severe, she was said to be very charming and to possess a radiant smile. Her most persistent suitor was the politician and poet Richard Monckton Milnes, but after a nine-year courtship, she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing.
In Rome in 1847, she met Sidney Herbert, a politician who had been Secretary at War who was on his honeymoon. He and Nightingale became lifelong close friends. Herbert would be Secretary of War again during the Crimean War when he and his wife would be instrumental in facilitating Nightingale's nursing work in Crimea. She became Herbert's key adviser throughout his political career, though she was accused by some of having hastened Herbert's death from Bright's disease in 1861 because of the pressure her programme of reform placed on him. Nightingale also much later had strong relations with academic Benjamin Jowett, who may have wanted to marry her.
Nightingale continued her travels as far as Greece and Egypt. While in Athens, Greece, Nightingale rescued a juvenile little owl from a group of children who were tormenting it, and she named the owl Athena. Nightingale often carried the owl in her pocket, until the pet died.
Her writings on Egypt, in particular, are testimony to her learning, literary skill, and philosophy of life. Sailing up the Nile as far as Abu Simbel in January 1850, she wrote of the Abu Simbel temples, "Sublime in the highest style of intellectual beauty, intellect without effort, without suffering... not a feature is correct — but the whole effect is more expressive of spiritual grandeur than anything I could have imagined. It makes the impression upon one that thousands of voices do, uniting in one unanimous simultaneous feeling of enthusiasm or emotion, which is said to overcome the strongest man."
At Thebes, she wrote of being "called to God", while a week later near Cairo she wrote in her diary : "God called me in the morning and asked me would I do good for him alone without reputation." Later in 1850, she visited the Lutheran religious community at Kaiserswerth-am-Rhein in Germany, where she observed Pastor Theodor Fliedner, Friederike Fliedner and the deaconesses working for the sick and the deprived. She regarded the experience as a turning point in her life and issued her findings anonymously in 1851; The Institution of Kaiserswerth on the Rhine, for the Practical Training of Deaconesses, etc. was her first published work. She also received four months of medical training at the institute, which formed the basis for her later care.
On 22 August 1853, Nightingale took the 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 , which allowed her to live comfortably and to pursue her career.
Crimean War
Florence Nightingale's most famous contribution came during the Crimean War, which became her central focus when reports got back to Britain about the horrific conditions for the wounded at the military hospital on the Asiatic side of the Bosporus, opposite Constantinople, at Scutari. Britain and France entered the war against Russia on the side of the Ottoman Empire. On 21 October 1854, she and the staff of 38 women volunteer nurses including her head nurse Eliza Roberts and her aunt Mai Smith, and 15 Catholic nuns were sent to the Ottoman Empire. On the way, Nightingale was assisted in Paris by her friend Mary Clarke. The volunteer nurses worked about away from the main British camp across the Black Sea at Balaklava, in the Crimea.Nightingale arrived at Selimiye Barracks in Scutari early in November 1854. Her team found that poor care for wounded British soldiers was being delivered 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:
After Nightingale sent a plea to The Times for a government solution to the poor condition of the facilities, the British Government commissioned Isambard Kingdom Brunel to design a prefabricated hospital that could be built in England and shipped to the Dardanelles. The result was Renkioi Hospital, a civilian facility that, under the management of Edmund Alexander Parkes, had a death rate less than one tenth of that of Scutari.
Stephen Paget in the Dictionary of National Biography 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. For example, Nightingale implemented handwashing in the hospital where she worked.
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. With overcrowding, defective sewers and lack of ventilation, the Sanitary Commission had to be sent out by the British government to Scutari in March 1855, almost six months after Nightingale had arrived. The commission flushed out the sewers and improved ventilation. Death rates were sharply reduced, but she never claimed credit for helping to reduce the death rate. Head Nurse Eliza Roberts nursed Nightingale through her critical illness of May 1855.
In 2001 and 2008, the BBC released documentaries that were critical of Nightingale's performance in the Crimean War, as were some follow-up articles published in The Guardian and the Sunday Times. Nightingale scholar Lynn McDonald has dismissed these criticisms as "often preposterous", arguing they are not supported by primary sources.
Nightingale still believed that the death rates were due to poor nutrition, lack of supplies, stale air, and overworking of the soldiers. After she returned to Britain and began collecting evidence before the Royal Commission on the Health of the Army, 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 peacetime deaths in the army and turned her attention to the sanitary design of hospitals and the introduction of sanitation in working-class homes.
File:Nightingale receiving the Wounded at Scutari by Jerry BarrettFXD.jpg|thumb|The Mission of Mercy: Florence Nightingale receiving the Wounded at Scutari |alt=A painting of Florence Nightingale by Jerry Barrett in 1857.
According to some secondary sources, Nightingale had a frosty relationship with her fellow nurse Mary Seacole, who ran a hotel/hospital for officers in the Crimea itself, many miles east of Scutari. Seacole's own memoir, Wonderful Adventures of Mrs. Seacole in Many Lands, records only one, friendly, meeting with her, when she asked her for a bed for the night and got it; Seacole was in Scutari en route to the Crimea to join her business partner and start their business. However, Seacole pointed out that when she tried to join Nightingale's group, one of Nightingale's colleagues rebuffed her, and Seacole inferred that racism was at the root of that rebuttal. Nightingale told her brother-in-law, in a private letter, that she was worried about contact between her work and Seacole's business, claiming that while "she was very kind to the men and, what is more, to the Officers – and did some good made many drunk". Nightingale reportedly wrote, "I had the greatest difficulty in repelling Mrs. Seacole's advances, and in preventing association between her and my nurses ... Anyone who employs Mrs. Seacole will introduce much kindness – also much drunkenness and improper conduct". On the other hand, Seacole told the French chef Alexis Soyer that "You must know, M Soyer, that Miss Nightingale is very fond of me. When I passed through Scutari, she very kindly gave me board and lodging."
The arrival of two waves of Irish nuns, the Sisters of Mercy, to assist with nursing duties at Scutari met with different responses from Nightingale. Mary Clare Moore headed the first wave and placed herself and her Sisters under the authority of Nightingale. The two were to remain friends for the rest of their lives. The second wave, headed by Mary Francis Bridgeman met with a cooler reception as Bridgeman refused to give up her authority over her Sisters to Nightingale while at the same time not trusting Nightingale, whom she regarded as ambitious.