Florence Nightingale

Florence Nightingale, the Lady with the Lamp, was a celebrated English Nurse and Pioneering Modern Nursing, Writer and Statistician born on 12 May 1820 at the Villa La Columbaia, near the Porta Romana at Bellosguardo in Florence, Italy; she was named after the city of her birth. Her father, William Edward Nightingale (1794-1874), was son of William Shore, a Sheffield banker. When Nightingale came of age on 21 February 1815 he inherited the Derbyshire estates at Lea Hurst and Woodend in Derbyshire from, and assumed the surname of Peter Nightingale, his mother's uncle. On 1 June 1818 he married Frances Smith, a strong supporter of the abolition of slavery. They had two daughters, Parthenope and Florence. "Parthe" was given the classical name of Naples where she was born.

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. 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. However, nursing was seen as employment that needed neither study nor intelligence; nurses were considered to be little less than prostitutes at that time. Inspired by what she took as a call from God in February 1837 while at Embley Park, Florence announced her decision to enter nursing in 1844, despite the intense anger and distress of her mother and sister. In this, she rebelled against the expected role for a woman of her status, which was to become a wife and mother. Nightingale worked hard to educate herself in the art and science of nursing, in spite of opposition from her family and the restrictive societal code for affluent young English women. Nightingale was courted by politician and poet Richard Monckton Milnes, 1st Baron Houghton, but she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing.

Florence Nightingale with Lamp

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-organized Sisters made better nurses than women in England.

Florence Nightingale

In Rome in 1847, she met Sidney Herbert, a brilliant politician who had been Secretary at War (1845–1846), a position he would hold again during the Crimean War. Herbert was on his honeymoon; he and Nightingale became lifelong close friends. Herbert and his wife were instrumental in facilitating Nightingale's nursing work in the Crimea, and she became a key adviser to him in 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 Benjamin Jowett, who may have wanted to marry her. 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 administrative post when she became superintendent of the Hospital for Invalid Gentlewomen.

In March 1854 the Crimean War broke out, her 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 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. 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. The death count was the highest of all hospitals in the region.

Nightingale and Sir H.Verney with group of nurses at Claydon House

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 recognize 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.

A ward of the hospital at Scutari where Nightingale worked

The military and medical authorities at Scutari viewed Nightingale's intervention as a reflection on themselves. Many of her own volunteers were inexperienced and the behaviour of the orderlies was offensive to the women. However, before the end of 1854, Nightingale and her nurses had brought the Scutari hospital into better order. The relief fund organised by The Times sent out stores; other voluntary associations at home were helpful. In December forty-six more nurses went to the Crimea. Nightingale quickly established a vast kitchen and a laundry; she looked after the soldiers' wives and children, and to provide daily necessities for them. She was on her feet for twenty hours a day and her nurses were also overworked; however, she was the only woman whom she allowed to be in the wards after eight at night, when the other nurses' places were taken by orderlies. The wounded men called her ‘The Lady of the Lamp.’ Longfellow tried to express the feelings for Nightingale in his poem, Santa Filomena.

Early in 1855, because of the defects in the sanitation system, there was a great increase in the number of cases of cholera and of typhus fever among Nightingale's patients. Seven of the army doctors and three of the nurses died. Frost-bite and dysentery from exposure in the trenches before Sevastopol made the wards fuller than before. There were over 2000 sick and wounded in the hospital and in February 1855 the death-rate rose to 42%. The War Office ordered the sanitary commissioners at Scutari to carry out sanitary reforms immediately, after which the death-rate declined rapidly until in June it had fallen to 2%.

In May 1855 Nightingale visited the hospitals at and near Balaclava along with Mr. Bracebridge and Alexis Soyer. Nightingale fell ill from Crimean fever and she was dangerously ill for twelve days. Early in June she returned to Scutari and resumed her work there. In addition to her nursing work she tried to provide reading and recreation rooms for the men and their families. In March 1856 she returned to Balaclava and remained there until July when the hospitals were closed. She returned to England privately in August 1856, in a French ship. She entered England unnoticed and went home to Lea Hurst.

Florence Nightingale in Crimean War

In September 1856 Nightingale visited Queen Victoria at Balmoral and told the Queen and Prince Albert about everything that 'affects our present military hospital system and the reforms that are needed'. In November 1855 a Nightingale fund had been set up to found a training school for nurses. This was the only recognition of her services of which Nightingale would approve. By 1860, £50,000 had been collected and the Nightingale School and Home for Nurses was established at St. Thomas's Hospital. Nightingale's health and other occupations prevented her from accepting the post of superintendent but she watched the progress of the new institution with practical interest. She was able to use her experiences in the Crimea for the benefit of the nursing profession.

Nightingale receiving the injured at Scutari

She settled in London and lived the retired life of an invalid, although she spent a great deal of time offering advice and encouragement through her writing and also verbally. In 1857 she issued an exhaustive and confidential report on the workings of the army medical departments in the Crimea and in 1858 she published Notes on Matters affecting the Health, Efficiency and Hospital Administration of the British Army. In 1858 a Commission was appointed to inquire into the sanitary condition of the army: it set a high value on her evidence. In 1859 an army medical college was opened at Chatham and the first military hospital was established in Woolwich in 1861. During the American Civil War and the Franco-Prussian War of 1870-71 her advice was sought by the respective governments. Nightingale was involved in establishing the East London Nursing Society (1868), the Workhouse Nursing Association and National Society for providing Trained Nurses for the Poor (1874) and the Queen's Jubilee Nursing Institute (1890).

Nightingale's Statue, Derby

When the Indian Mutiny broke out in 1857 Nightingale offered to leave for India immediately if there was anything she could do. Her services were not required but she became interested in the sanitary condition of the army and people there. From her work, a Sanitary Department was established in the Indian government. She became familiar with many facets of Indian life and demanded that there should be improvements in health and sanitation there. She did not visit India. She wrote papers on the causes of famine, the need of irrigation and the poverty of the people of India. In 1890 she contributed a paper on village sanitation in India. Her book, notes on nursing first appeared in 1860 and was reprinted many times during in her lifetime.

She received was the Order of Merit in 1907 and in 1908 she 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. On 10 May 1910 she was presented with the badge of honour of the Norwegian Red Cross Society. Nightingale died peacefully in her sleep at 10, South Street, Park Lane, London, on 13 August 1910 at the age of ninety and was buried on 20 August 1910 in the graveyard at St.Margaret Church in East Wellow, Hampshire. Memorial services took place in St. Paul's Cathedral and Liverpool Cathedral, among many other places.

Florence Nightingale's statue, Waterloo Place, London

The grave of Florence Nightingale in the churchyard of 
St.Margaret's Church, East Wellow