The name Florence Nightingale summons up images of the devoted nurse who patiently and tirelessly made rounds to check on her wards late at night. But this ‘Lady With the Lamp” was not just a compassionate carer to the sick and wounded but also a pioneer of modern nursing and the sanitation practices that we know of and follow today.
Born in Italy in 1820 to a wealthy and extensively connected British family, Nightingale had a comfortable upbringing in England which included a good education. As a teenager she felt a deep calling to help those less fortunate and she found the social obligations of her affluent family very uncomfortable, preferring to be away from the attention of others. At the age of sixteen, she preferred to minister to the poor and the ill in their village. Her family was opposed to her decision to become a nurse, as the expectation of women in those times (and especially of her status) was to become a wife and a mother. Despite this opposition, Florence threw herself into her study of nursing as an art and a science, waving off the prospect of marriage, as she believed it would be an obstacle to her goal of becoming a nurse.
In 1850, Nightingale was visiting a pastor in Germany where she observed him treat the sick and the destitute in an institution. She wrote a paper about her findings on the institution, Kaiserswerth which became her first piece of published work. Her foundation for nursing care also came from this institution, where she spent four months developing her medical training.
A year later, she began to work at the Institute for the Care of Sick Gentlewomen in London. Her parents supported her financially during this time, ensuring she led a comfortable life and also allowing her to travel extensively and further her career.
It was during the Crimean War that Florence was able to give what was said to be her most significant contribution in the field of nursing and sanitation. On October 21, 1854, she and several others were deployed to the British camp in Crimea to tend to the wounded that were suffering in what could only be described as horrific conditions. Nightingale arrived in November of the same year and immediately noted the shortage of medical supplies, neglect for proper hygiene, poor nutrition, an alarming rate of infection spreading and a lack of food processing equipment. She noted all this in a letter to the The Times, and the government responded accordingly by erecting the prefabricated Renkioi Hospital.
With this act, she was able to reduce the death rate of the wounded to 2% from a staggering 42%, along with personal improvements in hygiene and persistently calling for action from the Sanitary Commission. Ever so humble, she refused to take credit for her part in drastically improving the hospital and care conditions of the wounded. Her time at Crimea was also where she gained the moniker ‘The Lady With the Lamp’, often seen as the gentle angel who faithfully came to check on her wards late in the night.
Her experience in Crimea formed the foundation of her advocacy for sanitary living conditions for both war times and in peace. Upon returning to Britain, Nightingale focused her attention on hospital sanitary design and introducing better hygiene standards in working class homes.
In November 1855, her efforts were rewarded with the establishment of the Nightingale Fund, with the aim of training nurses to improve proper care and sanitation practices. This fund had many wealthy donors, and so she had enough money from the Fund to also open the Nightingale Training School in July 1860. Apart from training, she also tirelessly campaigned and raised funds for hospitals in need of better sanitation and nursing.
Her book Notes on Nursing (1859) is considered to be the classic foundation tome on nursing and was well-received by the public, even though it was simply the curriculum material used at the Nightingale School and many other nursing schools. Its significance was such that she was able to cover important topics that went beyond patient recovery and care for infection: it also touched on topics such as sanitation of the environment and the importance of cleanliness. Her school for nursing gave the public nurses and caregivers who were more than just able-bodied: they were knowledgeable in the fields of medicine and science, and could dispense proper care to patients. This set a standard in Ireland and England beginning in the 1860s and onwards.
Nightingale spent the rest of her life promoting and improving the nursing profession, with her work also being noticed in the United States during the time of the Civil War. She was requested by the American government to help organize field medicine and she became the inspiration of nurses there, and spurred volunteer work through the United States Sanitary Commission. She also personally trained Linda Richards, who is considered to be the first trained nurse in America, in the 1870s. Thanks to the tutelage of Nightingale, Richards was able to set up high quality programs for nursing schools in the United States and in Japan.
Her hard work and dedication resulted in the receipt of several prestigious awards: the Royal Red Cross (1883), the appointment of a Lady of Grace of the Order of St. John (1904), the first woman recipient of the Order of Merit award (1907), and the Honorary Freedom Award of London (1908). Today, her birthday is commemorated as International Chronic Fatigue Awareness (CFS) Day.
In 1857, Nightingale began suffering from depression and was frequently bedridden due to brucellosis and spondylitis. Despite this, she was remarkably productive in her work on social reform and spent her bedridden years mapping out pioneering work in the study of hospital planning. Despite having very little written output in her last years (due to her blindness and deteriorating mental faculties), she nonetheless was able to provide improvements that were quickly applied by Britain and other nations.
Florence Nightingale peacefully died in her sleep at the age of 90 on August 13, 1910, leaving behind not only her legacy of a textbook on nursing and the establishment of key educational and training facilities for nurses but also hundreds of notes and unpublished works which are a testament to her tireless devotion to her advocacy and her unwavering compassion for those who most need it.
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