Peter Abelard, French scholar & lover of Aeloise
Godried II, Count of Louvain & Duke of Brabant
Gulielmus of Vercelli, Italian hermit, monastry founder, saint
Peter Abelard, French scholar & lover of Aeloise
Godried II, Count of Louvain & Duke of Brabant
Gulielmus of Vercelli, Italian hermit, monastry founder, saint
Melissa Gilbert, 60
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Del Gray, 56
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Robert Johnson (May 8, 1911-August 16, 1938)
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Innocent II (Gregorio de' Papareschi), Italian Pope
King Fulk of Jerusalem
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Eva Peron (May 7, 1919-July 26, 1952)
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Tim Russert (May 7, 1950-June 13, 2008)
Celestine II (Guido), Italian Pope
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Abo e 'l-Kasim Mahmoed ibn Omar al-Zapowersjad, theologist
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Rudolph Valentino (May 6, 1895-August 23, 1926)
Orson Welles (May 6, 1915-October 10, 1985)
John Rhys-Davies, 80
Danielle Fishel, 43
Henry Cavill, 41
Adele, 36
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Death
In 1939 Belgium issued a semi-postal stamp in honour of
Nightingale in recognition of her work with the Red Cross when in Belgium
Florence Nightingale died peacefully in her sleep in her
room at 10 South Street, Mayfair, London, on 13 August 1910, at the age of 90.
The offer of burial in Westminster Abbey was declined by her relatives and she
is buried in the churchyard of St Margaret's Church in East Wellow, Hampshire,
near Embley Park with a memorial with just her initials and dates of birth and
death. She left a large body of work, including several hundred notes that were
previously unpublished. A memorial monument to Nightingale was created in
Carrara marble by Francis William Sargant in 1913 and placed in the cloister of
the Basilica of Santa Croce, in Florence, Italy.
Contributions
Statistics and sanitary
reform
Florence Nightingale exhibited a gift for mathematics from
an early age and excelled in the subject under the tutelage of her father.
Later, Nightingale became a pioneer in the visual presentation of information
and statistical graphics. She used methods such as 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 especially well known for her usage of a polar area
diagram, or occasionally the Nightingale rose diagram, equivalent to a modern
circular histogram, to illustrate seasonal sources of patient mortality in the
military field hospital she managed. While frequently credited as the creator
of the polar area diagram, it is known to have been used by André-Michel Guerry
in 1829 and Léon Louis Lalanne by 1830. Nightingale called a compilation of
such diagrams a "coxcomb",
but later that term would frequently be used for 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 1859, Nightingale was elected the first
female member of the Royal Statistical Society. In 1874 she became an honorary
member of the American Statistical Association.
"Diagram of the causes of mortality in the army in the East"
by Florence Nightingale
Her attention turned to the health of the British Army in
India and she demonstrated that bad drainage, contaminated water, overcrowding,
and poor ventilation were causing the high death rate. Following the report The
Royal Commission on India (1858–1863), which included drawings done by her
cousin, artist Hilary Bonham Carter, with whom Nightingale had lived,
Nightingale concluded that the health of the army and the people of India had
to go hand in hand and so campaigned to improve the sanitary conditions of the
country as a whole.
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 services 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".
The Royal Sanitary Commission of 1868–1869 presented
Nightingale with an opportunity to press for compulsory sanitation in private
houses. She lobbied the minister responsible, James Stansfeld, to strengthen
the proposed Public Health Bill to require owners of existing properties to pay
for connection to mains drainage. The strengthened legislation was enacted in
the Public Health Acts of 1874 and 1875. At the same time, she combined with
the retired sanitary reformer Edwin Chadwick to persuade Stansfeld to devolve
powers to enforce the law to Local Authorities, eliminating central control by
medical technocrats. Her Crimean War statistics had convinced her that
non-medical approaches were more effective given the state of knowledge at the
time. Historians now believe that both drainage and devolved enforcement played
a crucial role in increasing average national life expectancy by 20 years
between 1871 and the mid-1930s during which time medical science made no impact
on the most fatal epidemic diseases.
Literature and the
women's movement
Historian of science I. Bernard Cohen argues:
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.
Lytton Strachey was famous for his book debunking
19th-century heroes, Eminent Victorians (1918). Nightingale gets a full
chapter, but instead of debunking her, Strachey praised her in a way that
raised her national reputation and made her an icon for English feminists of
the 1920s and 1930s.
While better known for her contributions to the nursing and
mathematical fields, Nightingale is also an important link in the study of
English feminism. She wrote some 200 books, pamphlets, and articles throughout
her life. 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; 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". Nightingale was
initially reluctant to join the Women's Suffrage Society when asked by John
Stuart Mill, but Josephine Butler was convinced 'that women's enfranchisement is absolutely essential to a nation if
moral and social progress is to be made'.
In 1972, the poet Eleanor Ross Taylor wrote "Welcome Eumenides", a poem
written in Nightingale's voice and quoting frequently from Nightingale's
writings. Adrienne Rich wrote that "Eleanor
Taylor has brought together the waste of women in society and the waste of men
in wars and twisted them inseparably."
Theology
Despite being named as a Unitarian in several older sources,
Nightingale's own rare references to conventional Unitarianism are mildly
negative. She remained in the Church of England throughout her life, albeit
with unorthodox views. Influenced from an early age by the Wesleyan tradition,
Nightingale felt that genuine religion should manifest in active care and love
for others. She wrote a work of theology: Suggestions for Thought, her own
theodicy, which develops her heterodox ideas. Nightingale questioned the
goodness of a God who would condemn souls to hell and was a believer in
universal reconciliation – the concept that even those who die without being
saved will eventually make it to heaven. She would sometimes comfort those in
her care with this view. For example, a dying young prostitute being tended by
Nightingale was concerned she was going to hell and said to her "Pray God that you may never be in the
despair I am in at this time". The nurse replied, "Oh, my girl, are you not now more merciful than the God you think
you are going to? Yet the real God is far more merciful than any human creature
ever was or can ever imagine."
Despite her intense personal devotion to Christ, Nightingale
believed for much of her life that the pagan and Eastern religions had also
contained genuine revelation. She was a strong opponent of discrimination both
against Christians of different denominations and against those of
non-Christian religions. Nightingale believed religion helped provide people
with the fortitude for arduous good work and would ensure the nurses in her
care attended religious services. However, she was often critical of organized
religion. She disliked the role the 19th-century Church of England would
sometimes play in worsening the oppression of the poor. Nightingale argued that
secular hospitals usually provided better care than their religious
counterparts. While she held that the ideal health professional should be
inspired by a religious as well as professional motive, she said that in
practice many religiously motivated health workers were concerned chiefly with
securing their own salvation and that this motivation was inferior to the
professional desire to deliver the best possible care.
Legacy
Nursing
Nightingale's lasting contribution has been her role in
founding the modern nursing profession. She set an example of compassion,
commitment to patient care, and diligent and thoughtful hospital administration.
The first official nurses' training program, her Nightingale School for
Nurses, opened in 1860 and is now called the Florence Nightingale Faculty of
Nursing and Midwifery at King's College London.
She belongs to that
select band of historical characters that are instantly recognizable: the Lady
with the Lamp, ministering to the wounded and dying. – BBC profile of Nightingale.
In 1912, the International Committee of the Red Cross
instituted the Florence Nightingale Medal, which is awarded every two years to
nurses or nursing aides for outstanding service. It is the highest
international distinction a nurse can achieve and is awarded to nurses or
nursing aides for "exceptional
courage and devotion to the wounded, sick or disabled or to civilian victims of
a conflict or disaster" or "exemplary
services or a creative and pioneering spirit in the areas of public health or
nursing education". Since 1965, International Nurses Day has been
celebrated on her birthday (12 May) each year. The President of India honors
nursing professionals with the "National
Florence Nightingale Award" every year on International Nurses Day.
The award, established in 1973, is given in recognition of the meritorious services
of nursing professionals characterized by devotion, sincerity, dedication, and
compassion.
The Nightingale
Pledge
The Nightingale Pledge is a modified version of the
Hippocratic Oath which nurses in the United States recite at their pinning
ceremony at the end of training. Created in 1893 and named after Nightingale the founder of modern nursing, the pledge is a statement of the ethics and
principles of the nursing profession.
The Florence Nightingale Declaration Campaign, established
by nursing leaders throughout the world through the Nightingale Initiative for
Global Health (NIGH), aims to build a global grassroots movement to achieve two
United Nations Resolutions for adoption by the UN General Assembly of 2008.
They will declare: The International Year of the Nurse–2010 (the centenary of
Nightingale's death); The UN Decade for a Healthy World – 2011 to 2020 (the
bicentenary of Nightingale's birth). NIGH also works to rekindle awareness
about the important issues highlighted by Florence Nightingale, such as
preventive medicine and holistic health. As of 2016, the Florence Nightingale
Declaration has been signed by over 25,000 signatories from 106 countries.
During the Vietnam War, Nightingale inspired many US Army
nurses, sparking a renewal of interest in her life and work. Her admirers
include Country Joe of Country Joe and the Fish, who has assembled an extensive
website in her honor. The Agostino Gemelli Medical School in Rome, the first
university-based hospital in Italy and one of its most respected medical
centers, honored Nightingale's contribution to the nursing profession by
giving the name "Bedside
Florence" to a wireless computer system it developed to assist nursing.
Hospitals
Four hospitals in Istanbul are named after Nightingale:
Florence Nightingale Hospital in Şişli (the biggest private hospital in
Turkey), Metropolitan Florence Nightingale Hospital in Gayrettepe, European
Florence Nightingale Hospital in Mecidiyeköy, and Kızıltoprak Florence
Nightingale Hospital in Kadıköy, all belonging to the Turkish Cardiology
Foundation.
In 2011, an appeal was made for the former Derbyshire Royal
Infirmary Hospital in Derby, England to be named after Nightingale. It was
suggested the name could be either Nightingale Community Hospital or Florence
Nightingale Community Hospital. The area where the hospital is situated is
sometimes referred to as the "Nightingale
Quarter".
During the COVID-19 pandemic, several temporary NHS
Nightingale Hospitals were set up in readiness for an expected rise in the
number of patients needing critical care. The first was housed in the ExCeL
London and several others followed across England. Celebrations to mark her
bicentenary in 2020, were disrupted by the coronavirus pandemic and
Nightingale's contribution to scientific and statistical analysis of infectious
disease and nursing practice may have led to the new temporary hospitals being
in her name, in Scotland named the NHS Louisa Jordan after a nurse who followed
in Nightingale's footsteps in battlefield nursing in World War One.
Museums and monuments
A statue of Florence Nightingale by the 20th-century war
memorialist Arthur George Walker stands in Waterloo Place, Westminster, London,
just off The Mall. There are three statues of Nightingale in Derby – one
outside the Derbyshire Royal Infirmary (DRI), one in St Peter's Street, and one
above the Nightingale-Macmillan Continuing Care Unit opposite the Derbyshire
Royal Infirmary. A pub named after her stands close to the DRI. The Nightingale-Macmillan
continuing care unit is now at the Royal Derby Hospital, formerly known as The
City Hospital, Derby.
A stained glass window was commissioned for inclusion in the
DRI chapel in the late 1950s. When the chapel was demolished the window was
removed and installed in the replacement chapel. At the closure of the DRI, the
window was again removed and stored. In October 2010, £6,000 was raised to
reposition the window in St Peter's Church, Derby. The work features nine
panels, of the original ten, depicting scenes of hospital life, Derby
townscapes, and Nightingale herself. Some of the work was damaged and the tenth
panel was dismantled for the glass to be used in the repair of the remaining
panels. All the figures, which are said to be modeled on prominent Derby town
figures of the early sixties, surround and praise a central pane of the
triumphant Christ. A nurse who posed for the top right panel in 1959 attended
the rededication service in October 2010.
The Florence Nightingale Museum at St Thomas' Hospital in
London reopened in May 2010 in time for the centenary of Nightingale's death.
Another museum devoted to her is at her sister's family home, Claydon House,
now a property of the National Trust.
Upon the centenary of Nightingale's death in 2010, and to
commemorate her connection with Malvern, the Malvern Museum held a Florence
Nightingale exhibit with a school poster competition to promote some events.
In Istanbul, the northernmost tower of the Selimiye Barracks
building is now the Florence Nightingale Museum. And in several of its rooms,
relics and reproductions related to Florence Nightingale and her nurses are on
exhibition.
When Nightingale moved on to the Crimea itself in May 1855,
she often traveled on horseback to make hospital inspections. She was later
transferred to a mule cart and was reported to have escaped serious injury when
the cart was toppled in an accident. Following this, she used a solid
Russian-built black carriage, with a waterproof hood and curtains. The carriage
was returned to England by Alexis Soyer after the war and subsequently given to
the Nightingale training school. The carriage was damaged when the hospital was
bombed during the Second World War. It was restored and transferred to Claydon
House and is now displayed at the Army Medical Services Museum in Mytchett, Surrey,
near Aldershot.
A bronze plaque, attached to the plinth of the Crimean
Memorial in the Haydarpaşa Cemetery, Istanbul, Turkey, and unveiled on Empire
Day, 1954, to celebrate the 100th anniversary of her nursing service in that
region, bears the inscription: "To
Florence Nightingale, whose work near this Cemetery a century ago relieved much
human suffering and laid the foundations for the nursing profession.” Other
monuments of Nightingale include a statue at Chiba University in Japan, a bust
at Tarlac State University in the Philippines, and a bust at Gun Hill Park in
Aldershot in the UK. Other nursing schools around the world are named after
Nightingale, such as in Anápolis in Brazil.
Audio
Florence Nightingale's voice was saved for posterity in a
phonograph recording from 1890 preserved in the British Library Sound Archive.
The recording, made in aid of the Light Brigade Relief Fund and available to
hear online, says:
When I am no longer
even a memory, just a name, I hope my voice may perpetuate the great work of my
life. God bless my dear old comrades of Balaclava and bring them safely to shore.
Florence Nightingale.
Theater
The first theatrical representation of Nightingale was
Reginald Berkeley's The Lady with the Lamp, premiering in London in 1929 with
Edith Evans in the title role. It does not portray her as an entirely
sympathetic character and draws much characterization from Lytton Strachey's
biography of her in Eminent Victorians. It
was adapted as a film of the same name in 1951. In 2009, a stage musical play
representation of Nightingale entitled The Voyage of the Lass was produced by
the Association of Nursing Service Administrators of the Philippines.
Film
In 1912, a biographical silent film titled The Victoria
Cross, starring Julia Swayne Gordon as Nightingale, was released, followed in
1915 by another silent film, Florence Nightingale, featuring Elisabeth Risdon.
In 1936, Kay Francis played Nightingale in the film titled The White Angel. In
1951, The Lady with a Lamp starred Anna Neagle. In 1993, Nest Entertainment
released an animated film, Florence Nightingale, describing her service as a
nurse in the Crimean War.
Television
Portrayals of Nightingale on television, in documentary as
in fiction, vary – the BBC's 2008 Florence Nightingale, featuring Laura Fraser,
emphasized her independence and feeling of religious calling, but in Channel
4's 2006 Mary Seacole: The Real Angel of the Crimea, she is portrayed as narrow-minded
and opposed to Seacole's efforts.
Other portrayals include:
Laura Morgan in Victoria episode #3.4 "Foreign Bodies" (2018)
Kate Isitt in the Magic Grandad episode "Famous People: Florence Nightingale" (1994)
Jaclyn Smith in the TV biopic Florence Nightingale (1985)
Emma Thompson in the ITV sketch comedy series Alfresco
episode #1.2 (1983)
Jayne Meadows in the PBS series Meeting of Minds (1978)
Janet Suzman in the British theatre-style biopic Miss Nightingale
(1974)
Julie Harris in Hallmark Hall of Fame episode #14.4 "The Holy Terror" (1965)
Sarah Churchill in Hallmark Hall of Fame episode #1.6 "Florence Nightingale" (1952)
Banknotes
Florence Nightingale's image appeared on the reverse of £10
Series D banknotes issued by the Bank of England from 1975 until 1994. As well
as a standing portrait, she was depicted on the notes in a field hospital,
holding her lamp. Nightingale's note was in circulation alongside the images of
Isaac Newton, William Shakespeare, Charles Dickens, Michael Faraday, Sir
Christopher Wren, the Duke of Wellington, and George Stephenson, and before
2002, other than the female monarchs, she was the only woman whose image had
ever adorned British paper currency.
Photographs
Nightingale had a principled objection to having photographs
taken or her portrait painted. An extremely rare photograph of her, taken at
Embley on a visit to her family home in May 1858, was discovered in 2006 and is
now at the Florence Nightingale Museum in London. A black-and-white photograph
taken in about 1907 by Lizzie Caswall Smith at Nightingale's London home in
South Street, Mayfair, was auctioned on 19 November 2008 by Dreweatts auction
house in Newbury, Berkshire, England, for £5,500.
Biographies
The first biography of Nightingale was published in England
in 1855. In 1911, Edward Tyas Cook was authorized by Nightingale's executors to
write the official life, published in two volumes in 1913. Nightingale was also
the subject of one of Lytton Strachey's four mercilessly provocative
biographical essays, Eminent Victorians. Strachey regarded Nightingale as an
intense, driven woman who was both personally intolerable and admirable in her
achievements.
Cecil Woodham-Smith, like Strachey, relied heavily on Cook's
Life in her 1950 biography, though she did have access to new family material
preserved at Claydon. In 2008, Mark Bostridge published a major new life of
Nightingale, almost exclusively based on unpublished material from the Verney
Collections at Claydon and from archival documents from about 200 archives
around the world, some of which had been published by Lynn McDonald in her
projected sixteen-volume edition of the Collected Works of Florence Nightingale
(2001 to date).
Other
In 2002, Nightingale was ranked number 52 in the BBC's list
of the 100 Greatest Britons following a UK-wide vote. In 2006, the Japanese
public ranked Nightingale number 17 in The Top 100 Historical Persons in Japan.
Several churches in the Anglican Communion commemorate
Nightingale with a feast day on their liturgical calendars. The Evangelical
Lutheran Church in America commemorates her as a Renewer of Society with Clara
Maass on 13 August. Florence Li Tim-Oi, the first woman ordained priest in the
Anglican Communion, in 1944, took Florence as her baptismal name after Florence
Nightingale.
Washington National Cathedral celebrates Nightingale's
accomplishments with a double-lancet stained glass window featuring six scenes
from her life, designed by artist Joseph G. Reynolds and installed in 1983.
The US Navy ship the USS Florence Nightingale (AP-70) was
commissioned in 1942. Beginning in 1968, the US Air Force operated a fleet of
20 C-9A "Nightingale" aeromedical
evacuation aircraft, based on the McDonnell Douglas DC-9 platform. The last of
these planes was retired from service in 2005.
In 1981, the asteroid 3122 Florence was named after her. A
Dutch KLM McDonnell-Douglas MD-11 (registration PH-KCD) was also named in her
honor; it served the airline for 20 years, from 1994 to 2014. Nightingale has
appeared on international postage stamps, including, the UK, Alderney,
Australia, Belgium, Dominica, Hungary (showing the Florence Nightingale medal
awarded by the International Red Cross), and Germany.
Florence Nightingale is remembered in the Church of England
with a commemoration on 13 August. Celebrations to mark her bicentenary in 2020
were disrupted by the coronavirus pandemic, but the NHS Nightingale hospitals
were named after her. Nightingale Road (Chinese: 南丁格爾路) in Hong Kong, between the Queen
Elizabeth Hospital and the nursing school, was officially named by the Lands
Department after Florence Nightingale in 2008.
Works
Nightingale, Florence (1979). Cassandra. The Feminist Press.
ISBN 978-0-912670-55-3. Archived from the original on 10 March 2021. Retrieved
6 July 2010.
"Notes on
Nursing: What Nursing Is, What Nursing is Not". Philadelphia, London,
Montreal: J.B. Lippincott Co. 1946 Reprint. First published London, 1859:
Harrison & Sons. Retrieved 6 July 2010.
Nightingale, Florence (2001). McDonald, Lynn (ed.). Florence
Nightingale's Spiritual Journey: Biblical Annotations, Sermons and Journal
Notes. Collected Works of Florence Nightingale. Vol. 2. Ontario, Canada:
Wilfrid Laurier University Press. ISBN 978-0-88920-366-2. Archived from the
original on 10 March 2021. Retrieved 6 July 2010.
Nightingale, Florence (2002). McDonald, Lynn (ed.). Florence
Nightingale's Theology: Essays, Letters and Journal Notes. Collected Works of
Florence Nightingale. Vol. 3. Ontario, Canada: Wilfrid Laurier University
Press. ISBN 978-0-88920-371-6. Archived from the original on 10 March 2021.
Retrieved 6 July 2010.
Nightingale, Florence (2003). Vallee, Gerard (ed.).
Mysticism and Eastern Religions. Collected Works of Florence Nightingale. Vol.
4. Ontario, Canada: Wilfrid Laurier University Press. ISBN 978-0-88920-413-3.
Archived from the original on 10 March 2021. Retrieved 6 July 2010.
Nightingale, Florence (2008). McDonald, Lynn (ed.).
Suggestions for Thought. Collected Works of Florence Nightingale. Vol. 11.
Ontario, Canada: Wilfrid Laurier University Press. ISBN 978-0-88920-465-2.
Archived from the original on 10 March 2021. Retrieved 6 July 2010. Privately
printed by Nightingale in 1860.
Notes on Nursing for the Laboring Classes. London: Harrison.
1861. Retrieved 6 July 2010.
The Family, a critical essay in Fraser's Magazine (1870)
"Introductory
Notes on Lying-In Institutions". Nature. 5 (106). London: 22–23. 1871.
Bibcode: 1871Natur...5...22.. doi:10.1038/005022a0. S2CID 3985727. Retrieved 6
July 2010.
Una and the Lion. Cambridge: Riverside Press. 1871.
Retrieved 6 July 2010. Note: The first few pages missing. The title page is present.
Una and Her Paupers, Memorials of Agnes Elizabeth Jones, by
her sister. With an introduction by Florence Nightingale. New York: George
Routledge and Sons, 1872. 1872. Retrieved 6 July 2010... See also 2005
publication by Diggory Press, ISBN 978-1-905363-22-3
Nightingale, Florence (1987). Letters from Egypt: A Journey
on the Nile 1849–1850. Weidenfeld & Nicolson. ISBN 1-55584-204-6.
Nightingale, Florence (1867). Workhouse nursing. London:
Macmillan and Co.
Florence Nightingale OM RRC DStJ (/ˈnaɪtɪŋɡeɪl/; 12 May 1820 – 13 August 1910) 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 organized care for wounded soldiers at Constantinople. She significantly reduced death rates by improving hygiene and living standards. Nightingale gave nursing a favorable 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 professionalizing 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 honor, 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 a pioneer in statistics; she represented her
analysis in graphical forms to ease drawing conclusions and actionables from
data. She is famous for the usage of the polar area diagram, also called the
Nightingale rose diagram, equivalent to a modern circular histogram. This
diagram is still regularly used in data visualization.
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. She was also a pioneer in data visualization with the use of infographics, using graphical presentations of statistical data effectively. 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 (1794–1874), and Frances ("Fanny")
Nightingale (née Smith; 1788–1880). William's mother Mary (née Evans) 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 (Florence's maternal grandfather) 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, the more academic of the two girls, displayed an
extraordinary ability for collecting and analyzing data which she would use to
great effect in later life."
Young Florence
Nightingale
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 while her
ideas did not always agree with those of her guests, "she was incapable of boring anyone." Her behavior 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 companies
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 were to remain 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 of 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 demeanor was often severe, she was said to be
very charming and have a radiant smile. Her most persistent suitor was
the politician and poet Richard Monckton Milnes. Still, 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 (1845–1846) 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 program 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 (now with Charles and
Selina Bracebridge) 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 (shortly before Nightingale left for Crimea).
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 (as distinct from her far longer letters that her elder sister
Parthenope was to print after her return): "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 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 £500 (roughly £40,000/US$65,000 in present
terms), which allowed her to live comfortably and 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
(modern-day Üsküdar in Istanbul). 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 (mobilized by Henry Edward Manning) were
sent (under the authorization of Sidney Herbert) to the Ottoman Empire. On the
way, Nightingale was assisted in Paris by her friend Mary Clarke. The volunteer
nurses worked about 295 nautical miles (546 km; 339 mi) away from the main
British camp across the Black Sea at Balaklava, in the Crimea.
Letter from Nightingale to Mary Mohl, 1881
Nightingale arrived at Selimiye Barracks in Scutari early in
November 1854. Her team found that poor care for wounded 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:
This frail young woman
... embraced in her solicitude the sick of three armies. — Lucien Baudens, La guerre de Crimée, les campements, les abris, les
ambulances, les hôpitaux, p. 104.
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 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
the 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 (see Statistics and Sanitary Reform).
According to some secondary sources, Nightingale had a
frosty relationship with her fellow nurse Mary Seacole, who ran a
hotel/hospital for officers. 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
(she) 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 (absolutely out of the question!) ... 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.
The Lady with the
Lamp
During the Crimean War, Nightingale gained the nickname "The Lady with the Lamp" 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.— William
Russell, Cited in Cook, E. T. (1913). The Life of Florence Nightingale. Vol. 1,
p. 237.
The phrase was further popularized 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.
Nightingale was nicknamed "the lady with the hammer" by the troops after using a
hammer to break into locked storage to access medicine to treat the wounded.
However, Russell thought the behavior was unladylike, and invented an
alternative, leading to "The Lady
with the Lamp".
Later career
In the Crimea on 29 November 1855, the Nightingale Fund was
established for the training of nurses during a public meeting to recognize
Nightingale for her work in the war. There was an outpouring of generous
donations. Sidney Herbert served as honorary secretary of the fund and the Duke
of Cambridge was chairman. In her 1856 letters, she described spas in the
Ottoman Empire, detailing the health conditions, physical descriptions, dietary
information, and other vital details of patients whom she directed there. She
noted that the treatment there was significantly less expensive than in
Switzerland.
Nightingale had £45,000 at her disposal from the Nightingale
Fund to set up the first nursing school, the Nightingale Training School, at St
Thomas' Hospital on 9 July 1860. The first trained Nightingale nurses began
work on 16 May 1865 at the Liverpool Workhouse Infirmary. Now called the
Florence Nightingale Faculty of Nursing and Midwifery, the school is part of
King's College London. In 1866 she said the Royal Buckinghamshire Hospital in
Aylesbury near her sister's home Claydon House would be "the most beautiful hospital in England", and in 1868, called it "an excellent model to
follow".
Nightingale wrote Notes on Nursing (1859). The book served
as the cornerstone of the curriculum at the Nightingale School and other
nursing schools, though it was written specifically for the education of those
nursing at home. Nightingale wrote, "Every
day sanitary knowledge, or the knowledge of nursing, or in other words, of how
to put the constitution in such a state as that it will have no disease, or
that it can recover from disease, takes a higher place. It is recognized as the
knowledge which every one ought to have – distinct from medical knowledge,
which only a profession can have".
Notes on Nursing also sold well to the general reading
public and is considered a classic introduction to nursing. Nightingale spent
the rest of her life promoting and organizing the nursing profession. In the
introduction to the 1974 edition, Joan Quixley of the Nightingale School of
Nursing wrote: "The book was the
first of its kind ever to be written. It appeared at a time when the simple
rules of health were only beginning to be known when its topics were of vital
importance not only for the well-being and recovery of patients when hospitals
were riddled with infection, when nurses were still mainly regarded as
ignorant, uneducated persons. The book has, inevitably, its place in the
history of nursing, for it was written by the founder of modern nursing".
As Mark Bostridge has demonstrated, one of Nightingale's
signal achievements was the introduction of trained nurses into the workhouse
system in Britain from the 1860s onwards. This meant that sick paupers were no
longer being cared for by other, able-bodied paupers, but by properly trained
nursing staff. In the first half of the 19th century, nurses were usually
former servants or widows who found no other job and therefore were forced to
earn their living by this work. Charles Dickens caricatured the standard of
care in his 1842–1843 published novel Martin Chuzzlewit in the figure of Sarah
Gamp as being incompetent, negligent, alcoholic, and corrupt. According to
Caroline Worthington, director of the Florence Nightingale Museum, "When she [Nightingale] started out
there was no such thing as nursing. The Dickens character Sarah Gamp, who was
more interested in drinking gin than looking after her patients, was only a
mild exaggeration. Hospitals were places of last resort where the floors were
laid with straw to soak up the blood. Florence transformed nursing when she got
back [from Crimea]. She had access to people in high places and she used it to
get things done. Florence was stubborn, opinionated, and forthright but she had
to be those things to achieve all that she did."
Though Nightingale is sometimes said to have denied the
theory of infection for her entire life, a 2008 biography disagrees, saying
that she was simply opposed to a precursor of germ theory known as
contagionism. This theory held that diseases could only be transmitted by
touch. Before the experiments of the mid-1860s by Pasteur and Lister, hardly
anyone took germ theory seriously; even afterward, many medical practitioners
were unconvinced. Bostridge points out that in the early 1880s, Nightingale
wrote an article for a textbook in which she advocated strict precautions
designed, she said, to kill germs. Nightingale's work served as an inspiration
for nurses in the American Civil War. The Union government approached her for
advice in organizing field medicine. Her ideas inspired the volunteer body of
the United States Sanitary Commission.
Nightingale advocated autonomous nursing leadership, and
that her new style of matrons had full control and discipline over their
nursing staff. The infamous "Guy's
Hospital dispute" in 1879–1880 between matron Margaret Burt and
hospital medical staff highlighted how doctors sometimes felt that their
authority was being challenged by these new-style Nightingale matrons. This was
not an isolated episode and other matrons experienced similar issues, such as
Eva Luckes.
In the 1870s, Nightingale mentored Linda Richards, "America's first trained nurse",
and enabled her to return to the United States with adequate training and
knowledge to establish high-quality nursing schools. Richards went on to become
a nursing pioneer in the US and Japan.
By 1882, several Nightingale nurses had become matrons at
several leading hospitals, including, in London (St Mary's Hospital,
Westminster Hospital, St Marylebone Workhouse Infirmary, and the Hospital for
Incurables at Putney) and throughout Britain (Royal Victoria Hospital, Netley;
Edinburgh Royal Infirmary; Cumberland Infirmary and Liverpool Royal Infirmary),
as well as at Sydney Hospital in New South Wales, Australia.
In 1883, Nightingale became the first recipient of the Royal
Red Cross. In 1904, she was appointed a Lady of Grace of the Order of St John
(LGStJ).
In 1907, she became the first woman to be awarded the Order
of Merit. In the following year, she was given the Honorary Freedom of the City
of London.
Her birthday is now celebrated as International May 12th
Awareness Day.
From 1857 onwards, Nightingale was intermittently bedridden
and suffered from depression. A recent biography cites brucellosis and associated
spondylitis as the cause. Most authorities today accept that Nightingale
suffered from a particularly extreme form of brucellosis, the effects of which
only began to lift in the early 1880s. Despite her symptoms, she remained
phenomenally productive in social reform. During her bedridden years, she also
did pioneering work in the field of hospital planning, and her work propagated
quickly across Britain and the world. Nightingale's output slowed down
considerably in her last decade. She wrote very little during that period due
to blindness and declining mental abilities, though she still retained an
interest in current affairs.
Relationships
Although much of Nightingale's work improved the lot of
women everywhere, Nightingale believed that women craved sympathy and were not
as capable as men. She criticized early women's rights activists for decrying
an alleged lack of careers for women at the same time those lucrative medical
positions, under the supervision of Nightingale and others went perpetually
unfilled. She preferred the friendship of powerful men, insisting they had done
more than women to help her attain her goals, writing: "I have never found one woman who has altered her life by one iota
for me or my opinions.” She often referred to herself as, for example, "a man of action" and "a man of business".
However, she did have several important and long-lasting
friendships with women. Later in life, she kept up a prolonged correspondence
with Irish nun Mary Clare Moore, with whom she had worked in Crimea. Her most
beloved confidante was Mary Clarke, an Englishwoman she met in Paris in 1837
and kept in touch with throughout her life.
Some scholars of Nightingale's life believe that she
remained chaste for her entire life, perhaps because she felt a religious
calling to her career.