14 August 2010: The death centenary of Florence Nightingale who became famous as the founder of the nursing profession was observed all over the world on 13 August 2010. Florence Nightingale, who believed that she was called to be a nurse and her selfless work in difficult conditions during the Crimean War (1854-56) where she worked with great dedication brought her to prominence. As she would make rounds during the nights to see the condition of the wounded and tend them if necessary earned her the epithet ‘The Lady with the Lamp’. Florence Nightingale laid the foundation of professional nursing with the establishment of a nursing school at St. Thomas Hospital in London which is considered to be the first secular nursing school in the world.
Florence Nightingale was born on 12 May 1820 into a wealthy and well-connected British family in Florence, Italy and she was named after the city of her birth. 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 much interested in looking after those who were ill. She visited hospitals in London and around the country to investigate possible occupations for women. However, nursing was seen as an employment that needed neither study nor intelligence.
Inspired by what she understood to be a divine calling, Nightingale made a commitment to nursing, a career with a poor reputation and filled mostly by poorer women. Traditionally, the role of nurse was handled by female attendants who followed the armies. Nightingale was particularly concerned with the miserable conditions of medical care for the soldiers during battles and wars. In spite of strong opposition from her mother and sisters Florence Nightingale made up her mind and took up nursing profession in 1844. In this, she rebelled against the expected role for a woman just 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 wealthy young English women.
Nightingale’s hospital visits began in 1844 and continued for eleven years. During one of her journeys in Paris she met two St. Vincent de Paul sisters who gave her an introduction to their convent at Alexandria in Egypt. Nightingale saw that the disciplined and well-organised Sisters made better nurses than women in England. In 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 women. In 1851 she spent four months at Kaiserswerth, training as a nurse. When she returned home, she undertook more visits to London hospitals and 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 and the reports of the sufferings of the sick and wounded soldiers in the English camps moved Florence Nightingale who offered her services to the War Office and proceeded to Crimea in October 1854 with thirty-eight nurses: ten Roman Catholic Sisters, eight Anglican Sisters of Mercy, six nurses from St. John’s Institute, and fourteen from various hospitals.
On arriving at Crimea, Nightingale 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 infection was common. According to an estimate the death rate was ten times more from illnesses such as typhoid, cholera and dysentery than from battle wounds. Conditions at the temporary barracks hospital were fatal to the patients because of overcrowding and the hospital’s defective sewerage system and lack of ventilation.
In spite of all these difficulties Florence Nightingale and her nurses tried their best to care for the wounded and sick soldiers. They began by thoroughly cleaning the hospital and equipment, and reorganizing patient care. Although Nightingale met with resistance from the doctors and officers, the changes brought by her greatly improved conditions for the wounded and soon the mortality rate dropped from 40 per cent to just two per cent.
Following the end of the Crimean War in 1956, Florence Nightingale returned to England. She met Queen Victoria and told her about everything that affected the military hospital system and the reforms that were needed. Soon a Nightingale fund had been set up to establish a training school for nurses. By 1860, £50,000 had been collected and the Nightingale School and Home for Nurses was established at St. Thomas’s Hospital, London. Nightingale’s health and other occupations prevented her from accepting any responsible post. However, she followed the progress of the new institution with great interest. She was able to use her experiences in the Crimean War for the benefit of the nursing profession.
Nightingale was an advocate for the improvement of care and conditions in the military and civilian hospitals in England. Among her popular books are ‘ Notes on Hospitals’, which deals with the correlation of sanitary techniques to medical facilities; ‘Notes on Nursing’, which was the most valued nursing textbook of the day; and ‘Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army’. In 1883 Queen Victoria awarded Florence Nightingale the Royal Red Cross and in 1907 she became the first woman to be awarded the Order of Merit. In 1908 she was given the Honorary Freedom of the City of London.
From 1857 onwards, Nightingale was intermittently bedridden and suffered from depression. However, during her bedridden years, she did pioneering work in the field of hospital planning, and her work propagated quickly across Britain and the world. She could not leave her bed after 1896 and died on 13 August 1910.
Florence Nightingale’s lasting contribution has been her role in founding the nursing profession, and in the shining example she set for nurses through commitment to patient care and hospital administration. There are countless examples of Florence Nightingale’s continuing legacy in the nursing profession. Every year, her birthday on 12 May is celebrated as International Nurses Day.