“When I am no longer even a memory”: Florence Nightingale

1820 – 1910

Karen Saucier Lundy, PhD, RN, FAANProfessorThe University of Southern Mississippi School of Nursing

Absorbing, superbly written, and authoritative, this is a terrific biography of a woman to whom we owe a great deal,

but would perhaps never want to meet."—The Atlantic Monthly

From the reviews….. "Devout and unforgiving, inexhaustible and chronically

unwell, the farsighted and exacting Florence Nightingale famously gnawed her way through the barriers that kept genteel Victorian women trapped 'in a meaningless round of trivial occupations' in order to promote her vision of a modern public health-care system.”

“By sheer will and an intellect that combined creativity and detailed analysis, Nightingale changed the way we perceive public health.”

Florence Nightingale

Born 12 May 1820Florence, Grand Duchy of Tuscany

Died 13 August 1910 (aged 90)Park Lane, London, United Kingdom

The Nightingale Family

William Edward ShoreNightingale (WEN)Fanny Smith

Nightingale

Parthenope NightingaleVerney

Curriculum Vitae

“But the happiest time of my life was during a year's illness, which I had when I was 6 years old. I never learnt to write till I was 11 or 12, owing to a weakness in my hands. And I was shy to misery. “ F.N. at Kaiserworth 1851

Florence Nightingale

One of Florence Nightingale’s childhood homes – Lea Hurst, Derbyshire

FN Birth Certificate

Embley Park

Nightingale was courted by several suitors, but in agony refused them, convinced that marriage would interfere with her ability to follow her calling to nursing.

Those were the days…before Nightingale

She was a fat old woman, this Mrs. Gamp, with a husky voice and a moist eye, which she had a remarkable power of turning up and showing the white of it. Having very little neck, it cost her some trouble to look over herself, if one may say so, to those to whom she talked. She wore a very rusty black gown, rather the worse for snuff, and a shawl and bonnet to correspond. . . . The face of Mrs. Gamp-the nose in particular-was somewhat red and swollen, and it was difficult to enjoy her society without becoming conscious of the smell of spirits. Like most persons who have attained to great eminence in their profession, she took to hers very kindly; insomuch, that setting aside her natural predilections as a woman, she went to a lying-in [birth] or a laying-out [death] with equal zest and relish.

Charles Dickens, 1910

And Then There Was Nightingale .

Florence Nightingale was named one of the 100 most influential persons of the last millennium by Life Magazine

Kaiserworth 1851 ….”I took all the training that was to be

had- there was none to be had in England, but Kaiserwerth was far from having trained me.”

Kaiserworth 1851

“But the first idea I can recollect when I was a child was a desire to nurse the sick. My day dreams were all of hospitals and I visited them whenever I could. I never communicated it to any one, it would have been laughed at; but I thought God had called me to serve Him in that way.”

First nursing position…straight to the top

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.

Nightingale on Women

“Why have women passion, intellect, moral activity-these three-in a place in society where no one of the three can be exercised?"

Nightingale, 1852

Cassandra

On Women….. “Women never have a half-hour in all their lives

(excepting before or after anybody is up in the house) that they can call their own, without fear of offending or of hurting someone. Why do people sit up so late, or, more rarely, get up so early? Not because the day is not long enough, but because they have no time in the day to themselves.”

“You do not want the effect of your good things to be, "How wonderful for a woman!“…But you want to do the thing that is good, whether it is "suitable for a woman" or not.”

On Faith and Spirituality… Nightingale inspired by the voice of God calling her in her

youth, her deep religious belief was mystical, unorthodox and free of any taint of religiosity (1837 Embley).

FN disliked religious ritual and did not identify with any denomination.

It was science that illuminated divine purpose to her, and in particular the new discipline of statistics: 'a sacred science which could permit man to read the mind of God.‘

Second call from God in Thebes Greece (1850):

"God called me in the morning and asked me would I do good for him alone without reputation.”

Is she speaking to us…now?

“The progressive world is necessarily divided into two classes — those who take the best of what there is and enjoy it — those who wish for something better and try to create it. Without these two classes the world would be badly off. They are the very conditions of progress, both the one and the other. Were there none who were discontented with what they have, the world would never reach anything better.”

Florence Nightingale: Duty Calls and the Dream is Realized

The Crimean Experience 21 October 1854 Set sail with 38 self-proclaimed nurses

with varied training and experiences, of whom 24 were Catholic and Anglican nuns.

6,000 men, four miles of hospital beds “…a thing unknown and undreamt of ..”

London Times, 1910 (FN Obituary)

The Lady with the Lamp Mortality rate from the

Crimean War was estimated to be from 42% to 73%. Nightingale is credited with reducing that rate to 2% within 6 months of her arrival at Scutari.

Possible credit to FN overstated?

What about the Crimean nurses? 1854-56

229 women total 11 died in Scutari hospitals 17 remained for duration 49 women dismissed (18 for intoxication)

Larger than life….?

“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….she may be observed alone, with a little lamp in her hand, making her solitary rounds.”

(London Times, 1855)

“Lo! in that house of miseryA lady with a lamp I seePass through the glimmering gloom,And flit from room to room.”

Henry Wadsworth Longfellow (1857)

Santa Filomena

“What a comfort it was to see her pass even. She would speak to one and nod and smile to as many more, but she could not do it all, you know. We lay there by hundreds, but we could

kiss her shadow as it fell, and lay our heads on the pillow again content.”

The Crimean War

“I Can Stand Out the War with Any Man"

Barracks Hospital today

‘Florence was Joan come round again’

“There is not an official who world not burn me like Joan of Arc if he could, but they know that the War Office cannot turn me out because the country is with me. That is the position.” (1855 to Sidney Herbert)

1856 “It does not

make a thing good, that it is remarkable that a woman should have been able to do it. Neither does it make a thing bad, which would have been good had a man done it, that it has been done by a woman.”

“Miss Nightingale had stamped the profession of nurse with her own image. . . in the midst of the muddle and the filth, the agony and the defeats;

she had brought about a revolution. “

Woodham-Smith, 1951, p. 179

Pearls From Flo

There are five essential points in securing the health of houses:

Pure water Efficient drainage Cleanliness Light Pure airFlorence Nightingale. (1860). Notes on Nursing: What It Is and What It Is

Not. London: Harrison.

St. Thomas School of Nursing The Nightingale Training School

School of Nursing

9 July 1860. Public fund £50,000

Notes on Nursing: What it is and what it is not (1859).

In 1859 Nightingale was elected the first female member of the Royal Statistical Society

On Education

Unrecognized for her educational impact No outlet for her own education until 31 Emphasis on practicality and application,

praxis “…only widowhood or poverty could give

an educated woman a reason to work.”

“…the first thought I can remember and the last was nursing work and in the absence of this, education work, but more the education of the bad than of the young. But for this, I had no education myself.” (1848)

“…while the intellectual foot has made a step in advance, the practical foot has remained behind. Woman stands askew. Her education for action has not kept pace with her education for acquirement.” (Nightingale, 1851)

Two major themes in FN’s Writing

Nurses must be trained differently and instructed specifically in district and instructive nursing.

The focus on the role of the nurse. She clearly distinguished the role of the health nurse in promoting what we today call self-care

Monteiro, 1985

Quotes and Vision: Hospitals

“Money would be better spent in maintaining health in infancy and childhood than in building hospitals to cure disease.” (1894)

“My view you know is that the ultimate destination of all nursing is the nursing of the sick in their own homes. . . . I look to the abolition of all hospitals and workhouse infirmaries. But no use to talk about the year 2000.” (1860)

Quotes and Vision:Evidence Based Practice

Evidence, which we have means to strengthen for or against a proposition, is our proper means for attaining truth.

So may times our information regarding the questions at issue was by no means as full as we could wish – indeed it was almost nothing. Our only resource was to deal with such statistical information as we possessed, and to ascertain fairly what it told us.

Nightingale and Disaster

Preparation Empowerment of the population: policy Sanitation and prevention Evaluation and epidemiological assessment.

Extensive report post Crimean resulted in far reaching changes in medical and nursing education, government role

I look to the day when there are no nurses to the sick but only nurses to the well. (I893)Florence Nightingale

F.N. 1858 Age 38 years

You may not know…

She was not completely in opposition to germ theory: FN was opposed to a precursor of germ theory known as "contagionism" which held that diseases could only be transmitted by touch.

No, she did not have syphilis. Controversy: Lesbian relationships Yes, she did oppose licensure for nurses. Yes, she had at one time 17 cats.

Early pioneer in pet therapy

“ A small pet animal is often an excellent companion for the sick, for long chronic cases especially. A pet bird in a cage is sometimes the only pleasure of an invalid confined for years to the same room. If he can feed and clean the animal himself, he ought always to be encouraged to do so. “

In the event of my death…1908

Request made to the Lord Mayor that for a planned gold casket might be substituted for a plain wooden one, the money thereby saved being handed over at Miss Nightingale's wish to the Queen Victoria Jubilee Institute of Nurses.

British Order of Merit 1908

In Death….

: "FN. Born 1820. Died 1910."

East Wellow churchHampshire, England

The Death of an Icon

Death in London of Florence Nightingale at age 90 years.

Funeral…”will be of the quietest possible character in accordance with her strongly expressed wish.” (London Times 1910)

Post Trauma?

"Oh my poor men; I am a bad mother to come home and leave you in your Crimean graves. . . . I can never forget. . . . I stand at the altar of the murdered men and while I live, I fight their cause"

Funeral procession 1910

Athena 1850- -1854

Florence Nightingale Museum 2003

Nightingale: Leave in the archives!

Obsessive-compulsiveness Racism Sexism and elitism Lack of social life and interactions Lack of attention to nurse to nurse relations Leadership style: autocratic

The vision we keep and use!

Nurse as autonomous professional Focus on holistic self care and patient

empowerment Focus on scientific basis of nursing care Endless curiosity about the world Diverse interests Love of cats

Sense of humor

“She does not want to hear facts; she wants to be enthusiastic.” (1896 about Mrs. Josephine Butler)

“Agitate, agitate.” (1863) “I can fire my own guns.” ((1856 to Dr. Farr) “A little gin would be more popular.” (1855 to

Queen Victoria)

The Voice of an Iconhttp://catalogue.wellcome.ac.uk/record=1590740

'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 safe to shore. Florence

Nightingale.‘30 July 1890

Ever Yours….

Selected References F.N. Nightingale, F. (1851). The institution of Kaiserwerth on the Rhine, for the

practical training of deaconesses, under the direction of the Rev. Pastor Fliedner, embracing the support and care of a hospital, infant and industrial schools, and a female penitentiary. London: Colonial Ragged Training School.

Nightingale, F. (1858). Notes on Matters Affecting The Health, Efficiency and Hospital Administration of the British Army. London: Harrison and Sons.

Nightingale, F. (1859). Notes on Hospitals. London: John W. Parker and Sons. Nightingale, F. (1859). Notes on Nursing: What it is and What it is not.

London: Harrison. Nightingale, F. (1860). Suggestions for Thought to the Searchers After Truth

Among the Artizans of England. London: Eyre and Spottiswoode. Nightingale, F. (1871). Notes on Lying-in Institutions. London: Longmans,

Green and Co.

Selected References (About) Attewell, A. (1999). Florence Nightingale. PROSPECTS: The

quarterly review of comparative education. International Bureau of Education Paris UNESCO: 28: 1, 153-66.

Bostridge, M. (2008). Florence Nightingale: The making of an icon . London: Farrar, Straus and Giroux.

Cook,, E.T. (1913). The life of Florence Nightingale, 2 vols. London: Macmillan.

Woodham-Smith, C. (1952). Florence Nightingale 1820 – 1910. London: The Reprint Society.

Young, D.A. (1995). Florence Nightingale's fever. BMJ. 311(7021): 1697–1700.