NIGHTINGALE, FLORENCE

NIGHTINGALE, FLORENCE (1820–1910), is remembered as a nurse, yet she wrote in her seventies that, when planning her future as a young woman, her one idea was not to organize a hospital but to organize a religion. Nursing researchers, sociologists, and scholars of religion, who are now examining Nightingale's voluminous but previously unpublished ideological and religious writings, are discovering the truth of these words.

Nightingale's Life

Nightingale was born on May 12, 1820, the second daughter of William and Frances Nightingale, members of the upper class from Derbyshire, England. Although Florence Nightingale was raised in the Church of England, her Cambridge-educated father instilled in her his Unitarian heritage while tutoring her in many languages, history, science, and philosophy. The young Nightingale disdained her privileged life, preferring to help the village poor. At age seventeen she received a call to serve God. Encountering family resistance, she bided her time, studying hospital reports and documents on social reform. Trips to Europe exposed her to emerging political, religious, and social thought. She visited convents, observed their work, and adopted their spiritual exercises even though her religious ideas prevented her from joining a Catholic religious order. While in Egypt at age thirty, Nightingale received a second call to serve the poor and made a private vow to God. She visited a Protestant deaconess order serving the poor in Kaiserswerth, Germany, in 1850 and 1851, but further plans were sabotaged by her family. Nightingale channeled her rage into Cassandra (1852), an autobiographical fiction about powerless Victorian women that foreshadowed later feminist arguments. After receiving another call to serve England's poor, she began a theological treatise, Suggestions for Thought to the Searchers after Truth among the Artizans of England (1852).

Leaving home in 1853, Nightingale became superintendent of a home for destitute governesses. The following year Lord Sidney Herbert, the secretary of war, sent her to the Crimea to care for wounded British soldiers. After sixteen months Nightingale returned a heroine but refused to start a nursing school with the Nightingale Fund established in her honor, focusing instead on reform of the army and its medical services. She wrote a lengthy report on army health; helped launch royal commissions on Britain's army in England and India; analyzed her Crimean medical statistics; wrote Notes on Hospitals (1859) and Notes on Nursing (1860), and declared herself an invalid. She retired to her home, where prominent politicians came to consult with her. The Nightingale Training School for Nurses was established at Saint Thomas's Hospital in London in 1860. While Nightingale submitted proposals, her first visit to the school did not occur until many years later. Nightingale lived for many years as an invalid in seclusion while pursuing her many reforms. She died on August 13, 1910, and is buried in East Wellow, Hampshire, England.

Theological Ideas and Activities

Nightingale's religious vocation was central to her life, and her work lies within this vocation. Each year she reviewed her spiritual progress, and later she celebrated the jubilee of her first call. She read and translated medieval mystics in preparation for writing a book. Her invalidism has been attributed to chronic illness, post-traumatic stress, and a desire to escape from family demands, yet it also created a monastic existence in lieu of a religious or secular order. In 1860 Nightingale expanded Suggestions for Thought, sending drafts to six scholars, including Benjamin Jowett of Balliol College, Oxford, and the reformer John Stuart Mill. The manuscript addressed the same issues as Essays and Reviews (1860), a Church of England Broad Church Movement publication that resulted in heresy trials. While Essays and Reviews critiqued the church, Nightingale's Suggestions for Thought offered the working class a reasonable religion that rejected the prevailing teaching that poverty was God's will. Nightingale's topics included God, universal law, God's will, human will, sin, evil, family life, women, spirituality, and life after death. Mill quoted her in his parliamentary speech on women's rights, and Jowett acknowledged the qualities of her mind, beginning a thirty-year intimate friendship with Nightingale.

Nightingale's theology prefigured twentieth-century liberation theology, which begins not with traditional doctrines and ancient texts but with the experience of the oppressed, as does feminist theology. Nightingale suggested that oppressive social systems were human constructions held in place by the powerful, whether government or church, not God's will. A liberating religion should not ask people to passively believe and accept their lot but make rational sense to everyone. Since God's spirit was in all people, rich or poor, all could participate in God's new society by learning, through observation, education, and statistical analysis, God's will written in the universe. Nightingale called statistics a "sacred science" because it transcended individual experiences to uncover God's larger thoughts, as her Crimean statistics demonstrated.

Prefiguring another contemporary debate, Nightingale argued that the concept of God evolved through history and was still evolving. While primal people propitiated an all-powerful God with sacrifice, worship, and prayer, believing suffering reflected divine displeasure, an arbitrary God intervening at will was not viable for a scientific age. A moratorium on God language was necessary until divine metaphors were reshaped. For Nightingale, God was embodied (incarnated) in the universe. Humans, as part of the universe, participated in this divinity, being drawn into mystic union with God through learning divine universal laws more reliable than claims of special revelation delivered in culturally bound language through selected interpreters. Good health and social conditions did not come by divine intervention but through human observation and application of divine laws.

Incarnation, Trinity, and theories localizing God in one incarnation and one day of suffering, while ignoring God's suffering, work, and passion through eternity, needed rethinking. Medieval atonement ideas of God's Son sacrificed because of divine offense at human sin were culturally bound explanations from an era demanding judgment and punishment, not reform. Instead, Nightingale's Trinity comprised: (1) God as thought, purpose, and will-engendering development; (2) Son as divine manifestation in all humanity developing according to God's will, Jesus being the perfect example and greatest teacher; and (3) Spirit as the divine in each, through which God as thought communicates. Life was about progressive learning from errors with the Spirit's help, as well as help from many human saviors, like Nightingale, to lead to truth, both in this world and other reincarnations.

Women's Issues

Nightingale challenged a divine order of creation automatically placing men over women; she believed that women were also called to serve God as handmaids of the Lord. She advocated a secular order of trained, salaried single women across all classes to serve the poor while also gaining economic independence—her nursing model. Her parliamentary efforts changed laws restricting women's rights to children, property, and divorce. She did not work for women's suffrage in the 1860s because she was busy with army reform and knew that, because not all men could vote, any women's votes would go to a privileged few. The Adam and Eve story justifying male headship was tightly woven into Britain's religion, class, and family systems and needed challenging before women could vote.

When Nightingale died at age ninety, she left a formidable literary legacy. Her writings in the British Library form one of its largest single collections. Since women of her era could not obtain university degrees, her scholarly writings remained largely unpublished and unheeded until the late twentieth century, yet her religious ideas parallel contemporary process and relational theology and prefigure by one hundred years liberation and feminist theology.

See Also

Feminist Theology, article on Christian Feminist Theology; God, article on God in Postbiblical Christianity; Liberation Theology.

Bibliography

Calabria, Michael D., and Janet A. Macrae, eds. Suggestions for Thought: Selections and Commentaries. Philadelphia, 1994. Seminal analysis of extracts of Nightingale's unpublished manuscript.

Cook, Sir Edward T. The Life of Florence Nightingale. 2 vols. London, 1913. Nightingale's authorized biography published three years after her death.

Dossey, Barbara Montgomery. Florence Nightingale: Mystic, Visionary, Healer. Springhouse, Pa., 2000. A comprehensive study of Nightingale and her context, including her social activism and mysticism.

Jowett, Benjamin. Dear Miss Nightingale. Edited by Vincent Quinn and John Prest. Oxford, 1987. Thirty years of letters from Benjamin Jowett to Nightingale.

McDonald, Lynn, ed. Florence Nightingale: An Introduction to Her Life and Family. Collected Works of Florence Nightingale, vol. 1. Waterloo, Ontario, 2002. A proposed 16 vols. of Nightingale's known writings, with analysis, is planned. The sheer volume of this project indicates the wide range of Nightingale's creativity in the areas of social and philosophical thought, religion, spirituality, and mysticism.

McDonald, Lynn, ed. Florence Nightingale's Spiritual Journey: Biblical Annotations, Sermons, and Journal Notes. Collected Works of Florence Nightingale, vol. 2. Waterloo, Ontario, 2002.

McDonald, Lynn, ed. Florence Nightingale's Theology: Essays, Letters, and Journal Notes. Collected Works of Florence Nightingale, vol. 3. Waterloo, Ontario, 2002.

McDonald, Lynn, ed. Florence Nightingale on Society and Politics, Philosophy, Science, Education, and Literature. Collected Works of Florence Nightingale, vol. 5. Waterloo, Ontario, 2003.

McDonald, Lynn, ed. Florence Nightingale on Public Health Care. Collected Works of Florence Nightingale, vol. 6. Waterloo, Ontario, 2004.

Sullivan, Mary C., ed. The Friendship of Florence Nightingale and Mary Clare Moore. Philadelphia, 1999. Twenty years of correspondence between Nightingale and Mother Mary Clare Moore of the Sisters of Mercy, who was with Nightingale in the Crimea.

Vallée, Gérard, ed. Florence Nightingale on Mysticism and Eastern Religions. Collected Works of Florence Nightingale, vol. 4. Waterloo, Ontario, 2003.

Webb, Val. Florence Nightingale: The Making of a Radical Theologian. St. Louis, Mo., 2002. An analysis of Nightingale's lifelong religious vocation and her radical theology for England's poor that provides ample evidence that her theological thought resonates more with contemporary feminist, liberation, and process theology than with dominant Victorian ideas of her own day.

Woodham Smith, Cecil Blanche Fitz Gerald. Florence Nightingale, 1820–1910. London, 1950. A biography including material not available for Sir Edward Cook's 1913 biography.

Val Webb (2005)

Florence Nightingale

Born: May 12, 1820
Florence, Italy
Died: August 13, 1910
London, England
English nurse

The English nurse Florence Nightingale was the founder of modern nursing and made outstanding contributions to the knowledge and improvement of public health.

Early years and study

Florence Nightingale was born in Florence, Italy, on May 12, 1820; she was named after the city of her birth. Her father, William E. Nightingale, was a wealthy landowner who had inherited an estate in Derbyshire, England. Like many members of the wealthy class, he and Florence's mother, Fanny, dedicated themselves to the pursuit of active social lives. Florence and her sister, Parthenope, were tutored by their father in languages, mathematics, and history. Though Florence was tempted by the idea of a brilliant social life and marriage, she also wanted to achieve independence, importance in some field of activity, and obedience to God through service to society.

In 1844 Nightingale decided that she wanted to work in hospitals. Her family objected strongly to her plan; hospital conditions at that time were known to be terrible, and nurses were untrained and thought to be of questionable morals. Ignoring all resistance, Nightingale managed to visit some hospitals and health facilities. She then received permission from her parents to spend a few months at Kaiserworth, a German training school for nurses and female teachers. In 1853 she became superintendent of the London charity-supported Institution for Sick Gentlewomen in Distressed Circumstances. This opportunity allowed her to become independent from her family and also to try out new ideas in organizing and managing an institution, conducted in a scientific, nonreligious setting.

War efforts

In October of 1854 Nightingale organized a party of thirty-eight nurses, mostly from different religious orders, for service in the Crimean War (1853–56), in which Great Britain, France, and Sardinia fought against Russian expansion in Europe. The nurses arrived at Constantinople (now Istanbul, Turkey) in November. Conditions at the British base hospital at Scutari (now Uskudar, Turkey) were awful and grew steadily worse as the number of sick and wounded soldiers rapidly increased. The British army did not have enough medical services and used what it did have poorly—a confusing and complicated supply system actually cut off deliveries to the patients. The Barrack Hospital, where Nightingale and her nurses worked and lived, was built on a massive cesspool (an underground area into which liquid waste flows), which poisoned the water and even the building itself. The general attitude was that the common soldier was a drunken brute on whom all comforts would be wasted.

Nightingale saw that her first task was to get the military doctors to accept her and the other nurses. Her determined personality, combined with the continuing arrival of the newly sick and wounded, soon brought this about. She also had a large fund of private money—much of it raised by the London Times —with which she could obtain badly needed supplies. By the end of 1854, some order had been created and the hospital was cleaner—not only through Nightingale's efforts but also through improvements made by a governmental sanitary commission. The death rate among patients fell by two-thirds. But with improvement came new problems, including anger from officials who were found at fault for the poor hospital conditions and rising disputes among the nurses.

Hospital reform efforts back home

Florence Nightingale left Scutari in the summer of 1856, soon after the war ended. By then she was famous among the troops and the public as the "Lady with the Lamp" and the "Nightingale in the East." This popular image is not quite accurate. Although she did some active nursing in the wards, Nightingale's real work lay outside the expression of tenderness and concern. It began with her refusal to respond to public praise and with her use of her influence in high places, including with the queen, to fight for effective reform of the entire system of military hospitals and medical care.

In Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army (1857) Nightingale used the experiences of the war to prove that a new system was necessary. Within five years this effort led to the reconstruction of the administrative structure of the War Office. Nightingale's Notes on Hospitals (1859) detailed the proper arrangements for civilian institutions (places that were not a part of the military). In the next year she presided over the founding of the Nightingale School for the training of nurses at St. Thomas's Hospital in London, England. After 1858 she was recognized as the leading expert on military and civilian sanitation (the removal of water-transported waste) in India. She also believed that irrigation (the supplying of water to an area using artificial methods) was the solution to the problem of famine. In 1907 Nightingale was the first woman to be awarded the Order of Merit.

Later years

Nightingale's personality is well documented. She rebelled against the idle, sheltered existence of her family her entire life. She achieved a leading position in a world dominated by men, driving and directing her male coworkers as hard as she did herself. She often complained that women were selfish, and she had no time for the growing women's rights movement. But she also developed an idea of spiritual (relating to or affecting the spirit) motherhood and saw herself as the mother of the men of the British army—"my children"—whom she had saved. Florence Nightingale never really recovered from the physical strain of the Crimean War. After 1861 she rarely left her home and was confined to her bed much of the time. She died on August 13, 1910, in London, England.

For More Information

Dossey, Barbara Montgomery. Florence Nightingale: Mystic, Visionary, Healer. Springhouse, PA: Springhouse Corp., 2000.

Small, Hugh. Florence Nightingale: Avenging Angel. New York: St. Martin's Press, 1999.

Vickers, Rebecca. Florence Nightingale. Chicago: Heinemann Library, 2000.

Wellman, Sam. Florence Nightingale: Lady with the Lamp. Uhrichsville, OH: Barbour, 1999.

Woodham-Smith, Cecil. Florence Nightingale. New ed. London: Constable, 1996.

NIGHTINGALE, FLORENCE

NIGHTINGALE, FLORENCE (1820–1910), British nurse.

Born in Florence, Italy, on 12 May 1820, Florence Nightingale would become one of the world's most recognized women during her lifetime and a cultural icon after her death. The second child of William Edward and Frances Nightingale, she was raised in the Church of England to satisfy her mother's social and political ambitions, although the family was Unitarian by descent. Educated at home by her father, Nightingale excelled at academic subjects, preferring Greek and Latin to the domestic arts encouraged for women. After much persuasion, Nightingale's father allowed her an annual maintenance of £50, enabling her financial security.

Greatly admired and expected to make a good match, Nightingale refused the marriage proposal of Richard Monckton Milnes (1809–1885) despite their shared status and social values. Her refusal illustrates the conflicts shared by many intellectual women during the Victorian era: Nightingale explained that Milnes would satisfy her intellectual and passionate nature, but that her "moral …active nature … requires satisfaction, and that would not find it in his life" (Woodham-Smith, p. 51).

Nightingale believed herself to be called from God to perform active service—not service through

a husband. Occurring at pivotal moments in her life, Nightingale believed these experiences to be much like those of Joan of Arc (c. 1412–1431). First "called" in 1837 at seventeen, Nightingale believed God called her three subsequent times—in 1853 (prior to working at the Hospital for Gentlewomen), in 1854 (before going to the Crimea), and again in 1861 (after the death of Sidney Herbert [1810–1861]).

Visiting the hospital and school for Deaconesses at Kaiserwerth, Germany, Nightingale recognized in nursing an answer to this call to service. Because nursing was considered a low and disreputable profession, Nightingale met with resistance to her desires to study and pursue this vocation, especially from her mother. In a letter to her cousin Hilary Bonham Carter (1821–1865), she detailed her plan, "I thought something like a Protestant Sisterhood, without vows, for women of educated feeling, might be established" (Cook, vol. 1, p. 44).

During this period of depression, Nightingale wrote the three-volume Suggestions For Thought to Searchers After Religious Truth (privately printed, 1860), which explored what she saw as a conflict between divine and secular values. Her semi-autobiographical treatise on women's lives, "Cassandra," is included in the second volume. In 1853, Nightingale received permission to study nursing at the Kaiserwerth School for three months. Upon her return, Nightingale became the superintendent at the Establishment for Gentlewomen During Illness in London.

In 1854 Britain declared war on Russia; although England and its allies considered their Crimean engagement a military victory, the conflict exposed the appalling conditions of British military hospitals. At the request of Sidney Herbert, Minister at War, Nightingale traveled to Scutari, Turkey, with thirty-eight nurses to reform the military facilities. Nightingale quickly won the respect of the wounded soldiers, who called her "the lady with the lamp."

Returning from the Crimea, Nightingale experienced recurring bouts of a disabling illness, often preventing her from walking. Nightingale continued, however, as an advocate for health reforms.

Her statistical research influenced reforms in hospital administration and design, including the pavilion model, as well as reforms in hygiene and health care for the poor. Stressing preventative care and patient comfort, Nightingale insisted upon fresh air and water, proper drainage, cleanliness, and light for hospital wards.

In 1860, she established the Nightingale Training School for Nurses and published Notes on Nursing. That same year, Nightingale was the first woman elected a fellow to the Statistical Society in recognition of her statistical analyses that contributed to the reduction of the mortality rate in military hospitals. In 1883 Nightingale received the Royal Red Cross from Queen Victoria (r. 1837–1901), and in 1907 Edward VII (r. 1901–1910) honored her with the Order of Merit, making Nightingale the first woman to receive this award.

While the Crimean war may have immortalized Nightingale, Lytton Strachey, in his biographical sketch of her, describes this experience as only "the fulcrum with which she hoped to move the world. … For more than a generation she was to sit in secret, working her lever: her real life began at the very moment when, in the popular imagination, [it] ended" (p. 158).

On 13 August 1910, Nightingale died. In respect to her wishes, Nightingale's family declined a national funeral and interment in Westminster Abbey, burying her instead beside family.

See alsoCrimean War; Nurses; Professions; Red Cross.

bibliography

Primary Sources

Nightingale, Florence. Notes on Nursing: What It Is, and What It Is Not. New York, 1969.

——. Cassandra: An Essay. Old Westbury, N.Y., 1979.

——. Ever Yours, Florence Nightingale: Selected Letters. Edited by Martha Vicinus and Bea Nergaard. Cambridge, Mass., 1990.

——. Suggestions for Thought to Searchers After Religious Truth. Philadelphia, 1994.

——. Collected Works of Florence Nightingale. 6 vols. Edited by Lynn McDonald. Waterloo, Ont., 2002.

Secondary Sources

Bullough, Vern, Bonnie Bullough, and Marietta P. Stanton, eds. Florence Nightingale and Her Era: A Collection of New Scholarship. New York, 1990.

Cook, Sir Edward. The Life of Florence Nightingale. 2 vols. London, 1913.

Dossey, Barbara Montgomery. Florence Nightingale: Mystic, Visionary, Healer. Springhouse, Pa., 2000.

Gill, Gillian. Nightingales: The Extraordinary Upbringing and Curious Life of Miss Florence Nightingale. New York, 2004.

Strachey, Lytton. Eminent Victorians: Cardinal Manning, Florence Nightingale, Dr. Arnold, and General Gordon. New York, 1963.

Woodham-Smith, Cecil Blanche Fitz Gerald. Florence Nightingale, 1820–1910. New York, 1951.

Ruth Y. Jenkins

Florence Nightingale

The English nurse Florence Nightingale (1820-1910) was the founder of modern nursing and made outstanding contributions to knowledge of public health.

Florence Nightingale was born in Florence, Italy, on May 12, 1820, of wealthy parents. Her father was heir to a Derbyshire estate. Her mother, from solid merchant stock, dedicated herself to the pursuit of social pleasure within the circumscribed life then proper for women of high station. Though Florence was tempted by prospects of a brilliant social life and marriage, she had a stronger strain that demanded independence, dominance in some field of activity, and obedience to God by selfless service to society.

In 1844 Nightingale decided to work in hospitals. Her family furiously resisted her plan, on the ostensible ground that nurses were not "ladies" but menial drudges, usually of questionable morals. Nevertheless, she managed to do some private nursing and then to spend a few months at Kaiserworth, a German school and hospital. In 1853 she became superintendent of the London charity-supported Institution for Sick Gentlewomen in Distressed Circumstances. This opportunity allowed her to achieve effective independence from her family and also to try out novel techniques of institutional organization and management, conducted in a scientific, nonsectarian spirit.

In October 1854 Nightingale organized a party of 38 nurses, mostly from various religious orders, for service in the Crimean War. They arrived at Constantinople in November. Conditions at the British base hospital at Scutari were appalling and grew steadily worse as the flow of sick and wounded soldiers from the Crimea rapidly increased. The medical services of the British army were both insufficient and inefficient: a supply system of infinite and archaic complexity actually cut off deliveries to the patients; the Barrack Hospital, where Nightingale and her nurses were quartered, sat over a massive cesspool which poisoned the water and even the fabric of the building itself. However, the attitude still prevailed that the common soldier was an uncivilized, drunken brute on whom all comforts and refinements would be wasted.

Nightingale saw that her first task was to convert the military doctors to accept her and her nurses. Her discretion and diplomacy, combined with the influx of new sick and wounded, soon brought this about. She also had a large fund of private money, much of it raised by the London Times, with which she could cut through the clogged supply system. By the end of 1854 some order and cleanliness had been created, not only through her efforts but also through the revelations and improvements made by a governmental sanitary commission. The death rate among patients fell by two-thirds. But with improvement came new problems, with the defensiveness and hostility of the officials responsible for conditions now exposed and with the sectarian squabbling among the nurses, which Nightingale called the "Protestant Howl" and the "Roman Catholic Storm."

Florence Nightingale left Scutari in the summer of 1856, soon after the hostilities ended. By now she was idolized by the troops and the public as the "Lady with the Lamp" and the "Nightingale in the East." But this popular image is essentially false. Although she did active nursing in the wards, her real work lay outside the expression of tenderness and compassion. It began with her deliberate refusal to respond to public adulation and with her use of her influence in high places, even to the Queen and Prince Albert, to fight for effective reform of the entire system of military hospitals and medical care. Nightingale planned tactics from behind the scenes. In Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army (1857) she used the experiences of the war as a body of data to prove the necessity of a new system. Within 5 years this effort led to the reconstruction of the administrative structure of the War Office.

Nightingale's Notes on Hospitals (1859) detailed the proper arrangements for civilian institutions. In the next year she presided over the founding of the Nightingale School for the training of nurses at St. Thomas's Hospital in London. After 1858 she was recognized as the leading expert on military and civilian sanitation in India, in which capacity she advocated irrigation as the solution to the problem of famine.

Nightingale's personality is well documented. Her whole life she rebelled against the idle, sheltered existence of her family. She achieved a dominant position in a masculine world, driving and directing her male allies with the same ruthless force she applied to herself. She frequently complained of women's selfishness, and she ironically had no sympathy with the growing feminist movement. But she also developed a conception of spiritual motherhood and saw herself as the mother of the men of the British army— "my children"—whom she had saved.

Florence Nightingale never really recovered from the physical strain of the Crimea. After 1861 she was house-bound and bedridden. She died on Aug. 13, 1910.

Further Reading

There are two substantial standard biographies of Miss Nightingale: Sir Edward Cook, The Life of Florence Nightingale (2 vols., 1913), and Cecil Woodham-Smith, Florence Nightingale (1951), a most effective and satisfying treatment. Other biographies are Irene Cooper Willis, Florence Nightingale: A Biography (1930), and Margaret Goldsmith, Florence Nightingale, The Woman and the Legend (1937). Florence Nightingale is the subject of a famous chapter in Lytton Strachey, Eminent Victorians (1918); though unduly harsh, it rests on solid insight and has shaped the understanding of her personality. □

Florence Nightingale

1820-1910

Nurse

Sources

Middle-Class Upbringing. Florence Nightingale was born into a solidly upper–middle–class family. She and her elder sister, Panthenope, were educated by governesses until her Cambridge–educated father took over the task, teaching his children about the classics, the Bible, and contemporary politics. At age twenty Florence Nightingale overcame her parents’ objections and was allowed to receive tutoring in her preferred subject, mathematics, at which she excelled. Becoming a tutor herself, she grew particularly interested in the application of statistical methods to social and political problems.

Answering a Call. In 1837, Nightingale believed God called her to a life of service. Strongly influenced by the example of the Sisters of Saint Vincent de Paul, whom she encountered during a visit to Egypt, she sought to become a nurse, even though that profession was not considered appropriate for an educated woman. In 1851 she received three months of nursing training at the Institute for Protestant Deaconesses at Kaiserwerth, near Düsseldorf in Prussia. She then worked for a time at a hospital run by the Sisters of Mercy near Paris before returning in 1853 to London, where she found work on Harley Street, the center of medicine in London, becoming the (unpaid) superintendent at the Establishment for Gentlewomen during Illness.

Crimea. Only a few months later, in March 1854, England and France joined the Ottoman Turks in the Crimean War against Russia. After newspaper accounts criticized the poor care given to British soldiers in the field, Secretary of War Sidney Herbert (1810–1861), a friend of Nightingale’s, asked her to oversee the establishment of nurses in the field hospitals. She and thirty-eight nurses (of whom eighteen were Anglican or Roman Catholic nuns) arrived near Constantinople (now Istanbul) in early November 1854. Despite the resentment and outright opposition of doctors and military commanders, Nightingale set out to reform the sanitation, food, water supplies, and organization of the hospitals. Not only did she oversee personnel, she also performed nursing work. Because of her habit of inspecting hospitals at night, she became known as the “Lady with the Lamp.” Using her mathematical skills, Nightingale established a system of keeping records and collected data that enabled her to calculate mortality rates. The results of her calculations showed that British soldiers were seven times more likely to die of diseases such as cholera or typhus in fieldhospitals than they were to perish in battle—a statistic she attributed to appalling sanitary conditions in the hospitals. Her reforms and the acquisition of better medical equipment caused the mortality rate to fall from 60 per-cent at her arrival to 43 percent in February 1855 and then to 2.2 percent by May. This success made Nightin–gale a national hero in England and changed the practice of medicine. Nursing became an accepted and even a prestigious profession for women, who began to play an increasing role in the health field.

Medical Reform. When she returned to England in February 1856, Nightingale took up the cause of military–hospital reform because her statistics showed that, even during peacetime, soldiers aged twenty to thirty–five suffered twice the mortality rate of civilians. Largely as a result of her efforts, Queen Victoria and Prince Albert, along with Prime Minister Henry John Temple, Viscount Palmerston (1784–1865), created the Royal Commission on the Health of the Army, which implemented important improvements in the medical care of the British armed forces at home and abroad. Afte an illness contracted in the Crimea kept Nightingale from working as a nurse, she became an influential voice on public-health reform. She wrote extensively on the need for proper training of nurses and midwives and sanitary reform in India, the correct design of hospital wards and buildings, andways to improve public-health standards, particularly in rural areas. Grateful benefactors from the Crimean War era created the Nightingale Fund, which was used in 1860 to establish the Nightingale Training School and Home for Nurses, located at St. Thomas’ Hospital in London. Nightingale also influenced the founding in 1861 of a system of district nursing in Liverpool, which was widely imitated. At the end of her long life, in the course of which she was frequently ill, Nightingale’s contributions to public health were recognized by King Edward VII, who awarded her the Order of Merit in 1907. She was the first woman to be so honored. Although best known for her role as the “Lady with the Lamp,” Nightingale contributed to a wide range of health reforms, and she consistently applied her mathematical training and organizational skills to practical problems.

Sources

Vern L. Bullough, Bonnie Bullough, and Marietta P. Stanton, eds., Florence Nightingale and Her Era: A Collection of New Scholarship (New York: Garland, 1990).

Sue M. Goldie, ed., I Have Done My Duty: Florence Nightingale in the Crimean War, 1854–56 (Iowa City: University of Iowa Press, 1987).

Elspeth Huxley, Florence Nightingale (London: Weidenfeld & Nicolson, 1975).

Martha Vicinus and Bea Nergaard, eds., Ever Yours, Florence Nightingale: Selected Letters (London: Virago, 1989).