Florence Nightengale And The History Of Nursing
In the popular imagination, the historical figure Florence Nightengale is almost single-handedly synonymous with the image of the nurse. Born into a wealthy and well-connected British family at the ‘Villa Colombaia’ in Florence, Italy, she was named after the city of her birth, as was her older sister, who was named after Parthenope, the older name for the city of Naples. A brilliant and strong-willed woman, Florence fought against the well-entrenched ideas of what a women should be and act like in her era.
Florence Nightingale was brought up at Lea Hall and in 1825 the family moved to the Lea Hurst estate. In 1826, here father also purchased an estate at Embley Park in the province of Hampshire where he successfully took on the role of sheriff in 1828. The family typically spent the summer at their home in Lea Hurst and the winters at Embley Park, with occassional stints in London. With a fairly privledged background, the future nurse received an expansive education. In many ways because of this, she eventually came to dislike the lack of opportunity generally available to women in her social arena. Later, she began to visit the poor and developed a keen interest in looking after those in poor physical health. She visited hospitals in London and around the country to investigate possible occupations for women there. However, at the time, nursing was typically viewed as a less-than-desireable profession that required little intelligence and training.
Nightingale’s hospital visits began in 1844 and continued for eleven years. Her first introduction to nursing as a serious profession came on a visit to Egypt in the winter and spring of 1849-50. On other journey from Paris, she met two St. Vincent de Paul sisters who introduced her to their convent at Alexandria. Here, Nightengale saw first hand how these highly trained women were much more effective than the nurses of the era in England. Between 31 July to 13 August 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 here was instrumental in firmly planting the idea with Nightengale that nursing could be a highly instructive and desirable vocation for the females of the time. She spent four months at a hospital in Kaiserwerth in training, and when she returned to London, she began to visit additional London hospitals. Finally, in 1853, she took on her first managerial post, beccoming the superintendent of the a London hospital.
Nightengale’s Trial-By-Fire In the Crimean War
In March of 1856, the Crimean War broke out, and news of the sick and wounded quickly reached the news outlets of Britain. A London Times correspondent described in a series of narratives the sufferings of the sick and wounded in the English camps and described the difference in the hospital care of the English and French soldiers. Famously, he asked: “Are there no devoted women among us, able and willing to go forth to minister to the sick and suffering soldiers of the East in the hospitals of Scutari? Are none of the daughters of England, at this extreme hour of need, ready for such a work of mercy? Must we fall so far below the French in self-sacrifice and devotedness?”
Nightingale offered her services to the War Office on 14 October but her friend Sidney Herbert the Secretary for War already had written to her, suggesting that she should go out to the Crimea. Herbert said that she would ‘have plenary authority over all the nurses and … the fullest assistance and co-operation from the medical staff’. He also promised ‘unlimited power of drawing on the government for whatever you think requisite for the success of your mission’.
Nightingale left for the Crimea in October with a team of 38 nurses and a host of Anglican sisters from St. John’s Institute.
She set up her headquarters in the barracks of the Scutari hospital — an environment that was simultaneously huge and infected beyond belief. Some descriptions of the place from Nightengale give an idea of the wretched conditions:
“There were no vessels for water or utensils of any kind; no soap, towels, or clothes, no hospital clothes; the men lying in their uniforms, stiff with gore and covered with filth to a degree and of a kind no one could write about; their persons covered with vermin . . .
We have not seen a drop of milk, and the bread is extremely sour. The butter is most filthy; it is Irish butter in a state of decomposition; and the meat is more like moist leather than food. Potatoes we are waiting for, until they arrive from France.”
The authorities at Scutari viewed Nightengale’s reports as a bad reflection on their leadership. However, before the end of 1854, Nightengale and her nurses had brought the military hospital into much better shape. The Times of London had set up a relief fund and brought back news of the effort to England via regular stories in the paper. In December of the same year, 46 more nurses came to join the effort, and Nightengale quickly established a large kitchen and clothes washing facility. It was in this setting that she earned her ultimate fame with the moniker among soldiers of “Lady of The Lamp”. Her contemporary, Henry Wadsworth Longfellow, would try to express his gratitude for Nightengale in the poem, “Santa Filomena”.
Early in 1855, because of the defects in the sanitation system, there was a great increase in the number of cases of cholera and of typhus fever among Nightingale’s patients. Seven of the army doctors and three of the nurses died. Frost-bite and dysentery from exposure in the trenches before Sevastopol made the wards fuller than before. There were over 2000 sick and wounded in the hospital and in February 1855 the death-rate rose to 42%. The War Office ordered the sanitary commissioners at Scutari to carry out sanitary reforms immediately, after which the death-rate declined rapidly until in June it had fallen to 2%.
In May 1855 Nightingale visited the hospitals at and near Balaclava along with Mr. Bracebridge and Alexis Soyer. Nightingale fell ill from Crimean fever and she was dangerously ill for twelve days. Early in June she returned to Scutari and resumed her work there. In addition to her nursing work she tried to provide reading and recreation rooms for the men and their families. In March 1856 she returned to Balaclava and remained there until July when the hospitals were closed. She returned to England privately in August 1856, in a French ship. She entered England unnoticed and went home to Lea Hurst.
In September 1856 Nightingale visited Queen Victoria at Balmoral and told the Queen and Prince Albert about everything that ‘affects our present military hospital system and the reforms that are needed’. In November 1855 a Nightingale fund had been set up to found a training school for nurses. This was the only recognition of her services of which Nightingale would approve. By 1860, 50,000 had been collected and the Nightingale School and Home for Nurses was established at St. Thomas’s Hospital. Nightingale’s health and other occupations prevented her from accepting the post of superintendent but she watched the progress of the new institution with practical interest. She was able to use her experiences in the Crimea for the benefit of the nursing profession.
She settled in London and lived the retired life of an invalid, although she spent a great deal of time offering advice and encouragement through her writings. In 1857 she issued an exhaustive report on the army medical departments in the war in Crimea, and she later published notes that affected the Health, Efficiency and Hospital Administration of the British Army. In 1858 a Commission was appointed to inquire into the sanitary condition of the army: it set a high value on her evidence. In 1859 an army medical college was opened at Chatham and the first military hospital was established in Woolwich in 1861. During the American Civil War and the Franco-Prussian War of 1870-1 her advice was sought by the respective governments. Nightingale was involved in establishing the East London Nursing Society (1868), the Workhouse Nursing Association and National Society for providing Trained Nurses for the Poor (1874) and the Queen’s Jubilee Nursing Institute (1890).
When the Indian Mutiny broke out in 1857, Nightingale offered to perform the same services in that country. She did not go but she continued to take a strong interest in the sanitary conditions there. From her work, a Sanitary Department was established with the government in India.
Nightengale received was the Order of Merit in 1907 and in 1908 she was awarded the Freedom of the City of London. She had already received the German order of the Cross of Merit and the French gold medal of Secours aux Bless_s Militaires. On 10 May 1910 she was presented with the badge of honour of the Norwegian Red Cross Society. Nightingale died in South Street, Park Lane, London, on 13 August 1910 at the age of ninety and was buried on 20 August in the family plot at East Wellow, Hampshire. An offer of burial in Westminster Abbey was refused by her relatives. Memorial services took place in St. Paul’s Cathedral and Liverpool Cathedral, among many other places.
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