Florence Nightingale.docx

Florence Nightingale.docx

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FlorenceNightingale

FlorenceNightingale,OM,RRC（pronounced/ˈflɒrənsˈnaɪtɨŋɡeɪl/,historically[ˈflɒɾəns];12May1820–13August1910）wasacelebratedEnglishnurse,writerandstatistician.AChristianuniversalist,NightingalebelievedthatGodhadcalledhertobeanurse.ShecametoprominenceforherpioneeringworkinnursingduringtheCrimeanWar,whereshetendedtowoundedsoldiers.Shewasdubbed"TheLadywiththeLamp"afterherhabitofmakingroundsatnight.

Nightingalelaidthefoundationofprofessionalnursingwiththeestablishment,in1860,ofhernursingschoolatStThomas'HospitalinLondon,thefirstsecularnursingschoolintheworld.TheNightingalePledgetakenbynewnurseswasnamedinherhonour,andtheannualInternationalNursesDayiscelebratedaroundtheworldonherbirthday.

Biography

Earlylife

FlorenceNightingalewasbornintoarich,upper-class,well-connectedBritishfamilyattheVillaColombaia,[1]nearthePortaRomanaatBellosguardoinFlorence,Italy,andwasnamedafterthecityofherbirth.Florence'soldersisterFrancesParthenope（pronounced/pɑrˈθiːnəpɪ/）hadsimilarlybeennamedafterherplaceofbirth,Parthenopolis,aGreeksettlementnowpartofthecityofNaples.

HerparentswereWilliamEdwardNightingale,bornWilliamEdwardShore（1794–1874）andFrances（"Fanny"）NightingalenéeSmith（1789–1880）.William'smotherMarynéeEvanswasthenieceofonePeterNightingale,underthetermsofwhosewillWilliaminheritedhisestateLeaHurstinDerbyshire,andassumedthenameandarmsofNightingale.Fanny'sfather（Florence'smaternalgrandfather）wastheabolitionistWilliamSmith.（Forfamilytrees,see[2]）

InspiredbywhatshetookasacallfromGodinFebruary1837whileatEmbleyPark,Florenceannouncedherdecisiontoenternursingin1844,despitetheintenseangeranddistressofhermotherandsister.Inthis,sherebelledagainsttheexpectedroleforawomanofherstatus,whichwastobecomeawifeandmother.Nightingaleworkedhardtoeducateherselfintheartandscienceofnursing,inspiteofoppositionfromherfamilyandtherestrictivesocietalcodeforaffluentyoungEnglishwomen.

NightingalewascourtedbypoliticianandpoetRichardMoncktonMilnes,1stBaronHoughton,butsherejectedhim,convincedthatmarriagewouldinterferewithherabilitytofollowhercallingtonursing.

InRomein1847,shemetSidneyHerbert,abrilliantpoliticianwhohadbeenSecretaryatWar（1845–1846）,apositionhewouldholdagainduringtheCrimeanWar.Herbertwasonhishoneymoon;heandNightingalebecamelifelongclosefriends.HerbertandhiswifewereinstrumentalinfacilitatingNightingale'snursingworkintheCrimea,andshebecameakeyadvisertohiminhispoliticalcareer,thoughshewasaccusedbysomeofhavinghastenedHerbert'sdeathfromBright'sDiseasein1861becauseofthepressureherprogrammeofreformplacedonhim.

NightingalealsomuchlaterhadstrongrelationswithBenjaminJowett,whomayhavewantedtomarryher.

Nightingalecontinuedhertravels（nowwithCharlesandSelinaBracebridge）asfarasGreeceandEgypt.HerwritingsonEgyptinparticulararetestimonytoherlearning,literaryskillandphilosophyoflife.SailinguptheNileasfarasAbuSimbelinJanuary1850,shewrote"Idon'tthinkIeversawanythingwhichaffectedmemuchmorethanthis."And,consideringthetemple:

"Sublimeinthehigheststyleofintellectualbeauty,intellectwithouteffort,withoutsuffering...notafeatureiscorrect–butthewholeeffectismoreexpressiveofspiritualgrandeurthananythingIcouldhaveimagined.Itmakestheimpressionupononethatthousandsofvoicesdo,unitinginoneunanimoussimultaneousfeelingofenthusiasmoremotion,whichissaidtoovercomethestrongestman."

AtThebesshewroteofbeing"calledtoGod"whileaweeklaternearCairoshewroteinherdiary（asdistinctfromherfarlongerlettersthathereldersisterParthenopewastoprintafterherreturn）:

"GodcalledmeinthemorningandaskedmewouldIdogoodforhimalonewithoutreputation."[3]Laterin1850,shevisitedtheLutheranreligiouscommunityatKaiserswerth-am-RheininGermany,wheresheobservedPastorTheodorFliednerandthedeaconessesworkingforthesickandthedeprived.Sheregardedtheexperienceasaturningpointinherlife,andissuedherfindingsanonymouslyin1851;TheInstitutionofKaiserswerthontheRhine,forthePracticalTrainingofDeaconesses,etc.washerfirstpublishedwork;[4]shealsoreceivedfourmonthsofmedicaltrainingattheinstitutewhichformedthebasisforherlatercare.

On22August1853,NightingaletookthepostofsuperintendentattheInstitutefortheCareofSickGentlewomeninUpperHarleyStreet,London,apositionshehelduntilOctober1854.[5]Herfatherhadgivenheranannualincomeof£500（roughly£25,000/US$50,000inpresentterms）,whichallowedhertolivecomfortablyandtopursuehercareer.

CrimeanWar

FlorenceNightingale'smostfamouscontributioncameduringtheCrimeanWar,whichbecamehercentralfocuswhenreportsbegantofilterbacktoBritainaboutthehorrificconditionsforthewounded.On21October1854,sheandastaffof38womenvolunteernurses,trainedbyNightingaleandincludingherauntMaiSmith,[6]weresent（undertheauthorisationofSidneyHerbert）toOttomanEmpire,about295nauticalmiles（546km;339mi）acrosstheBlackSeafromBalaklavaintheCrimea,wherethemainBritishcampwasbased.

NightingalearrivedearlyinNovember1854atSelimiyeBarracksinScutari（modern-dayÜsküdarinIstanbul）.Sheandhernursesfoundwoundedsoldiersbeingbadlycaredforbyoverworkedmedicalstaffinthefaceofofficialindifference.Medicineswereinshortsupply,hygienewasbeingneglected,andmassinfectionswerecommon,manyofthemfatal.Therewasnoequipmenttoprocessfoodforthepatients.

UntilrecentlyitwascommonlyassertedthatNightingalereducedthedeathratefrom42%to2%eitherbymakingimprovementsinhygieneherselforbycallingfortheSanitaryCommission.Forexamplethe1911firsteditionoftheDictionaryofNationalBiographymadethisclaim,butthesecondeditionin2001didnot.However,deathratesdidnotdrop;onthecontrary,theybegantorise.Thedeathcountwasthehighestofallhospitalsintheregion.DuringherfirstwinteratScutari,4,077soldiersdiedthere.Tentimesmoresoldiersdiedfromillnessessuchastyphus,typhoid,choleraanddysenterythanfrombattlewounds.Conditionsatthetemporarybarrackshospitalweresofataltothepatientsbecauseofovercrowdingandthehospital'sdefectivesewersandlackofventilation.ASanitaryCommissionhadtobesentoutbytheBritishgovernmenttoScutariinMarch1855,almostsixmonthsafterFlorenceNightingalehadarrived,andeffectedflushingoutthesewersandimprovementstoventilation.[7]Deathratesweresharplyreduced.Duringthewarshedidnotrecognisehygieneasthepredominantcauseofdeath,andsheneverclaimedcreditforhelpingtoreducethedeathrate.[8]

Nightingalecontinuedbelievingthedeathrateswereduetopoornutritionandsuppliesandoverworkingofthesoldiers.ItwasnotuntilaftershereturnedtoBritainandbegancollectingevidencebeforetheRoyalCommissionontheHealthoftheArmythatshecametobelievethatmostofthesoldiersatthehospitalwerekilledbypoorlivingconditions.Thisexperienceinfluencedherlatercareer,whensheadvocatedsanitarylivingconditionsasofgreatimportance.Consequently,shereduceddeathsinthearmyduringpeacetimeandturnedattentiontothesanitarydesignofhospitals.

TheLadywiththeLamp

DuringtheCrimeanwar,FlorenceNightingalegainedthenickname"TheLadywiththeLamp",derivingfromaphraseinareportinTheTimes:

Sheisa‘ministeringangel’withoutanyexaggerationinthesehospitals,andasherslenderformglidesquietlyalongeachcorridor,everypoorfellow'sfacesoftenswithgratitudeatthesightofher.Whenallthemedicalofficershaveretiredforthenightandsilenceanddarknesshavesettleddownuponthosemilesofprostratesick,shemaybeobservedalone,withalittlelampinherhand,makinghersolitaryrounds.[9]

ThephrasewasfurtherpopularisedbyHenryWadsworthLongfellow's1857poem"SantaFilomena":

[10]

Lo!

inthathouseofmisery

AladywithalampIsee

Passthroughtheglimmeringgloom,

Andflitfromroomtoroom.

Latercareer

WhileshewasintheCrimea,on29November1855,apublicmeetingtogiverecognitiontoFlorenceNightingaleforherworkinthewarledtotheestablishmentoftheNightingaleFundforthetrainingofnurses.Therewasanoutpouringofgenerousdonations.SidneyHerbertservedashonorarysecretaryofthefund,andtheDukeofCambridgewaschairman.Nightingalewasconsideredapioneerintheconceptofmedicaltourismaswell,onthebasisofherlettersfrom1856inwhichshewroteofspasinOttomanEmpire,detailingthehealthconditions,physicaldescriptions,dietaryinformation,andothervitallyimportantdetailsofpatientswhomshedirectedthere（wheretreatmentwassignificantlylessexpensivethaninSwitzerland）.Itmaybeassumed[citationneeded]shewasdirectingpatientsofmeagremeanstoaffordabletreatment.

By1859Nightingalehad£45,000atherdisposalfromtheNightingaleFundtosetuptheNightingaleTrainingSchoolatSt.Thomas'Hospitalon9July1860.（ItisnowcalledtheFlorenceNightingaleSchoolofNursingandMidwiferyandispartofKing'sCollegeLondon.）ThefirsttrainedNightingalenursesbeganworkon16May1865attheLiverpoolWorkhouseInfirmary.ShealsocampaignedandraisedfundsfortheRoyalBuckinghamshireHospitalinAylesbury,nearherfamilyhome.

Nightingale