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