Florence Nightingale

Florence Nightingale

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Florence Nightingale, the daughter of the wealthy landowner, William Nightingale of Embly Park, Hampshire, was born in Florence, Italy, on 12th May, 1820. Her father was a Unitarian and a Whig who was involved in the anti-slavery movement. As a child, Florence was very close to her father, who, without a son, treated her as his friend and companion. He took responsibility for her education and taught her Greek, Latin, French, German, Italian, history, philosophy and mathematics.

Elizabeth Gaskell described her as "tall, willowy in figure, with thick shortish rich brown hair, a delicate complexion, and grey eyes that are generally pensive but could be the merriest." Her biographer, Colin Matthew, has pointed out: "Florence was a good mimic, attractive to men, and had a number of suitors; many of the men she met through her parents remained lifelong friends.... In spite of these advantages Florence Nightingale was an unhappy young woman. She suffered from bouts of depression and feelings of unworthiness, and she questioned the purpose of life for the upper classes. Unlike her mother and sister, who were content to do good works on the estates, she pondered on the need for charity and the causes of poverty and unemployment."

At seventeen she felt herself to be called by God to some unnamed great cause. Florence's mother, Fanny Nightingale, also came from a staunch Unitarian family. Fanny was a domineering woman who was primarily concerned with finding her daughter a good husband. She was therefore upset by Florence's decision to reject Lord Houghton's offer of marriage. Florence refused to marry several suitors, and at the age of twenty-five told her parents she wanted to become a nurse. Her parents were totally opposed to the idea as nursing was associated with working class women.

Florence Nightingale's desire to have a career in medicine was reinforced when she met Elizabeth Blackwell at St. Bartholomew's Hospital in London. Blackwell, who had to overcome considerable prejudice to achieve her ambition, encouraged her to keep trying and in 1851 Florence's father gave her permission to train as a nurse.

Florence Nightingale, now thirty-one, went to Kaiserwerth, Germany where she studied to become a nurse at the Institute of Protestant Deaconesses. Two years later she was appointed resident lady superintendent of a hospital for invalid women in Harley Street, London.

In March, 1853, Russia invaded Turkey. Britain and France, concerned about the growing power of Russia, went to Turkey's aid. This conflict became known as the Crimean War. Soon after British soldiers arrived in Turkey, they began going down with cholera and malaria. Within a few weeks an estimated 8,000 men were suffering from these two diseases.

William Howard Russell, who worked for The Times, reported the Siege of Sevastopol. He found Lord Raglan uncooperative and wrote to his editor, John Thadeus Delane alleging unfairly that "Lord Raglan is utterly incompetent to lead an army". Roger T. Stearn has argued: "Unwelcomed and obstructed by Lord Raglan, senior officers (except de Lacy Evans), and staff, yet neither banned, controlled, nor censored, William Russell made friends with junior officers, and from them and other ranks, and by observation, gained his information. He wore quasi-military clothes and was armed, but did not fight. He was not a great writer but his reports were vivid, dramatic, interesting, and convincing.... His reports identified with the British forces and praised British heroism. He exposed logistic and medical bungling and failure, and the suffering of the troops."

Russell's reports revealled the sufferings of the British Army during the winter of 1854-1855. These accounts upset Queen Victoria who described them as these "infamous attacks against the army which have disgraced our newspapers". Prince Albert, who took a keen interest in military matters, commented that "the pen and ink of one miserable scribbler is despoiling the country." Lord Raglan complained that Russell had revealed military information potentially useful to the enemy.

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William Howard Russell reported that British soldiers began going down with cholera and malaria. Within a few weeks an estimated 8,000 men were suffering from these two diseases. When Mary Seacole heard about the cholera epidemic she travelled to London to offer her services to the British Army. There was considerable prejudice against women's involvement in medicine and her offer was rejected. When Russell publicised the fact that a large number of soldiers were dying of cholera there was a public outcry, and the government was forced to change its mind. Florence Nightingale volunteered her services and was eventually given permission to take a group of thirty-eight nurses to Turkey.

Florence Nightingale found the conditions in the army hospital in Scutari appalling. The men were kept in rooms without blankets or decent food. Unwashed, they were still wearing their army uniforms that were "stiff with dirt and gore". In these conditions, it was not surprising that in army hospitals, war wounds only accounted for one death in six. Diseases such as typhus, cholera and dysentery were the main reasons why the death-rate was so high amongst wounded soldiers.

Edward T. Cook, the author of The Life of Florence Nightingale (1913), quoted one of the men in the hospital that she treated: "Florence Nightingale 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. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds."

Military officers and doctors objected to Nightingale's views on reforming military hospitals. They interpreted her comments as an attack on their professionalism and she was made to feel unwelcome. Florence Nightingale received very little help from the military until she used her contacts at The Times to report details of the way that the British Army treated its wounded soldiers. John Delane, the editor of newspaper took up her cause, and after a great deal of publicity, Nightingale was given the task of organizing the barracks hospital after the battle of Inkerman and by improving the quality of the sanitation she was able to dramatically reduce the death-rate of her patients.

Sidney Herbert wrote "There broke out in different parts of the country a feeling of immediate and spontaneous expression of public gratitude and isolated portions of the country were preparing to make gifts to her." Charles Dickens and Angela Burdett-Coutts were two people who wished to contribute. Nightingale had spoken about the "sodden misery in the hospital". On Dickens's advice, at the end of January 1855, Burdett-Coutts ordered from William Jeakes, an engineer working in Bloomsbury, a drying closet machine. It was built at a cost of £150. It was shipped out in parts and re-assembled in Istanbul. According to The Illustrated London News "1,000 articles of linen can be thoroughly dried in 25 minutes with the aid of Mr Jeakes centrifugal machine which took the wet out of the linen before it is placed in the drying closet." Dr Sutherland, who was working at the army hospital, wrote a letter of thanks to Jeakes: "The wet clothes give in as soon as they have seen it and dry up forthwith. The machine does great credit to Miss Coutt's philanthropy and also your engineering." Dickens commented that the machine was "the only solitary administrative thing, connected with the war that has been a success."

Although Mary Seacole was an expert at dealing with cholera, her application to join Florence Nightingale's team was rejected. Mary, who had become a successful business woman in Jamaica, decided to travel to the Crimea at her own expense. She visited Nightingale at her hospital at Scutari but once again Mary's offer of help was refused. Unwilling to accept defeat, Mary Seacole started up a business called the British Hotel, a few miles from the battlefront. Here she sold food and drink to the British soldiers. With the money she earned from her business Mary was able to finance the medical treatment she gave to the soldiers. Whereas Florence Nightingale and her nurses were based in a hospital several miles from the front, Mary Seacole treated her patients on the battlefield. On several occasions she was found treating wounded soldiers from both sides while the battle was still going on.

The war ended in March 1856. Out of 94,000 men sent to the war area, 4,000 died of wounds but 19,000 died of disease, and 13,000 were invalided out of the army. Florence Nightingale returned to England as a national heroine. She had been deeply shocked by the lack of hygiene and elementary care that the men received in the British Army. She later wrote: "I stand at the altar of murdered men and while I live I will fight their cause". Nightingale therefore decided to begin a campaign to improve the quality of of nursing in military hospitals. In October, 1856, she had a long interview with Queen Victoria and Prince Albert and the following year gave evidence to the 1857 Sanitary Commission. This eventually resulted in the formation of the Army Medical College.

To spread her opinions on reform, Florence Nightingale published two books, Notes on Hospital (1859) and Notes on Nursing (1859). With the support of wealthy friends and John Delane at The Times, Nightingale was able to raise £59,000 to improve the quality of nursing. In 1860, she used this money to found the Nightingale School & Home for Nurses at St. Thomas's Hospital. She also became involved in the training of nurses for employment in the workhouses that had been established as a result of the 1834 Poor Law Amendment Act.

Nightingale held strong opinions on women's rights. In her book Suggestions for Thought to Searchers after Religious Truths (1859) she argued strongly for the removal of restrictions that prevented women having careers. Read by John Stuart Mill, it influenced his book on women's rights, The Subjection of Women (1869).

Florence Nightingale was also strongly opposed to the passing of the Contagious Diseases Act. However, Nightingale was unwilling to become involved in the campaign led by Josephine Butler to get this legislation repealed. Nightingale preferred working behind the scenes to get laws changed and disapproved of women making speeches in public. Women such as Elizabeth Garrett Anderson and Sophia Jex-Blake were disappointed by Nightingale's lack of support for women's doctors. Nightingale had doubts at first about the wisdom of this campaign and argued that it was more important to have better trained nurses than women doctors.

Her biographer, Colin Matthew, has pointed out: "At the age of sixty Florence Nightingale considered herself old. Her friends and collaborators were dead, but her health improved. The thin, waspish woman who sent mordant, aphoristic letters to ministers now metamorphosed into a stout, benevolent old lady. She tried to keep up with public-health matters but she was increasingly out of touch.... She continued to write sentimental addresses to probationers until 1889, but by now her eyesight was failing.... She spent almost the whole of her final fifteen years in her room in South Street."

Florence Nightingale died in London on 13th August, 1910.

Women are never supposed to have any occupation of sufficient importance not to be interrupted, except "suckling their fools"; and women themselves have accepted this, have written books to support it, and have trained themselves so as to consider whatever they do as not of such value to the world as others, but that they can throw it up at the first "claim of social life". They have accustomed themselves to consider intellectual occupation as a merely selfish amusement, which it is their "duty" to give up for every trifler more selfish than themselves.

Women never have an half-hour in all their lives (except before and 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 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".

The family? It is too narrow a field for the development of an immortal spirit, be that spirit male or female. The family uses people, not for what they are, not for what they are intended to be, but for what it wants for - its own uses. It thinks of them not as what God has made them, but as the something which it has arranged that they shall be. This system dooms some minds to incurable infancy, others to silent misery.

I have a moral, an active nature which requires satisfaction and that I would not find in his life. I could be satisfied to spend a life with him in combining our different powers to some great object. I could not satisfy this nature by spending a life with him in making society and arranging domestic things.

Although the public have been presented with several portrait-sketches of the lady who has so generously left this country to attend to the sufferings of the sick and wounded at Constantinople, we have assurance that these pictures are "singularly and painfully unlike". We have, therefore, taken the most direct means of obtaining a sketch of this excellent lady, in the dress she now wears, in one of "the corridors of the sick".

Wherever there is disease in its most dangerous form, and the hand of the spoiler distressingly nigh, there is that incomparable woman sure to be seen; her benignant presence is an influence for good comfort even amid the struggles of expiring nature. She is a 'ministering angel' without any exaggeration in these hospitals, and, as her slender form glides quietly along each corridor, every fellow's face softens with gratitude at the sight of her.

I need hardly say that I think its views most absurd - just such as would originate in a little state like Geneva, which never can see war. They tend to remove responsibility from Governments. They are practically impracticable. And voluntary effort is desirable, just in so far as it can be incorporated into the military system.

If the present Regulations are not sufficient to provide for the wounded they should be made so. But it would be an error to revert to a voluntary system, or to weaken the military character of the present system by introducing voluntary effort, unless such effort were to become military in its organization.

To the many who pay their homage to Miss Nightingale, though a very humble person of a small country, Switzerland, I yet want to add my tribute of praise and admiration. As the founder of the Red Cross and the originator of the diplomatic Convention of Geneva, I feel emboldened to pay my homage. To Miss Nightingale I give all the honour of this humane Convention. It was her work in the Crimea that inspired me to go to Italy during the war of 1859, to share the horrors of war, to relieve the helplessness of the unfortunate victims of the great struggle on June 24, to soothe the physical and moral distress, and the anguish of so many poor men, who had come from all parts of France and Austria to fall victims to their duty, far from their native country, and to water the poetic land of Italy with their blood.

I have no peculiar gifts. And I can honestly assure any young lady, if she will but try to walk, she will soon be able to run the "appointed course". But then she must first learn to walk, and so when she runs she must run with patience. (Most people don't even try to walk.) But I would also say to all young ladies who are called to any particular vocation, qualify yourself for it as a man does for his work. Don't think you can undertake it otherwise.

Nursing is most truly said to be a high calling, an honourable calling. But what does the honour lie in? In working hard during your training to learn and to do all things perfectly. The honour does not lie in putting on Nursing like your uniform. Honour lies in loving perfection, consistency, and in working hard for it: in being ready to work patiently: ready to say not "How clever I am!" but "I am not yet worthy; and I will live to deserve to be called a Trained Nurse."

She is known to generations of children as the saintly, iron-willed Lady With the Lamp who battled to improve the conditions of wounded British soldiers and founded modern nursing, but a strikingly different picture of Florence Nightingale has emerged from the unpublished letters of one of her bitterest enemies.

"Miss Nightingale shows an ambitious struggling after power inimical to the true interests of the medical department," Sir John Hall, the chief British army medical officer in the Crimea, wrote to his superior in London.

When she went over his head to order supplies from his stores, observers, Sir John wrote, were astounded at the "petticoat imperium! in the medical imperio!"

When Nightingale arrived in Scutari in November 1854 with 38 women volunteers, sent by her close friend, the war secretary, Sydney Herbert, she was about to carve out her place in history and destroy Sir John's. Her determination to reform the army hospitals in which thousands of wounded and ill soldiers were treated in closely packed beds by overworked doctors and male medical orderlies, and untrained women whom she dismissed as drunken and slatternly, brought her into instant collision with Sir John - and she also became a media star in the first British war reported in detail by the press.

"It was absolutely as night follows day that her upper-class Victorian female morality would clash head on with his traditional closed male army world," said Richard Aspin, head of the archive and manuscripts at the Wellcome Trust, which recently bought Sir John's letters. "She simply ignored his authority. She would no more have dreamed of consulting him about her nurses than she would have sought the opinion of a husband, if she ever had one, about hiring a parlour maid."

Sir John's letters denounced her as a publicity seeking meddler. Her ambitions, which launched the modern career of nursing, "if not resisted", he wrote, "will, with the influence she has at present at home, throw us completely into the shade in future, as we are at present overlooked in all that is good and beneficial regarding our hospital arrangements, which are ascribed utterly to her presiding genius by great part of the press and her own itinerant eulogistic orators".

He accused her of squandering resources by sacking good nurses and orderlies and trying to take over control of others - "but in that she was disappointed, for they declined to serve under her orders".

It might be some consolation to poor Sir John that the scruffy marbled notebook containing his transcripts of the letters he considered most important cost the Wellcome Trust £4,000, while Nightingale's letters were bought for only £200. One letter from Nightingale, advising on how to find a reliable medical officer for a post in Egypt, warns against employing ex-army doctors: "The fact is, nearly all the half-pay list are blackguards".

Henry Wellcome, who founded the trust, shared the general reverence for the Lady with the Lamp. Hers was the only woman's name he included in the frieze of his library, and he bought the scuffed mocassins she wore at Scutari - now on view in the new museum galleries which opened in London this summer. The collection also owns, but has lent to the British Library, the only known recording of Nightingale's voice, on a wax cylinder.

Hall battled on, writing in February 1856: "The army is in splendid health, only seven deaths in a week and one of them a fit of apoplexy from drunkeness."

However, his view of history's treatment of Nightingale and himself was prophetic. He wrote sadly: "We shall to the end of time be made the victims of public odium in the way we were last winter ... the poor suffering sick soldier is a fine theme to ride off on."

When his long military service was rewarded with a knighthood, Nightingale commented to Sydney Herbert that the honour could only mean "knight of the Crimean burial grounds".[/

Most biographies of Florence Nightingale attest that she became a national hero after dramatically reducing the mortality rate at the Scutari hospital during the Crimean war. But new research casts doubt on her role in transforming the hospital after her arrival in 1854. Official records show that by February 1855, the mortality rate had fallen from 60% to 42.7% and then, once a fresh water supply was introduced, it dropped further to 2.2%.

Recently historians have suggested the death rate among soldiers did not fall immediately but rose, and was higher than any other hospital in the region. During Nightingale's first winter there, 4,077 soldiers died, mostly of typhus, typhoid, cholera and dysentery. Ten times more died of these illnesses than from battle wounds.

The death rate began to fall six months after she took charge - only after a sanitary commission was sent out by Lord Palmerston to improve ventilation and clean out the sewers.

Nightingale had believed the mortality rates were due to poor nutrition and overworking of soldiers. But Hugh Small, author of Florence Nightingale: Avenging Angel, claims an unpublished letter shows it was not until 1857 that she realised the conditions within the hospitals themselves had caused such a huge number of deaths.

Florence Nightingale

Florence Nightingale (b.1820-d.1910) founded modern nursing and helped improve the care provided by hospitals. She was named after her birthplace, Florence, Italy. Raised in England, her father provided her a good education through tutors, especially in classics and mathematics. Her family discouraged her from seeking a career in nursing, since up to that time nurses had mostly been religious, monastic women or untrained helpers of little training or low repute. Nonetheless, she perceived a calling, and trained in Egypt, Germany and France, before winding up serving in a home for "gentlewomen" suffering from illness in London.
From there, she went with 38 other nurses to help in the Crimean War (1854-56). She became famous for her dedication toward the welfare of her patients, earning the nickname "the Lady with the Lamp" for her tending the sick through the night. More significantly, she sought to improve sanitary conditions in the medical facilities. She proved her case through statistical analysis, using what she called "coxcombs," now known as "polar-area diagrams." Her proof of the effectiveness of proper hygiene for the recovery from wounds and disease led to a reform of the entire military hospital system.
After the war, using money donated from her former patients and the public, she founded the Nightingale Training School and Home for Nurses . This institution continued to improve what was becoming the nursing profession. But she remained unmarried, and retreated increasingly into the isolation of her home because of ill health. Yet through her writing, she remained an important consultant on health issues, winning fame, awards, and honors during her lifetime. In 1907, she was the first woman to be granted the British Order of Merit.

Florence Nightingale – The story behind the lady with the lamp

Florence Nightingale was a prominent figure in nursing whose exceptional work immensely affected 19th and 20th-century policies concerning proper care of patients. She helped hospitals transform into cleaner places, and demonstrated that well-trained nurses and taking care of hygiene in hospitals actually helped sick people get better. Nightingale most certainly made history and is remembered as the founder of modern nursing.

Born in 1820, into a high-class British family at a villa in the Italian city of Florence, she was given the name after her city of birth.

One of the first important journeys that Nightingale took was at the age of 18 when her father took the family on a trip to Europe. During the trip, the family connected with an English-born Parisian salon hostess known as May Clarke, and with whom Florence had instantly bonded. A very peculiar relationship, despite their 27-year age difference, the two of them remained close friends for 40 years. Clarke was a feminist, and she demonstrated that in every way possible throughout her life. The idea that women could be equals to men, was something that Florence most probably picked up from Clarke, and she lived the truth of that later in her life.

Young Florence Nightingale

At around the same age, Nightingale was undergoing some of her first experiences that she considered were calls from God. These occurrences prompted a strong desire in her to dedicate her life to the service of others. It was difficult initially for Florence to heed this call, as in the eyes of her family, such an idea was detestable.

Despite her outraged mother and sister, Nightingale eventually arrived at the decision to become a nurse in 1844, rebelling against the expected role of women of her status to become a wife and mother. Although she was faced with the opposition of her close family and as well, the rigid social codes that were applied to young, affluent English women of the time, Nightingale independently succeeded in obtaining her nursing education through her persistence and adamant resolve.

Embley Park, now a school, was the family home of Florence Nightingale, photo credit

It is important to mention her trip to Italy which took place in 1847. In Rome, she met with Sidney Herbert, an English politician who served as Secretary of War and remained a close friend of Florence’s. During the Crimean War, in which the Russian Empire had lost to an alliance of France, Britain, the Ottomans, and Sardinia (1853 – 1856), it was Herbert and his wife who largely facilitated Nightingale’s nursing work there.

Throughout the Crimean War, de facto, Nightingale’s nursing work came to prominence. She had served as a manager of nurses who she had personally trained. Alongside her, she had 38 female volunteer staff nurses who were deployed to the main British camp in Crimea. She organized the whole team, tending to the wounded soldiers, and she also began to change things around.

Upon arrival in Crimea, the women observed that the care for the wounded was poor, the medical staff was overworked, and that meanwhile, officials were indifferent to these pressing issues. Medicine supplies were short and hygiene was largely neglected, hence mass infections were common and often fatal. Nightingale had sent a plea to The Times so as to seek a government-led solution to the poor facilities. This was resolved after the famous engineer Isambard Kingdom Brunel was commissioned to design a prefabricated hospital. The Renkioi Hospital was built, a civilian facility made of wood that was constructed in England, and then shipped to the Dardanelles. The effort resulted in decreased rates of deaths among the soldiers who needed care.

“Florence Nightingale. An Angel of Mercy. Scutari Hospital 1855”. Colored mezzotint, c. 1855, by Tomkins after Butterworth, photo credit

Slowly but steadily, Nightingale was making a name for herself while also giving nursing a highly favorable reputation. She did, in fact, become an icon of Victorian culture, portrayed through the persona of “The Lady with the Lamp”, doing the night rounds amongst the injured. The nickname was inspired by a paragraph in a report by The Times which read, “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. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds “.

The Lady with the Lamp. Popular lithograph reproduction of a painting of Nightingale, by Henrietta Rae, 1891.

On the other hand, for some, Nightingale’s accomplishments in the Crimean War were slightly overrated by the newspapers, in order to nurture the public’s need for a hero and an icon. Nobody discredited her accomplishments that followed after the war, however, one of which was perfecting the nursing role for women.

In 1860, she established the nursing school at St Thomas’ Hospital in London. It became the first secular nursing school in the world, and today is part of King’s College London.

Apart from laying down the foundations of professional nursing, Nightingale was a social reformer. Her input improved healthcare in each segment of British society. She had further advocated for better hunger relief in India and also helped to abolish overly severe prostitution laws towards women. In general, Nightingale opened up new opportunities for women, pushing the limits of acceptable norms for women’s position in the workforce.

Florence Nightingale (middle) in 1886, with her graduating class of nurses from St Thomas’ outside Claydon House, Buckinghamshire, photo credit

The long-lasting legacy she left is illustrated through the Nightingale Pledge taken by new nurses, this is a kind of modified version of the Hippocratic Oath. The Florence Nightingale Medal is the highest international distinction a nurse can obtain, also named in her honor. The International Nurses Day is cherished all around the globe and is celebrated on her birthday.

Last but not least, Nightingale also wrote and published work that spread medical knowledge easily. Ever conscious of reaching out equally to all, her records were mostly written in simple English so that everyone, including the less educated, was able to understand it. She passed away in 1910, at the of 90.

Florence Nightingale - History

What comes to mind when the subject of nursing arises? Many people picture women wearing a white uniform with white shoes, and their hair tied in a bun. Others picture nurses as the doctor's assistance and only do what they are told. While some view nursing as a professional who are committed to helping and caring for others. Nursing was once viewed as a job of low status. Many nurses were untrained, had questionable moral characters, poor, and uneducated. Cleaning and caring for the sick in the 1820s were considered the tasks of servants and were not suited for a proper lady. Many people associate nursing to Florence Nightingale, the founder of modern nursing. Florence Nightingale achieved many things during her lifetime such as instilling practice for better hospitalizations. She was well educated, intelligent, and used her knowledge to improve and changed the perspective of nursing. The purpose of this paper is to discuss the history of Florence Nightingale, the hospital conditions prior to Florence Nightingale's arrival in Scutari, Turkey, and the lasting impression that Florence Nightingale made during the Crimean War.

Florence Nightingale was born on May 12th, 1820 into a wealthy British family in Florence, Italy. She had an older sister named Parthenope, and her parents were William and Fanny Nightingale (Nelson, 1999). William and Fanny Nightingale came from a Unitarian background and supported education of both genders (Foster, 2010). By good fortune, William Nightingale was a member of the British Academy of Sciences, and taught Florence and Parthenope many languages such as Latin, Greek, German, and French. Florence was also given lessons of philosophy and history by her father (Nelson, 1999). Florence and her sister Parthenope were known to be brilliant, thoughtful, and highly knowledgeable amongst their community (Foster, 2010). Although Florence's parents supported her education, she was still expected to maintain the status within their family line. It was expected of Florence to marry a man of similar social standing, engage in activities such as planning dinner parties, and embroidering (Nelson, 1999). There were many men who pursued Florence's hand in marriage, but one day she heard God speak and called her to his service. Since then she felt that her life was meant to serve another purpose, and from then on her life changed (Nelson, 1999). For years Florence felt trapped, and grew increasingly restless and impatient with a life that had no significant meaning or purpose (Nelson, 1999). At the age of 24, Florence declined a marriage proposal and felt her called to service was through nursing (Nelson, 1999).

William and Fanny Nightingale were shocked when Florence approached them with news of her pursuing nursing. At that time nursing was not a profession suited for a proper lady. English hospitals were known to have working nurses who were alcoholics, prostitutes, abandoned within the society, and had doubtful moral characters (Summer, 1989). Florence continued to listen to her parents and did not seek a hospital job, but she used her parents’ resources to her advantage and spent her time researching on national health conditions, and became an expert on hospitals and sanitation (Nelson, 1999). When Florence denied another marriage proposal in 1851, her parents finally allowed her to focus on nursing at the Institution of Protestant Deaconesses in Kaiserwerth, Germany (McDonald, 2010). Florence was able to study nursing for three months at the institution and learned about the basics of nursing skills, organizations within the hospital, and learned the significance in observing patients (McDonald, 2006). Soon, Florence accepted a position as Superintendent of the Institution for Care of Sick Gentlewomen in Distressed Circumstances (Nelson, 1999).

The Crimean War broke out in 1853. Many soldiers were dying from infection and diseases. Sir Sidney Herbert knew that Florence was the right person to care for the wound and wrote a letter to Florence in regards to the soldiers’ conditions fighting in the Crimean War. Florence Nightingale took the challenge of Sir Herbert and set sail with her thirty-eight trained nurses to the military hospital in Crimea where there were approximately four thousand wounded soldiers (Lundy, 2012, p.90, 104). Upon arrival, Florence found that the soldiers were dying in horrible unsanitary conditions. The walls of the hospital were filthy, rats were everywhere, the sewers were exposed throughout the hospital and the smell was foul (Nelson, 1999). Soldiers were dying of starvation, clothed in their uniform that soaked in their own blood, and were also dying from cholera, and typhus. There were no clean linens for the soldiers, so towels were one of the first purchases that Nightingale made. Nightingale also had clean shirts, soap, and utensils available because she believed what needed to be addressed were diet, dirt, and drains (Nelson, 1999). The mortality rate of the hospital was forty-two percent in February 1855 (Nelson, 1999). Nightingale lead, organized, and made things happen. Nightingale and her team of nurses proceeded to clean the rooms and provided a beneficent health care for the soldiers. Nightingale was very strict on clean bedding, well-cooked edible, and appealing food, proper sanitation, and fresh air (Lundy, 2012, p. 105). The sewage system in the hospital was repaired and soon the hospital had better ventilation. While the soldiers were sleeping, Nightingale made her rounds during the night with a lamp, and soon became known as “the lady with the lamp” (Nelson, 1999). Nightingale also documented her hospital operations, and progressions that she made. Lundy (2012) states that the mortality rate during the Crimea War was estimated to be from forty-two percent to seventy-three percent, and Nightingale was credited with reducing that rate to two percent within six months of her arrival (p. 105). Florence Nightingale has made a lasting impression in nursing history and its future in healthcare.

Florence Nightingale has made a lasting and impactful impression in nursing. Nursing was once held as a reputation of low status, nurses were known to be people who were discards of society, and caring for the ill in the 1820s were considered servant responsibilities. Nursing was not a respected amongst society. Florence Nightingale was born and raised in a privileged upper class family. She was profound in her academics and learned different languages, philosophy, and history taught by her father. Although her parents were against her pursuit in nursing, Nightingale was driven and determined to follow her passion. Nightingale’s belief in God’s calling was her motivation, and since then Nightingale has reformed nursing in many ways. During the Crimean War, Florence and her thirty-eight nurses cleansed and sanitized the military hospital in Scutari, Turkey where injured soldiers were dying from infection and diseases. Nightingale was able to improve the quality of care in the military hospital and decreased the mortality by two percent. Numerous nursing organizations were established with her help, and she received prestigious rewards such as the Royal Red Cross Award given to her by Queen Victoria in 1883. Florence Nightingale’s effort has changed the perspective in nursing by contributing to making nursing a desirable profession, raised the standards of education for nurses, and have improved many standards in nursing. Florence Nightingale has made a lasting impression in nursing history, and yearly International Nurses Day is celebrated on the date of Florence Nightingale’s birthday, May 12 th .

Foster, R. E. (2010). FLORENCE NIGHTINGALE: Icon and Iconoclast. History Review, (66), 6. Retrieved from http://www.historytoday.com/Archives.aspx?m=33107

Lundy, K. (2012). A History of Health Care and Nursing. In Concepts of professional nursing practice (pp. 89-126). Burlington, MA: Jones & Bartlett Learning

McDonald, L. (2006). Florence Nightingale as a social reformer. History Today, 56(1), 9. Retrieved from http://www.historytoday.com/

McDonald, L. (2010). Florence nightingale: Passionate statistician. Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association, 28(1), 92-98. doi: 10.1177/0898010109358769

Florence Nightingale

Florence Nightingale just wanted to help. As a young woman in England in the 1840s, she saw how hard it was for poor people to get help when they were sick. She wanted to be a nurse, but her rich parents thought that the job was beneath her, that she should instead marry a wealthy man. Defying what most women of her time would do, she went to Germany to study nursing.

Born on May 12, 1820, Nightingale was smart and observant. At her first job in the early 1850s, caring for sick teachers in London, England, she became superintendent after quickly showing her talent for helping the sick get better. It was also when she developed ideas that would change healthcare forever.

The mostly male doctors of the day focused on treating the diseases patients came into the hospital with, and not necessarily on how the diseases spread. (The idea of germs spreading diseases hadn’t quite caught on yet.) But while volunteering at a hospital during a cholera outbreak, Nightingale noticed that people were catching and spreading diseases inside the hospital itself. It was then she realized that dirty conditions inside hospitals might be spreading diseases, and that if hospitals were cleaner, patients might be safer.

In 1853, England and France went to war with Russia in what is now Turkey, an event called the Crimean War. Nightingale was asked to lead a team of 38 nurses at the British military hospital in Constantinople (now Istanbul, Turkey). When she arrived, she was shocked to discover that more soldiers were dying from infectious diseases like typhoid and cholera than from battle wounds. Taking charge, she had the hospital scrubbed, then created diagrams and graphs to show that if hospitals were cleaner, fewer people would die. According to some sources, because of her efforts the hospital’s death rate dropped from about 40 percent to around 2 percent.

The “Lady With the Lamp”—soldiers’ nickname for her because of her habit of walking dark hallways to care for them—returned to England after the war ended in 1856. Two years later she became the first woman member of the Royal Statistical Society for her use of graphs in healthcare, and in 1860 she founded the Nightingale Home and Training School for Nurses to properly train healthcare workers.

King George V sent Nightingale a personal birthday message on her 90 th birthday she died a few months later on August 13, 1910. But even today, doctors and nurses care for patients using the safe methods that she developed, making sure that those patients’ health only improves when they enter a hospital.

The Crimean War was the beginning of her hygiene movement

After briefly serving as superintendent of London’s Institution for Sick Gentlewomen in Distressed Circumstances, Nightingale found herself called into action following the outbreak of war in 1853 between Russia and the allied forces of Britain, France and the Ottoman Empire.

In 1854, news reports began carrying alarming headlines of the dangerous, deplorable conditions in British hospitals outside of Istanbul (then Constantinople). Nightingale swung into action, and by October, she and nearly 40 of her trained nurses were on their way to the front. They were shocked by what they found — severe overcrowding, poor food supplies, shoddy management and filthy quarters that were a breeding ground of infectious diseases like cholera, typhoid, typhus and dysentery, leading Nightingale to dub it the “Kingdom of Hell.” Male British officials initially refused to allow the women to work in the hospital, only relenting when a new wave of battle casualties flooded the ward.

Nightingale and her nurses went to work, scrubbing every inch of the facilities, insisting on regular bathing of patients and frequently changed, fresh linens from a newly established laundry. She solicited donations from Britain to purchase desperately needed bandages and soap and served specialized meals out of a new commissary. She railed against the poor ventilation and sewage system, insisting on bringing as much fresh air to the facility as possible, a decision that would influence the building of future hospitals around the world.

Within six months of her implemented changes, the hospital’s mortality rate had dropped precipitously from its previous high of 40 percent. Nightingale also introduced new approaches to the emotional and psychological side of patient care, with her nurses helping soldiers write letters home and Nightingale herself walking the ward at night with a lantern to check on her charges.

The Faith Behind the Famous: Florence Nightingale

Say &ldquoFlorence Nightingale,&rdquo and instantly the word nurse pairs with it. Probably she was the most extraordinary nurse in history. Kings, queens, and princes all consulted her, as did the president of the United States, who wanted her advice about military hospitals during the Civil War.

It was Florence Nightingale who revolutionized hospital methods in England&mdashand indeed throughout the world. During the Crimean War, she served in the first field hospital ever run and tended by women. She established schools for training nurses, and she introduced procedures that have been benefiting people ever since.

Still, this is an incomplete portrait. For years Florence acted as behind-the-scenes British secretary of war, managing to considerably better conditions for men in the armed services by setting up a system of health administration that was without precedent.

Suffering, wherever it existed, challenged her. She even set up a system for extending nursing care to the poor and the criminal underworld in the slums of English cities.

One reason Florence managed to accomplish so much was because any occupation but working for improved health standards seemed to her a waste of time. And Florence had remarkable stamina. When she was young, she sometimes worked twenty-two out of twenty-four hours.

Then, too, she was gifted with a peculiar genius: She could assimilate information in prodigious quantities, retain it, marshal her facts, and use them effectively. A relative wrote that when Flo was exhausted, the sight of a column of figures was &ldquoperfectly reviving to her.&rdquo Altogether she wrote eight lengthy reports and seventeen books on medical and nursing subjects.

Early Family Life

Florence was born in 1820 while her English parents, Fanny and William, were vacationing in Florence, Italy. She was named for her birthplace, although at that time Florence was not listed among feminine names, as it has been since Miss Nightingale gave it fame. She had an older sister, Parthenope (always called Parthe), who was also named for her birthplace.

Florence&rsquos beautiful and intelligent mother and her wealthy, dilettante father were not very compatible, nor were the two little girls. Parthe, though she all but adored her sister, at the same time was envious and selfishly possessive of her.

It was impossible to find a tutor with the intellectual prowess demanded by Mr. Nightingale. So he assumed the responsibility himself, teaching the children Latin, Greek, German, Italian, French, English grammar, philosophy, and history. A governess was trusted to teach them only music and drawing.

When Parthe was eighteen and Flo sixteen, study was somewhat curtailed. The girls were presented at court and introduced to society. Their life then included many parties and much travel on the Continent.

Flo was tall, willowy, graceful, and pretty. Two young men promptly fell in love with her and proposed marriage. She liked them both, but she wasn&rsquot ready to marry either.

Divine Mission

Then a strange thing happened. Though she did not think herself deeply religious and never thought she became so, on February 7, 1837, when she was scarcely 17 years old, she felt that God spoke to her, calling her to future &ldquoservice.&rdquo From that time on her life was changed.

At first the call disturbed her. Not knowing the nature of the &ldquoservice,&rdquo she feared making herself unworthy of whatever it was by leading the frivolous life that her mother and her social set demanded of her. Now she was given to periods of preoccupation, or to what she called &ldquodreams&rdquo of how to fulfill her mission. Meanwhile she spent all her spare time visiting the cottages on her family estate and bringing neighboring poor people food and medicine.

When a family friend died in childbirth, Flo begged her parents to let her stay at the country home year round and take care of the baby instead of making her go to London for the winter social season. They vetoed the idea, believing she should mingle in society, eventually choose a husband, and bear children of the family bloodline. Too, Parthe had hysterics at the thought of the &ldquoungrateful and unfeeling Flo&rdquo wanting to be separated from her.

In London one of Flo&rsquos suitors again pressed her for an answer to his marriage proposal. She liked him, but she could not bring herself to say yes, especially when she did not know what &ldquoservice&rdquo lay ahead.

Visiting her family home at the time were Dr. Howe and his wife, Julia Ward Howe (author of the &ldquoBattle Hymn of the Republic&rdquo). Florence asked Dr. Howe, &ldquoDo you think it unsuitable and unbecoming for a young Englishwoman to devote herself to works of charity in hospitals and elsewhere as Catholic sisters do? Do you think it would be a dreadful thing?&rdquo

He answered that it would be unusual and &ldquowhatever is unusual in England is thought unsuitable.&rdquo Nonetheless he advised her, &ldquoAct on your inspiration.&rdquo

If Florence was to consider nursing her &ldquoservice&rdquo&mdashand she was beginning to believe it must be&mdashthen she needed training. She proposed going to an infirmary run by a family friend.

Her parents were shocked, horrified, angry! She was a gentlewoman! Their objections were understandable. In that era English hospitals were places of degradation and filth. The malodorous &ldquohospital smell&rdquo was literally nauseating to many, and nurses usually drank heavily to dull their senses. Florence herself admitted that the head nurse of a London hospital told her that &ldquoin the course of her long experience she had never known a nurse who was not drunken, and there was immoral conduct in the very wards.&rdquo

Years of Preparation

But at least Florence could study on her own. From a friend in Parliament, Sidney Herbert, she procured government reports on national health conditions. Then she got up at predawn every morning and pored over them by the light of an oil lamp, filling notebook after notebook with facts and figures, which she indexed and tabulated.

She planned to acquire practical experience by going to the unquestionably moral Institution of Lutheran Deaconesses in Kaiserwerth, Germany. Although her father called the move &ldquotheatrical,&rdquo and although Parthe again had hysterics, her parents reluctantly allowed her to go. After the Kaiserwerth stint the old pattern reappeared: Her parents wanted her to lead a &ldquonormal&rdquo life and were baffled and annoyed when she turned down another eligible suitor and seemed indifferent to marriage.

Then Florence met and confided in Cardinal Manning. He understood her aims, and she wondered if Catholicism could be her gateway to &ldquoservice.&rdquo She proposed becoming a Catholic, but the cardinal demurred because she rejected certain Catholic tenets.

However he arranged for her to enter a Paris hospital staffed by nuns who obviously didn&rsquot resort to drink. She would wear the postulant habit but live apart from the nuns. Shortly after she arrived, ironically, she came down with measles and had to leave.

Back in England, the Institution for Care of Sick Gentlewomen in Distressed Circumstances needed a superintendent. Florence&rsquos study of health, hospital problems, and management recommended her. While she held this job, cholera broke out and nurses, fearing the disease, refused to serve, so Florence acted as a nurse herself and earned universal respect.

Opposition and Adulation

Then the Crimean War erupted. English military hospitals were a disgrace in them a wounded man had almost no chance of recovery. When a reporter wrote that the French took far better care of their wounded, English consciences were stung into action.

Sidney Herbert, now secretary of war, not only authorized the purchase of hospital equipment, but also created a new of official position to which he appointed the bestqualified person he knew, Florence Nightingale. She became &ldquoSuperintendent of the Female Nursing Establishment of the English General Hospitals in Turkey.&rdquo She was to go to Crimea with plenary authority, taking nurses of her choice.

Previously no woman had ever entered a military hospital. But because of Miss Nightingale&rsquos reputation (she was called Miss Nightingale by the public), the order was applauded.

Now to implement it! First, how was she to find good nurses? Through Cardinal Manning a great concession was made: ten Catholic sisters were allowed to go to Turkey under Miss Nightingale&rsquos leadership, subject to her orders. Eight Anglican sisters joined too, and Florence painstakingly gathered other women.

On arrival they found moldy food, scarce water, filth, overcrowding, no sanitary arrangements, no bedsheets, no operating tables, no medical supplies. The forty nurses were allotted a kitchen and five rat-and-vermin infested bedrooms this meant crowding many nurses into each room.

Miss Nightingale had authority to requisition supplies, so she quickly asked for towels and soap and insisted that clothes be washed and floors scrubbed. That&rsquos when she ran into trouble some officers and doctors grumbled about her power. The superior of the Catholic sisters, although she had agreed to accept Miss Nightingale&rsquos leadership, questioned why anyone but herself should direct the sisters, and she constantly made trouble. The Anglican nuns felt that Florence favored the Catholics.

Only the patients&mdashthe wounded men&mdashfully approved of her. They all but adored the &ldquoLady of the Lamp,&rdquo as they called her when she visited the wards at the end of the day. They spoke of &ldquokissing her very shadow&rdquo as she passed.

The Cost of Caring

Despite difficulties, Miss Nightingale went on working. She dressed wounds, administered or supervised medical treatments, instructed nurses, and made rounds of the wards. Then, before she dropped exhausted into bed near midnight, she spent an hour or two writing reports for the government at home.

She also suggested legislation to help the men. For example, the old law mandated that hospitalized men, since they were no longer in danger of being shot, have their pay cut. But their wounds often handicapped them for life, so Miss Nightingale opposed the pay cuts and wrote directly to Queen Victoria to explain why. The men&rsquos pay was restored, just one instance among many where she suggested or wrote legislation that her friend Sidney Herbert introduced in Parliament.

When the war ended, she was the sole hero to emerge. As one biographer said, &ldquoShe had the country at her feet.&rdquo The queen presented Florence with a diamond brooch. The inscription on the reverse side read, &ldquoTo Miss Florence Nightingale as a mark of esteem and gratitude for her devotion toward the queen&rsquos brave soldiers from Victoria R. 1855.&rdquo

Fighter for Reform

In Crimea, Florence had collapsed once or twice from overwork, and she returned home gaunt, pale, and suffering from several ailments. But she had no intention of resting. Military reforms were urgently needed. The mortality rate (73 percent in six months from diseases alone) was outrageous and resulted not from battlefield casualties but from the execrable state of the British army&rsquos health administration.

Her aims were furthered when the queen summoned her to palace visits. Amazingly, the queen even made informal visits to her home. The women became friends, and Florence convinced Victoria of the value of her reforms. Although royalty could not act directly, the queen summoned the secretary of state to the palace along with Florence, so that she had an opportunity to present her ideas to him and to try to persuade him to act. Florence kept at him until he at least appointed a commission to study the matter.

The secretary of state then asked her for a detailed report. Night and day, she worked on the report it ran 1,000 pages. Then she collapsed. She was seriously ill, but she had won her point. The government acted.

A friend, Sir John McNeill, wrote her, &ldquoTo you, more than to any other man or woman alive, will henceforth be due the welfare and efficiency of the British army. I thank God that I have lived to see your success.&rdquo

Adviser, Writer, Educator

When her health improved, people came to her for advice, among them the queen of Holland and the crown prince of Prussia. Between visitors, she wrote books. Notes on Hospitals ran into three editions and was widely translated into other languages. After its publication, the king of Portugal asked her to design a hospital in Lisbon, and the government of India consulted her. Her next book, Notes on Nursing, sold thousands of copies in factories, villages, and schools and was translated into French, German, and Italian.

Writing mostly at night and working by day, she opened a nurses&rsquo training school, using money given to a Nightingale Fund by the grateful British troops. If she had not done so before, surely now she changed forever the image of a nurse from that of a &ldquodrunken hussy&rdquo to that of an efficient attendant of the ill.

Despite illness, she pushed for reorganization of the War Office. One of her friends said that she was virtually secretary of state in the War Office for the next five years.

Her next big task came when a prominent Liverpool philanthropist approached her, begging nursing care for slum dwellers and workhouse inmates. She arranged to supply the care. Moreover, she called for legislation that would provide separate facilities for the children, the insane, and the victims of communicable diseases, who had previously lived cheek by jowl in the same workhouses.

No letup followed. Next came the Franco-Prussian War, during which Florence worked with the National Society for Aid to the Sick and Wounded, later called the British Red Cross Aid Society. When the war ended, Jean Henri Dunant said, &ldquoThough I&rsquom known as the founder of the Red Cross &hellip it is to an Englishwoman that all the honor is due. What inspired me &hellip was the work of Florence Nightingale.&rdquo

For an interval, however, she did slacken her public work to devote herself to nursing first her dying father, then her dying mother, and then her dying sister, Parthe, with whom she was closer than in bygone years.

Florence lived on into old age, always supervising work at the Nightingale Fund School and always and everywhere being treated with a respect akin to awe. In 1907 Edward VII bestowed on her the Order of Merit it was the first time it had ever been given to a woman. She continued to write until her sight failed, her memory dulled, and she became a little vague. On August 13, 1910, she fell asleep around noon and did not awaken.

Mary Lewis Coakley is the author of twelve books and resides in Wyncote, Pennsylvania.

Copyright © 1990 by the author or Christianity Today/Christian History magazine.
Click here for reprint information on Christian History.

The story of her life reveals a complex and private person, with a shrewd and analytical mind. Although her dedication during the Crimean War earned her a worldwide reputation, she only saw this as an opportunity for further work. Rejecting convention to follow what she believed was her calling, she devoted the rest of her life to reforming health care not just in the British army, but in all sections of society. Her social reforms include advocating better hunger relief in India, helping to abolish prostitution laws that were unfair to women and expanding the female participation in the workforce. Against a backdrop of family disapproval and recurring ill health, Florence wrote over 200 books, pamphlets and articles and advised on and oversaw the development of the nursing profession. Today her legacy can be found in nursing standards and hospital design principles and she remains an inspiration to healthcare professionals around the world and one of Britain’s greatest and most famous Victorians.

Here are eight things you (probably) didn’t already know about Florence Nightingale:

1. Florence’s parents named their children after the cities of their birth.

Florence was born in Italy on 12 May 1820, and was named after the city of her birth. She was the second daughter of wealthy English parents William and Frances Nightingale, who had been honeymooning abroad since their marriage in 1818. Their eldest child, Parthenope, also named after her birthplace in Naples, had been born a year earlier.

2. Florence’s father’s surname was originally Shore.

William, Florence’s father’s surname was originally Shore. He inherited his fortune from his mother’s uncle Peter Nightingale, and with it changed his name. Uncle Peter, nicknamed ‘Mad Peter’, was considered an eccentric and known as a wild gambler and heavy drinker.

3. Florence had a natural skill for analysing data.

Florence’s early letters – which often included lists and tables of information, meticulously catalogued flower specimens, transcriptions of poems, shell and coin collections – demonstrate that she had a natural skill for classifying, analysing and documenting data. It was a skill she would go on to develop and use further in her career. She was able to look at data, draw conclusions and create a picture in her mind of the results. She discovered that accurate statistics were the key to understanding how and why things happened. Working with Dr William Farr, a pioneering statistician, she created statistical diagrams to illustrate her findings in a clear and accessible way, calling them ‘coxcombes’ (the first pie charts). In 1860 she was elected the first woman Fellow of the Statistical Society.

4. Florence wrote a novel.

Florence wrote about the lives of women of her class, which evolved into her novel Cassandra. In it, she explored the oppression of the educated and privileged women of Britain, who, if allowed to use their intellect and talents, could contribute so much to life. Instead, they were confined to petty, boring duties within their families. Marriage was the only escape – but that brought it’s own confines. Years later the work was rediscovered and it has become an important feminist text.

5. Florence rescued and hand-reared an owl.

While in Athens in 1850, Florence saw some boys playing with a ball of fluff, which turned out to be a baby owl. She rescued the owlet, which she named Athena, and hand-reared her, carrying her around in her pocket. After Florence left for the Crimea, the poor creature was neglected and died. The bird was later stuffed.

6. Florence turned down several marriage proposals.

Once Florence decided what her calling in life was to be, she set out to secure an independent life for herself. Marriage was out of the question. She had several marriage proposals but refused them all, including her cousin Henry Nicholson, a young suitor called Marmaduke Wyville and Sir Henry Verney, who later married Florence’s sister, Parthemope. The man she came closest to accepting was the philanthropist and poet Richard Monckton Milnes, whom she met in 1842. She knew it was a match her mother would approve of and she thought he would be sympathetic to her interests. However, she eventually turned him down.

7. Florence was not impressed by the gift Queen Victoria offered the troops in the Crimea.

During the war the public at home began sending items to the Crimea to help the soldiers. People sent all sorts of things, sometimes useful and valuable, but some – although well intended – were useless. Florence listed and distributed all the free gifts that were sent and sometimes despaired of others that she had to store. When Queen Victoria offered to send the troops eau de cologne Florence responded that ‘a little gin would more popular’.

8. As Florence’s fame grew, her sister Parthenope acted as her manager.

The first image of Florence as ‘The Lady with the Lamp’ was published in the Illustrated London News on 24 February 1855. It launched her to an iconic status, one which still remains today. The legend of ‘The Lady with the Lamp’ gripped the world and her fame impacted dramatically on her family. Parthenope became her manager at home, collecting cuttings of her sister, and circulating information and reports to family, friends and acquaintances. Knowing that Florence would demand her privacy to be respected, Parthenope refused to consent to the release of photographs and pictures of her. Only two portraits, which had been drawn from life, were published with the family’s authorisation, but they were expensive and not intended for the mass market. This meant demand for portraits of Florence became insatiable and had to be created from the imagination. Many depictions of her were romantic and idealised, and looked nothing like her. She appeared on inexpensive products like paper bags, and a series of affordable Staffordshire figurines was created in 1855.

The legacy of the world's most famous nurse, Florence Nightingale

The world's most famous nurse, Florence Nightingale, aged 34, just after the Crimean War. BHT Mag.

Sandra Lawrence takes a look at the legacy of "The Lady With The Lamp" on the anniversary of her birth, May 12, 1820.

"Every nurse ought to be careful to wash her hands very frequently during the day.”

The advice could easily be from a 2020 manual for clinicians at the frontline of the COVID19 pandemic. It is actually from "Notes on Nursing", by Florence Nightingale, published in 1860. She continues, telling readers to “compare the dirtiness of the water in which you have washed when it is cold without soap, cold with soap, hot with soap. You will find the first has hardly removed any dirt at all, the second a little, the third a great deal more.”

The grisly truth is that before Florence Nightingale it hadn’t occurred to anyone that keeping things clean might have something to do with disease limitation. An even grislier truth is that, 160 years later, we still need to be reminded to wash our hands. That’s why, when the much-loved Florence Nightingale Museum reopens, none other than Nightingale herself, played by the museum’s famous ‘Florence’ actors, will be marshalling visitors in the practical arts of Victorian handwashing.

It is somehow grimly appropriate that the world’s most famous nurse echo so strongly during a global medical emergency, but it was a disaster for the museum in 2020, which was the 200th anniversary of her birth.

Read more

“Our bicentennial exhibition Nightingale in 200 Objects, People & Places had been open just ten days when Britain locked down,” says Museum Director David Green. It probably wasn’t much comfort to know that at least Nightingale’s name would grace NHS England’s seven temporary hospitals.

We all think we know Florence Nightingale – the Lady with the Lamp, the angel of the Crimean War, the founder of modern nursing – but the truth is more complicated. “She spent 17 years asking to be a nurse and about three years doing it,” says David Green. She would, however, spend another 50 using her experience and connections to build the foundations of modern nursing worldwide.

How it started

Florence Nightingale was born May 12, 1820, in Florence, Italy. Her parents were wealthy and she was intended to be ‘a lady’ who ‘married well’. That cosy dream started unravelling in her late teens. Instead of accepting an eligible proposal of marriage she announced she’d had a call from God: nursing.

Her parents were horrified. Nurses were the lowest of the low – untrained, filthy, often drunk. Indeed, the most famous nurse before Florence Nightingale was probably Sarah Gamp, the notorious gin-for-services ‘carer’ in Charles Dickens’s Martin Chuzzlewit.

Florence started studying medicine secretly and eventually began practicing in Germany. She was in her element, writing “now I know what it is to love life!”

The Crimean War

The Crimean War, where Russia fought an alliance of the Ottoman (Turkish) Empire, France, Sardinia and the United Kingdom, is one of the most brutal in history. In 1854 Nightingale learned of the appalling hospital conditions wounded British soldiers faced after one particularly bloody engagement, the Battle of Alma, and travelled to London to offer her services.

Florence Nightingale at the Scutari Hospital, in Turkey, during the Crimean War.

The Florence Nightingale Museum holds the register of the 38 women she took with her to the British army hospital at Scutari, Turkey. “It reads like an old school report," says David Green. “She only accepted the highest possible standards and was a famously hard taskmaster”. She invented the ‘Scutari Sash’, worn across the women’s clothes probably the world’s first professional nursing uniform. “It marked them out from other camp followers, prostitutes and hangers-on,” says Green, “and demanded respect and recognition as professional. It also made it easier for her to keep an eye on them.”

The hospital was infested with rats and bugs. The wards ran with sewage and desperately ill soldiers lay on the floor for lack of beds. It would have been a personal shock for Nightingale, who wrote to a friend about combing her hair for the first time, having always had a maid to do it in the past.

Read more


It seems almost impossible today that Nightingale’s insistence on sanitary conditions was considered revolutionary, but she regimented her team, brought order, new supplies and, above all, cleanliness to nursing. Soldiers were treated regardless of rank, and everything was boiled: “yourself and everything within your reach, including the surgeon," she would later advise. The results were remarkable. The death rate was reduced by two-thirds but, more than that, by installing a laundry, invalid’s kitchen, reading rooms, café and even a banking system, Florence Nightingale brought hope. The soldiers adored her.

Back home, the ‘Lady with the Lamp’ was suddenly a household name, even if the lamp itself was not quite how the Illustrated London News drew it. It’s in the exhibition, a fine Turkish lantern rather than the sturdy hurricane lamp most imagine, displayed with other possessions such as her personal medicine chest and examples of the vast amount of memorabilia the public clamored to buy. Queen Victoria gave Nightingale a commemorative jewel and she was also presented with around $250,000.

The lamp-lady herself hated her newfound celebrity, calling it ‘buzz-fuzz’ and even travelling incognito as ‘Miss Smith’ on her return. She was not insensible, however, to the doors fame could open. She determined to use it, along with the experience she had gained at Scutari, to make a difference to the world.

Nightingale's legacy

Florence Nightingale would spend the next 50 years working tirelessly to transform healthcare. Her advice was sought across the world, from Japan to the United States, where she advised on Civil War field hospitals. Above all, she wanted to make nursing a profession that was respected, had recognised skills and paid decent wages. A new generation of young women was inspired to enroll at the new Nightingale Training School for Nurses at St Thomas’s Hospital, just across the River Thames from the Houses of Parliament. Many were from wealthy backgrounds and some, like American heroine Linda Richards, would go on to great things themselves.

Florence Nightingale during her later years.

A pioneer of evidence-based healthcare, Nightingale gathered data and statistics to prove the importance of ward design, cleanliness, sanitation, training, infection control, and the compassionate treatment of patients.

There is an urban myth that Florence Nightingale invented the pie-chart. This is not true, but she was a pioneer in using data in her campaigns for social reform. “She knew the power of infographics,” says David Green. “She wrote 14,000 letters to members of the establishment and to get their attention she needed to make her points short and pithy”. In 1858 she became the first woman admitted to the Royal Statistical Society and she would later become an honorary member of the American Statistical Association.

All the while, Nightingale was suffering herself. “She probably had PTSD,” says David Green. Fever, insomnia, exhaustion and depression, all were ignored in her one-woman quest to reform public health care. It would, eventually, catch up with her, but she worked to the end.

Florence Nightingale died in 1910, at the age of 90. Her fame has never wavered. Between 1975 and 1992, she was the face of the £10 banknote. More recently, the museum has worked with Mattel to create a Florence Nightingale Barbie doll. Both are in the exhibition, as is a recording of her voice, made in 1890.

David Green is in no doubt about Nightingale’s legacy. “The whole of the country is practicing methods taught by Florence Nightingale. She would be proud, as we all are of all of the healthcare workers who are working on the front line to treat patients, fight the infection and reduce casualties.”

On the 4 November 1854, Florence Nightingale arrived in Turkey with a group of 38 nurses from England. Britain was at war with Russia in a conflict called the Crimean War (1854-1856). The army base hospital at Scutari in Constantinople was unclean, poorly supplied with bandages and soap and the patients did not have proper food or medicine.

Florence Nightingale found that wounded and dying men were sleeping in overcrowded, dirty rooms often without blankets. These conditions meant that they often caught other diseases like typhus, cholera and dysentery. Often more men died from these diseases than from their injuries.

When she arrived at the hospital, army doctors there did not want the nurses helping. Florence Nightingale realised that if the doctors were going to let her nurses to work then they had to do a very good job.

Use the sources in this lesson to explore why Florence Nightingale is considered a significant figure and the founder of modern nursing.


Look at Source 1

‘Florence Nightingale assessing a ward at the military hospital in Scutari’. Coloured lithograph, c. 1856, by E. Walker after W. Simpson. © Wellcome Library, London.

This is a picture of one of the wards at Scutari Hospital.

  • Can you find Florence Nightingale in the picture?
  • What is she doing?
  • How are patients being looked after by other people in this picture?
  • Why do you think that the windows are open in this room?
  • Do you think this would this have been a comfortable place to stay? Give your reasons.
  • This is a coloured printed drawing. What are the advantages and disadvantages for using this to find out about the work of Florence Nightingale?
  • What are the differences between this hospital ward and one today?

Look at Source 2

An extract from the ‘Report upon the state of the hospitals of the British Army in the Crimea and Scutari’ 1855, Catalogue ref: WO 33/1

This report describes the work of Florence Nightingale and her nurses in the hospital at Scutari.

  • What jobs did the nurses do at Scutari hospital?
  • What sort of person was needed to do this work?
  • What things have you seen nurses do when you have visited a hospital or the doctor?
  • What do you think are the main differences between nurses in Florence Nightingale’s time and today?
  • Why do you think this report was written?

Look at Source 3

This is a map of Europe to show the location of the hospital and main area of fighting.

  • Can you find Scutari hospital and Britain on the map?
  • How do you think Florence Nightingale and her nurses travelled from Britain to Scutari?
  • How do you think injured soldiers would have reached the hospital at Scutari?
  • Do you think this would have been an easy journey?
  • Why do you think the soldiers’ hospital was so far away from the fighting area shown in green?

Look at Source 4

Extract from a booklet for new nurses going to the Crimea called ‘Rules and Regulations for the Nurses Attached to the Military Hospitals in the East’. This listed the uniform to be provided by the government, other clothes to bring, and the duties of a nurse. Catalogue ref: WO 43/963

  • Why do you think these nurses needed so many different clothes?
  • How easy do you think it would have been to move around and work wearing these clothes?
  • Why do you think that the nurses were not given all their clothes at once?
  • How were they expected store their clothes?
  • Name any FOUR things nurses were expected to supply themselves (not including extra clothing)?
  • What kind of uniforms do nurses wear today?
  • Why are these uniforms more comfortable and easier to wear?

Look at Source 5

Photograph of Florence Nightingale’s original Crimean war carriage, 1905 Catalogue ref: Copy 1/489 (f130)

During the Crimean War, the London Illustrated News published a picture of Florence Nightingale in a curtained horse drawn carriage which she used when inspecting military hospitals in the Crimea. It was said to be nicknamed ‘Florrie’s Lorry’. Models of the carriage were made and bought by her many admirers at home. The original carriage was returned to Britain and given to the Nightingale Training School for Nurses at St Thomas’s Hospital. It now is on display at the home of Florence’s sister, Claydon House.

  • Why do you think Florence inspected the hospitals in the Crimea?
  • Why do you think she continued do this as part of her work?
  • What would it have been like to travel in this carriage?

Look at Source 6a

Front cover of a file about a statue for Florence Nightingale, Catalogue ref: WORK 20/67

This file is from the government Ministry of Works which has information about the planning, building and up keep of royal buildings and parks, public buildings and deals with the protection and care of ancient monuments and statues.

  • Can you spot the code ‘WORK’ on this document?
  • What does the code tell you about what this file might be about?
  • Now read the source. What is it about?
  • In what part of London was the statue of Florence Nightingale situated?
  • What two other statues were to be placed nearby?
  • Can you explain or find out how these three statues were connected?
  • When could this document to be seen by the public for the first time?
  • What was the old name for The National Archives?

Look at Source 6b

Photograph of Waterloo Place, London, viewed from the East showing the Crimean War memorial, and statues of Florence Nightingale and Sidney Herbert of Lea © Wikimedia Commons

  • Can you find the statues of Florence Nightingale Lord Sidney Herbert? The Crimea Memorial?
  • Who was Sidney Herbert (1810-61)?

Look at Source 7

Photograph of the statue of Mary Seacole, Jamaican born nurse unveiled at St Thomas’s Hospital, 2016 © Wikimedia Commons

When the Crimean War broke out Mary Seacole was determined to help. She was rejected by British authorities and Florence Nightingale in 1854 to nurse and so paid for her own passage to the Crimea. She worked on the battle front giving out medicine and food and set up the “British Hotel” with Thomas Day behind the frontline near Balaklava where they cared for the wounded.

  • Can you describe this memorial?
  • How has the artist shown Mary Seacole? [Clue: her position, her expression]
  • Why do you think it has taken a long time to create a statue in her memory?
  • Find out more about role of Mary Seacole in the Crimea.


Florence Nightingale (1820-1910) was a British nurse, social reformer and statistician. She was the founder of modern nursing. She came from a wealthy background was born in Italy and named after the city of her birth.

As she grew up, she decided that she wanted to help the sick and injured, and wanted to become a nurse. When Florence told her parents they were not happy as in their view, this was not a respectable profession.

Eventually, her father gave his permission for her to go to Germany to train in 1844 in a hospital in Kaiserwerth, Germany. When she returned she became the superintendent of a hospital for gentlewomen in Harley Street, London.

When war broke out in the Crimea in 1854, the government expected it to last several months, it actually lasted 2 years. They were not ready for how many soldiers would be injured, and this was one of the reasons why the hospitals were in such a bad state. A reporter for the Times newspaper sent back several reports about the hospitals, and people in Britain started demanding something was done about them. This was when the Minister for War, Sidney Herbert, stepped in and asked Florence Nightingale to arrange and take charge of nurses to send to the war.

To ensure that the wounded were kept clean and fed well, Florence Nightingale set up laundries to wash linen and clothing and kitchens to cook food. This greatly improved the medical and sanitary arrangements at Scutari reduced the death rate. The work of Florence Nightingale and her nurses set the standards for modern day nursing.

Florence Nightingale has frequently been described as “the lady with the lamp” and this quote relates to an article published about her in The Times newspaper 8th February 1855, which reads:

“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. When all the medical officers have retired for the night, and silence and darkness have settled down upon these miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.”
It took Florence and her nurses 13 days to reach Scutari, they travelled by ship to Boulogne, then overland to Marseilles where they had a break in the journey. From Marseilles, they took the mail steamer “Vectis” to Scutari.

Other women who nursed during the Crimean war are Mary Seacole and Elizabeth (Betsy) Davis. Both had approached Nightingale to work in her hospital at Scutari, but Seacole was turned down, and Davis was one of a party who were sent to Scutari but was not wanted by Nightingale.

Florence returned after the war as a national heroine. She had been shocked by the conditions in the hospital and began to campaign to improve the quality of nursing in military hospitals. In October 1856 she met with Queen Victoria and Prince Albert and in 1857 she gave evidence to a Sanitary Commission. This helped with the setting up of the Army Medical College.

In 1859, Florence published a book called “Notes on Nursing” which is still in print today. She also founded the Nightingale School & Home for Nurses at St Thomas’ Hospital in London in 1860. She had important influence on campaigns to improve healthcare in the 19th and 20th centuries.

Until her death, Nightingale encouraged the development in nursing in Britain and abroad. The main reason we remember her is that she did a lot of work educating people about the importance of keeping hospitals clean and free from infection, and this work is carried on today in modern hospitals.

However, Florence Nightingale should also be remembered for her skills as a statistician and because of this, she became the first female member of the Royal Statistical Society in 1858. She was able explain in diagram form that most of the deaths recorded in army hospitals came from disease, rather than from battle wounds and that disease could be controlled by good nutrition, ventilation, and shelter. Her diagram is now referred to as the “Rose Diagram.” It was a real breakthrough for those working with statistics and of course revealed in a very clear way, the absolute importance of good sanitation for the army and society.

Florence Nightingale became the first woman to be awarded the Order of Merit.

Teachers' notes

This lesson is intended for use in Key Stage 1 & 2 as part of an enquiry into Florence Nightingale. It is suggested that the more complex text sources are read by pupils and their teacher/helper together. You could also ask pupils to underline key words/phrases in the transcripts to help make sense of these sources. A simplified transcript is also supplied for Source 2 to be used as necessary. Pupils can work in pairs on the visual sources.

Aims of this lesson

  • To introduce pupils to the idea of using original sources to find out about the past
  • To consider what different sources we can use to find out about the past
  • What sort of questions should be asked of sources?
  • To introduce the concept of significance. Why do we remember certain figures?
  • Understand that significance is attributed to individuals at the time and on the way we live our lives today
  • Are statues important for commemoration?

What other original sources on Florence Nightingale can pupils explore?

An excellent source for more original documents to discuss with your pupils relating to Florence Nightingale are two National Archives blogs listed in the external links. Here you will find her birth certificate and ‘passport’ for the Crimea, an original photograph of Florence Nightingale at Scutari, more documents about her work and the last ever photograph of Florence Nightingale in old age, and another statue of Florence Nightingale in Derby, where she spent much of her childhood.

  • Can pupils discover if their textbooks/topic books support what they have learnt from the original sources used in this lesson?
  • Do these texts tell them anything new or different about Florence Nightingale?
  • Take your investigation wider and compare the role of Florence Nightingale to Mary Seacole, her contemporary.

Connections to curriculum

National Curriculum Key stage 1
The lives of significant individuals in the past who have contributed to national and international achievements

Extension activities

Mary Seacole

Pupils with support from their teacher, create a timeline for the life of Mary Seacole.

  • Compare some history textbooks from 1970s to those of today and see how they now tell the story of nursing in the Crimean War.
  • Discuss why was Mary Seacole’s role in the Crimean War has been overlooked in earlier history books
  • Why was a memorial built for Mary Seacole in 2016 at St. Thomas’s Hospital?

Edith Cavell

Compare the life and work of Florence Nightingale to someone from a different time, Edith Cavell, famous nurse during the First World War.

Florence Nightingale role play [Working in a groups of 3]

It is late September 1854. Florence Nightingale and Sidney Herbert, the Secretary of War are interviewing a woman who wants to go to the Crimea as a nurse.

  • What questions do you want to ask?
  • Use Source 2 to help you write your questions to decide what would make a good nurse. Write 6-8 questions.
  • Now get into a group of three. One person should play the part of the woman who wants to go to the Crimea as a nurse. The other two play Florence and Sidney and ask the questions you have decided on. At the end you must decide, the person gets the job as a nurse in the Crimea.

Illustration – COPY 1/11
Source 1 – ‘One of the wards of the hospital at Scutari’, an illustration published 21 April 1856 by Paul & Dominic Colnaghi & Co – Wellcome Library, London
Source 2 – Extract from the ‘Report upon the state of the hospitals of the British Army in the Crimea and Scutari’ Catalogue ref: WO 33/1
Source 3 – © Maps in Minutes, 1999
Source 4 – Extract from Rules and Regulations for the Nurses Attached to the Military Hospitals in the East. Catalogue ref: WO 43/963
Source 5 – Photograph of Florence Nightingale’s original Crimean war carriage, 1905 Catalogue ref: Copy 1/489 (f130)
Source 6a – Front cover of a file about a statue for Florence Nightingale, Catalogue ref: WORK 20/67
Source 6b – Photograph of Waterloo Place, London, viewed from the East showing the Crimean War memorial, and Statues of Florence Nightingale and Sidney Herbert of Lea © Wikimedia Commons
Source 7 – Photograph of the statue of Mary Seacole, Jamaican born nurse unveiled at St Thomas’s Hospital, 2016 © Wikimedia Commons

Watch the video: Florence Nightingale