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Nurses in History: Florence Nightingale

Nurses in History: Florence Nightingale

Nurses in History: Florence Nightingale

The evolution of medicine in the last few centuries is largely credited to physicians and scientists, but history books largely fail to do justice to the nurses that have shaped modern medicine. 

The landscape of the profession has shifted dramatically thanks to the devotion of nurses who were committed to patient care and the pursuit of medical advancements. We want to tell the stories of all nurses, from past to present, and what better nurse to begin with then the founder of modern medicine and our namesake, Florence Nightingale. Yes, if you didn’t know, Gales was named after this historic woman, who moved mountains in patient care standards and sanitation.

Florence Nightingale was born in May 1820 in Florence, Italy to an affluent British family. Although she was named after the picturesque city she was born in, her family moved back to Hampshire, England when she was 5 years old, and it was here that she would fall in love with nursing.

It is reported that from a very young age, Florence Nightingale was actively administering to the ill, most notably the poor from the village neighboring her family’s estate. 

By age 16, Florence knew that nursing was her calling, however when she told her parents about her desired profession, they were far from pleased. According to History.com, her parents even forbid her from pursuing nursing. 

This is unsurprising at the height of the Victorian Era, when it was expected for a young woman of Nightingales social status to marry an affluent man. At the time, nursing was considered an undesirable career, as many of society's elite viewed it as lower class labor.

When Nightingale was just 17 years old, her wisdom beyond her years was starting to become apparent. She declined a marriage proposal from a  gentleman deemed to be suitable by her father, citing that “while he stimulated her intellectually and romantically, her “moral…active nature…requires satisfaction, and that would not find it in this life.” 

Nightingale defied her parents, a remarkably courageous act for a woman her age at that period in history, and enrolled as a nursing student at the Lutheran Hospital of Pastor Fliedner in Kaiserwerth, Germany in 1844.

After completing her degree, Nightingale returned to London in the early 1950’s, where she began working at the Middlesex hospital for ailing governesses. Right off the bat, her superiors could recognize her talent. Her performance impressed her employer so much that, within a year, she was promoted to superintendent. This transition was not an easy one for Nightingale however, as she was tasked with navigating a cholera outbreak being worsened by the highly unsanitary conditions at the hospital. 

Unwilling to adhere to outdated practices, Nightingale worked tirelessly to improve hygiene practices through a number of ways, including increased ward cleanings and handwashing. 

She proclaimed “Every nurse ought to be careful to wash her hands very frequently during the day”. Her efforts drastically reduced the mortality rate thanks to her willingness to lead change. 

During the outbreak, she also set new expectations for non-discriminating patient care by showing kindness and compassion for prostitutes' and other groups deemed to be lower class by society. 

Even though she handled the outbreak masterfully, the tireless work did take a toll on her mental and physical health, however she would not get long to recuperate, as the Crimean War was about to erupt that would change the course of her life.

The Crimean War broke out in 1853, and by 1854, 18,000 soldiers had been admitted into military hospitals. At the time, there were no female nurses stationed at hospitals in the Crimea. But, after a particularly bloody battle, England was outraged at the neglect of their injured soldiers, who “not only lacked sufficient medical attention due to hospitals being horribly understaffed, but also languished in appallingly unsanitary and inhumane conditions”.

At the end of 1854, Nightingale received a letter from Secretary of War Sidney Herbert. In it, he was asking her to organize a team of nurses to tend to the sick and injured British soldiers in the Crimea. Naturally, Nightingale rose to the challenge, and worked quickly to assemble a team of 34 nurses that would travel with her to the war-torn Crimean territory.

No stranger to horrifying working environments, Nightingale and her nurses were appalled at the conditions they walked into at the military base. The hospital sat in a large cesspool, which contaminated the water and the hospital building itself. Everywhere, patients were laying in their own excrement, rodents were rampant and bugs were crawling on the walls and patients. There was a critical supply shortage of even the most basic supplies like bandages and soap. Sadly, more soldiers were dying from infectious diseases rather than from injuries sustained in battle.

Like she did during the height of the Cholera outbreak, Nightingale quickly got to work. Needing to improve things quickly, she enlisted the help of the least sick patients to help her and the other nurses scrub the hospital from floor to ceiling. Once she had sanitized the entire hospital, she spent “every waking minute caring for the soldiers”. She became known as the Lady with the Lamp around the ward, as she would carry a lamp while making her rounds where she would give every one of her patients unwavering kindness and medical care.

The soldiers were not only taken aback by the quality of care that they received, but also her kindness and compassion, with many of them referring to her as  “the Angel of the Crimea”. Ultimately, her work to improve sanitary conditions in Crimea reduced the hospital’s death rate by two-thirds.

Although she is largely credited for modern medical hygiene standards, Nightingale also created a number of patient services that helped to improve the quality of their stay in hospital. She created an “invalid’s kitchen” where higher quality and therefore more appealing food for patients with special dietary requirements was cooked in the hopes of helping patients eat more to get their strength back.

She introduced a laundry to her hospital so that patients were always guaranteed to have clean linens. Outside of physical care, she worked to improve the mental and emotional states of her patients by creating a classroom and a library for intellectual stimulation and entertainment.

She went on to become a scholar on the world of medicine–Nightingale wrote Matters Affecting the Health, Efficiency and Hospital Administration of the British Army, an 830-page report analyzing her experience working in military hospitals operating under the most deplorable conditions. 

Incredibly, Nightingales musings in the book would spark a complete restructuring of the War Office’s administrative department, including the establishment of a Royal Commission for the Health of the Army in 1857, which she was heavily involved in. Working with a team of statisticians to analyze casualty data, they found that a staggering 16,000 of the 18,000 total deaths were caused from preventable disease, not battle.

After the war, she returned to England in 1857, where she was rewarded by the Queen for her devotion to patient care. Queen Victoria  presented her with an engraved brooch that came to be known as the “Nightingale Jewel” and granted her a prize of $250,000 from the British government.

Staying true to herself by listening to her moral compass, Nightingale used the money awarded by the Queen to further her work, and in 1860, she funded the establishment of St. Thomas’ Hospital which would go on to house the Nightingale Training School for Nurses.

Sadly, Nightingale contracted “Crimean fever” during her service  and would never fully recover. By the time she was 38, she was bedridden, and would remain so for the rest of her life.

This didn’t stop Nightingale, as she continued her heroic work from bed. She was recognized as the authority and advocate of health care reform, even welcoming politicians to her home to discuss policy. She even worked as a consultant during the US Civil War about how to best manage military hospitals. In 1908, she was awarded the merit of honor by King Edward.

In August 1910, Florence became increasingly ill after showing signs of improving, and died unexpectedly at 2 p.m.

There’s no amount of words or lines that can properly articulate the impact Florence Nightingale had on nursing– it’s immeasurable.  Outside of redefining hygiene standards and reducing mortality rates, Nightingale inspired a new generation of nurses; even women from the wealthy upper classes started enrolling at nursing school. 

She is recognized as the founder of modern nursing; a title she truly earned. 

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