Florence Nightingale was a career nurse at a time when women did not have careers and nurses did not receive training. She was a hospital reformer and a pioneer in statistical analysis in an age when such accomplishments were reserved for men. Today, her legacy of caring, innovation and perseverance reminds us to never take no for an answer.
“I attribute my success to this—I never gave or took any excuse.”
Nightingale, named after Florence, Italy, where she was born on May 12, 1820, was the daughter of a wealthy British landowner. Her parents were progressive—active in the anti-slavery movement and believers in the education of women. Her father educated Nightingale and her sister Parthenope in European and classical languages, history, philosophy and mathematics.
In her youth, Nightingale became frustrated with the limited opportunities for women in her social class. She began to investigate possible occupations for women as she visited the sick among London hospitals. At the time, nursing involved little more than administering medicine, and society viewed it as an occupation for the uneducated and lower classes. But in her travels to Europe and Africa with her family, Nightingale was inspired by the discipline and organization of nuns caring for the less fortunate. The seeds of a new approach to nursing blossomed in her mind.
By the age of 25, Nightingale had rejected several offers of marriage, and she told her parents she wanted to become a nurse. They did not support her ambitions. But while visiting the sick in a London hospital, Nightingale met Elizabeth Blackwell, the first woman to qualify as a doctor in the United States. Blackwell told her of the considerable obstacles and prejudice she had overcome to pursue a career and encouraged Nightingale to persevere.
In 1851, her father finally gave his permission for Nightingale to study nursing at the Institute of Protestant Deaconesses in Germany. By 1853, she was appointed superintendent of the Hospital for Invalid Gentlewomen in London.
“How very little can be done under the spirit of fear.”
That same year, Russia invaded Turkey. The British and French went to Turkey’s aid, entering the Crimean War. The Times of London reported that thousands of British soldiers were dying, not of battle wounds, but of diseases such as typhus, cholera and dysentery. The public outcry led the secretary of war to recruit Nightingale as the superintendent of female nurses dispatched to the front at Scutari.
Although Nightingale was assured her help and expertise would be welcomed and supported, the prevailing prejudice against women in medicine thwarted her initial efforts to alleviate the horrid conditions she discovered in army hospitals. The unwashed soldiers lay without blankets, soap or decent food. They were covered in filth, and the facilities were overrun with vermin.
But the military officers and doctors took Nightingale’s protestations against the conditions as personal insults, and she received little help. So she used her contacts at The Times to report details to the public of how the wounded soldiers were being treated. British citizens organized relief funds, and Nightingale was soon given the task of reorganizing and sanitizing the army hospitals in Turkey.
She established laundry and kitchen operations, looked after the soldiers’ wives and children, and even provided reading and recreation rooms. Over the next year, the death rate among patients fell from over 40 percent to 2 percent, thanks to her innovations in sanitation and nutrition.
At night, she was the only woman allowed on the patient ward. She walked among the wounded, comforting them and tending to their needs. The soldiers began to call her “The Lady of the Lamp.”
"Were there none who were discontented with what they have, the world would never reach anything better.”
To achieve such remarkable results, Nightingale used her mathematics training to perform statistical analysis of hospital conditions. She developed polar-area charts to plot the incidence of preventable deaths and created diagrams to illustrate the results of her improvements to unsanitary conditions. Today, she is considered a pioneer in the field of applied statistics.
Based on her work in Turkey, Nightingale developed a system of record-keeping for hospitals to collect and generate data that would aid in making improvements. In 1858, she became a fellow of the Royal Statistical Society and an honorary member of the American Statistical Association in 1874.
“Why have women passion, intellect, moral activity—these three—and a place in society where no one of the three can be exercised?”
Nightingale returned to England in 1856 as a national heroine. She was unique among women in her ambition and her effectiveness in a professional setting. And her reforms had saved thousands of British lives. However, the only recognition she would accept for her achievements was a fund to create the Nightingale School and Home for Nurses.
Granted an audience with Queen Victoria and Prince Albert, Nightingale campaigned for improved nursing in all British military hospitals. In 1857, she reported her exhaustive evidence to the Sanitary Commission, which resulted in creation of an army medical college in 1859.
Governments sought her advice during the American Civil War and the Franco-Prussian War. She was instrumental through the next few decades in founding the East London Nursing Society, the Workhouse Nursing Association and the Queen’s Jubilee Nursing Institute. Nightingale’s dream of seeing a respected occupation for women was coming to fruition.
“You ask me why I do not write something…. I think one’s feelings waste themselves in words; they ought all to be distilled into actions and into actions which bring results.”
Despite her disdain for writing, Nightingale did produce written works that aided in her reform of hospitals and in the transformation of the nursing profession. In 1858, she published Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army, and in 1860, the first edition of her much reprinted book, Notes on Nursing, was released. In it, she revealed her philosophies on treating the whole person rather than just the symptoms of her patients. “I use the word nursing for want of a better,” she wrote. “It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet—all at the least expense of vital power to the patient.”
Nightingale also used her writing to express her revolutionary opinions on women’s rights. She believed in a woman’s right to a career. “The time is come,” she wrote in her book Cassandra, “when women must do something more than the ‘domestic hearth,’ which means nursing the infants, keeping a pretty house, having a good dinner and an entertaining party.”
Nightingale was awarded the German order of the Cross of Merit, the French gold medal of Secours aux Blessés Militaires, and was honored by the Norwegian Red Cross Society. In 1907, she received the Order of Merit and in 1908 the Freedom of the City of London.
By this time, Nightingale was blind and required her own full-time nurse. She passed away in London in August 1910 at the age of 90. Her stellar career was a testament to her unwillingness to surrender and her beliefs of equality in action.
