, OM, RRC (12 May 1820 – 13 August 1910), who came to
be known as "The Lady with the Lamp", was a pioneer of modern nursing, a writer
and a noted statistician.
Florence Nightingale was born into a rich, upper-class well-connected English
family at the Villa Colombaia, Florence, Grand Duchy of Tuscany, and was named
after the city of her birth.
Her parents were William Edward Nightingale (1794–1875) and Frances "Fanny"
Nightingale née Smith (1789–1880). William Nightingale was born William
Edward Shore. His mother Mary née Evans was the niece of one Peter
Nightingale, under the terms of whose will William Shore not only inherited his
estate Lea Hurst in Derbyshire, but also assumed the name and arms of
Nightingale. Fanny's father ( Florence's maternal grandfather) was the
abolitionist Will Smith.
Inspired by what she took as a Christian divine calling, experienced first in
1837 at Embley Park and later throughout her life, Nightingale committed herself
to nursing. This demonstrated a passion on her part, and also a rebellion
against the expected role for a woman of her status, which was to become a wife
and mother. In those days, nursing was a career with a poor reputation, filled
mostly by poorer women, "hangers-on" who followed the armies.
In fact, nurses were equally likely to function as cooks.
Nightingale announced her decision to enter nursing in 1845 bringing intense
anger and distress to her family particularly her mother.
She cared for poor and indigent people. In December 1844, in response to a
pauper's death in a workhouse infirmary in London that became a public scandal,
she became the leading advocate for improved medical care in the infirmaries and
immediately engaged the support of Charles Villiers, then president of the Poor
Law Board. This led to her active role in the reform of the Poor Laws, extending
far beyond the provision of medical care. She was later instrumental in
mentoring and then sending Agnes Elizabeth Jones and other Nightingale
Probationers to Liverpool Workhouse Infirmary.
Florence Nightingale, pioneer of modern nursing.
Nightingale was courted by politician and poet Richard Monckton Milnes, 1st
Baron Houghton, but she rejected him, convinced that marriage would interfere
with her ability to follow her calling to nursing. When in Rome in 1847,
recovering from a mental breakdown precipitated by a continuing crisis of her
relationship with Milnes, she met Sidney Herbert, a brilliant politician who had
been Secretary at War (1845–1846), a position he would hold again during the
Crimean War. Herbert was already married, but he and Nightingale were
immediately attracted to each other and they became lifelong close friends.
Herbert was instrumental in facilitating her pioneering work in Crimea and in
the field of nursing, and she became a key advisor to him in his political
career. In 1851 she rejected Milnes' marriage proposal against her mother's
Nightingale also had strong and intimate relations with Benjamin Jowett,
particularly about the time that she was considering leaving money in her will
to establish a Chair in Applied Statistics at the University of Oxford.
In 1850 she visited the Lutheran religious community at Kaiserswerth-am-Rhein
where she observed Pastor Theodor Fliedner and the deaconesses working for the
sick and the deprived. She regarded the experience as a turning point in her
life, and issued her findings anonymously in 1851; The Institution of
Kaiserswerth on the Rhine, for the Practical Training of Deaconesses, etc.
was her first published work.
On 22 August 1853, Nightingale took a post of superintendent at the Institute
for the Care of Sick Gentlewomen in Upper Harley Street, London, a position she
held until October 1854. Her father had given her an annual income of £500
(roughly US$50,000/£25,000 in present terms), which allowed her to live
comfortably and to pursue her career. James Joseph Sylvester was her mentor.
|"Were there none who were discontented with what they have, the world would never reach anything better."
Florence Nightingale's most famous contribution came during the Crimean War,
which became her central focus when reports began to filter back to Britain
about the horrific conditions for the wounded. On 21 October 1854, she and a
staff of 38 women volunteer nurses, trained by Nightingale and including her
aunt Mai Smith, were sent (under the
authorization of Sidney Herbert) to Turkey, some 545 km across the Black Sea
from Balaklava in the Crimea, where the main British camp was based.
Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari
(modern-day Üsküdar in Istanbul). She and her nurses found wounded soldiers
being badly cared for by overworked medical staff in the face of official
indifference. Medicines were in short supply, hygiene was being neglected, and
mass infections were common, many of them fatal. There was no equipment to
process food for the patients.
Florence and her compatriots began by thoroughly cleaning the hospital and
equipment and reorganizing patient care. However, during her time at Scutari,
the death rate did not drop; on the contrary, it began to rise. The death count
would be highest of all other hospitals in the region. During her first winter
at Scutari, 4077 soldiers died there. Ten times more soldiers died from
illnesses such as typhus, typhoid, cholera and dysentery than from battle
wounds. Conditions at the temporary barracks hospital were so fatal to the
patients because of overcrowding and the hospital's defective sewers and lack of
ventilation. A sanitary commission had to be sent out by the British government
to Scutari in March 1855, almost six months after Florence Nightingale had
arrived, which flushed out the sewers and improved ventilation. Death rates were
Nightingale continued believing the death rates were due to poor nutrition
and supplies and overworking of the soldiers. It was not until after she
returned to Britain and began collecting evidence before the Royal Commission on
the Health of the Army, that she came to believe that most of the soldiers at
the hospital were killed by poor living conditions. This experience would
influence her later career, when she advocated sanitary living conditions as of
great importance. Consequently, she reduced deaths in the Army during peacetime
and turned attention to the sanitary design of hospitals.
The Lady with the Lamp
During the Crimean campaign Florence Nightingale gained the nickname "The
Lady with the Lamp", deriving from a phrase in a report in The Times:
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 phrase was further popularised by Henry Longfellow's 1857 poem "Santa
Lo! in that hour of misery
A lady with a lamp I see
Pass through the glimmering gloom,
And flit from room to room.
Florence Nightingale returned to Britain a heroine on 7 August 1857, and,
according to the BBC, was arguably the most famous Victorian after Queen
Victoria herself. Nightingale moved from her family home in Middle Claydon,
Buckinghamshire, to the Burlington Hotel in Piccadilly. However, she was
stricken by a fever, probably due to a chronic form of Brucellosis ("Crimean
fever") that she contracted during the Crimean war.
She barred her mother and sister from her room and rarely left it.
In response to an invitation from Queen Victoria – and despite the
limitations of confinement to her room – Nightingale played the central role in
the establishment of the Royal Commission on the Health of the Army, of which
Sidney Herbert became chairman. As a woman, Nightingale could not be appointed
to the Royal Commission, but she wrote the Commission's 1,000-plus page report
that included detailed statistical reports, and she was instrumental in the
implementation of its recommendations. The report of the Royal Commission led to
a major overhaul of army military care, and to the establishment of an Army
Medical School and of a comprehensive system of army medical records.
While she was still in Turkey, on 29 November 1855, a public meeting to give
recognition to Florence Nightingale for her work in the war led to the
establishment of the Nightingale Fund for the training of nurses. There was an
outpouring of generous donations. Sidney Herbert served as honorary secretary of
the fund, and the Duke of Cambridge was chairman. Nightingale was also
considered a pioneer in the concept of medical tourism as well based on
her letters from 1856 in which she would write of spas in Turkey detailing the
health conditions, physical descriptions, dietary information, and other vitally
important details of patients whom she directed there (which was significantly
less expensive than Switzerland). She was obviously directing patients of meagre
means to affordable treatment.
By 1859 Nightingale had £45,000 at her disposal from the Nightingale Fund to
set up the Nightingale Training School at St. Thomas' Hospital on 9 July 1860.
(It is now called the Florence Nightingale School of Nursing and Midwifery and
is part of King's College London.) The first trained Nightingale nurses began
work on 16 May 1865 at the Liverpool Workhouse Infirmary. She also campaigned
and raised funds for the Royal Buckinghamshire Hospital in Aylesbury, near her
Nightingale wrote Notes on Nursing, which was published in 1860, a
slim 136 page book that served as the cornerstone of the curriculum at the
Nightingale School and other nursing schools established. Notes on Nursing
also sold well to the general reading public and is considered a classic
introduction to nursing. Nightingale would spend the rest of her life promoting
the establishment and development of the nursing profession and organizing it
into its modern form.
Nightingale's work served as an inspiration for nurses in the American Civil
War. The Union government approached her for advice in organizing field
medicine. Although her ideas met official resistance, they inspired the
volunteer body of United States Sanitary Commission.
In 1869, Nightingale and Elizabeth Blackwell opened the Women's Medical
In the 1870s, Nightingale mentored Linda Richards, "America's first trained
nurse", and enabled her to return to the USA with adequate training and
knowledge to establish quality nursing schools. Linda Richards went on to become
a great nursing pioneer in the USA and Japan.
By 1882, Nightingale nurses had a growing and influential presence in the
embryonic nursing profession. Some had become matrons at several leading
hospitals, including, in London, St Mary's Hospital, Westminster Hospital, St
Marylebone Workhouse Infirmary and the Hospital for Incurables at Putney; and
throughout Britain, e.g. Royal Victoria Hospital, Netley; Edinburgh Royal
Infirmary; Cumberland Infirmary; Liverpool Royal Infirmary as well as at Sydney
Hospital, in New South Wales, Australia.
In 1883, Nightingale was awarded the Royal Red Cross by Queen Victoria. In
1907, she became the first woman to be awarded the Order of Merit. In 1908, she
was given the Honorary Freedom of the City of London.
By 1896, Florence Nightingale was bedridden. She may have had what is now
known as chronic fatigue syndrome. Her birthday is now celebrated as the
International CFS Awareness Day. During her bedridden years, she also did
pioneering work in the field of hospital planning, and her work propagated
quickly across England and the world.
Nightingale was a Christian universalist.
On 7 February 1837 – not long before her 17th birthday – something happened that
would change her life: "God spoke to me", she wrote, "and called me to His
On 13 August 1910, at the age of 90, she died in her room at 10 South Street,
Park Lane. The offer of burial in Westminster Abbey was declined by her
relatives, and she is buried in the graveyard at St. Margaret Church in East
Florence Nightingale had exhibited a gift for mathematics from an early age
and excelled in the subject under the tutorship of her father. She had a special
interest in statistics, a field in which her father, a pioneer in the nascent
field of epidemiology, was an expert. She made extensive use of statistical
analysis in the compilation, analysis and presentation of statistics on medical
care and public health.
Nightingale was a pioneer in the visual presentation of information. Among
other things she used the pie chart, which had first been developed by William
Playfair in 1801. After the Crimean War, Nightingale used the polar area chart,
equivalent to a modern circular histogram or rose diagram, to illustrate
seasonal sources of patient mortality in the military field hospital she
managed. Nightingale called a compilation of such diagrams a "coxcomb", but
later that term has frequently been used for the individual diagrams. She made
extensive use of coxcombs to present reports on the nature and magnitude of the
conditions of medical care in the Crimean War to Members of Parliament and civil
servants who would have been unlikely to read or understand traditional
In her later life Nightingale made a comprehensive statistical study of
sanitation in Indian rural life and was the leading figure in the introduction
of improved medical care and public health service in India.
In 1859 Nightingale was elected the first female member of the Royal
Statistical Society and she later became an honorary member of the American
Literature and the women's movement
While better known for her contributions in the medical and mathematical
fields, Nightingale is also an important link in the study of English feminism.
During 1850 and 1852, she was struggling with her self-definition and the
expectations of an upper-class marriage from her family. As she sorted out her
thoughts, she wrote Suggestions for Thought to Searchers after Religious
Truth. The three-volume book has never been printed in its entirety, but a
section, called Cassandra, was published by Ray Strachey in 1928.
Strachey included it in The Cause, a history of the women's movement.
Apparently, the writing served the original purpose of sorting out thoughts;
Nightingale left soon after to train at the Institute for deaconesses at
Cassandra protests the over-feminization of women into near
helplessness, such as Nightingale saw in her mother and older sister's lethargic
lifestyle, despite their education. She rejected their life of thoughtless
comfort for the world of social service. The work also reflects her fear of her
ideas being ineffective, as were Cassandra's. Cassandra is a virgin-priestess of
Apollo who receives a divinely-inspired prophecy, but her prophetic warnings go
unheeded. Elaine Showalter called Nightingale's writing "a major text of English
feminism, a link between Wollstonecraft and Woolf."
Suggestions for Thought is also Nightingale's great work of theology,
her own theodicee, where she develops her radical heterodox ideas. She was not
only a militant feminist but also a radical liberation theologist long before
the concept was coined.
Legacy and memory
Florence Nightingale's lasting contribution has been her role in founding the
modern nursing profession. She set a shining example for nurses everywhere of
compassion, commitment to patient care, and diligent and thoughtful hospital
The work of the Nightingale School of Nursing continues today. The
Nightingale building in the School of Nursing and Midwifery at the University of
Southampton is named after her. International Nurses Day is celebrated on her
birthday each year.
The Florence Nightingale Declaration Campaign,
established by nursing leaders throughout the world through the Nightingale
Initiative for Global Health (NIGH), aims to build a global grassroots movement
to achieve two United Nations Resolutions for adoption by the UN General
Assembly of 2008 which will declare: The International Year of the Nurse–2010
(the centennial of Nightingale's death); The UN Decade for a Healthy World–2011
to 2020 (the bicentennial of Nightingale's birth). NIGH also works to rekindle
awareness about the important issues highlighted by Florence Nightingale, such
as preventive medicine and holistic health. So far, The Florence Nightingale
Declaration has been signed by over 13,000 signatories from 78 countries.
During the Vietnam War, Nightingale inspired many US Army nurses, sparking a
renewal of interest in her life and work. Her admirers include Country Joe of
Country Joe and the Fish, who has assembled an extensive website in her honour.
Three hospitals in Istanbul are named after Nightingale: F. N. Hastanesi in
Şişli (the biggest private hospital in Turkey), Metropolitan F.N. Hastanesi in
Gayrettepe, and Avrupa F.N. Hastanesi in Mecidiyeköy, all belonging to the
Turkish Cardiology Foundation.
The Agostino Gemelli Medical Center
in Rome, the first university-based hospital in Italy and one of its most
respected medical centres, honoured Nightingale's contribution to the nursing
profession by giving the name "Bedside Florence" to a wireless computer system
it developed to assist nursing.
There are many foundations named after Florence Nightingale. Most are nursing
foundations, but there is also Nightingale Research Foundation in Canada,
dedicated to the study and treatment of chronic fatigue syndrome which
Nightingale is believed to have had.
There is a psychological effect known as the "Florence Nightingale Effect",
whereby nurses and doctors fall in love with their patients.
A bronze plaque, attached to the plinth of the Crimean Memorial in the
Haydarpaşa Cemetery, Istanbul and unveiled on Empire Day, 1954 to celebrate the
100th anniversary of her nursing service in that region, bears the inscription:
"To Florence Nightingale, whose work near this Cemetery a century ago
relieved much human suffering and laid the foundations for the nursing
There is a Florence Nightingale Museum in London and another museum devoted
to her at her sister's family home, Claydon House, now a property of the
The northmost tower of the Selimiye Barracks building is today a museum, and
in several of its rooms, relics and reproductions relevant to Florence
Nightingale and her nurses are on exhibition.
When she first arrived in Turkey, Nightingale would travel on horseback to
make inspections. She then transferred to a mule cart and was reported to have
escaped serious injury when the cart was toppled in an accident. Following this
episode, she used a solid Russian-built carriage, with a waterproof hood and
curtains. The carriage was returned to England after the war and subsequently
given to the Nightingale training school for nurses, which she founded at St
Thomas's Hospital. The carriage was damaged when the hospital was bombed in the
Blitz. It was later restored and transferred to the Army Museum in Aldershot.
Florence Nightingale's voice was saved for posterity in a phonograph
recording from 1890 preserved in the British Library Sound Archive.
Several churches in the Anglican Communion commemorate Nightingale with a
feast day on their liturgical calendars. So does the Evangelical Lutheran Church
in America, which commemorates her as a renewer of society with Clara Maass on
The airline KLM has named one of their MD-11 airliners in her memory.
Nightingale Corona, on the surface of Venus is named after her.
The United States Air Force maintains a fleet of 20 McDonnell Douglas C-9A
"Nightingale" aeromedical evacuation aircraft.
In the TV series Star Trek Voyager the character Ensign Harry Kim
names an alien medical vessel after her.
MC Smith, dedicated nurse historian, credits Nightingale with making the
profession "...appealing to the masses."
i think she was a great lady