FLORENCE NIGHTINGALE 1820 - 1910

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Acknowledgements

Nightingale: by the English photographer Henry Hering (1814-1893), and copied by the London photographic studio of Joseph John Elliott (1835-1903) and Clarence Edmund Fry (1840-1897), 1858 – National Portrait Gallery, London. Scutari: by the English painter Jerry Barrett (1824-1906) – National Portrait Gallery, London. Lady with the lamp: attributed to J. Butterworth (active 1839-1854) – Wellcome Library, London. Seacole: by the London artist Albert Charles Challen (1847-1881), c1869 – National Portrait Gallery, London. Russell: by the English artist Herbert Watkins (1828-c1901), late 1850s – National Portrait Gallery, London. Blackwell: detail, by the American portrait artist Joseph Stanley Kozlowski (1912-1992), 1905 – Medical School Collection, Syracuse University, New York. Anderson: attributed to the English portrait painter Reginald Grenville Eves (1876-1941), 1900 – Royal Free Hospital, Hampstead, London.

xxxxxThe English nurse Florence Nightingale, known as the “Lady with the Lamp” during the Crimean War, was born in Florence (hence her name). The daughter of a rich country gentlemen, she lived her early life in Derbyshire and London, England, and received much of her education directly from her father. Determined to become a nurse, despite her family’s opposition, in 1849 she visited a number of hospitals on the continent, and then the following year took a training course for nurses at the Institute for Protestant Deaconesses at Kaiserswerth, Germany. On her return to England in 1853 she took charge of the Hospital for the Care of Sick Gentlewomen in London. There she made noticeable improvements, but found insufficient scope for her ambitious plans. She dismissed her institution as a “little molehill”, and made it plain that she was looking for a mountain to climb.

xxxxxHer opportunity to reach greater heights came with the outbreak of the Crimean War in October 1853. Havingxlearnt of the appalling conditions being suffered by the wounded, and encouraged by the then Secretary of State for War Sidney Herbert (1810-1861), she took a team of 38 volunteer nurses and Sisters of Mercy to Scutari (now Üsküdar) where the main military hospital - a former Turkish barracks - was situated. On arrival she found conditions in these bare, dirty halls nothing short of horrific, and even worse than expected. There was little, if any, sanitation, very few nursing staff, and virtually no basic medical necessities. Furthermore, because of the lack of beds and bedding, many of the wounded were lying on the bare floors of the make-do wards, still wearing their blood-stained uniforms. Scutari, she declared, was founded on two things - bad administration and bad drains.

xxxxxTasked with the direction of all nursing operations in the war zone, and learning that more men were dying of disease than from their wounds, in 1855 she introduced a thorough reorganisation of the hospital system in Scutari and, later, Balaclava, purchasing local supplies to raise the standard of hygiene and general nursing care. Her dogged determination and her rare gift for administration paid off. By her tireless efforts the death rate among the sick and the wounded fell from 42% to under 3% in all the hospitals in Scutari, but not before the War Office had been persuaded to back the necessary reforms and improvements.

xxxxxThe revolution she achieved in army medical care, and her own nursing skills and devotion to duty, made her a legend in her lifetime, a household name in England and a famous figure throughout Europe. She devoted herself to the welfare of the troops, nursing the worst cases by day, assisting in the operations, and making her solitary round of the wards at night, lamp in hand, to bring comfort where it was needed. Such devotion won her much public support, and she returned home a national heroine, but she refused any official reception and shunned the limelight. From then on, though constantly ill from overwork, she devoted her life to reforming the nursing profession, raising the standards of public health, and improving the welfare of the British soldier. In 1860, for example, using a testimonial fund of £50,000 - raised as a tribute to her work - she founded the Nightingale School and Home for Nurses at St. Thomas’ Hospital, London, the very first establishment specifically built to provide nurses with a professional training. Aided by some influential friends - including Sidney Herbert until his death in August 1861 - she then went on to raise the status of nursing throughout the country - making it a skilled and responsible profession -, introduced training for midwives, and took part in the reform of workhouses and their infirmaries.

xxxxxIn her determination to improve the health and living conditions of the British soldier, she had private interviews with Queen Victoria and Prince Albert, and eventually persuaded the government to appoint a Royal Commission on the Health of the Army. Out of it came the founding of the Army Medical School in 1857 and a host of improvements, later outlined in her Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army. And following the Indian Mutiny in 1857, she turned her attention to the health of the army in India, gaining by her efforts another royal commission, and the ultimate establishment of a Sanitary Department within the India Office.

xxxxxBy the end of the century her system of education and training had been adopted across the Western world and throughout much of the British Empire, influenced in large measure by her own writings. These included Notes on Nursing in 1860 - the very first textbook for nurses - , Notes on Hospitals, published a year earlier, and Notes on Nursing for the Labouring Classes, produced in 1861. For her services to hospital reform and the nursing profession in general, she was honoured by a number of foreign governments, and in 1907 she became the first woman to receive the British Order of Merit. Her sight began to fail in 1901, doubtless the result of her long working day, and she died in London in August 1910. She had declined the offer of a national funeral and burial in Westminster Abbey, but five years later the Crimean Monument in Waterloo Place, London, was erected in her honour.

xxxxxIncidentally, Nightingale’s work during the Crimean War was admired and supported by Queen Victoria, and the American poet Henry Wadsworth Longfellow, referring to her routine visits to the wards during the night, wrote “A lady with a lamp shall stand in the great annals of the land”.

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xxxxxAnother nurse who gained much popularity for her work during the Crimean War was the Jamaican Mary Seacole (1805-81). She was born in Kingston, and learned her nursing skills from her mother. A determined, energetic woman, she worked as a nurse and healer in the Caribbean and Panama, and paid two visits to England. It was on her second visit in 1854 that she learned of the Crimean War and the plight of the wounded. She applied to go to the Crimea as an army nurse, but the War Office turned down her application, as did one of Florence Nightingale’s nursing teams. Suspecting racial prejudice but undaunted, she joined up with a relative and made her own way to the Crimea, setting up a general store and hotel near Balaclava. From there she dispensed medicines, and tended the sick and wounded near the besieged city of Sevastopol, where she affectionately became known as “Mother Seacole”. Frequently in the front line, and often under fire, she was the first woman to enter Sevastopol when it fell in 1856.

xxxxxOn her return to England at the end of the war she was feted as the “Angel of the Crimea”, but she was virtually destitute, having lost all her possessions to the Russians. However, The Times and the magazine Punch raised money on her behalf, as did a four-day musical festival, held in the Royal Surrey Gardens. In recognition of her services she was awarded the Crimean Medal, and the French Legion of Honour. In 1857 she published her autobiography, Wonderful Adventures of Mrs Seacole in Many Lands. In the preface to this work, The Times war correspondent, William Howard Russell (illustrated), whose despatches had highlighted her courage and devotion, wrote: “I trust that England will not forget one who nursed her sick, who sought out her wounded to aid and succour them, and who performed the last offices for some of her illustrious dead.” But after a time, England did forget, and the last twenty years of her life were spent in obscurity. Only in relatively recent years has the service she rendered been fully recognised.

xxxxxIncidentally, itxwas William Howard Russell (1820-1907), The Times’ correspondent during the Crimean War, who, more than any other journalist, exposed the mismanagement of the campaign and drew attention to the lack of medical care for the sick and wounded. His dispatches from the front greatly influenced Florence Nightingale’s decision to take out a team of nurses to improve the conditions of the fighting soldier.

xxxxxIt was in the early 1850s that Florence Nightingale met Elizabeth Blackwell (1821-1910), the first woman to qualify as a doctor of medicine. They became close friends, and in 1869 they worked together in setting up the first medical school for women in Britain. She was born in Bristol, England, but her family emigrated to the United States in 1832, and she became an American citizen in 1849.

xxxxxDetermined as a young woman to become a doctor, she worked as a teacher in Kentucky and later in North and South Carolina in order to raise money for her medical education, but she was then rejected by all the New York and Philadelphia colleges. After a dozen more rejections, she was eventually accepted by the medical school of Geneva in New York State (allegedly because her application was thought to be a hoax!) and graduated as a doctor in 1849. Perhaps not surprisingly, she then found that no hospital in America would employ her! Undeterred, in 1857, after training as a midwife in Paris, she established her own infirmary for Women and Children in Manhattan, and two years later became the first woman to be entered on the British Medical Register. Then in 1868, after playing a valuable part in selecting and training nurses during the American Civil War, she expanded her infirmary in New York to include a medical college for the training of women doctors, the first of its kind.

 

xxxxxIn 1869 she left New York and spent the rest of her life in Great Britain. She lectured and worked at the London School of Medicine for Women, and in 1875 was appointed Professor of Gynaecology, a post she held until 1907. She died of a stroke at her home in Hastings, Sussex, and was buried in St, Mun’s cemetery at Kilmun on Holy Loch, western Scotland. Throughout her life she was active in the anti-slavery movement, and an ardent supporter of women’s rights. Her publications included Medicine as a Profession for Women in 1860, and Address on the Medical Education of Women four years later.

xxxxxIncidentally, while in Paris in the late 1840s, taking a course in midwifery, she caught a serious eye infection and had to have her right eye removed. This put pay to her hopes of becoming a surgeon. ……

xxxxx…… The first woman to gain a medical qualification in Britain (and to be the first woman mayor in England) was Elizabeth Garrett Anderson (1836-1917) in 1865. She thus became the second woman to have her name entered on the British Medical Register, and in 1873 she was the first woman to gain membership of the British Medical Association. She played a major role in the development of the New Hospital for Women and (along with Elizabeth Blackwell) in the creation of the London School of Medicine for Women in 1874. She was elected mayor of Aldeburg, Suffolk, in 1908, and it was there that she was buried in 1917.