Florence Nightingale - More than a Lady with a lamp

There are few women whose name is as instantly recognisable as that of Florence Nightingale. Commonly titled 'the Lady with the Lamp', Nightingale was a reformer, an excellent statistician, and a strong leader. Her work overturned the military hospitals in the Crimea and when she returned to the UK her work continued for 50 years. Remarkably, considering Nightingale was a strong woman who defied the expectations placed upon someone of her class and gender, she was not a feminist as she found many women to be lazy, ignorant, and lacking moral purpose - her nurses were not permitted to be too young, upper class or too pretty, as this might impede their ability to nurse well. The Victorian populous - who loved all things romantic - were captivated by the stories of this wealthy woman who became a nurse and radically changed nursing as a profession. To them she was the embodiment of brave and beautiful, and her story has captivated the British public ever since.

Florence Nightingale - the lady with the lamp

Nightingale was extremely fortunate in her circumstances. She was born to a wealthy family and was raised by liberal parents who supported women's education. As such, she was afforded an excellent education including several languages and mathematics. Her parents' social connections also enabled her to network with some of the greatest minds in Victorian England. Her father's preference for discipline was a trait she would take with her to the Crimean war front and was fundamental to some of her reforms. Whilst a young woman she spent three months at the Deaconesses institute in Kaiserwerth, where she trained in nursing, Her European travels allowed her the opportunity to observe various European hospitals and improved her understanding of order and nursing techniques.

In 1853, war broke out between Russia and an alliance involving Britain, France, and the Ottoman Empire. Through impassioned reporting, news reached the UK that the military hospitals in the Crimea and Turkey were short on nurses - a matter considered outrageous considering the French had sent 50 sisters of mercy (nurses). As such an appeal was made for help. Florence Nightingale did not hesitate to be asked. She spoke to the wife of the Secretary for War - a friend of hers - and offered her services. Already known among the upper class for her aptitude for nursing, her offer was accepted, and she was tasked with putting together a team of nurses to take to the Crimea. Nightingale was incredibly selective in her recruitment and refused anyone upper class and anyone middle class (unless they had exceptional experience). In addition, anyone under 24 or too pretty was turned away. On October 21st, 1854, Florence Nightingale left England with a team of 38 nurses. This was not without controversy. Many believed nursing was no place for a woman of such breeding as Nightingale and there was additional disapproval of the recruitment of both protestant and catholic women to Nightingale's team.

Upon arrival at Scutari Hospital, in Constantinople, it became clear that conditions were beyond awful. The food and water were unhygienic, there was no kitchen or laundry, the patients did not have any clean clothes, and the wards were unclean. Nightingale was quick to link filth to disease, so she and her nurses set to work cleaning the ward. The soldiers were given clean clothes, the food and water were clean, and the results were evident. When the nurses arrived at Scutari there was a 32% death rate, by the time Nightingale left it had dropped dramatically to 2%. Moreover, Nightingale was a strong and capable leader who would not take no for an answer. In one case, she used a hammer to break open a locked medicine cabinet which contained medicines intended for use on officers only. Following Scutari, she visited hospitals all over the region recommending reforms, although not all these reforms were welcomed by the commanding officers some of whom considered her unfeminine and a nuisance. Whilst travelling across the region, Nightingale fell ill with fever. Despite coming close to death, she refused to return to England. Once recovered, Nightingale returned to her vigorous efforts in improving the hospitals of the Crimea.

Florence Nightingale with nurses of the Nightingale school and Sir Harry Verney, at Claydon house. Photograph courtesy of the Welcome LIbrary, London.

News of Nightingales reform spread across the UK - the London Times was more than keen to share the stories. Yet when she returned there was no fanfare. She did not leave the Crimea until every soldier had been sent home, her arrival back in the UK was only noticed when she arrived at her father's house unannounced. Nightingale spent the following 50 years travelling the country delivering lectures and conducting research. Through her study of statistics, she found the 7x more men had died in the Crimean war from disease than from battle-wounds and she recommended that in order to reduce hospital deaths wards should have fewer patients and hygiene must be improved. Her research also helped encourage the British government to pass a law resulting in the construction of a London sewerage system. She also founded a nursing school in which she could impart the knowledge and experience which she had accumulated over the years.

Of the several thousand medals awarded following the Crimean war not even one was awarded to a nurse. Florence Nightingale herself only accepted the Order of Merit a couple of years before her death. But her legacy lives on. It is interesting that Nightingale has become such a hero of nursing. She was by no means the first trained nurse, nor was she the only nurse to cause change in the Crimean war - Mary Seacole is another noteworthy nurse who had been rejected from Nightingales program. Nor was Nightingale the first to establish a nursing school. Perhaps Nightingales legacy was therefore fuelled not by what she did but by the character with which she did it. Before Nightingale nursing had a reputation for lacking moral standards and virtues. Nursing was woman's work - and the only women who worked were those so poor that the wages were required to feed their families. Although many of these women were no doubt kind, the poor treatment they endured resulted in a reputation for drunkenness or carelessness. In contrast, Nightingale was a well to do woman - a lady. She embodied the Victorian love for romanticism as she was sophisticated, educated, and attractive. Perhaps then, Nightingale is remembered because she changed the reputation of nursing. She turned it from a job for the desperately poor, into a career for the 'respectable woman' - nursing became a moral calling. The research that Nightingale began has been continued ever since, one must wonder what she would think of modern hospitals - would she approve of modern hygiene practice? How would she react to the existence of hospital diseases such as MRSA? No doubt she would have a lot to say about nursing shortages and hospital organisation. Professional nursing has a lot to admire in Florence Nightingale. She was far much more than just the lady with the lamp.