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Saturday 4 July 2009

Florence Nightingale

Florence Nightingale, the daughter of the we

althy landowner, William Nightingale of Embly Park, Hampshire, was born in Florence, Italy, on 12th May, 1820. Her father was a Unitarian and a Whig who was involved in the anti-slavery movement. As a child, Florence was very close to her father, who, without a son, treated her as his friend and companion. He took responsibility for her education and taught her Greek, Latin, French, German, Italian, history, philosophy and mathematics.

At seventeen she felt herself to be called by God to some unnamed great cause. Florence's mother, Fanny Nightingale, also came from a staunch Unitarian family. Fanny was a domineering woman who was primarily concerned with finding her daughter a good husband. She was therefore upset by Florence's decision to reject Lord Houghton's offer of marriage. Florence refused to marry several suitors, and at the age of twenty-five told her parents she wanted to become a nurse. Her parents were totally opposed to the idea as nursing was associated with working class women.

Florence's desire to have a career in medicine was reinforced when she met Elizabeth Blackwell at St. Bartholomew's Hospital in London. Blackwell was the first woman to qualify as a doctor in the United States. Blackwell, who had to overcome considerable prejudice to achieve her ambition, encouraged her to keep trying and in 1851 Florence's father gave her permission to train as a nurse.

Florence, now thirty-one, went to Kaiserwerth, Germany where she studied to become a nurse at the Institute of Protestant Deaconesses. Two years later she was appointed resident lady superintendent of a hospital for invalid women in Harley Street, London.
In March, 1853, Russia invaded Turkey. Britain and France, concerned about the growing power of Russia, went to Turkey's aid. This conflict became known as the Crimean War. Soon after British soldiers arrived in Turkey, they began going down with cholera and malaria. Within a few weeks an estimated 8,000 men were suffering from these two diseases.
When Mary Seacole heard about the cholera epidemic she travelled to London to offer her services to the British Army. There was considerable prejudice against women's involvement in medicine and her offer was rejected. When The Times publicised the fact that a large number of British soldiers were dying of cholera there was a public outcry, and the government was forced to change its mind. Nightingale volunteered her services and was eventually given permission to take a group of thirty-eight nurses to Turkey.

Nightingale found the conditions in the army hospital in Scutari appalling. The men were kept in rooms without blankets or decent food. Unwashed, they were still wearing their army uniforms that were "stiff with dirt and gore". In these conditions, it was not surprising that in army hospitals, war wounds only accounted for one death in six. Diseases such as typhus, cholera and dysentery were the main reasons why the death-rate was so high amongst wounded soldiers.

Military officers and doctors objected to Nightingale's views on reforming military hospitals. They interpreted her comments as an attack on their professionalism and she was made to feel unwelcome. Nightingale received very little help from the military until she used her contacts at The Times to report details of the way that the British Army treated its wounded soldiers. John Delane, the editor of newspaper took up her cause, and after a great deal of publicity, Nightingale was given the task of organizing the barracks hospital after the battle of Inkerman and by improving the quality of the sanitation she was able to dramatically reduce the death-rate of her patients.
Although Mary Seacole was an expert at dealing with cholera, her application to join Florence Nightingale's team was rejected. Mary, who had become a successful business woman in Jamaica, decided to travel to the Crimea at her own expense. She visited Nightingale at her hospital at Scutari but once again Mary's offer of help was refused.
Unwilling to accept defeat, Mary Seacole started up a business called the British Hotel, a few miles from the battlefront. Here she sold food and drink to the British soldiers. With the money she earned from her business Mary was able to finance the medical treatment she gave to the soldiers.
Whereas Florence Nightingale and her nurses were based in a hospital several miles from the front, Mary Seacole treated her patients on the battlefield. On several occasions she was found treating wounded soldiers from both sides while the battle was still going on.
In 1856 Florence Nightingale returned to England as a national heroine. She had been deeply shocked by the lack of hygiene and elementary care that the men received in the British Army. Nightingale therefore decided to begin a campaign to improve the quality of of nursing in military hospitals. In October, 1856, she had a long interview with Queen Victoria and Prince Albert and the following year gave evidence to the 1857 Sanitary Commission. This eventually resulted in the formation of the Army Medical College.

To spread her opinions on reform, Nightingale published two books, Notes on Hospital (1859) and Notes on Nursing (1859). With the support of wealthy friends and John Delane at The Times, Nightingale was able to raise £59,000 to improve the quality of nursing. In 1860, she used this money to found the Nightingale School & Home for Nurses at St. Thomas's Hospital. She also became involved in the training of nurses for employment in the workhouses that had been established as a result of the 1834 Poor Law Amendment Act.
Nightingale held strong opinions on women's rights. In her book Suggestions for Thought to Searchers after Religious Truths (1859) she argued strongly for the removal of restrictions that prevented women having careers. Read by John Stuart Mill, it influenced his book on women's rights, The Subjection of Women (1869).

Nightingale was also strongly opposed to the passing of the Contagious Diseases Act. However, Nightingale was unwilling to become involved in the campaign led by Josephine Butler to get this legislation repealed. Nightingale preferred working behind the scenes to get laws changed and disapproved of women making speeches in public.

Women such as Elizabeth Garrett Anderson and Sophia Jex-Blake were disappointed by Nightingale's lack of support for women's doctors. Nightingale had doubts at first about the wisdom of this campaign and argued that it was more important to have better trained nurses than women doctors.

In later life Florence Nightingale suffered from poor health and in 1895 went blind. Soon afterwards, the loss of other faculties meant she had to receive full-time nursing. Although a complete invalid she lived another fifteen years before her death in London on 13th August, 1910.
Florence Nightingale and Mary Seacole: Classroom Activities

(1) In 1852 Florence Nightingale wrote Cassandra but on the advice of friends she never published the book.

Women are never supposed to have any occupation of sufficient importance not to be interrupted, except "suckling their fools"; and women themselves have accepted this, have written books to support it, and have trained themselves so as to consider whatever they do as not of such value to the world as others, but that they can throw it up at the first "claim of social life". They have accustomed themselves to consider intellectual occupation as a merely selfish amusement, which it is their "duty" to give up for every trifler more selfish than themselves.

Women never have an half-hour in all their lives (except before and after anybody is up in the house) that they can call their own, without fear of offending or of hurting someone. Why do people sit up late, or, more rarely, get up so early? Not because the day is not long enough, but because they have "no time in the day to themselves".

The family? It is too narrow a field for the development of an immortal spirit, be that spirit male or female. The family uses people, not for what they are, not for what they are intended to be, but for what it wants for - its own uses. It thinks of them not as what God has made them, but as the something which it has arranged that they shall be. This system dooms some minds to incurable infancy, others to silent misery.

(2) In her diary Florence Nightingale explained why she decided to turn down the offer of marriage to Richard Moncton Milnes.

I have a moral, an active nature which requires satisfaction and that I would not find in his life. I could be satisfied to spend a life with him in combining our different powers to some great object. I could not satisfy this nature by spending a life with him in making society and arranging domestic things.

(3) Illustrated London News (24th February, 1855)

Although the public have been presented with several portrait-sketches of the lady who has so generously left this country to attend to the sufferings of the sick and wounded at Constantinople, we have assurance that these pictures are "singularly and painfully unlike". We have, therefore, taken the most direct means of obtaining a sketch of this excellent lady, in the dress she now wears, in one of "the corridors of the sick".


Illustrated London News (24th February, 1855)

(4) Letter in The Times on the activities of Florence Nightingale at Scutari (February, 1855)

Wherever there is disease in its most dangerous form, and the hand of the spoiler distressingly nigh, there is that incomparable woman sure to be seen; her benignant presence is an influence for good comfort even amid the struggles of expiring nature. She is a 'ministering angel' without any exaggeration in these hospitals, and, as her slender form glides quietly along each corridor, every fellow's face softens with gratitude at the sight of her.

(5) Florence Nightingale, letter to Thomas Longmore on the Geneva Convention (23rd July, 1864)

I need hardly say that I think its views most absurd - just such as would originate in a little state like Geneva, which never can see war. They tend to remove responsibility from Governments. They are practically impracticable. And voluntary effort is desirable, just in so far as it can be incorporated into the military system.

If the present Regulations are not sufficient to provide for the wounded they should be made so. But it would be an error to revert to a voluntary system, or to weaken the military character of the present system by introducing voluntary effort, unless such effort were to become military in its organization.

(6) Henri Dunant, speech on Florence Nightingale at the Geneva Convention (August, 1864)

To the many who pay their homage to Miss Nightingale, though a very humble person of a small country, Switzerland, I yet want to add my tribute of praise and admiration. As the founder of the Red Cross and the originator of the diplomatic Convention of Geneva, I feel emboldened to pay my homage. To Miss Nightingale I give all the honour of this humane Convention. It was her work in the Crimea that inspired me to go to Italy during the war of 1859, to share the horrors of war, to relieve the helplessness of the unfortunate victims of the great struggle on June 24, to soothe the physical and moral distress, and the anguish of so many poor men, who had come from all parts of France and Austria to fall victims to their duty, far from their native country, and to water the poetic land of Italy with their blood.

(7) Florence Nightingale, letter published in the Englishwoman's Review (January, 1869)

I have no peculiar gifts. And I can honestly assure any young lady, if she will but try to walk, she will soon be able to run the "appointed course". But then she must first learn to walk, and so when she runs she must run with patience. (Most people don't even try to walk.) But I would also say to all young ladies who are called to any particular vocation, qualify yourself for it as a man does for his work. Don't think you can undertake it otherwise.

(8) Florence Nightingale, Advice to Nursing Students (1873)

Nursing is most truly said to be a high calling, an honourable calling. But what does the honour lie in? In working hard during your training to learn and to do all things perfectly. The honour does not lie in putting on Nursing like your uniform. Honour lies in loving perfection, consistency, and in working hard for it: in being ready to work patiently: ready to say not "How clever I am!" but "I am not yet worthy; and I will live to deserve to be called a Trained Nurse.

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