Florence Nightingale () (12 May 1820 – 13 August 1910) was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War, in which she organised care for wounded soldiers at Constantinople. She significantly reduced death rates by improving hygiene and living standards. Nightingale gave nursing a favourable reputation and became an icon of Victorian culture, especially in the persona of "The Lady with the Lamp" making ward rounds for wounded soldiers at night.
Recent commentators have asserted that Nightingale's Crimean War achievements were exaggerated by the media at the time, but critics agree on the importance of her later work in professionalising nursing roles for women. In 1860, she laid the foundation of professional nursing with the establishment of her nursing school at St Thomas' Hospital in London. It was the first secular nursing school in the world and is now part of King's College London. In recognition of her pioneering work in nursing, the Nightingale Pledge taken by new nurses, and the Florence Nightingale Medal, the highest international distinction a nurse can achieve, were named in her honour, and the annual International Nurses Day is celebrated on her birthday. Her social reforms included improving healthcare for all sections of British society, advocating better hunger relief in India, helping to abolish prostitution laws that were harsh for women, and expanding the acceptable forms of female participation in the workforce.
Nightingale was an innovator in statistics; she represented her analysis in graphical forms to ease drawing conclusions and actionables from data. She is famous for usage of the polar area diagram, also called the Nightingale rose diagram, which is equivalent to a modern circular histogram or pie chart. This diagram is still regularly used in data visualisation.
Nightingale was a prodigious and versatile writer. In her lifetime, much of her published work was concerned with spreading medical knowledge. Some of her tracts were written in simple English so that they could easily be understood by those with poor literary skills. Much of her writing, including her extensive work on religion and mysticism, has only been published posthumously.
Early life
Florence Nightingale was born on 12 May 1820 at Villa Colombaia, near the Porta Romana in Florence, where her parents, William Edward Nightingale and Frances "Fanny" ( Smith), were staying during a European tour. Like her older sister Frances Parthenope, who had been named partly after Parthenope, the Greek settlement on the site of Naples, Nightingale was named after her birthplace. The family returned to England in 1821, when Nightingale was a year old. Lea Hurst in Derbyshire became one of her early homes, though the family first lived at Kynsham Court, Presteigne, while Lea Hurst was being completed. From 1825, after William Nightingale purchased Embley Park in Hampshire, the family divided its time chiefly between Embley and Lea Hurst, with some time also spent in London.
William Edward Nightingale had been born William Edward Shore, and assumed the Nightingale name after inheriting the Lea estate from Peter Nightingale. Fanny Nightingale was the daughter of the abolitionist and Unitarian William Smith. William Nightingale held views on women's intellectual education that were advanced for his time. Although the daughters had a governess in their early years, William supervised their education and provided much of their later instruction himself. Their curriculum included French, German, Italian, Latin, Greek, mathematics, constitutional history, grammar, composition, English literature and music. Nightingale's study of Latin had practical value in later life, as it sometimes enabled communication with abbots and monks she encountered while travelling.
In 1838, William Nightingale took the family on another European tour, during which Nightingale met the English-born Parisian hostess Mary Clarke. Clarke became close to the Nightingale family, especially Florence, whom she treated as an intellectual equal. Clarke disliked the social conventions that constrained upper-class young women, reportedly saying that, if forced to choose, she would rather be "a galley-slave" than a woman. Her independence and intellectual circle helped show Nightingale a world in which women could participate in intellectual life alongside men.
Nursing vocation and training
On 7 February 1837, at the age of sixteen, she experienced what she later described as the first of several calls from God to service, though the call did not specify what form that service should take. It took several years for her vocation to become focused on nursing, and resistance from her mother and sister, Parthenope, delayed her attempts to act on it. Despite the anger and distress of her mother and sister, she rejected the expected role for a woman of her status to become a wife and mother. Nightingale worked hard to educate herself in the art and science of nursing, in the face of opposition from her family and the restrictive social code for affluent young English women. As a young woman, Nightingale was described as attractive, slender, and graceful. While her demeanour was often severe, she was said to be very charming and to possess a radiant smile. Her most persistent suitor was the politician and poet Richard Monckton Milnes, but after a nine-year courtship, she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing.
In Rome in 1847, she met Sidney Herbert, a politician who had been Secretary at War (1845–1846) who was on his honeymoon. He and Nightingale became lifelong close friends. Herbert would be Secretary of War again during the Crimean War when he and his wife would be instrumental in facilitating Nightingale's nursing work in Crimea. She became Herbert's key adviser throughout his political career, though she was accused by some of having hastened Herbert's death from Bright's disease in 1861 because of the pressure her programme of reform placed on him. Nightingale also much later had strong relations with academic Benjamin Jowett, who may have wanted to marry her.Bostridge, Mark (2008). Florence Nightingale. pg. 8. London
Nightingale continued her travels (now with Charles and Selina Bracebridge) as far as Greece and Egypt. While in Athens, Greece, Nightingale rescued a juvenile little owl from a group of children who were tormenting it, and she named the owl Athena. Nightingale often carried the owl in her pocket, until the pet died (shortly before Nightingale left for Crimea).
Her writings on Egypt, in particular, are testimony to her learning, literary skill, and philosophy of life. Sailing up the Nile as far as Abu Simbel in January 1850, she wrote of the Abu Simbel temples, "Sublime in the highest style of intellectual beauty, intellect without effort, without suffering ... not a feature is correct — but the whole effect is more expressive of spiritual grandeur than anything I could have imagined. It makes the impression upon one that thousands of voices do, uniting in one unanimous simultaneous feeling of enthusiasm or emotion, which is said to overcome the strongest man."
At Thebes, she wrote of being "called to God", while a week later near Cairo she wrote in her diary (as distinct from her far longer letters that her elder sister Parthenope was to print after her return): "God called me in the morning and asked me would I do good for him alone without reputation." Later in 1850, she visited the Lutheran religious community at Kaiserswerth-am-Rhein in Germany, where she observed Pastor Theodor Fliedner, Friederike 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. She also received four months of medical training at the institute, which formed the basis for her later care.
On 22 August 1853, Nightingale took the post of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London, a position she held until October 1854. (commercial website) Her father had given her an annual income of (), which allowed her to live comfortably and to pursue her career.
Crimean War
Florence Nightingale's most famous contribution came during the Crimean War, which became her central focus when reports got back to Britain about the horrific conditions for the wounded at the military hospital on the Asiatic side of the Bosporus, opposite Constantinople, at Scutari (modern-day Üsküdar in Istanbul). Britain and France entered the war against Russia on the side of the Ottoman Empire. On 21 October 1854, she and the staff of 38 women volunteer nurses including her head nurse Eliza Roberts and her aunt Mai Smith, and 15 Catholic nuns (mobilised by Henry Edward Manning) citing were sent (under the authorisation of Sidney Herbert) to the Ottoman Empire. On the way, Nightingale was assisted in Paris by her friend Mary Clarke.Patrick Waddington (January 2007) [first published 2004]. "Mohl, Mary Elizabeth (1793–1883)". Oxford Dictionary of National Biography (online ed.). Oxford University Press. Accessed 7 February 2015. The volunteer nurses worked about away from the main British camp across the Black Sea at Balaklava, in the Crimea.
Nightingale arrived at Selimiye Barracks in Scutari early in November 1854. Her team found that poor care for wounded British soldiers was being delivered 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:
After Nightingale sent a plea to The Times for a government solution to the poor condition of the facilities, the British Government commissioned Isambard Kingdom Brunel to design a prefabricated hospital that could be built in England and shipped to the Dardanelles. The result was Renkioi Hospital, a civilian facility that, under the management of Edmund Alexander Parkes, had a death rate less than one tenth of that of Scutari."Report on Medical Care". . United Kingdom: The National Archives (WO 33/1 ff.119, 124, 146–7). 23 February 1855.
Stephen Paget in the Dictionary of National Biography asserted that Nightingale reduced the death rate from 42% to 2%, either by making improvements in hygiene herself, or by calling for the Sanitary Commission. For example, Nightingale implemented handwashing in the hospital where she worked.
During her first winter at Scutari, 4,077 British soldiers died there. Ten times more soldiers died from illnesses such as typhus, typhoid, cholera, and dysentery than from battle wounds. With overcrowding, defective sewers and lack of ventilation, the Sanitary Commission had to be sent out by the British government to Scutari in March 1855, almost six months after Nightingale had arrived. The commission flushed out the sewers and improved ventilation. Death rates were sharply reduced, but she never claimed credit for helping to reduce the death rate. Head Nurse Eliza Roberts nursed Nightingale through her critical illness of May 1855.McDonald, Lynn, ed. Florence Nightingale: The Crimean War in Collected Works. vol. xiv, 2010, pp. 65, 384 & 1038
In 2001 and 2008, the BBC released documentaries that were critical of Nightingale's performance in the Crimean War, as were some follow-up articles published in The Guardian and the Sunday Times. Nightingale scholar Lynn McDonald has dismissed these criticisms as "often preposterous", arguing they are not supported by primary sources.