Born into a wealthy and well-connected
British family in Florence, Italy, she was named after the city of her birth, as was her older
sister born at Parthenope. A brilliant and strong-willed woman, she rebelled
against the expected role for a woman of her status, which was to become
an obedient wife.
Inspired by what she understood to
be a Divine calling, (first experienced in 1837 at the age of 17 at Embley and later throughout her life),
Nightingale made a commitment to nursing, a career with a poor reputation
and filled mostly by poorer women. Nightingale was particularly concerned
with the appalling conditions of medical care for the legions of the
poor and indigent. She announced her decision to her family in 1845, evoking intense anger and distress from her family, particularly
her mother.
In December 1844, in response to a pauper's death in a workhouse infirmary
in London that became a public scandal, Nightingale became the leading
advocate for improved medical care in the infirmaries, and immediately
engaged the support of Charles Villiers, the 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.
In 1846 she visited Kaiserwerth, a pioneering hospital established
and managed by an order of Catholic
sisters in Germany, and was greatly impressed by the quality of medical
care and by the commitment and practises of the sisters.
Florence
Nightengale lived a long and remarkable life. Although she is
known as the founder of modern nursing and one of the most famous women
in history, few people know that she spent the last half of her life
confined to her home and often bedridden, suffering from an illness
similar to what we now call ME/CFS (Myalgic Encephalomyelitis/Chronic
Fatigue Syndrome).
She
was born on May 12, 1820 to wealthy British parents travelling in Italy.
Named for the city in which she was born, young Florence never quite
fit the mold of a Victorian lady. She was well educated in literature,
music, drawing and the domestic arts. A women of her social standing
was expected to marry and devote her life to her family, entertaining,
and cultural pursuits. However, she felt an early calling to serve,
and refused to marry. When she attempted to go to work as a nurse,
her horrified family repeatedly opposed her. In those days, hospitals
were often dirty and dark and nurses were untrained, sometimes drunken
women. Finally, at age 33 she was able to obtain some minimal
training and begin her career.
In
1854, the British press began reporting that soldiers wounded in the
Crimean War were being poorly cared for in deplorable conditions.
Nightingale recruited and equipped a group of nurses and went off to
Turkey to help. Her arrival was not celebrated by the surgeons
there, who resented the interference of a woman. Undaunted, she
worked tirelessly to improve conditions in the hospital. Her changes
revolutionized British military medical care, increasing standards for
sanitation and nutrition and dramatically lowering mortality rates.
While visiting the front lines, she became ill and never really recovered.
Although
an invalid for the rest of her life, Nightingale continued to have an
influence on standards of nursing care and training. In 1859 she
helped to establish the first Visiting Nurse Association and in 1860,
she established a school that became a model for modern nurses training.
She was considered an expert on the scientific care of the sick and
was asked by the United States for her advice on caring
for the wounded soldiers of the Civil War. Through correspondence
and reports, she continued her influence throughout her last years.
She was the first women to receive the British Order of Merit.
In 1907 the International Conference of Red Cross Societies listed her
as a pioneer of the Red Cross Movement. She died in 1910 at the
age of ninety.
was
known by the British soldiers in the Crimea as the “lady with the lamp”
because of the late hours that she worked tending to the sick and wounded.
Today, she is remembered as a symbol of selfless caring and tireless
service.
Nightingale is best remembered for
her work as a nurse during the Crimean War and her contribution towards
the reform of the sanitary conditions in military field hospitals. However,
what is less well known about this amazing woman is her love of mathematics,
especially statistics, and how this love played an important part in
her life's work.
Named after the city of her birth,
Nightingale was born at the Villa Colombia in Florence, Italy, on 12
May 1820. Her parents, William Edward Nightingale and his wife Frances
Smith, were touring Europe for the first two years of their marriage.
Nightingale's elder sister had been born in Naples the year before.
The Nightingales gave their first born the Greek name for the city,
which was Parthenope.
William Nightingale had been born with
the surname Shore but he had changed it to Nightingale after inheriting
from a rich relative, Peter Nightingale of Lea, near Matlock, Derbyshire.
The girls grew up in the country spending much of their time at Lea
Hurst in Derbyshire. When Nightingale was about five years old her father
bought a house called Embley near Romsey in Hampshire. This now meant
that the family spent the summer months in Derbyshire, while the rest
of the year was spent at Embley. Between these moves there were trips
to London, the Isle of Wight, and to relatives.
The early education of Parthenope and
Florence was placed in the hands of governesses, later their Cambridge
educated father took over the responsibility himself. Nightingale loved
her lessons and had a natural ability for studying. Under her father's
influence Nightingale became acquainted with the classics, Euclid,
Aristotle,
the Bible, and political matters.
In 1840, Nightingale begged her parents
to let her study mathematics instead of:-
... worsted work and practising
quadrilles,
but her mother did not approve of this
idea. Although William Nightingale loved mathematics and had bequeathed
this love to his daughter, he urged her to study subjects more appropriate
for a woman. After many long emotional battles, Nightingale's parents
finally gave their permission and allowed her to be tutored in mathematics.
Her tutors included Sylvester,
who developed the theory of invariants with Cayley.
Nightingale was said to be Sylvester's
most distinguished pupil. Lessons included learning arithmetic, geometry
and algebra and prior to Nightingale entered nursing, she spent time
tutoring children in these subjects.
Nightingale's interest in mathematics
extended beyond the subject matter. One of the people who also influenced
Nightingale was the Belgium scientist Quetelet.
He had applied statistical methods to data from several fields, including
moral statistics or social sciences.
Religion played an important part in
Nightingale's life. Her unbiased view on religion, unusual at the time,
was owed to the liberal outlook Nightingale found in her home. Although
her parents were from a Unitarian background, Frances Nightingale found
a more conventional denomination preferable and the girls were brought
up as members of the Church of England. On 7 February 1837 Nightingale
believed she heard her calling from God, whilst walking in the garden
at Embley, although at this time though she did not know what this calling
was.
Nightingale developed an interest in
the social issues of the time, but in 1845 her family was firmly against
the suggestion of Nightingale gaining any hospital experience. Until
then the only nursing that she had done was looking after sick friends
and relatives. During the mid-nineteenth century nursing was not considered
a suitable profession for a well-educated woman. Nurses of the time
were lacking in training and they also had the reputation of being coarse,
ignorant women, given to promiscuity and drunkenness.
While Nightingale was on a tour of
Europe and Egypt starting in 1849, with family friends Charles and Selina
Bracebridge, she had the chance to study the different hospital systems.
In early 1850 Nightingale began her training as a nurse at the Institute
of St Vincent de Paul in Alexandria, Egypt, which was a hospital run
by the Roman Catholic Church. Nightingale visited Pastor Theodor Fliedner's
hospital at Kaiserswerth, near Düsseledorf, in July 1850. Nightingale
returned to Kaiserswerth, in 1851, to undertake 3 months of nursing
training at the Institute for Protestant Deaconesses and from Germany
she moved to a hospital in St Germain, near Paris, run by the Sisters
of Mercy. On returning to London in 1853 Nightingale took up the unpaid
position as the Superintendent at the Establishment for Gentlewomen
during Illness at No 1 Harley Street.
March of 1854 brought the start of
the Crimean War, with Britain, France and Turkey declaring war on Russia.
Although the Russians were defeated at the battle of the Alma River,
on 20 September 1854, The Times newspaper criticised the British
medical facilities. In response to this Nightingale was asked in a letter
from her friend Sidney Herbert, the British Secretary for War, to become
a nursing administrator to oversee the introduction of nurses to military
hospitals. Her official title was Superintendent of the Female Nursing
Establishment of the English General Hospitals in Turkey. Nightingale
arrived in Scutari, an Asian suburb of Constantinople, (now Istanbul),
with 38 nurses on 4 November 1854 [2]:-
... her zeal, her devotion, and
her perseverance would yield to no rebuff and to no difficulty. She
went steadily and unwearyingly about her work with a judgement, a self-sacrifice,
a courage, a tender sympathy, and withal a quiet and unostentatious
demeanour that won the hearts of all who were not prevented by official
prejudices from appreciating the nobility of her work and character.
Although being female meant Nightingale
had to fight against the military authorities at every step, she went
about reforming the hospital system. With conditions which resulted
in soldiers lying on bare floors surrounded by vermin and unhygienic
operations taking place it is not surprising that, when Nightingale
first arrived in Scutari, diseases such as cholera and typhus were rife
in the hospitals. This meant that injured soldiers were 7 times more
likely to die from disease in hospital, than on the battlefield. Whilst
in Turkey, Nightingale collected data and organised a record keeping
system, this information was then used as a tool to improve city and
military hospitals. Nightingale's knowledge of mathematics became evident
when she used her collected data to calculate the mortality rate in
the hospital. These calculations showed that an improvement of the sanitary
methods employed would result in a decrease in the number of deaths.
By February 1855 the mortality rate had dropped from 60% to 42.7%. Through
the establishment of a fresh water supply as well as using her own funds
to buy fruit, vegetables and standard hospital equipment, the mortality
rate in the spring had dropped further to 2.2%.
Nightingale used this statistical data to create her Polar Area Diagram,
or "coxcombs" as she called them. These were used to give
a graphical representation of the mortality figures during the Crimean
War (1854 - 56).
The area of each coloured wedge, measured
from the centre as a common point, is in proportion to the statistic
it represents. The blue outer wedges represent the deaths from:-
... preventable or mitigable zymotic
diseases
or in other words contagious diseases
such as cholera and typhus. The central red wedges show the deaths from
wounds. The black wedges in between represent deaths from all other
causes. Deaths in the British field hospitals reached a peak during
January 1855, when 2,761 soldiers died of contagious diseases, 83 from
wounds and 324 from other causes making a total of 3,168. The army's
average manpower for that month was 32,393. Using this information,
Nightingale computed a mortality rate of 1,174 per 10,000 with 1,023
per 10,000 being from zymotic diseases. If this rate had continued,
and troops had not been replaced frequently, then disease alone would
have killed the entire British army in the Crimea.
These unsanitary conditions, however,
were not only limited to military hospitals in the field. On her return
to London in August 1856, four months after the signing of the peace
treaty, Nightingale discovered that soldiers during peacetime, aged
between 20 and 35 had twice the mortality rate of civilians. Using her
statistics, she illustrated the need for sanitary reform in all military
hospitals. While pressing her case, Nightingale gained the attention
of Queen Victoria and Prince Albert as well as that of the Prime Minister,
Lord Palmerston. Her wishes for a formal investigation were granted
in May 1857 and led to the establishment of the Royal Commission on
the Health of the Army. Nightingale hid herself from public attention,
and became concerned for the army stationed in India. In 1858, for her
contributions to army and hospital statistics Nightingale became the
first woman to be elected to be a Fellow of the Royal Statistical Society.
In 1860, the Nightingale Training School
and Home for Nurses based at St Thomas' Hospital in London, opened with
10 students. It was financed by the Nightingale Fund, a fund of public
contributions set up during Nightingale's time in the Crimea and had
raised a total of 50,000. It was based around two
principles. Firstly that the nurses should have practical training in
hospitals specially organised for that purpose. The other was that the
nurses should live in a home fit to form a moral life and discipline.
Due to the foundation of this school Nightingale had achieved the transformation
of nursing from its disreputable past into a responsible and respectable
career for women. Nightingale responded to the British war office's
request for advice on army medical care in Canada and was also a consultant
to the United States government on army health during the American Civil
War.
For most of the remainder of her life
Nightingale was bedridden due to an illness contracted in the Crimea,
which prevented her from continuing her own work as a nurse. This illness
did not stop her, however, campaigning to improve health standards;
she published 200 books, reports and pamphlets. One of these publications
was a book entitled Notes on Nursing (1860). This was the first
textbook specifically for use in the teaching of nurses and was translated
into many languages. Nightingale's other published works included Notes
on Hospitals (1859) and Notes on Nursing for the Labouring Classes
(1861). deeply believed that her work had been her calling from God.
In 1874 she became an honorary member of the American Statistical Association and in 1883 Queen
Victoria awarded Nightingale the Royal Red Cross for her work. She also
became the first woman to receive the Order of Merit from Edward VII
in 1907.
Nightingale died on 13 August 1910
aged 90. She is buried at St Margaret's Church, East Wellow, near Embley
Park. Nightingale never married, although this was not from lack of
opportunity. She believed, however, that God had decided she was one
whom he:-
... had clearly marked out ... to
be a single woman.
The Crimean Monument, erected in 1915
in Waterloo Place, London, was done so in honour of the contribution
had made to this war and the health of the army.