A Conversation With Florence Nightingale

Apr 24, 2019

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The very first requirement in a hospital is that it should do the sick no harm.

Florence Nightingale

Florence Nightingale (May 12, 1820-Aug. 13, 1910) was an English social reformer, statistician and the founder of modern nursing. Born in Florence, Italy, into a wealthy family, she defied the expectations of the time and pursued what she called her “God-given calling” of nursing. Determined to practice her true calling despite her parents’ objections, Nightingale eventually enrolled as a nursing student at the Institution of Protestant Deaconesses in Kaiserswerth, Germany, from 1850-1851. Nightingale came to prominence during the Crimean War while serving as a manager of nurses trained by her, where she organized the tending to wounded soldiers. She improved the reputation of nursing and became an icon of Victorian culture, especially as “The Lady with the Lamp,” making the rounds of wounded soldiers at night.

To honor her service, Queen Victoria presented Nightingale with an engraved brooch (now known as the “Nightingale Jewel”). A “Nightingale Fund” was also established at this time, raising £45,000 (equivalent to 4.5 million in current dollars) through private donations. She used the money to further her cause, funding the establishment of St. Thomas’ Hospital and, within it, the Nightingale Training School for Nurses. Nightingale was a beloved public figure, with poems, songs and plays written in her honor and young women aspiring to be like her. Even women from the wealthy upper classes began enrolling at Nightingale’s school. Because of her efforts, nursing was no longer frowned upon as an occupation. In fact, it had begun to be considered an honorable vocation.

What in particular do you owe your success to?

I attribute my success to this: I never gave or took any excuse. So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself.

You worked mostly with English patients. Was there anything exceptional about working with them?

The only English patients I have ever known to refuse tea have been typhus cases; and the first sign of their getting better was their craving again for tea.

If you were building a hospital, what is the first requirement you would have?

The very first requirement in a hospital is that it should do the sick no harm.

Do you have a motto you live by?

Rather, 10 times, die in the surf, heralding the way to a new world, than stand idly on the shore.

You accomplished so much. How was this possible? Weren’t you afraid of failure?

How very little can be done under the spirit of fear. I am of certain convinced that the greatest heroes are those who do their duty in the daily grind of domestic affairs whilst the world whirls as a maddening dreidel.

Is there a principle or statement that helps guide your practice?

Let whoever is in charge keep this simple question in her head (not, ‘how can I always do this right thing myself?), but ‘how can I provide for this right thing to be always done?’

What is nursing to you?

Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the fine arts: I almost said the finest of fine arts.

And what makes a good nurse?

Women should have the true nurse calling, the good of the sick first, the second only the consideration of what is their ‘place’ to do — and that women who want for a housemaid to do this or the charwoman to do that, when the patient is suffering, have not the making of a nurse in them.

That sounds like you’re being a little critical of your fellow nurses. What exactly do you mean?

If a nurse declines to do these kinds of things for her patient, “because it is not her business,” I should say that nursing was not her calling. I have seen surgical “sisters,” women whose hands were worth to them two or three guineas a week, down upon their knees scouring a room or hut, because they thought it otherwise not fit for their patients to go into. I am far from wishing nurses to scour. It is a waste of power. But I do say that these women had the true nurse-calling — the good of their sick first, and second only the consideration what it was their “place” to do — and that women who wait for the housemaid to do this, or for the charwoman to do that, when their patients are suffering, have not the making of a nurse in them.

When you received the call asking for your service in the war, why did you go?

I did not think of going to give myself a position, but for the sake of common humanity.

You treated a lot of wounded soldiers. What did that teach you?

What the horrors of war are, no one can imagine. They are not wounds and blood and fever, spotted and low, or dysentery, chronic and acute, cold and heat and famine. They are intoxication, drunken brutality, demoralization and disorder on the part of the inferior … jealousies, meanness, indifference, selfish brutality on the part of the superior.

You were one of the first to embrace data collection and statistics to support your theories or conclusions. Why?

I collected my figures with a purpose in mind, with the idea that they could be used to argue for change. Of what use are statistics if we do not know what to make of them? What we wanted at that time was not so much an accumulation of facts, as to teach the men who are to govern the country the use of statistical facts.

And what did you learn?

In watching diseases, both in private houses and in public hospitals, the thing which strikes the experienced observer most forcibly is this, that the symptoms or the sufferings generally considered to be inevitable and incident to the disease are very often not symptoms of the disease at all, but of something quite different — of the want of fresh air, or of light, or of warmth, or of quiet, or of cleanliness, or of punctuality and care in the administration of diet, of each or of all these. And this quite as much in private as in the hospital nursing. The reparative process which Nature has instituted and which we call disease has been hindered by some want of knowledge or attention, in one or in all of these things, and pain, suffering or interruption of the whole process sets in. If the patient is cold, if the patient is feverish, if the patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault not of the disease, but of the nursing.

You wrote more than 200 books, pamphlets and articles, yet you claim you are not a big fan of writing. Why?

I think one’s feelings waste themselves in words; they ought all to be distilled into actions which bring results.

When you reflect on your life, do you have any regrets?

There is no part of my life upon which I can look back without pain.

Finally, what do you say about your life, and what you were able to accomplish?

If I could give you information on my life it would be to show how a woman of very ordinary ability has been led by God in strange and unaccustomed paths to do in His service what He has done in her. And if I could tell you all, you would see how God has done all, and I nothing. I have worked hard, very hard, that is all; and I have never refused God anything.

Resources on Florence Nightingale

Florence Nightingale Museum in London

National Women’s History Museum

Florence Nightingale: Saving Lives With Statistics

Florence Nightingale: The National Archives

Florence Nightingale: Biography.com