(18 2 0-1910)
Reformer of the British army medical service. Popularly known as "the Lady with the Lamp," Florence Nightingale was throughout her long life an active campaigner for high standards of military and civilian nursing and improved conditions in the hospitals of the British Army. She is best known for her tireless work during the Crimean War (1854-1856), during which she made the British public aware of the ghastly conditions facing the sick and wounded troops, and exposed numerous weaknesses within the army medical services. In the face of entrenched attitudes and deep-seated inertia, Nightingale imposed order out of chaos, filth, and needless deprivation through a new regime of cleanliness, strict standards of hygiene, and regular hot meals for patients.
In May 1951 the East German Communist regime renamed Prinz-Abrecht-Strasse—the former location of the Gestapo headquarters— Niederkirchner Strasse.
Through personal example and in the face of determined opposition from conservative officialdom, Nightingale displayed a remarkable flair for organization, eventually establishing nursing as a respectable vocation based on sound principles of hygiene, domestic science, and methodical care. Her work became the stuff of legend even before the war had ended. Although she antagonized many doctors, nurses, and government officials, she was venerated by the troops, and the public and press at home.
Nightingale was born into a wealthy Derbyshire family, which she shocked by her desire to enter nursing, work widely viewed as the preserve of disreputable, ignorant, and frequently drunk women from the lowest classes. Intelligent and well-connected both professionally and socially, Nightingale defied prevailing attitudes and educated herself about public administration and statistics. She inspected hospitals in Britain, studied government reports on health, and worked in several hospitals in France and Germany. As a result of her experience, and her personal friendship with Secretary of War Sidney Herbert, Nightingale was, in October 1854, dispatched with a party of thirty-eight nurses to Turkey to take charge of the Barrack Hospital at Scutari, on the opposite side of the Bosphorus from Constantinople.
She arrived just after the Battle of Inkerman and found appalling conditions of filth, starvation, infection, and an acute shortage of even the most basic amenities. There were few orderlies; clothes, utensils, beds and bedding, soap, medical equipment, and drugs were almost entirely absent. Even food and water were in short supply. Undaunted, Nightingale immediately set about using the large sums of money raised by public subscription through the Times (London) relief fund for the sick and wounded, gifts from friends, and even her own resources, to buy all manner of supplies.
The urgent need for cleanliness and proper hygiene was equally apparent. Overflowing sewers, blocked privies, and the human excrement that covered the floors were not merely responsible for an unearthly stench but also for the production of noxious fumes that caused widespread illness among men already weakened by other ailments such as cholera and dysentery, or by wounds.
Nightingale discovered hundreds of men infested with vermin, laid out in rows on filthy floors and denied even basic attention, sometimes for days at a time. Those orderlies who were in evidence showed little compassion and practiced a good deal of roughness. Worse still, many of the doctors, overworked and understaffed, looked on Nightingale’s arrival with suspicion and sometimes scarcely veiled hostility.
Run the "Appointed Course"
"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."
—Florence Nightingale,
letter published in the Englishwoman’s Review, January, 1869.
Yet with patient numbers constantly on the rise, doctors became utterly overwhelmed and were obliged to tolerate the services of her staff.
Under her management—at times overbearing and acerbic—Nightingale had the wards repaired, cleaned, and properly equipped. She instituted a regime for the regular washing of patients’ clothes and bedding with soap and warm water—a service previously unavailable. She had boilers installed and established a scheme to pay soldiers’ wives to launder clothes and dressings, and she had the kitchen service placed on a proper footing, with a system for feeding invalids who had previously gone without food for days at a time.
Florence Nightingale.
Within eight weeks of her arrival the immediate crisis had passed, thanks to the Herculean efforts of Nightingale and her staff. Her transformation of a virtual charnel house brought a radical reduction in the hitherto staggering mortality rate. The eventual arrival of four different commissions sent out by the government to investigate the scandalous conditions under which soldiers lived and died further reduced the death toll. Nightingale was not alone in reporting the shocking conditions of the military hospitals. Soldiers’ letters and the dispatches of journalist William Howard Russell supported her findings. Many people admired the Christian zeal that underpinned Nightingale’s work, though Elizabeth Gaskell referred unflatteringly to her "visible march to heaven" (Uglow 1993, 365), emphasizing Nightingale’s championing of great causes over the cultivation of good relations with individuals.
Nightingale was forced to fight not only disease and squalor, but also the complacent, inefficient, and at times, corrupt officials in the medical services, the commissariat, and other departments. She walked miles a day up and down the wards, functioning with a minimum of sleep; yet, in addition to her ordinary administrative duties at Scutari, she was still able to write lengthy letters to the War Office and other government departments in London in her campaign to improve the soldiers’ lot. So relentless were her efforts that she nearly died of fever in June 1855.
For the remainder of her long life, Nightingale devoted herself to the reformation and reorganization of the army medical service, thus securing for herself a place in the pantheon of great Victorians. In 1860 she founded a nursing school at St. Thomas’s Hospital in London. In 1881 an Army Nursing Service was formed. Three years later the Army Nursing Reserve was created, and by the time of the Boer War (1899-1902) female nurses were a well-established component of the British Army, both on campaign and at home. Nightingale’s legacy continues today, and she is justly credited as the founder of modern nursing.
