The Lady with the Lamp: Florence Nightingale
Florence Nightingale (1820-1910), known as “The Lady With the Lamp,” was a British nurse, social reformer and statistician best known as the founder of modern nursing. In honour of Florence Nightingale’s birthday, May 12, May 6-12 is celebrated as National Nursing Week.
Her experiences as a nurse during the Crimean War were foundational in her views about sanitation. She established St. Thomas’ Hospital and the Nightingale Training School for Nurses in 1860. Her efforts to reform healthcare greatly influenced the quality of care in the 19 and 20 centuries.
Florence Nightingale: Early Life
Florence Nightingale was born on May 12, 1820, in Florence, Italy to Frances Nightingale and William Shore Nightingale. She was the younger of two children. Nightingale’s affluent British family belonged to elite social circles. Her mother, Frances, hailed from a family of merchants and took pride in socializing with people of prominent social standing. Despite her mother’s interest in social climbing, Florence herself was reportedly awkward in social situations. She preferred to avoid being the center of attention whenever possible. Strong-willed, Florence often butted heads with her mother, whom she viewed as overly controlling. Still, like many daughters, she was eager to please her mother. “I think I am got something more good-natured and complying,” Florence wrote in her own defense, concerning the mother-daughter relationship.
Florence’s father was William Shore Nightingale, a wealthy landowner who had inherited two estates—one at Lea Hurst, Derbyshire, and the other in Hampshire, Embley Park—when Florence was five years old. Florence was raised on the family estate at Lea Hurst, where her father provided her with a classical education, including studies in German, French and Italian.
From a very young age, Florence Nightingale was active in philanthropy, ministering to the ill and poor people in the village neighboring her family’s estate. By the time she was 16 years old, it was clear to her that nursing was her calling. She believed it to be her divine purpose.
When Nightingale approached her parents and told them about her ambitions to become a nurse, they were not pleased. In fact, her parents forbade her to pursue nursing. During the Victorian Era, a young lady of Nightingale’s social stature was expected to marry a man of means—not take up a job that was viewed as lowly menial labor by the upper social classes. When Nightingale was 17 years old, she refused a marriage proposal from a “suitable” gentleman, Richard Monckton Milnes. Nightingale explained her reason for turning him down, saying that while he stimulated her intellectually and romantically, her “moral…active nature…requires satisfaction, and that would not find it in this life.” Determined to pursue her true calling despite her parents’ objections, in 1844, Nightingale enrolled as a nursing student at the Lutheran Hospital of Pastor Fliedner in Kaiserwerth, Germany.
Florence Nightingale and Nursing
In the early 1850s, Nightingale returned to London, where she took a nursing job in a Middlesex hospital for ailing governesses. Her performance there so impressed her employer that Nightingale was promoted to superintendent within just a year of being hired. The position proved challenging as Nightingale grappled with a cholera outbreak and unsanitary conditions conducive to the rapid spread of the disease. Nightingale made it her mission to improve hygiene practices, significantly lowering the death rate at the hospital in the process. The hard work took a toll on her health. She had just barely recovered when the biggest challenge of her nursing career presented itself.
Florence Nightingale and the Crimean War
In October of 1853, the Crimean War broke out. The British Empire was at war against the Russian Empire for control of the Ottoman Empire. Thousands of British soldiers were sent to the Black Sea, where supplies quickly dwindled. By 1854, no fewer than 18,000 soldiers had been admitted into military hospitals.
At the time, there were no female nurses stationed at hospitals in the Crimea. The poor reputation of past female nurses had led the war office to avoid hiring more. But, after the Battle of Alma, England was in an uproar about the neglect of their ill and injured soldiers, who not only lacked sufficient medical attention due to hospitals being horribly understaffed, but also languished in appallingly unsanitary and inhumane conditions.
In late 1854, Nightingale received a letter from Secretary of War Sidney Herbert, asking her to organize a corps of nurses to tend to the sick and fallen soldiers in the Crimea. Nightingale rose to her calling. She quickly assembled a team of 34 nurses from a variety of religious orders and sailed with them to the Crimea just a few days later.
Although they had been warned of the horrid conditions there, nothing could have prepared Nightingale and her nurses for what they saw when they arrived at Scutari, the British base hospital in Constantinople. The hospital sat on top of a large cesspool, which contaminated the water and the hospital building itself. Patients lay on in their own excrement on stretchers strewn throughout the hallways. Rodents and bugs scurried past them. The most basic supplies, such as bandages and soap, grew increasingly scarce as the number of ill and wounded steadily increased. Even water needed to be rationed. More soldiers were dying from infectious diseases like typhoid and cholera than from injuries incurred in battle.
The no-nonsense Nightingale quickly set to work. She procured hundreds of scrub brushes and asked the least infirm patients to scrub the inside of the hospital from floor to ceiling. Nightingale herself spent every waking minute caring for the soldiers. In the evenings she moved through the dark hallways carrying a lamp while making her rounds, ministering to patient after patient. The soldiers, who were both moved and comforted by her endless supply of compassion, took to calling her “the Lady with the Lamp.” Others simply called her “the Angel of the Crimea.” Her work reduced the hospital’s death rate by two-thirds.
In additional to vastly improving the sanitary conditions of the hospital, Nightingale created a number of patient services that contributed to improving the quality of their hospital stay. She instituted the creation of an “invalid’s kitchen” where appealing food for patients with special dietary requirements was cooked. She established a laundry so that patients would have clean linens. She also instituted a classroom and a library for patients’ intellectual stimulation and entertainment. Based on her observations in the Crimea, Nightingale wrote Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army, an 830-page report analyzing her experience and proposing reforms for other military hospitals operating under poor conditions. The book would spark a total restructuring of the War Office’s administrative department, including the establishment of a Royal Commission for the Health of the Army in 1857.
Nightingale remained at Scutari for a year and a half. She left in the summer of 1856, once the Crimean conflict was resolved, and returned to her childhood home at Lea Hurst. To her surprise she was met with a hero’s welcome, which the humble nurse did her best to avoid. The Queen rewarded Nightingale’s work by presenting her with an engraved brooch that came to be known as the “Nightingale Jewel” and by granting her a prize of $250,000 from the British government.
Florence Nightingale, Statistician
With the support of Queen Victoria, Nightingale helped create a Royal Commission into the health of the army. It employed leading statisticians of the day, William Farr and John Sutherland, to analyze army mortality data, and what they found was horrifying: 16,000 of the 18,000 deaths were from preventable diseases—not battle. But it was Nightingale’s ability to translate this data into a new visual format that really caused a sensation. Her polar area diagram, now known as a “Nightingale Rose Diagram,” showed how the Sanitary Commission’s work decreased the death rate and made the complicated data accessible to all, inspiring new standards for sanitation in the army and beyond. She became the first female member of the Royal Statistical Society and was named an honorary member of the American Statistical Association.
Florence Nightingale’s Impact on Nursing
Nightingale decided to use the money to further her cause. In 1860, she funded the establishment of St. Thomas’ Hospital, and within it, the Nightingale Training School for Nurses. Nightingale became a figure of public admiration. Poems, songs and plays were written and dedicated in the heroine’s honor. Young women aspired to be like her. Eager to follow her example, even women from the wealthy upper classes started enrolling at the training school. Thanks to Nightingale, nursing was no longer frowned upon by the upper classes; it had, in fact, come to be viewed as an honorable vocation.
While at Scutari, Nightingale had contracted “Crimean fever” and would never fully recover. By the time she was 38 years old, she was homebound and bedridden, and would be so for the remainder of her life. Fiercely determined and dedicated as ever to improving health care and alleviating patients’ suffering, Nightingale continued her work from her bed.
Residing in Mayfair, she remained an authority and advocate of health care reform, interviewing politicians and welcoming distinguished visitors from her bed. In 1859, she published Notes on Hospitals, which focused on how to properly run civilian hospitals.
Throughout the U.S. Civil War, she was frequently consulted about how to best manage field hospitals. Nightingale also served as an authority on public sanitation issues in India for both the military and civilians, although she had never been to India herself.
In 1908, at the age of 88, she was conferred the merit of honor by King Edward. In May of 1910, she received a congratulatory message from King George on her 90th birthday.
Florence Nightingale: Death and Legacy
In August 1910, Florence Nightingale fell ill, but seemed to recover and was reportedly in good spirits. A week later, on the evening of Friday, August 12, 1910, she developed an array of troubling symptoms. She died unexpectedly at 2 p.m. the following day, Saturday, August 13, 1910, at her home in London.
The Florence Nightingale Museum, which sits at the site of the original Nightingale Training School for Nurses, houses more than 2,000 artifacts commemorating the life and career of the “Angel of the Crimea.” To this day, Florence Nightingale is broadly acknowledged and revered as the pioneer of modern nursing.