Florence Nightingale, OM, RRC; 12 May 1820 - 13 August 1910), who came to be known as "The Lady with the Lamp", was a pioneering nurse, writer and noted statistician.
Florence Nightingale was born into a well-connected British family at the Villa Colombaia, Florence, Grand Duchy of Tuscany, and was named after the city of her birth.
Florence's older sister Parthenope had similarly been named after her place of birth, a Greek settlement now part of the city of Naples.
Her parents were William Edward Nightingale (1794-1874) and Frances ("Fanny") Nightingale née Smith (1789-1880). William Nightingale was born William Edward Shore. His mother Mary née Evans was the niece of one Peter Nightingale, under the terms of whose will William Shore not only inherited his estate Lea Hurst in Derbyshire, but also assumed the name and arms of Nightingale. Fanny's father (Florence's maternal grandfather) was the abolitionist William Smith. Inspired by what she took as a Christian divine calling, experienced first in 1837 at Embley Park and later throughout her life, Florence announced her decision to enter nursing in 1845, despite the intense anger and distress of her family, particularly her mother. Nightingale worked hard to educate herself in the art and science of nursing, in spite of opposition from her family and the restrictive societal code for affluent young English women. She cared for people in poverty. In December 1844, she became the leading advocate for improved medical care in the infirmaries and immediately engaged the support of Charles Villiers, then 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. She was later instrumental in mentoring and then sending Agnes Elizabeth Jones and other Nightingale Probationers to Liverpool Workhouse Infirmary. Nightingale was courted by politician and poet Richard Monckton Milnes, 1st Baron Houghton, but she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing. When in Rome in 1847, recovering from a mental breakdown precipitated by a continuing crisis of her relationship with Milnes, she met Sidney Herbert, a brilliant politician who had been Secretary at War (1845-1846), a position he would hold again during the Crimean War. Herbert was already married, but he and Nightingale were immediately attracted to each other and they became lifelong close friends. Herbert was instrumental in facilitating her pioneering work in the Crimea and in the field of nursing, and she became a key adviser to him in his political career. In 1851, she rejected Milnes' marriage proposal, against her mother's wishes. Nightingale also had strong and intimate relations with Benjamin Jowett, particularly about the time that she was considering leaving money in her will to establish a Chair in Applied Statistics at the University of Oxford.
Nightingale continued her travels with Charles and Selina Bracebridge as far as Greece and Egypt. Her writings on Egypt in particular are fascinating testimony to her learning, literary skill and philosophy of life. She sailed up the Nile as far as Abu Simbel in January 1850. At Thebes she wrote of being "called to God". Later in 1850, she visited the Lutheran religious community at Kaiserswerth-am-Rhein where she observed Pastor Theodor 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.
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. Her father had given her an annual income of £500, which allowed her to live comfortably and to pursue her career.
Florence Nightingale's most famous contribution came during the Crimean War, which became her central focus when reports began to filter back to Britain about the horrific conditions for the wounded. On 21 October 1854, she and a staff of 38 women volunteer nurses, trained by Nightingale and including her aunt Mai Smith, were sent (under the authorization of Sidney Herbert) to Turkey, about 545 km across the Black Sea from Balaklava in the Crimea, where the main British camp was based. Nightingale arrived early in November 1854 at Selimiye Barracks in Scutari (modern-day Üsküdar in Istanbul). She and her nurses found wounded soldiers being badly cared for 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.
The death count was the highest of all hospitals in the region. During her first winter at Scutari, 4,077 soldiers died there. Ten times more soldiers died from illnesses such as typhus, typhoid, cholera and dysentery than from battle wounds. Conditions at the temporary barracks hospital were so fatal to the patients because of overcrowding and the hospital's defective sewers and lack of ventilation. A Sanitary Commission had to be sent out by the British government to Scutari in March 1855, almost six months after Florence Nightingale had arrived, and effected flushing out the sewers and improvements to ventilation. Death rates were sharply reduced. It is directly through her thorough observations that the association linking sanitary conditions and healing became recognized and established. Within 6 months of her arrival in Scutari, the mortality rate dropped from 42.7 percent to 2.2 percent. Florence insisted on adequate lighting, diet, hygiene, and activity.
Nightingale continued believing the death rates were due to poor nutrition and supplies and overworking of the soldiers. It was not until after she returned to Britain and began collecting evidence before the Royal Commission on the Health of the Army that she came to believe that most of the soldiers at the hospital were killed by poor living conditions. This experience influenced her later career, when she advocated sanitary living conditions as of great importance. Consequently, she reduced deaths in the army during peacetime and turned attention to the sanitary design of hospitals.
During the Crimean campaign, Florence Nightingale gained the nickname "The Lady with the Lamp", deriving from a phrase in a report in The Times.
Nightingale returned to Britain a heroine on 7 August 1856, and, according to the BBC, was arguably the most famous Victorian after Queen Victoria herself. Nightingale moved from her family home in Middle Claydon, Buckinghamshire, to the Burlington Hotel in Piccadilly, where she was stricken by a fever, probably due to a chronic form of brucellosis ("Crimean fever") that she contracted during the Crimean war. She barred her mother and sister from her room and rarely left it. In response to an invitation from Queen Victoria and despite the limitations of confinement to her room Nightingale played the central role in the establishment of the Royal Commission on the Health of the Army, of which Sidney Herbert became chairman. Nightingale wrote the commission's 1,000-plus page report, that included detailed statistical reports, and she was instrumental in the implementation of its recommendations. The report led to a major overhaul of army military care, and to the establishment of an Army Medical School and of a comprehensive system of army medical records.
While she was still in Turkey, on 29 November 1855, a public meeting to give recognition to Florence Nightingale for her work in the war led to the establishment of the Nightingale Fund for the training of nurses. There was an outpouring of generous donations. Sidney Herbert served as honorary secretary of the fund, and the Duke of Cambridge was chairman. Nightingale was considered a pioneer in the concept of medical tourism as well, based on her letters from 1856 in which she would write of spas in Turkey detailing the health conditions, physical descriptions, dietary information, and other vitally important details of patients whom she directed there (where treatment was significantly less expensive than in Switzerland). It may be assumed she was directing patients of meagre means to affordable treatment. By 1859 Nightingale had £45,000 at her disposal from the Nightingale Fund to set up the Nightingale Training School at St. Thomas' Hospital on 9 July 1860. (It is now called the Florence Nightingale School of Nursing and Midwifery and is part of King's College London.) The first trained Nightingale nurses began work on 16 May 1865 at the Liverpool Workhouse Infirmary. She also campaigned and raised funds for the Royal Buckinghamshire Hospital in Aylesbury, near her family home. Nightingale wrote Notes on Nursing, which was published in 1860, a slim 136-page book that served as the cornerstone of the curriculum at the Nightingale School and other nursing schools established. Notes on Nursing also sold well to the general reading public and is considered a classic introduction to nursing. Nightingale would spend the rest of her life promoting the establishment and development of the nursing profession and organizing it into its modern form. Nightingale was an advocate for the improvement of care and conditions in the military and civilian hospitals in Britain. Among her popular books are Notes on Hospitals, which deals with the correlation of sanitary techniques to medical facilities; Notes on Nursing, which was the most valued nursing textbook of the day; Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army. Nightingale's work served as an inspiration for nurses in the American Civil War. The Union government approached her for advice in organizing field medicine. Although her ideas met official resistance, they inspired the volunteer body of the United States Sanitary Commission.
In 1869, Nightingale and Dr Elizabeth Blackwell opened the Women's Medical College. In the 1870s, Nightingale mentored Linda Richards, "America's first trained nurse", and enabled her to return to the USA with adequate training and knowledge to establish high-quality nursing schools. By 1882, Nightingale nurses had a growing and influential presence in the embryonic nursing profession. Some had become matrons at several leading hospitals. In 1883, Nightingale was awarded the Royal Red Cross by Queen Victoria. In 1907, she became the first woman to be awarded the Order of Merit. In 1908, she was given the Honourary Freedom of the City of London. By 1896, Florence Nightingale was bedridden. Her birthday is now celebrated as International CFS Awareness Day. During her bedridden years, she also did pioneering work in the field of hospital planning, and her work propagated quickly across Britain and the world.
On 13 August 1910, at the age of 90, she died peacefully in her sleep in her room at 10 South Street, Park Lane. The offer of burial in Westminster Abbey was declined by her relatives, and she is buried in the graveyard at St. Margaret Church in East Wellow, Hampshire.
In her later life Nightingale made a comprehensive statistical study of sanitation in Indian rural life and was the leading figure in the introduction of improved medical care and public health service in India. In 1859 Nightingale was elected the first female member of the Royal Statistical Society and she later became an honorary member of the American Statistical Association.
Suggestions for Thought is also Nightingale's great work of theology, her own theodicy. Nightingale was a Christian universalist.
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The first official nurses training program, the Nightingale School for Nurses, opened in 1860. The mission of the school was to train nurses to work in hospitals, work with the poor, and to teach. Florence Nightingale's lasting contribution has been her role in founding the modern nursing profession. She set an example of compassion, commitment to patient care, and diligent and thoughtful hospital administration. The work of the Nightingale School of Nursing continues today. The Nightingale building in the School of Nursing and Midwifery at the University of Southampton is named after her. International Nurses Day is celebrated on her birthday each year. Four hospitals in Istanbul are named after Nightingale: F. N. Hastanesi in Sisli (the biggest private hospital in Turkey), Metropolitan F.N. Hastanesi in Gayrettepe, Avrupa F.N. Hastanesi in Mecidiyeköy, and Kiziltoprak F.N. Hastanesi in Kadiköy, all belonging to the Turkish Cardiology Foundation. There are many foundations named after Florence Nightingale. Most are nursing foundations, but there is also Nightingale Research Foundation in Canada, dedicated to the study and treatment of chronic fatigue syndrome, which Nightingale is believed to have had.
A statue of Florence Nightingale stands in Waterloo Place, Westminster, London, just off The Mall. There are three statues of Florence Nightingale in Derby - one outside the Derby Royal Infirmary, one in St. Peter's Street, and one above the Nightingale-Macmillan Continuing Care Unit opposite the Derby Royal Infirmary. A public house named after her stands close to the Derby Royal Infirmary. There is a Florence Nightingale Museum in London and another museum devoted to her at her sister's family home, Claydon House, now a property of the National Trust. The northernmost tower of the Selimiye Barracks building is today a museum, and in several of its rooms, relics and reproductions relevant to Florence Nightingale and her nurses are on exhibition. When she first arrived in Turkey, Nightingale would travel on horseback to make inspections. She then transferred to a mule cart and was reported to have escaped serious injury when the cart was toppled in an accident. Following this episode, she used a solid Russian-built carriage, with a waterproof hood and curtains. The carriage was returned to England after the war and subsequently given to the Nightingale training school for nurses, which she founded at St Thomas's Hospital. The carriage was damaged when the hospital was bombed by Nazi Germany during the Second World War. It was later restored and transferred to the Army Medical Services Museum in Mytchett, Surrey, near Aldershot. Florence Nightingale's voice was saved for posterity in a phonograph recording from 1890 preserved in the British Library Sound Archive.
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