Nightingale, Florence

born May 12, 1820, Florence, Italy

died Aug. 13, 1910, London, Eng.

Italian-born British nurse, founder of trained nursing as a profession.

As a volunteer nurse, she was put in charge of nursing the military in Turkey during the Crimean War. Her first concern was sanitation: patients' quarters were infested with rats and fleas, and the water allowance was one pint per head per day for all purposes. She used her own finances to purchase supplies. She also spent many hours in the wards; her night rounds giving personal care to the wounded established her image as the "Lady with the Lamp." Her efforts to improve soldiers' welfare led to the Army Medical School and a Sanitary Department in India. She started the first scientifically based nursing school, was instrumental in setting up training for midwives and nurses in workhouse infirmaries, and helped reform workhouses. She was the first woman awarded the Order of Merit (1907).

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▪ English nurse

byname  Lady of the Lamp  

born May 12, 1820, Florence, Italy

died August 13, 1910, London, England

 English nurse and the founder of trained nursing as a profession. In 1854–56, during the Crimean War, she was in charge of nursing in the military hospitals at Scutari, Turkey, where she coped with conditions of crowding, inadequate sanitation, and shortage of basic necessities. In 1860 she established in London the Nightingale School for Nurses, the first such in the world.

      The second daughter of William Edward Nightingale (originally Shore) and Frances (Fanny) Smith, Florence was named after her birthplace, where her well-to-do parents were temporarily resident. She grew up in Derbyshire, Hampshire, and London, where her family maintained comfortable homes. She was educated largely by her father, who taught her Greek, Latin, French, German, Italian, history, philosophy, and mathematics. Throughout her life she read widely in many languages. Social life was generally unsatisfying for Nightingale. On February 7, 1837, she believed that she heard the voice of God informing her that she had a mission, but it was not until nine years later that she realized what that mission was. Meanwhile, she strove to escape to a life of her own. Her proposal to study nursing at a hospital was scotched. She was then persuaded to study parliamentary reports, and in three years she was regarded by influential friends as an expert on public health and hospitals.

      In 1846 a friend sent Nightingale the Year Book of the Institution of Protestant Deaconesses at Kaiserswerth, Germany, which trained country girls of good character to nurse the sick. Four years later she entered the institution and went through the full course of training as a nurse. In 1853 she was appointed superintendent of the Institution for the Care of Sick Gentlewomen, in London. The changes that she made and her administration were very successful. But she yearned for a wider field; by January 1854 she was referring to the institution as “this little molehill.”

      The Crimean War broke out in March 1854, and the allied British and French armies landed on the Crimea in September. Almost at once the British conscience was dismayed by published graphic reports of the disgraceful conditions suffered by sick and wounded British soldiers. Women were urged to serve as nurses like the French Sisters of Charity. Nightingale volunteered at once to leave in three days for Constantinople, taking three nurses with her. Meanwhile, she was officially approached by her old friend, the then secretary of state at war, Sidney Herbert (later Lord Herbert of Lea), to take out a much larger party of nurses. She was to have complete charge of the nursing in the military hospitals in Turkey (i.e., at Scutari). The party left England on October 21, 1854, and entered the Barrack Hospital at Scutari on November 5.

      On her party's arrival she found that they had no decent facilities whatever. Their quarters were infested with rats and fleas, and the water allowance was one pint per head per day for all purposes. She had to use the provisions brought with her. The doctors were hostile, and at first the nurses were not allowed in the wards. After the Battle of Inkerman (fought on the very day of her arrival) the hospital was soon grossly overcrowded with sick and wounded. Furniture, clothing, and bedding were deficient, and in the corridors men lay on straw palliasses amidst filth caused by inadequate sanitation. Nightingale was then asked to help, and one of her first requisitions was for 200 scrubbing brushes. She next arranged for the patients' filthy clothes to be washed outside the hospital.

      All supplies had completely broken down, but Nightingale had authority to purchase outside the hospital; she had brought £30,000 with her. By the end of the year she was purveying the hospital. She was harassed by the cares of administration, a vast correspondence, and the writing of numerous official and private reports, as well as by the insubordination of her nurses, some of whom had to be sent home because of drunkenness or immorality. She spent many hours a day in the wards, and there was scarcely a man whom she had not personally attended. After 8:00 PM she would allow no woman in the wards except herself. The night nursing—such as it was—was done by convalescent orderlies. Each night, however, she made her rounds, giving comfort and advice and establishing the wounded soldiers' conception of “The Lady with the Lamp.”

      By May 1855 nursing the sick had become her secondary interest, and her prime concern now was the welfare of the British Army. She now transferred herself and some of her nurses to the Crimea, and on landing at Balaklava she was very ill with Crimean fever. Then her opponent, the inspector general of hospitals, contended that she had authority only at Scutari and none in the Crimea. It was not until March 16, 1856, that her position as general superintendent of the Female Nursing Establishment of the Military Hospitals of the Army was confirmed in general orders.

      Shortly after the last patient left the Barrack Hospital, Nightingale sailed for England, where she had long been a national hero. But she refused official transport home and every kind of public reception. Nightingale returned home determined to destroy her popular image and to inaugurate official action to improve the health, living conditions, and food of the British soldier. In the first she succeeded extraordinarily well. In the second she encountered difficulties, as the important men regarded her scheme tolerantly but without enthusiasm. In October 1856, however, she had a long interview with Queen Victoria, the Prince Consort, and Lord Panmure, Herbert's successor. She later had a private interview with the Queen, and Panmure promised a royal commission.

      The Royal Commission on the Health of the Army was appointed in May 1857. Nightingale gave extensive evidence and compiled an immense confidential report, covering the whole field of army medical and hospital administration, which was later privately printed as her Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army (1858). One consequence of the commission's activities was the foundation of the Army Medical School in 1857. The Indian Mutiny in the same year turned Nightingale's interest to the health of the army in India, and for that purpose another royal commission was appointed in 1859. This resulted in 1868 in the establishment of a Sanitary Department in the India Office with supreme authority in India.

      Meanwhile, Nightingale had been engaged in other pioneering activities. In 1860 she used the Nightingale Fund of £45,000, subscribed by the public to commemorate her Crimean work, to establish at St. Thomas's Hospital the Nightingale School for Nurses—the first of its kind in the world. Within a few years she was largely instrumental in inaugurating training for midwives and for nurses in workhouse infirmaries, and she played a part in the reform of workhouses. All these works were accomplished by a woman generally supposed to have died. From 1857 Nightingale had lived, mainly in London, as an invalid. Her correspondence was enormous. Lying on her couch year after year, she received innumerable visitors, from the highest to the humblest, and few came who did not give information or receive it. Although she had never been to India, she was an acknowledged master of most things Indian, and successive viceroys consulted her before assuming their offices. She drove her influential friends to obtain for her those things that she felt her cause needed. When Sidney Herbert, a dying man, was forced to discontinue his active cooperation in their work, she sent him a very cruel letter.

      It has never been shown that Nightingale had any organic illness; her invalidism may have been partly neurotic and partly intentional. By this apparent stratagem she was able to devote herself night and day to the task at hand. Her sight gradually failed, until in 1901 she became completely blind. In 1907 the king conferred on her the Order of Merit—the first woman ever to receive it. Nightingale died in 1910. The offer of a national funeral and burial in Westminster Abbey was, by her wish, declined.

E. Ashworth Underwood

Additional Reading

Nightingale's life and influence are recounted in Edward Cook, The Life of Florence Nightingale, 2 vol. (1913, reissued in 1 vol., 1942); Cecil Woodham-Smith, Florence Nightingale, 1820–1910 (1950, reprinted 1983), a full and well-written modern biography; F.B. Smith, Florence Nightingale: Reputation and Power (1982); and Monica E. Baly, Florence Nightingale and the Nursing Legacy: Building the Foundations of Modern Nursing & Midwifery, 2nd ed. (1986). A selection of Nightingale's correspondence has been collected in Sue M. Goldie (ed.), “I Have Done My Duty”: Florence Nightingale in the Crimean War, 1854–56 (1987, reissued as Florence Nightingale: Letters from the Crimea, 1854–1856, 1997).

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