Tuesday, September 12, 2017

Florence Nightingale


Florence Nightingale,12 May 1820 – 13 August 1910 was an English social reformer and statistician, and the founder of modern nursing. She came to prominence while serving as a manager of nurses trained by her during the Crimean War, where she organised the tending to wounded soldiers.She gave nursing a highly favourable reputation and became an icon of Victorian culture, especially in the persona of "The Lady with the Lamp" making rounds of wounded soldiers at night.Some recent commentators have asserted Nightingale's achievements in the Crimean War were exaggerated by the media at the time, to satisfy the public's need for a hero.Nevertheless, critics agree on the decisive importance of her follow-up achievements in professionalising nursing roles for women. In 1860, Nightingale laid the foundation of professional nursing with the establishment of her nursing school at St Thomas' Hospital in London. It was the first secular nursing school in the world, now part of King's College London. In recognition of her pioneering work in nursing, the Nightingale Pledge taken by new nurses, and the Florence Nightingale Medal, the highest international distinction a nurse can achieve, were named in her honour, and the annual International Nurses Day is celebrated around the world on her birthday. Her social reforms include improving healthcare for all sections of British society, advocating better hunger relief in India, helping to abolish prostitution laws that were over-harsh to women, and expanding the acceptable forms of female participation in the workforce. Nightingale was a prodigious and versatile writer. In her lifetime, much of her published work was concerned with spreading medical knowledge. Some of her tracts were written in simple English so that they could easily be understood by those with poor literary skills. She also helped popularise the graphical presentation of statistical data. Much of her writing, including her extensive work on religion and mysticism, has only been published posthumously.Florence Nightingale was born on 12 May 1820 into a rich, upper-class, well-connected British family at the Villa Colombaia, in Florence, Italy, and was named after the city of her birth. Florence's older sister Frances Parthenope had similarly been named after her place of birth, Parthenope, a Greek settlement now part of the city of Naples. The family moved back to England in 1821, with Nightingale being brought up in the family's homes at Embley, Hampshire and Lea Hurst, Derbyshire.Her parents were William Edward Nightingale, born William Edward Shore (1794–1874) and Frances ("Fanny") Nightingale née Smith (1789–1880). William's mother Mary née Evans was the niece of Peter Nightingale, under the terms of whose will William inherited his estate at Lea Hurst, and assumed the name and arms of Nightingale. Fanny's father (Florence's maternal grandfather) was the abolitionist and Unitarian William Smith.Nightingale's father educated her.
In 1838, her father took the family on a tour in Europe where he was introduced to the English-born Parisian hostess Mary Clarke, with whom Florence bonded. She recorded that "Clarkey" was a stimulating hostess who did not care for her appearance, and while her ideas did not always agree with those of her guests, "she was incapable of boring anyone." Her behaviour was said to be exasperating and eccentric and she had no respect for upper-class British women, whom she regarded generally as inconsequential. She said that if given the choice between being a woman or a galley slave, then she would choose the freedom of the galleys. She generally rejected female company and spent her time with male intellectuals. However, Clarkey made an exception in the case of the Nightingale family and Florence in particular. She and Florence were to remain close friends for 40 years despite their 27-year age difference. Clarke demonstrated that women could be equals to men, an idea that Florence had not obtained from her mother.Nightingale underwent the first of several experiences that she believed were calls from God in February 1837 while at Embley Park, prompting a strong desire to devote her life to the service of others. In her youth she was respectful of her family's opposition to her working as a nurse, only announcing her decision to enter the field in 1844. Despite the intense anger and distress of her mother and sister, she rebelled against the expected role for a woman of her status to become a wife and mother. Nightingale worked hard to educate herself in the art and science of nursing, in the face of opposition from her family and the restrictive social code for affluent young English women.As a young woman, Nightingale was described as attractive, slender and graceful. While her demeanour was often severe, she was said to be very charming and possess a radiant smile. Her most persistent suitor was the politician and poet Richard Monckton Milnes, but after a nine-year courtship she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing.In Rome in 1847, she met Sidney Herbert, a politician who had been Secretary at War (1845–1846) who was on his honeymoon. He and Nightingale became lifelong close friends. Herbert would be Secretary of War again during the Crimean War, when he and his wife would be instrumental in facilitating Nightingale's nursing work in the Crimea. She became Herbert's key adviser throughout his political career, though she was accused by some of having hastened Herbert's death from Bright's Disease in 1861 because of the pressure her programme of reform placed on him. Nightingale also much later had strong relations with academic Benjamin Jowett, who may have wanted to marry her.
Nightingale continued her travels (now with Charles and Selina Bracebridge) as far as Greece and Egypt. Her writings on Egypt in particular are testimony to her learning, literary skill and philosophy of life. Sailing up the Nile as far as Abu Simbel in January 1850, she wrote of the Abu Simbel temples, "Sublime in the highest style of intellectual beauty, intellect without effort, without suffering … not a feature is correct but the whole effect is more expressive of spiritual grandeur than anything I could have imagined. It makes the impression upon one that thousands of voices do, uniting in one unanimous simultaneous feeling of enthusiasm or emotion, which is said to overcome the strongest man."At Thebes, she wrote of being "called to God", while a week later near Cairo she wrote in her diary (as distinct from her far longer letters that her elder sister Parthenope was to print after her return): "God called me in the morning and asked me would I do good for him alone without reputation."Later in 1850, she visited the Lutheran religious community at Kaiserswerth-am-Rhein in Germany, 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.She also received four months of medical training at the institute, which formed the basis for her later care. 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.
In the Crimea on 29 November 1855, the Nightingale Fund was established for the training of nurses during a public meeting to recognise Nightingale for her work in the war. 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 1856 letters describing spas in the Ottoman Empire. She detailed the health conditions, physical descriptions, dietary information, and other vital details of patients whom she directed there. The treatment there was significantly less expensive than in Switzerland.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. The first trained Nightingale nurses began work on 16 May 1865 at the Liverpool Workhouse Infirmary. Now called the Florence Nightingale School of Nursing and Midwifery, the school is part of King's College London. She also campaigned and raised funds for the Royal Buckinghamshire Hospital in Aylesbury near her sister's home, Claydon House. Nightingale wrote Notes on Nursing (1859). The book served as the cornerstone of the curriculum at the Nightingale School and other nursing schools, though it was written specifically for the education of those nursing at home. Nightingale wrote "Every day sanitary knowledge, or the knowledge of nursing, or in other words, of how to put the constitution in such a state as that it will have no disease, or that it can recover from disease, takes a higher place. It is recognised as the knowledge which every one ought to have distinct from medical knowledge, which only a profession can have".Notes on Nursing also sold well to the general reading public and is considered a classic introduction to nursing. Nightingale spent the rest of her life promoting and organising the nursing profession. In the introduction to the 1974 edition, Joan Quixley of the Nightingale School of Nursing wrote: "The book was the first of its kind ever to be written. It appeared at a time when the simple rules of health were only beginning to be known, when its topics were of vital importance not only for the well-being and recovery of patients, when hospitals were riddled with infection, when nurses were still mainly regarded as ignorant, uneducated persons. The book has, inevitably, its place in the history of nursing, for it was written by the founder of modern nursing".As Mark Bostridge has demonstrated, one of Nightingale's signal achievements was the introduction of trained nurses into the workhouse system in Britain from the 1860s onwards.This meant that sick paupers were no longer being cared for by other, able-bodied paupers, but by properly trained nursing staff. In the first half of the 19th century, nurses were usually former servants or widows who found no other job and therefore were forced to earn their living by this work. Charles Dickens caricatured the standard of care in his 1842–1843 published novel Martin Chuzzlewit in the figure of Sarah Gamp as being incompetent, negligent, alcoholic and corrupt. According to Caroline Worthington, director of the Florence Nightingale Museum, “When she started out there was no such thing as nursing. The Dickens character Sarah Gamp, who was more interested in drinking gin than looking after her patients, was only a mild exaggeration. Hospitals were places of last resort where the floors were laid with straw to soak up the blood. Florence transformed nursing when she got back [from Crimea]. She had access to people in high places and she used it to get things done. Florence was stubborn, opinionated and forthright but she had to be those things in order to achieve all that she did."Though Nightingale is sometimes said to have denied the theory of infection for her entire life, a 2008 biography disagrees,saying that she was simply opposed to a precursor of germ theory known as contagionism. This theory held that diseases could only be transmitted by touch. Before the experiments of the mid 1860s by Pasteur and Lister, hardly anyone took germ theory seriously; even afterwards, many medical practitioners were unconvinced. Bostridge points out that in the early 1880s Nightingale wrote an article for a textbook in which she advocated strict precautions designed, she said, to kill germs. Nightingale's work served as an inspiration for nurses in the American Civil War. The Union government approached her for advice in organising field medicine. Her ideas inspired the volunteer body of the United States Sanitary Commission.In the 1870s, Nightingale mentored Linda Richards, "America's first trained nurse", and enabled her to return to the United States with adequate training and knowledge to establish high-quality nursing schools.Richards went on to become a nursing pioneer in the US and Japan.By 1882, several Nightingale nurses had become matrons at several leading hospitals, including, in London (St Mary's Hospital, Westminster Hospital, St Marylebone Workhouse Infirmary and the Hospital for Incurables at Putney) and throughout Britain (Royal Victoria Hospital, Netley; Edinburgh Royal Infirmary; Cumberland Infirmary and Liverpool Royal Infirmary), as well as at Sydney Hospital in New South Wales, Australia. In 1883, Nightingale became the first recipient of the Royal Red Cross. In 1904, she was appointed a Lady of Grace of the Order of St John (LGStJ).In 1907, she became the first woman to be awarded the Order of Merit.In the following year she was given the Honorary Freedom of the City of London. Her birthday is now celebrated as International CFS Awareness Day.From 1857 onwards, Nightingale was intermittently bedridden and suffered from depression. A recent biography cites brucellosis and associated spondylitis as the cause.Most authorities today accept that Nightingale suffered from a particularly extreme form of brucellosis, the effects of which only began to lift in the early 1880s. Despite her symptoms, she remained phenomenally productive in social reform. 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. Nightingale's output slowed down considerably in her last decade. She wrote very little during that period due to blindness and declining mental abilities, though she still retained an interest in current affairs.

LEGACY:

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 first official nurses' training programme, her Nightingale School for Nurses, opened in 1860 and is now called the Florence Nightingale Faculty of Nursing and Midwifery at King's College London.In 1912, the International Committee of the Red Cross instituted the Florence Nightingale Medal, which is awarded every two years to nurses or nursing aides for outstanding service.It is the highest international distinction a nurse can achieve and is awarded to nurses or nursing aides for "exceptional courage and devotion to the wounded, sick or disabled or to civilian victims of a conflict or disaster" or "exemplary services or a creative and pioneering spirit in the areas of public health or nursing education".Since 1965, International Nurses Day has been celebrated on her birthday (12 May) each year.The President of India honours nursing professionals with the "National Florence Nightingale Award" every year on International Nurses Day.The award, established in 1973, is given in recognition of meritorious services of nursing professionals characterised by devotion, sincerity, dedication and compassion.The Nightingale Pledge is a modified version of the Hippocratic Oath which nurses recite at their pinning ceremony at the end of training.Created in 1893 and named after Nightingale as the founder of modern nursing, the pledge is a statement of the ethics and principles of the nursing profession.The Florence Nightingale Declaration Campaign,established by nursing leaders throughout the world through the Nightingale Initiative for Global Health (NIGH), aims to build a global grassroots movement to achieve two United Nations Resolutions for adoption by the UN General Assembly of 2008. They will declare: The International Year of the Nurse 2010 (the centenary of Nightingale's death); The UN Decade for a Healthy World 2011 to 2020 (the bicentenary of Nightingale's birth). NIGH also works to rekindle awareness about the important issues highlighted by Florence Nightingale, such as preventive medicine and holistic health. As of 2016, the Florence Nightingale Declaration has been signed by over 25,000 signatories from 106 countries.During the Vietnam War, Nightingale inspired many US Army nurses, sparking a renewal of interest in her life and work. Her admirers include Country Joe of Country Joe and the Fish, who has assembled an extensive website in her honour.The Agostino Gemelli Medical School in Rome, the first university-based hospital in Italy and one of its most respected medical centres, honoured Nightingale's contribution to the nursing profession by giving the name "Bedside Florence" to a wireless computer system it developed to assist nursing.
Four hospitals in Istanbul are named after Nightingale: Florence Nightingale Hospital in Şişli (the biggest private hospital in Turkey), Metropolitan Florence Nightingale Hospital in Gayrettepe, European Florence Nightingale Hospital in Mecidiyeköy, and Kızıltoprak Florence Nightingale Hospital in Kadiköy, all belonging to the Turkish Cardiology Foundation.An appeal is being considered for the former Derbyshire Royal Infirmary hospital in Derby, England to be named after Nightingale. The suggested new name will be either Nightingale Community Hospital or Florence Nightingale Community Hospital. The area in which the hospital lies in Derby has recently been referred to as the "Nightingale Quarter".
A statue of Florence Nightingale stands in Waterloo Place, Westminster, London, just off The Mall. There are three statues of Nightingale in Derby one outside the London Road Community Hospital formerly known as the Derbyshire Royal Infirmary (DRI), one in St Peter's Street, and one above the Nightingale-Macmillan Continuing Care Unit opposite the Derbyshire Royal Infirmary. A public house named after her stands close to the DRI. The Nightingale-Macmillan continuing care unit is now at the Royal Derby Hospital, formerly known as The City Hospital, Derby. A stained glass window was commissioned for inclusion in the Derbyshire Royal Infirmary chapel in the late 1950s. When the chapel was demolished the window was removed and installed in the replacement chapel. At the closure of the DRI the window was again removed and stored. In October 2010, £6,000 was raised to reposition the window in St Peter's Church, Derby. The work features nine panels, of the original ten, depicting scenes of hospital life, Derby townscapes and Nightingale herself. Some of the work was damaged and the tenth panel was dismantled for the glass to be used in repair of the remaining panels. All the figures, who are said to be modelled on prominent Derby town figures of the early sixties, surround and praise a central pane of the triumphant Christ. A nurse who posed for the top right panel in 1959 attended the rededication service in October 2010.The Florence Nightingale Museum at St Thomas' Hospital in London reopened in May 2010 in time for the centenary of Nightingale's death.Another museum devoted to her is at her sister's family home, Claydon House, now a property of the National Trust. Upon the centenary of Nightingale's death in 2010, and to commemorate her connection with Malvern, the Malvern Museum held a Florence Nightingale exhibit with a school poster competition to promote some events.In Istanbul, the northernmost tower of the Selimiye Barracks building is now the Florence Nightingale Museum.and in several of its rooms, relics and reproductions related to Florence Nightingale and her nurses are on exhibition.When Nightingale moved on to the Crimea itself in May 1855, she often travelled on horseback to make hospital inspections. She later transferred to a mule cart and was reported to have escaped serious injury when the cart was toppled in an accident. Following this, she used a solid Russian-built carriage, with a waterproof hood and curtains. The carriage was returned to England by Alexis Soyer after the war and subsequently given to the Nightingale training school. The carriage was damaged when the hospital was bombed during the Second World War. It was restored and transferred to the Army Medical Services Museum, now in Mytchett, Surrey, near Aldershot. A bronze plaque, attached to the plinth of the Crimean Memorial in the Haydarpaşa Cemetery, Istanbul, Turkey and unveiled on Empire Day, 1954, to celebrate the 100th anniversary of her nursing service in that region, bears the inscription: "To Florence Nightingale, whose work near this Cemetery a century ago relieved much human suffering and laid the foundations for the nursing profession."Other monuments of Nightingale include a statue at Chiba University in Chiba, Japan, and a bust at Tarlac State University, Tarlac City, Philippines.

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