nhsManagers.net | Briefing | 27 January 2018 Medicine for Managers Dr Paul Lambden BSc MB BS BDS FDSRCSEng MRCS LRCP DRCOG MHSM FRSM Florence Nightingale Born on May 12 th 1820, she lived until the age of ninety and, of course, she will be forever known as the woman who laid the foundations of modern nursing care and, more sensitively as the ‘Lady with the Lamp’. Florence Nightingale was born into a wealthy British family in Florence, Italy. Her father, who was a landowner in Debryshire, had made his money as a merchant. As she grew up, Florence was expected to play her part in the social activities that her mother and father enjoyed. However, it is said that Florence did not enjoy socialising and, from a young child, developed a wish to become a nurse, fostered as a result of the philanthropy in which she became engaged and underpinned by obedience to God. She cared for elderly and sick people in the village near her parents’ estate. Florence told her parents of her wish to become a nurse when she was a teenager. They expressly forbade her to do so and did all they could to prevent her from taking on such lowly work. In 1849, the 29 year-old refused a marriage proposal, much to the displeasure of her parents but she was determined to enter nursing and in 1850, she applied to do nursing training at Kaiserswerth in Germany. In 1851 she returned to England where she took a post in the Harley Street Hospital as a governess. She rapidly became the superintendent but worked in her spare time at the Middlesex Hospital in Mortimer Street treating patients struck down with cholera. It is said to be during this period that she recognised the insanitary conditions which Medicine for Managers articles are not intended to be a source of medical advice. Their purpose is to familiarise the non-medical reader about current key medical disorders. Any medical or medicinal products mentioned by name are examples only and should not be regarded as an endorsement of their use. I have, over the years, written about Hippocrates, Galen, Pasteur, Koch, Hodgkin, Hunter and Lister, amongst others. They were all great Physicians and Surgeons who shaped healthcare for over two millennia. There are other doctors about whom I have not written and who are equally deserving but, also, there are other professionals and pre-eminent amongst them must be Florence Nightingale.
Transcript
nhsManagers.net | Briefing | 27 January 2018
Medicine for Managers
Dr Paul Lambden BSc MB BS BDS FDSRCSEng MRCS LRCP DRCOG MHSM FRSM
Florence Nightingale
Born on May 12th 1820, she lived until the age of ninety and, of course, she will be forever known as the woman who laid the foundations of modern nursing care and, more sensitively as the ‘Lady with the Lamp’.
Florence Nightingale was born into a wealthy British family in Florence, Italy. Her father, who was a landowner in Debryshire, had made his money as a merchant.
As she grew up, Florence was expected to play her part in the social activities that her mother and father enjoyed.
However, it is said that Florence did not enjoy socialising and, from a young child, developed a wish to become a nurse, fostered as a result of the philanthropy in which she became engaged and underpinned by obedience to God.
She cared for elderly and sick people in the village near her parents’ estate. Florence told her parents of her wish to become a nurse when she was a teenager. They expressly forbade her to do so and did all
they could to prevent her from taking on such lowly work.
In 1849, the 29 year-old refused a marriage proposal, much to the displeasure of her parents but she was determined to enter nursing and in 1850, she applied to do nursing training at Kaiserswerth in Germany.
In 1851 she returned to England where she took a post in the Harley Street Hospital as a governess.
She rapidly became the superintendent but worked in her spare time at the Middlesex Hospital in Mortimer Street treating patients struck down with cholera. It is said to be during this period that she recognised the insanitary conditions which
Medicine for Managers articles are not intended to be a source of medical advice. Their purpose is to familiarise the non-medical reader about current key medical disorders. Any medical or medicinal products mentioned by name are examples only and should not be regarded as an endorsement of their use.
I have, over the years, written about Hippocrates, Galen, Pasteur, Koch, Hodgkin, Hunter and Lister, amongst others. They were all great Physicians and Surgeons who shaped healthcare for over two millennia. There are other doctors about whom I have not written and who are equally deserving but, also, there are other professionals and pre-eminent amongst them must be Florence Nightingale.
promoted the spread of the disease and she set out to improve hygiene.
War broke out in the Crimea in the Autumn of 1853. British and French troops were sent to the Black Sea to fight Russian troops and, by 1854, nearly 20,000 troops had been admitted to military hospitals.
The care of these men was appalling.
The so-called hospitals were grossly understaffed with dreadful unsanitary conditions.
At that time nurses were generally untrained, often elderly, casual and offering little care to the ill in their charge.
In 1854, the Secretary or War wrote to Florence Nightingale asking her to organise a team of nurses to travel to the Crimea to provide nursing care for the ill and injured men.
See put together a group of thirty-eight nurses and set sail within a few days. On her arrival at the military hospital at Scutari, she was completely unprepared for the horrendous conditions that she encountered.
The rat and fly infested hospital, which actually stood on a large cesspool, had unimaginably dreadful conditions.
Even the most basic supplies of bandages, soap and any sort of disinfectant were very scarce. Clean water was in desperately short supply.
She quickly realised that typhoid, cholera and other diseases were killing far more British troops than the injuries which they suffered in battle.
Florence immediately set about rectifying the appalling situation. She quickly obtained acceptance from the medical staff and was aided by a large fund of money largely raised by the London Times.
She obtained hundreds of scrubbing brushes, soap and bandages.
She engaged local labour and she started the programme whereby the least ill patients set about cleaning the hospital and providing basic assistance to the more
seriously ill and injured.
She worked every waking hour, even during periods when she herself was unwell.
In recognition of the importance of 24-hour nursing care she would walk through the wards at night, helping, caring for and comforting the sick.
The care that she provided rapidly became legendary and she was known as ‘The Lady with the Lamp´ and also as
‘The Angel of the Crimea’.
She quickly reduced the death rate at the hospital by two-thirds. Her work was not confined to making the hospital clean and fundamentally improving the sanitary conditions.
She dramatically improved the kitchens, providing wholesome food and instituting diets for those people with special needs. She quickly addressed the problem of clean linen and blankets by establishing an efficient laundry system.
She even put in place a library to provide facilities for the patients to occupy their time during their recovery. On her return to England at the end of the war in 1856,
Medicine for Managers articles are not intended to be a source of medical advice. Their purpose is to familiarise the non-medical reader about current key medical disorders. Any medical or medicinal products mentioned by name are examples only and should not be regarded as an endorsement of their use.
she was welcomed as a saviour although she did her best to avoid the celebrity and adulation with which she felt intensely uncomfortable.
Queen Victoria rewarded her with an engraved brooch and the Government gave her a quarter of a million pounds in recognition of the work she had done.
Although she did nurse, her real strengths were in using her influence with everyone, including the Government and the Queen to achieve major improvements for hospitals and medical care generally.
Based on records kept by Florence Nightingale, a Royal Commission for the Health of the Army was established in 1857 and the following year a report was published detailing the requirements for military hospitals and a programme of reform.
Incorporated into the changes was the introduction of pie charts, which Florence had used in Scutari to demonstrate the pattern of mortality and which In 1849, the 29 year-old refused a marriage proposal, much to the displeasure of her parents formed the basis of early epidemiology.
She used the money awarded by the Queen to establish, in 1860, a school of nursing at St Thomas’s Hospital in London.
The school later came to be known as the Nightingale school. She became a role
model for young women who wished, like her, to care for the ill and the debilitated.
Nursing started to be recognised as a noble and important profession and the stigma which had been attached to the work, and which Florence herself had to fight against, evaporated.
Florence Nightingale herself contracted brucellosis from which she never fully recovered. She became housebound and often bed-bound by the time she was 40.
However, she still continued her pioneering work from her bed when necessary. She wrote extensively about the ways in which civilian hospitals could be improved and subsequently advised on nursing care and hospital operation during the US civil war and the strife in India.
In 1907, she became the first woman to receive the Order of Merit, conferred on her by King Edward VII and she received birthday wishes from King George when she reached her ninetieth birthday.
She died after a short illness August 13th 1910. She left instructions that she
wanted a simple funeral and her relatives, aware of her instructions, declined a national funeral.
She is buried in St Margaret’s Church, East Wellow, in Hampshire. Florence Nightingale was
a truly amazing, inspirational and visionary woman, still recognised today as the pioneer of modern day nursing.
She transformed nursing into a respectable profession and the first school of nursing at St Thomas’s remains a lasting testament.
Medicine for Managers articles are not intended to be a source of medical advice. Their purpose is to familiarise the non-medical reader about current key medical disorders. Any medical or medicinal products mentioned by name are examples only and should not be regarded as an endorsement of their use.
The Florence Nightingale Museum is located at St Thomas’s Hospital, 2
Lambeth Palace Road, near Westminster Bridge, London. It is
