Florence Nightingale: Founder of Modern Nursing

Born in Florence, Italy, (from where she got her name) on May 12, 1820 – a time when wealthy women were expected to be wives and mothers and nothing else – Florence Nightingale’s father believed in the advancement of women’s education so, she and her older sister studied history, mathematics, languages, philosophy, etc.

It was only when she decided to pursue a career outside the home that her mother and sister objected. But in 1844, she left anyway, following what she considered calls from God into medicine and service to others.

Her studies took her far from England. During one trip, she visited a Lutheran religious community in Germany where a pastor and deaconess worked with the sick. She received medical training at their institute and later wrote that the experience was a turning point in her life and the ‘foundation of her advancements’.

In 1853, when she was superintendent at the Institute for the Care of Sick Gentlewomen in London, the Crimean War broke out. She, her head nurse, her aunt, and fifteen Catholic nuns traveled to a military hospital in Scutari. They found that more British soldiers were dying from typhus, cholera, and dysentery than from their wounds.

The poor care and shortage of medical equipment and supplies included lack of equipment to process food, fix defective sewers, or increase ventilation. The reason was the indifference of the British Military hierarchy, who ignored the pleas for help from her and others. In desperation, she sent letters to The Times (a British daily) and the Sanitary Commission begging for a government solution. A prefabricated hospital was created, shipped, and run by civilians. It brought the death rate down more than 90%.

Meanwhile Nightingale and her team set up a radical program of sanitation and hygiene – mostly handwashing, which was not a common practice in medicine at that time, and reduced the camp’s death rates from 42% to 2%.

It was during this time that she received the nickname she’d have the rest of her life: Lady of the Lamp.

It came from an article by William Russel in The Times in which he said:

She is a “ministering angel” without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow's face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.

According to Wikipedia, her actual nickname was “the lady with the hammer," given to her by the soldiers she nursed after she used a hammer to break into a locked storage area to access medicine to treat the wounded. Russell, however, thought the behavior was unladylike, and invented a (to him) more acceptable alternative.

The fabricated nickname was further popularized by Henry Wadsworth Longfellow in his 1857 poem about her called "Santa Filomena.”

Lo! in that house of misery A lady with a lamp I see

Pass through the glimmering gloom, And flit from room to room.

After the war, she returned to England and visited hospitals which were almost as bad what she’d experienced in Crimea. With her access to people in high places, her education, her stubbornness, and her non-traditional ideas, she went on to transform hospital nursing over the next 40 years.

She had always excelled at math, so it was natural for her to use her knowledge of statistics and medicine, to develop the Polar Area Diagram, an early visual representation of data. This assisted nurses in diagnosing patients and developing actionable items for patient care – the forerunner of what we know as quality and risk analysis in nursing today.

In 1860, she founded the Nightingale School of Nursing, the first professional School of Nursing. Her book, ‘Notes on Nursing’ became the foundational text for student nurses. During her career, she made advancements on public health, revolutionized hospital design, advocated international relief of hunger (a problem we continue to battle, as illustrated by SDG 2), helped to abolish harsh prostitution laws against women, and facilitated the acceptance of female participation in the workforce.

Awards signifying her achievements:

• 1883 – first recipient of the Royal Red Cross
• 1904 – appointed Lady of Grace of the Order of St John
• 1907 – first recipient of the Order of Merit

In 1982, President Ronald Regan declared May 6th National Nurses Day in the United States. It is the first day of National Nurses Week, which ends on her birthday, May 12th.

The Florence Nightingale Medal is the highest international distinction a nurse can achieve.

At many nursing schools, graduates hold a lantern as they recite the Nightingale Pledge, a modified version of the Hippocratic Oath created in 1893 by Lystra Gretter specifically for nurses It emphasizes ethical principles such as commitment to patient care, integrity, and professionalism.

Nightingale’s history encouraged me to become certified in quality and risk analysis and legal nursing. Hopefully, I have also improved nursing in my generation.

Bonnie O’Leary BSN, RN, LGBHC, LNC