Florence Nightingale: Difference between revisions

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{{Infobox Medical Person
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|name = Florence Nightingale
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|image = Florence Nightingale.png
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|box_width =
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|image_width = 250px
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|caption =
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|birth_date = {{birth date|1820|5|12|df=y}}
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|birth_place = [[Florence]], [[Grand Duchy of Tuscany]]
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|death_date = {{death date and age|1910|8|13|1820|5|12|df=y}}
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|death_place = [[Park Lane (road)|Park Lane]], [[London]], [[United Kingdom]]
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|profession = [[Nurse]] and [[Statistician]]
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|specialism = Hospital [[hygiene]] and [[sanitation]]
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|research_field =
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|known_for = Pioneering modern nursing
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|years_active =
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|education =
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|work_institutions = [[Selimiye Barracks]], [[Üsküdar|Scutari]]
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|awards = [[Royal Red Cross]] (1883) <br>[[Order of Merit (Commonwealth)|Order of Merit]] (1907)
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|relations =
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}}
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'''Florence Nightingale''', [[Order of Merit (Commonwealth)|OM]], [[Royal Red Cross|RRC]] ({{pron-en|ˈflɒrəns ˈnaɪtɪŋɡeɪl}}, historically {{IPA2|ˈflɒɾəns|}}; 12 May 1820 – 13&nbsp;August 1910) was an [[English people|English]] [[nurse]], [[writer]] and [[statistician]]. She came to prominence during the [[Crimean War]] for her pioneering work in [[nursing]], and was dubbed "The Lady with the Lamp" after her habit of making rounds at night to tend injured soldiers. Nightingale laid the foundation stone of professional nursing with the principles summarised in the book ''[[Notes on Nursing]]''. The [[Nightingale Pledge]] taken by new nurses was named in her honour, and the annual [[International Nurses Day]] is celebrated around the world on her birthday.
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== Biography ==
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=== Early life ===
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[[Image:Embley Park.jpg|thumb|right|[[Embley Park]], now a school, was the family home of Florence Nightingale.]]
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Florence Nightingale was born into a rich, upper-class, well-connected [[United Kingdom|British]] family at the [[Villa Colombaia]],<ref>''[http://www.countryjoe.com/nightingale/house.htm Florence Nightingale's birthplace]'' with photo of commemorative plaque</ref> near the [[Porta Romana]] in Florence, [[Italy]], and was named after the city of her birth. Florence's older sister [[Frances Parthenope Verney|Parthenope]] ({{pronEng|pɑrˈθi:nəpɪ}}) had similarly been named after her place of birth, a [[Ancient Greece|Greek]] settlement now part of the city of [[Naples]].
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Her parents were [[William Nightingale|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 [[Dethick, Lea and Holloway|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 (abolitionist)|William Smith]].
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Inspired by what she took as a [[Christian]] [[vocation|divine calling]], which she 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. In this, she rebelled against the expected role for a woman of her status, which was to become a wife and 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.
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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.
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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, 1st Baron Herbert of Lea|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 Milne's marriage proposal, against her mother's wishes.
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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 [[Statistics|applied statistics]] at the [[University of Oxford]].<ref>Bibby, John. (1986) Notes towards a history of teaching statistics</ref>
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Nightingale continued her travels with Charles and Selina Bracebridge as far as Greece and Egypt. Though not mentioned by the ''Oxford Dictionary of National Biography'', 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<blockquote>"I don't think I ever saw anything which affected me much more than this." And, considering the temple: "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."</blockquote> 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."<ref>Edward Chaney, "Egypt in England and America: The Cultural Memorials of Religion, Royalty and Revolution", in: ''Sites of Exchange: European Crossroads and Faultlines'', eds. M. Ascari and A. Corrado (Rodopi, Amsterdam and New York, 2006), 39-74.</ref> Later in 1850, she visited the Lutheran religious community at [[Düsseldorf-Kaiserswerth|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.<ref>Oxford Dictionary of National Biography</ref>
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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.<ref name=hsguide>''[http://www.harleystreetguide.co.uk/about/history/ History of Harley Street]'' at Harley Street Guide (commercial website)</ref> Her father had given her an annual income of £500 (roughly £25,000/US$50,000 in present terms), which allowed her to live comfortably and to pursue her career. [[J. J. Sylvester|James Joseph Sylvester]] is said to have been her mentor.
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=== Crimean War ===
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[[File:Balaklava_sick_2.jpg|thumb|250px|right|A tinted [[lithograph]] by [[William Simpson]] illustrating conditions of the sick and injured in [[Balaklava]]]]
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[[File:Hospital at Scutari 2a.jpg|right|250px|thumb|A ward of the hospital at [[Üsküdar|Scutari]] where Nightingale worked, from an 1856 lithograph.]]
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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,<ref>{{cite journal
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| last = Gill
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| first = Christopher J.
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| authorlink =
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| coauthors = Gillian C. Gill
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| title =Nightingale in Scutari: Her Legacy Reexamined
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| journal =Clinical Infectious Diseases
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| volume =40
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| issue =12
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| pages =1799–1805
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| publisher =
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| location =
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|date=2005
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| url =http://www.journals.uchicago.edu/doi/abs/10.1086/430380
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| doi =10.1086/430380
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| id =
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| accessdate =2007-10-07
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| format =
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| pmid = 15909269
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| month = Jun
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| last1 = Gill
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| first1 = CJ
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| last2 = Gill
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| first2 = GC
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| issn = 1058-4838
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}}</ref> were sent (under the authorization of Sidney Herbert) to [[Turkey]], about 545&nbsp;km across the [[Black Sea]] from [[Balaklava]] in the [[Crimea]], where the main British camp was based.
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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. [[Medicine]]s were in short supply, [[hygiene]] was being neglected, and mass [[infection]]s were common, many of them fatal. There was no equipment to process food for the patients.
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Death rates did not drop; on the contrary, they began to rise. 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 [[sanitary sewer|sewer]]s 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.<ref>[http://books.google.com/books?id=dRpgFsQ7nqkC&pg=PA114&lpg=PA114&dq=sanitary+commissioner+Scutari&source=bl&ots=d0MkZWFS46&sig=EbU9zrZiYx8wkhv5YnW7ZeLJOlw&hl=en&sa=X&oi=book_result&resnum=2&ct=result Florence Nightingale: Measuring Hospital Care Outcomes]</ref> Death rates were sharply reduced. Until recently it was commonly asserted that Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene herself or by calling for the Sanitary Commission. For example the 1911 first edition of the Dictionary of National Biography made this claim, but the second edition in 2001 did not. During the war she did not recognize hygiene as the predominant cause of death, and she never claimed credit for helping to reduce the death rate.<ref name="Florence Nightingale 1998">''Florence Nightingale, Avenging Angel'' by Hugh Small (Constable 1998)</ref>
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Nightingale continued believing the death rates were due to poor nutrition and supplies and overworking of the soldiers.<!-- not consistent with her belief in Miasma theory of disease stated earlier ??? check --> 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.
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====The Lady with the Lamp ====
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During the Crimean campaign, Florence Nightingale gained the nickname "The Lady with the Lamp", deriving from a phrase in a report in ''The Times'':
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<blockquote>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.<ref>Cited in Cook, E. T. ''The Life of Florence Nightingale.'' (1913) Vol 1, p 237.</ref> </blockquote>
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[[File:Nightingale receiving the Wounded at Scutari by Jerry Barrett.jpg|thumb|250px|right|"Nightingale receiving the Wounded at Scutari", a portrait by [[Jerry Barrett]].]]
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The phrase was further popularised by [[Henry Wadsworth Longfellow]]'s 1857 poem "Santa Filomena":
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<blockquote>Lo! in that house of misery<br>
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A lady with a lamp I see<br>
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Pass through the glimmering gloom,<br>
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And flit from room to room.</blockquote>
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=== Later career ===
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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 [[Prince George, Duke of Cambridge|Duke of Cambridge]] was chairman. Nightingale was considered a pioneer in the concept of ''[[medical tourism]]'' as well, on the basis of her letters from 1856 in which she wrote 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.
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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&nbsp;May 1865 at the Liverpool Workhouse Infirmary. She also campaigned and raised funds for the [[Royal Buckinghamshire Hospital]] in [[Aylesbury]], near her family home.
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Nightingale wrote ''[[Notes on Nursing]]'', which was published in 1859, a slim 136-page book that served as the cornerstone of the curriculum at the Nightingale School and other nursing schools established. 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".<ref name="FlorenceNightingale">{{cite book | title= Notes on Nursing: What it is and what it is not | last= Nightingale| first= Florence | chapter=Preface| editor=…| year= 1974. First published 1859 | publisher= Blackie & Son Ltd.| location= Glasgow & London|isbn=0-216-89974-5 | ISBN-status= May be invalid - please double check}}.</ref>
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''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 the establishment and development of the nursing profession and organizing it into its modern form. 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".<ref name="QuixleyonNightingale">{{cite book | title= Notes on Nursing: What it is and what it is not | last= Nightingale| first= Florence | chapter=Introduction by Joan Quixley| editor=…| year= 1974. First published 1859 | publisher= Blackie & Son Ltd. | isbn= 0397550073}}</ref>
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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''.
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It is commonly stated that Nightingale "went to her grave denying the germ theory of infection". Mark Bostridge in his recent biography<ref>''Florence Nightingale, the Woman and her Legend'', by Mark Bostridge (Viking 2008)</ref> disagrees with this, saying that she was opposed to a precursor of germ theory known as "contagionism" which 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 and 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 (American Civil War)|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]].
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In 1869, Nightingale and Dr [[Elizabeth Blackwell]] opened the Women's Medical College.
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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. Linda Richards went on to become a great nursing pioneer in the USA and Japan.
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By 1882, Nightingale nurses had a growing and influential presence in the embryonic nursing profession. Some had become matrons at several leading hospitals, including, in London, [[St Mary's Hospital (London)|St Mary's Hospital]], Westminster Hospital, St Marylebone Workhouse Infirmary and the [[Hospital for Incurables]] at [[Putney]]; and throughout Britain, e.g., [[Royal Victoria Hospital]], [[Netley]]; Edinburgh Royal Infirmary; Cumberland Infirmary and Liverpool Royal Infirmary, as well as at [[Sydney Hospital]] in [[New South Wales]], [[Australia]].
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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 (Commonwealth)|Order of Merit]]. In 1908, she was given the Honorary Freedom of the [[City of London]]. Her birthday is now celebrated as International CFS Awareness Day.
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From 1857 onwards, Nightingale was intermittently bedridden and suffered from depression. A recent biography cites [[brucellosis]] and associated [[spondylitis]] as the cause.<ref>Bostridge (2008)</ref> An alternative explanation for her depression is based on her discovery after the war that she had been mistaken about the reasons for the high death rate.<ref name="Florence Nightingale 1998"/> 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.
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===Relationships===
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Although much of Nightingale's work improved the lot of women everywhere, she had little affection for women in general<ref>In [http://books.google.com/books?id=totpAAAAMAAJ&pg=PA15&lpg=PA15&dq=They+scream+out+at+you+for+sympathy+all+day+long&source=bl&ots=9z8nGWQlFs&sig=ysuwy9SPRkQGd__vVH8ugTCXVfw&hl=en&ei=AkW0SsvCL4WYsgOtrvnRDA&sa=X&oi=book_result&ct=result&resnum=1#v=onepage&q=They%20scream%20out%20at%20you%20for%20sympathy%20all%20day%20long&f=false an 1861 letter], Nightengale wrote "''Women have no sympathy.'' [...] Women crave for being loved, not for loving. They scream out at you for sympathy all day long, they are incapable of giving any in return, for they cannot remember your affairs long enough to do so. ... They cannot state a fact accurately to another, nor can that other attend to it accurately enough for it to become information.".</ref> preferring the friendship of powerful men. She often referred to herself in the masculine, as for example "a man of action".{{Citation needed|date=January 2010}}<!--I.Bernard Cohen's Scientific American article on Nightingale was previously cited for this quote. However, the quote is not in this article.-->
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She did, however, have several important and passionate friendships with women. As a young woman she adored both an aunt and a female cousin. Later in life she kept up a prolonged correspondence with an Irish nun, Sister Mary Clare Moore, with whom she had worked in Crimea.<ref>[http://www.ourladyofmercy.org.uk Institute of Our Lady of Mercy, Great Britain]</ref> Her most beloved confidante was Mary Clarke, an Englishwoman she met in 1837 and kept in touch with throughout her life.<ref>Cannadine, David. "Ever Yours, Florence Nightingale: Selected Letters." The New Republic. 203.7 (August 13, 1990): 38-42.</ref>
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In spite of these deep emotional attachments to women, some scholars of Nightingale's life believe that she remained chaste for her entire life; perhaps because she felt an almost religious calling to her career, or because she lived in a time of sexual repression.<ref>Dossey, Barbara Montgomery. ''Florence Nightingale: Mystic, Visionary, Reformer''. Philadelphia: Lippincott Williams & Wilkins, 1999.</ref>
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[[Image:St Margarets FN grave.jpg|thumb|left|The grave of Florence Nightingale in the churchyard of St. Margaret's Church, [[Wellow, Hampshire|East Wellow]].]]
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===Death===
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On 13 August 1910, at the age of 90, she died peacefully in her sleep in her room at 10 South Street, Park Lane.<ref name="obit">{{cite news | title=Miss Nightingale Dies, Aged Ninety | url=http://www.nytimes.com/learning/general/onthisday/bday/0512.html | quote=Florence Nightingale, the famous nurse of the Crimean war, and the only woman who ever received the Order of Merit, died yesterday afternoon at her London home. Although she had been an invalid for a long time, rarely leaving her room, where she passed the time in a half-recumbent position, and was under the constant care of a physician, her death was somewhat unexpected. A week ago she was quite sick, but then improved, and on Friday was cheerful. During that night alarming symptoms developed, and she gradually sank until 2 o'clock Saturday afternoon, when the end came. | publisher=[[The New York Times]] |date=1910-08-15 | accessdate=2007-07-21 }}</ref> The offer of burial in [[Westminster Abbey]] was declined by her relatives, and she is buried in the graveyard at St. Margaret Church in [[Wellow, Hampshire|East Wellow]], Hampshire.<ref>http://www.countryjoe.com/nightingale/joe_grave.jpg</ref><ref>[http://www.countryjoe.com/nightingale/wellow.htm Florence Nightingale: The Grave at East Wellow]</ref>
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== Contributions ==
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=== Statistics and sanitary reform ===
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[[Image:Nightingale-mortality.jpg|thumb|right|"''[[polar area diagram|Diagram]] of the causes of mortality in the army in the East''" by Florence Nightingale.]]
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Florence Nightingale had exhibited a gift for [[mathematics]] from an early age and excelled in the subject under the tutorship of her father. Later, Nightingale became a pioneer in the visual presentation of information and [[statistical graphics]].<ref>{{cite book | last=Lewi | first=Paul J. | authorlink=Paul Lewi | title=Speaking of Graphics| year=2006 | url=http://www.datascope.be/sog.htm}}</ref> Among other things she used the [[pie chart]], which had first been developed by [[William Playfair]] in 1801.
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Indeed, Nightingale is described as "a true pioneer in the graphical representation of statistics", and is credited with developing a form of the pie chart now known as the [[polar area diagram]],<ref name=Cohen1984>{{Citation| last= Cohen | first=I. Bernard | author-link=I. Bernard Cohen | title=Florence Nightingale | journal=Scientific American | volume=250| pages=128-37| date=March | year=1984}} (alternative pagination depending on country of sale: 98-107. This quote p.107. Bibliography on p.114)</ref> or occasionally the '''Nightingale rose diagram''', equivalent to a modern [[circular histogram]] to illustrate seasonal sources of patient mortality in the military field hospital she managed. Nightingale called a compilation of such diagrams a "coxcomb", but later that term has frequently been used for the individual diagrams. She made extensive use of coxcombs to present reports on the nature and magnitude of the conditions of medical care in the Crimean War to [[Parliament of the United Kingdom|Members of Parliament]] and civil servants who would have been unlikely to read or understand traditional statistical reports.
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In her later life Nightingale made a comprehensive statistical study of [[sanitation]] in [[India]]n rural life and was the leading figure in the introduction of improved medical care and public health service in India. In 1858 and 1859 she successfully lobbied for the establishment of a Royal Commission into the Indian situation. Two years later she provided a report to the commission, which completed its own study in 1863. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000".<ref name=Cohen1984p107>Cohen, I. Bernard (1984), p.107 </ref>
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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]].
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=== Literature and the women's movement ===
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{{cquote | Nightingale's achievements are all the more impressive when they are gauged against the background of social restraints on women in Victorian England. Her father, William Edward Nightingale, was an extremely wealthy landowner, and the family moved in the highest circles of English society. In those days, women of Nightingale's class did not attend universities and did not pursue professional careers; their purpose in life was to marry and bear children. Nightingale was fortunate. Her father believed women should be educated, and he personally taught her Italian, Latin, Greek, philosophy, history and - most unusual of all for women of the time - writing and mathematics.<ref name=Cohen1984p98>Cohen, I. Bernard (1984), p.98 </ref>}}
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But while better known for her contributions in the nursing and mathematical fields, Nightingale is also an important link in the study of English [[feminism]]. During 1850 and 1852, she was struggling with her self-definition and the expectations of an upper-class marriage from her family. As she sorted out her thoughts, she wrote ''[[Suggestions for Thought to Searchers after Religious Truth]]''. The three-volume book has never been printed in its entirety, but a section, called ''[[Cassandra]]'', was published by [[Ray Strachey]] in 1928. Strachey included it in ''The Cause'', a history of the women's movement. Apparently, the writing served its original purpose of sorting out thoughts; Nightingale left soon after to train at the Institute for deaconesses at [[Kaiserswerth]].
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''Cassandra'' protests the over-feminization of women into near helplessness, such as Nightingale saw in her mother's and older sister's lethargic lifestyle, despite their education. She rejected their life of thoughtless comfort for the world of social service. The work also reflects her fear of her ideas being ineffective, as were [[Cassandra]]'s. Cassandra was a princess of [[Troy]] who served as a [[priest|priestess]] in the temple of [[Apollo]] during the [[Trojan War]]. The god gave her the gift of [[prophecy]] but when she refused his advances he cursed her so that her prophetic warnings would go unheeded. [[Elaine Showalter]] called Nightingale's writing "a major text of English feminism, a link between Wollstonecraft and Woolf."<ref>Gilbert, Sandra M. and Susan Gubar. "Florence Nightingale." ''The Norton Anthology of Literature by Women: The Traditions in English''. New York: W.W. Norton, 1996. 836-837.</ref>
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=== Theology ===
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''Suggestions for Thought'' is also Nightingale's work of theology, her own [[theodicy]], where she develops her radical heterodox ideas.
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Nightingale was a [[Universal reconciliation|Christian universalist]].<ref>[http://www.tentmaker.org/biographies/florence-nightingale.htm Florence Nightingale] at [http://www.tentmaker.org Tentmaker.org]. Accessed July 13, 2007.</ref> She claimed that on 7 February 1837 – not long before her 17th birthday: "God spoke to me", she wrote, "and called me to His service."{{Citation needed|date=October 2007}}
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== Legacy and memory ==
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[[Image:Florence Nightingale - Project Gutenberg 13103.jpg|thumb|A young Florence Nightingale]]
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===Nursing===
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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. This intended that students cared for people in their homes, an appreciation that is still advancing in reputation and professional opportunity for nurses today.<ref>Neeb, Kathy. Mental Health Nursing. 3rd. Philadelphia: F.A. Davis Company, 2006.</ref>
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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.
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The work of her School of Nursing continues today as the [[Florence Nightingale School of Nursing and Midwifery]] at [[King's College London]]. The Nightingale Building in the School of Nursing and Midwifery at the [[University of Southampton]] is also named after her. [[International Nurses Day]] is celebrated on her birthday each year.
  +
  +
The Florence Nightingale Declaration Campaign,<ref>[http://www.nightingaledeclaration.net/ Florence Nightingale Declaration Campaign]</ref> 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 which will declare: The International Year of the Nurse–2010 (the centennial of Nightingale's death); The UN Decade for a Healthy World–2011 to 2020 (the bicentennial 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. So far, the Florence Nightingale Declaration has been signed by over 18,500 signatories from 86 countries.
  +
  +
During the [[Vietnam War]], Nightingale inspired many [[United States Army|U.S. Army]] nurses, sparking a renewal of interest in her life and work. Her admirers include [[Country Joe McDonald|Country Joe]] of [[Country Joe and the Fish]], who has assembled an extensive website in her honour.<ref>[http://www.countryjoe.com/nightingale/ Country Joe McDonald's Tribute to Florence Nightingale]</ref>
  +
  +
Four hospitals in Istanbul are named after Nightingale: [[F. N. Hastanesi]] in [[Şişli]] (the biggest private hospital in Turkey), [[Metropolitan F.N. Hastanesi]] in [[Gayrettepe]], [[Avrupa F.N. Hastanesi]] in [[Mecidiyeköy]], and [[Kızıltoprak F.N. Hastanesi]] in [[Kadiköy]], all belonging to the [[Turkish Cardiology Foundation]].<ref>http://www.florence.com.tr/tr/index.asp Florence</ref>
  +
  +
The Agostino Gemelli Medical School<ref>[http://www3.unicatt.it/pls/unicatt/consultazione.mostra_pagina?id_pagina=9396&id_lingua=4 Università Cattolica del Sacro Cuore - The Rome Campus<!-- Bot generated title -->]</ref> 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.<ref>http://www.gesi.it/MS%20bedside(e).pdf</ref>
  +
  +
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.
  +
  +
There is a psychological effect known as the "[[Florence Nightingale Effect]]", whereby patients fall in love with their caregivers.{{Citation needed|date=December 2009}}
  +
  +
===Museums and monuments===
  +
[[Image:Florence Nightingale monument London closeup 607.jpg|thumb|Statue of Florence Nightingale in [[Waterloo Place]], [[London]]]]
  +
A statue of Florence Nightingale stands in Waterloo Place, Westminster, [[London]], just off [[The Mall (London)|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.<ref>[http://www.derby-guide.co.uk/florence_nightingale.html Derby Guide: Florence Nightingale]</ref>
  +
  +
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 for Places of Historic Interest or Natural Beauty|National Trust]].
  +
  +
The northernmost tower of the Selimiye Barracks building is today a [[Florence Nightingale Museum, Istanbul|museum]], and in several of its rooms, relics and reproductions relevant to Florence Nightingale and her nurses are on exhibition.<ref>[http://www.florence-nightingale-avenging-angel.co.uk/tower.htm Florence Nightingale]</ref>
  +
  +
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]].
  +
  +
A bronze plaque, attached to the plinth of the Crimean Memorial in the [[Haydarpaşa Cemetery]], Istanbul and unveiled on [[Empire Day]], 1954, to celebrate the 100th anniversary of her nursing service in that region, bears the inscription:<ref>[http://www.cwgc.org/admin/files/cwgc_haidar.pdf Commenwealth War Graves Commission Haidar Pasha Cemetery]</ref>
  +
<blockquote>"To Florence Nightingale, whose work near this Cemetery a century ago relieved much human suffering and laid the foundations for the nursing profession."</blockquote>
  +
  +
Florence Nightingale's voice was saved for posterity in a [[phonograph]] recording from 1890 preserved in the [[British Library Sound Archive]].
  +
  +
===Theatre===
  +
The first theatrical representations of Nightingale was [[Reginald Berkeley (writer)|Reginald Berkeley]] in his "The Lady with the Lamp", premiering in London in 1929 with [[Edith Evans]] in the title role. This does not portray her as an entirely sympathetic character and draws much characterisation from [[Lytton Strachey]]'s biography of her in ''[[Eminent Victorians]]''.<ref>Mark Bostridge, ''Florence Nightingale - The Woman and Her Legend''</ref> It was adapted as a film of the same name in 1951. Nightingale also appears in [[Edward Bond]]'s surrealist play ''[[Early Morning (play)|Early Morning]]'', in which she is depicted having a lesbian affair with [[Victoria of the United Kingdom|Queen Victoria]].
  +
  +
In 2009, a stage musical play representation of Nightingale was produced by the Association of Nursing Service Administrators of the Philippines (ANSAP), entitled "The Voyage of the Lass". The play depicts the story of love and vocation on the nursing communities' icon Florence Nightingale, shown on all Fridays of February 2009 at the AFP Theatre, Camp Crame, Philippines. The play tells the story of Nightingale's early life and her struggles during the Crimean War. "The Voyage of the Lass" was a two-hour play that showcased Philippine local registered nurses from various hospitals of the country, exposing their talents on the performing arts.
  +
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===Television===
  +
Portrayals of Nightingale on television, in documentary as in fiction, vary - the BBC's 2008 ''[[Florence Nightingale (documentary)|Florence Nightingale]]'' emphasised her independence and feeling of religious calling, but in Channel 4's 2006 ''[[Mary Seacole]]: The Real Angel of the Crimea'' she was portrayed as narrow-minded and opposed to Seacole's efforts. In 1985 a TV biopic "Florence Nightingale", starring [[Jaclyn Smith]] as Florence, was produced.
  +
  +
===Film===
  +
In 1912 a biographical silent film titled ''The Victoria Cross'' starring [[Julia Swayne Gordon]] as Nightingale was produced.
  +
In 1915 another biographical silent film titled ''Florence Nightingale'' was produced starring [[Elisabeth Risdon]].
  +
In 1936 a biographical film titled ''White Angel'' was produced, starring [[Kay Francis]] as Nightingale.
  +
A 1951 a second "talkie" biographical film titled ''The Lady With The Lamp'' was produced starring [[Anna Neagle]].
  +
  +
===Banknotes===
  +
Florence Nightingale's image appeared on the reverse of Series D £10 [[Banknotes of the pound sterling|banknotes]] issued by the [[Bank of England note issues|Bank of England]] from 1975 until 1994. As well as a standing portrait, she was depicted on the notes in a field hospital in the Crimea, holding her lamp.<ref name="bankofengland">{{cite web|url=http://www.bankofengland.co.uk/banknotes/denom_guide/index.htm|title=Withdrawn banknotes reference guide|publisher=Bank of England|accessdate=2008-10-17}}</ref>
  +
  +
===Photography===
  +
A rare black and white photograph of Florence Nightingale taken in 1910 by [[Lizzie Caswall Smith]] in her London home in Park Lane was auctioned on 19 November 2008 by Dreweatts auction house in Newbury, Berkshire, England, for £5,500.<ref name="photograph">{{cite web|url=http://news.bbc.co.uk/1/hi/england/7737130.stm|title=Rare Nightingale photo sold off|publisher=BBC News|accessdate=2008-11-19 | date=19 November 2008}}</ref>
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===Other===
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Several churches in the [[Anglican Communion]] commemorate Nightingale with a feast day on their [[liturgical calendar]]s. The [[Evangelical Lutheran Church in America]] commemorates her as a renewer of society with [[Clara Maass]] on 13 August.
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Beginning in 1968, the [[United States Air Force|U.S. Air Force]] operated a fleet of 20 [[McDonnell Douglas C-9|C-9A "Nightingale"]] [[Medical evacuation|aeromedical evacuation]] [[aircraft]], based on the [[McDonnell Douglas DC-9]] platform.<ref>[http://www.amcmuseum.org/Collections/Aircraft/C9Nightingale.htm Air Mobility Command Museum: "C-9 Nightingale"].</ref> The last of these planes was retired from service in 2005.<ref>[http://www.af.mil/news/story.asp?storyID=123011872 Air Force Link: "Historic C-9 heads to Andrews for retirement"].</ref>
  +
  +
==See also==
  +
* [[Ethel Bedford-Fenwick|Bedford-Fenwick, Ethel]]
  +
* [[Crimean War Memorial]]
  +
* [[History of feminism]]
  +
* [[Licensed practical nurse]]
  +
* [[List of suffragists and suffragettes]]
  +
* [[Mary Seacole]]
  +
* [[Nightingale's environmental theory]]
  +
* [[Nursing]]
  +
* [[Nursing process]]
  +
* [[Pie chart]]
  +
* [[Registered Nurse]]
  +
* [[Women's suffrage in the United Kingdom]]
  +
  +
== Works ==
  +
* ''Cassandra'' (1851)
  +
* ''Notes on Nursing: What Nursing Is, What Nursing is Not'' (1859)
  +
* ''Suggestions for Thought (to Searchers after Religious Truth)''
  +
* ''Mysticism and Eastern Religions''
  +
* ''Florence Nightingale's Theology''
  +
* ''Florence Nightingale's Spiritual Journey''
  +
* ''The Family'', a critical essay in Fraser's Magazine (1870)
  +
* ''Una and Her Paupers, Memorials of [[Agnes Elizabeth Jones]]'' with an introduction by Florence Nightingale. Diggory Press ISBN 978-1905363223
  +
* ''Letters from Egypt: A Journey on the Nile 1849-1850'' (1987) ISBN 1-55584-204-6
  +
  +
==Sources==
  +
* Baly, Monica E. and H. C. G. Matthew, "Nightingale, Florence (1820–1910)"; ''[[Oxford Dictionary of National Biography]]'', [[Oxford University Press]] (2004); online edn, May 2005 [http://www.oxforddnb.com/view/article/35241, accessed 28 October 2006]
  +
* {{cite book
  +
| first= Mark
  +
| last= Bostridge
  +
| authorlink= Mark Bostridge
  +
| year= 2008
  +
| title= Florence Nightingale: The Woman and Her Legend
  +
| publisher= Viking
  +
| location= London
  +
| isbn= 9780670874118 }}
  +
* Gill, G. ''The extraordinary upbringing and curious life of Miss Florence Nightingale'' Random House, New York (2005)
  +
* McDonald, Lynn ed., ''Collected Works of Florence Nightingale''. Wilfrid Laurier University Press
  +
* Pugh, Martin; ''The march of the women: A revisionist analysis of the campaign for women's suffrage 1866-1914'', Oxford (2000), at 55.
  +
* Sokoloff, Nancy Boyd.; ''Three Victorian women who changed their world'', Macmillan, London (1982)
  +
* Webb, Val; ''The Making of a Radical Theologician'', Chalice Press (2002)
  +
* Woodham Smith, Cecil; ''Florence Nightingale'', Penguin (1951), rev. 1955
  +
  +
==References==
  +
{{Reflist|2}}
  +
  +
== Further reading ==
  +
* {{cite news
  +
|author=Julie Rehmeyer
  +
|title=Florence Nightingale: The Passionate Statistician
  +
|date=2008-11-26
  +
|work=[[Science News]]
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|url=http://www.sciencenews.org/index/generic/activity/view/id/38937/title/Florence_Nightingale_The_passionate_statistician
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|accessdate=2008-12-04
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}}
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* {{cite book |last= Richards |first= Linda |authorlink= Linda Richards |title= America's First Trained Nurse: My Life as a Nurse in America, Great Britain and Japan 1872-1911 |year= 2006 | publisher= Diggory Press |isbn= 9781846850684 }}
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* {{cite book |last= Strachey |first= Lytton |authorlink= Lytton Strachey |title= [[Eminent Victorians]] |year= 1918 |isbn= 0848646045 |publisher= Garden City Pub. Co., Inc. |location= Garden City, N.Y. }}
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* {{cite book |last= Davey |first= Cyril J. |title= Lady with a Lamp |year= 1958 | publisher= Lutterworth Press |isbn= 9780718826413 }}
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* Edward Chaney, 'Egypt in England and America: The Cultural Memorials of Religion, Royalty and Revolution', in: ''Sites of Exchange: European Crossroads and Faultlines'', eds. M. Ascari and A. Corrado (Rodopi, Amsterdam and New York,2006), 39-74.
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==External links==
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{{sisterlinks|wikt=no|b=no|n=no|v=no|s=Author:Florence Nightingale}}
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{{Nursingportal}}
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* [http://www.archive.org/details/f_nightingale UCLA Elmer Belt Florence Nightingale Collection], hosted at [[Internet Archive]]
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* [http://www.bartleby.com/189/201.html Eminent Victorians: Florence Nightingale] by Lytton Strachey
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* [http://www.nightingaledeclaration.net Florence Nightingale Declaration Campaign for Global Health] established by the Nightingale Initiative for Global Health (NIGH)
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* {{gutenberg author | id=Florence_Nightingale | name=Florence Nightingale}}
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* {{MacTutor Biography|id=Nightingale}}
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* {{imdb title|id=0956136|title=Animated Hero Classics: Florence Nightingale (1993)}}
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* [http://www.1911encyclopedia.org/Florence_Nightingale 1911 Encyclopedia Britannica article]
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* [http://www.amstat.org/about/statisticians/index.cfm?fuseaction=biosinfo&BioID=12 Florence Nightingale] at American Statistical Association: Statisticians in History
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* [http://www.florence-nightingale.co.uk/index.htm Florence Nightingale Museum]
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* {{cite news
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|author=
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|title=New photo of 'Lady of the Lamp'
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|date=2006-08-06
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|work=[[BBC News]]
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|url=http://news.bbc.co.uk/1/hi/england/5250188.stm
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|accessdate=2008-08-07
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}}
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* [http://www.pubmedcentral.gov/articlerender.fcgi?artid=1139928 Correspondence] between Nightingale and Benjamin Jowett
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* [http://www.fyne.co.uk/index.php?item=211 Gay Great - Florence Nightingale]
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* [http://www.sociology.uoguelph.ca/fnightingale/ University of Guelph: Collected Works of Florence Nightingale project]
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* {{NRA|P21253}}
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* [http://www.bl.uk/onlinegallery/onlineex/voiceshist/flonight/index.html Florence Nightingale recording] in aid of the [[Charge of the Light Brigade|Light Brigade Relief Fund]], 1890, London
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<!-- Metadata: see [[Wikipedia:Persondata]] -->
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{{Persondata
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|NAME=Nightingale, Florence
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|ALTERNATIVE NAMES=
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|SHORT DESCRIPTION=English [[nurse]] and [[statistician]]
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|DATE OF BIRTH=12 May 1820
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|PLACE OF BIRTH=[[Florence]], [[Italy]]
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|DATE OF DEATH=13 August 1910
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|PLACE OF DEATH=[[London]], [[England]]
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}}
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{{DEFAULTSORT:Nightingale, Florence}}
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<!--Categories-->
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[[Category:English theologians]]
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[[Category:Christian theologians]]
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[[Category:British people of the Crimean War]]
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[[Category:Female wartime nurses]]
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Revision as of 19:50, 15 February 2010

Florence Nightingale
Florence Nightingale.png
Born(1820-05-12)12 May 1820
Died13 August 1910(1910-08-13) (aged 90)
Known forPioneering modern nursing
Medical career
ProfessionNurse and Statistician
InstitutionsSelimiye Barracks, Scutari
Sub-specialtiesHospital hygiene and sanitation

Florence Nightingale, OM, RRC (pronounced /ˈflɒrəns ˈnaɪtɪŋɡeɪl/ (deprecated template), historically [ˈflɒɾəns]; 12 May 1820 – 13 August 1910) was an English nurse, writer and statistician. She came to prominence during the Crimean War for her pioneering work in nursing, and was dubbed "The Lady with the Lamp" after her habit of making rounds at night to tend injured soldiers. Nightingale laid the foundation stone of professional nursing with the principles summarised in the book Notes on Nursing. The Nightingale Pledge taken by new nurses was named in her honour, and the annual International Nurses Day is celebrated around the world on her birthday.

Biography

Early life

Embley Park, now a school, was the family home of Florence Nightingale.

Florence Nightingale was born into a rich, upper-class, well-connected British family at the Villa Colombaia,[1] near the Porta Romana in Florence, Italy, and was named after the city of her birth. Florence's older sister Parthenope (Template:PronEng) 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, which she 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. In this, she rebelled against the expected role for a woman of her status, which was to become a wife and 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 Milne's 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.[2]

Nightingale continued her travels with Charles and Selina Bracebridge as far as Greece and Egypt. Though not mentioned by the Oxford Dictionary of National Biography, 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

"I don't think I ever saw anything which affected me much more than this." And, considering the temple: "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."[3] 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.[4]

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.[5] Her father had given her an annual income of £500 (roughly £25,000/US$50,000 in present terms), which allowed her to live comfortably and to pursue her career. James Joseph Sylvester is said to have been her mentor.

Crimean War

A tinted lithograph by William Simpson illustrating conditions of the sick and injured in Balaklava
A ward of the hospital at Scutari where Nightingale worked, from an 1856 lithograph.

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,[6] 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.

Death rates did not drop; on the contrary, they began to rise. 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.[7] Death rates were sharply reduced. Until recently it was commonly asserted that Nightingale reduced the death rate from 42% to 2% either by making improvements in hygiene herself or by calling for the Sanitary Commission. For example the 1911 first edition of the Dictionary of National Biography made this claim, but the second edition in 2001 did not. During the war she did not recognize hygiene as the predominant cause of death, and she never claimed credit for helping to reduce the death rate.[8]

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.

The Lady with the Lamp

During the Crimean campaign, Florence Nightingale gained the nickname "The Lady with the Lamp", deriving from a phrase in a report in The Times:

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.[9]

"Nightingale receiving the Wounded at Scutari", a portrait by Jerry Barrett.

The phrase was further popularised by Henry Wadsworth Longfellow's 1857 poem "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.

Later career

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, on the basis of her letters from 1856 in which she wrote 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 1859, a slim 136-page book that served as the cornerstone of the curriculum at the Nightingale School and other nursing schools established. 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".[10]

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 the establishment and development of the nursing profession and organizing it into its modern form. 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".[11]

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.

It is commonly stated that Nightingale "went to her grave denying the germ theory of infection". Mark Bostridge in his recent biography[12] disagrees with this, saying that she was opposed to a precursor of germ theory known as "contagionism" which 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 and 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 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. Linda Richards went on to become a great nursing pioneer in the USA and Japan.

By 1882, Nightingale nurses had a growing and influential presence in the embryonic nursing profession. Some 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, e.g., 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 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 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.[13] An alternative explanation for her depression is based on her discovery after the war that she had been mistaken about the reasons for the high death rate.[8] 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.

Relationships

Although much of Nightingale's work improved the lot of women everywhere, she had little affection for women in general[14] preferring the friendship of powerful men. She often referred to herself in the masculine, as for example "a man of action".[citation needed]

She did, however, have several important and passionate friendships with women. As a young woman she adored both an aunt and a female cousin. Later in life she kept up a prolonged correspondence with an Irish nun, Sister Mary Clare Moore, with whom she had worked in Crimea.[15] Her most beloved confidante was Mary Clarke, an Englishwoman she met in 1837 and kept in touch with throughout her life.[16]

In spite of these deep emotional attachments to women, some scholars of Nightingale's life believe that she remained chaste for her entire life; perhaps because she felt an almost religious calling to her career, or because she lived in a time of sexual repression.[17]

The grave of Florence Nightingale in the churchyard of St. Margaret's Church, East Wellow.

Death

On 13 August 1910, at the age of 90, she died peacefully in her sleep in her room at 10 South Street, Park Lane.[18] 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.[19][20]

Contributions

Statistics and sanitary reform

"Diagram of the causes of mortality in the army in the East" by Florence Nightingale.

Florence Nightingale had exhibited a gift for mathematics from an early age and excelled in the subject under the tutorship of her father. Later, Nightingale became a pioneer in the visual presentation of information and statistical graphics.[21] Among other things she used the pie chart, which had first been developed by William Playfair in 1801.

Indeed, Nightingale is described as "a true pioneer in the graphical representation of statistics", and is credited with developing a form of the pie chart now known as the polar area diagram,[22] or occasionally the Nightingale rose diagram, equivalent to a modern circular histogram to illustrate seasonal sources of patient mortality in the military field hospital she managed. Nightingale called a compilation of such diagrams a "coxcomb", but later that term has frequently been used for the individual diagrams. She made extensive use of coxcombs to present reports on the nature and magnitude of the conditions of medical care in the Crimean War to Members of Parliament and civil servants who would have been unlikely to read or understand traditional statistical reports.

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 1858 and 1859 she successfully lobbied for the establishment of a Royal Commission into the Indian situation. Two years later she provided a report to the commission, which completed its own study in 1863. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000".[23]

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.

Literature and the women's movement

But while better known for her contributions in the nursing and mathematical fields, Nightingale is also an important link in the study of English feminism. During 1850 and 1852, she was struggling with her self-definition and the expectations of an upper-class marriage from her family. As she sorted out her thoughts, she wrote Suggestions for Thought to Searchers after Religious Truth. The three-volume book has never been printed in its entirety, but a section, called Cassandra, was published by Ray Strachey in 1928. Strachey included it in The Cause, a history of the women's movement. Apparently, the writing served its original purpose of sorting out thoughts; Nightingale left soon after to train at the Institute for deaconesses at Kaiserswerth.

Cassandra protests the over-feminization of women into near helplessness, such as Nightingale saw in her mother's and older sister's lethargic lifestyle, despite their education. She rejected their life of thoughtless comfort for the world of social service. The work also reflects her fear of her ideas being ineffective, as were Cassandra's. Cassandra was a princess of Troy who served as a priestess in the temple of Apollo during the Trojan War. The god gave her the gift of prophecy but when she refused his advances he cursed her so that her prophetic warnings would go unheeded. Elaine Showalter called Nightingale's writing "a major text of English feminism, a link between Wollstonecraft and Woolf."[25]

Theology

Suggestions for Thought is also Nightingale's work of theology, her own theodicy, where she develops her radical heterodox ideas.

Nightingale was a Christian universalist.[26] She claimed that on 7 February 1837 – not long before her 17th birthday: "God spoke to me", she wrote, "and called me to His service."[citation needed]

Legacy and memory

A young Florence Nightingale

Nursing

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. This intended that students cared for people in their homes, an appreciation that is still advancing in reputation and professional opportunity for nurses today.[27]

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 her School of Nursing continues today as the Florence Nightingale School of Nursing and Midwifery at King's College London. The Nightingale Building in the School of Nursing and Midwifery at the University of Southampton is also named after her. International Nurses Day is celebrated on her birthday each year.

The Florence Nightingale Declaration Campaign,[28] 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 which will declare: The International Year of the Nurse–2010 (the centennial of Nightingale's death); The UN Decade for a Healthy World–2011 to 2020 (the bicentennial 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. So far, the Florence Nightingale Declaration has been signed by over 18,500 signatories from 86 countries.

During the Vietnam War, Nightingale inspired many U.S. 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.[29]

Four hospitals in Istanbul are named after Nightingale: F. N. Hastanesi in Şişli (the biggest private hospital in Turkey), Metropolitan F.N. Hastanesi in Gayrettepe, Avrupa F.N. Hastanesi in Mecidiyeköy, and Kızıltoprak F.N. Hastanesi in Kadiköy, all belonging to the Turkish Cardiology Foundation.[30]

The Agostino Gemelli Medical School[31] 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.[32]

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.

There is a psychological effect known as the "Florence Nightingale Effect", whereby patients fall in love with their caregivers.[citation needed]

Museums and monuments

Statue of Florence Nightingale in Waterloo Place, London

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.[33]

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.[34]

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.

A bronze plaque, attached to the plinth of the Crimean Memorial in the Haydarpaşa Cemetery, Istanbul and unveiled on Empire Day, 1954, to celebrate the 100th anniversary of her nursing service in that region, bears the inscription:[35]

"To Florence Nightingale, whose work near this Cemetery a century ago relieved much human suffering and laid the foundations for the nursing profession."

Florence Nightingale's voice was saved for posterity in a phonograph recording from 1890 preserved in the British Library Sound Archive.

Theatre

The first theatrical representations of Nightingale was Reginald Berkeley in his "The Lady with the Lamp", premiering in London in 1929 with Edith Evans in the title role. This does not portray her as an entirely sympathetic character and draws much characterisation from Lytton Strachey's biography of her in Eminent Victorians.[36] It was adapted as a film of the same name in 1951. Nightingale also appears in Edward Bond's surrealist play Early Morning, in which she is depicted having a lesbian affair with Queen Victoria.

In 2009, a stage musical play representation of Nightingale was produced by the Association of Nursing Service Administrators of the Philippines (ANSAP), entitled "The Voyage of the Lass". The play depicts the story of love and vocation on the nursing communities' icon Florence Nightingale, shown on all Fridays of February 2009 at the AFP Theatre, Camp Crame, Philippines. The play tells the story of Nightingale's early life and her struggles during the Crimean War. "The Voyage of the Lass" was a two-hour play that showcased Philippine local registered nurses from various hospitals of the country, exposing their talents on the performing arts.

Television

Portrayals of Nightingale on television, in documentary as in fiction, vary - the BBC's 2008 Florence Nightingale emphasised her independence and feeling of religious calling, but in Channel 4's 2006 Mary Seacole: The Real Angel of the Crimea she was portrayed as narrow-minded and opposed to Seacole's efforts. In 1985 a TV biopic "Florence Nightingale", starring Jaclyn Smith as Florence, was produced.

Film

In 1912 a biographical silent film titled The Victoria Cross starring Julia Swayne Gordon as Nightingale was produced. In 1915 another biographical silent film titled Florence Nightingale was produced starring Elisabeth Risdon. In 1936 a biographical film titled White Angel was produced, starring Kay Francis as Nightingale. A 1951 a second "talkie" biographical film titled The Lady With The Lamp was produced starring Anna Neagle.

Banknotes

Florence Nightingale's image appeared on the reverse of Series D £10 banknotes issued by the Bank of England from 1975 until 1994. As well as a standing portrait, she was depicted on the notes in a field hospital in the Crimea, holding her lamp.[37]

Photography

A rare black and white photograph of Florence Nightingale taken in 1910 by Lizzie Caswall Smith in her London home in Park Lane was auctioned on 19 November 2008 by Dreweatts auction house in Newbury, Berkshire, England, for £5,500.[38]

Other

Several churches in the Anglican Communion commemorate Nightingale with a feast day on their liturgical calendars. The Evangelical Lutheran Church in America commemorates her as a renewer of society with Clara Maass on 13 August.

Beginning in 1968, the U.S. Air Force operated a fleet of 20 C-9A "Nightingale" aeromedical evacuation aircraft, based on the McDonnell Douglas DC-9 platform.[39] The last of these planes was retired from service in 2005.[40]

See also

Works

  • Cassandra (1851)
  • Notes on Nursing: What Nursing Is, What Nursing is Not (1859)
  • Suggestions for Thought (to Searchers after Religious Truth)
  • Mysticism and Eastern Religions
  • Florence Nightingale's Theology
  • Florence Nightingale's Spiritual Journey
  • The Family, a critical essay in Fraser's Magazine (1870)
  • Una and Her Paupers, Memorials of Agnes Elizabeth Jones with an introduction by Florence Nightingale. Diggory Press ISBN 978-1905363223
  • Letters from Egypt: A Journey on the Nile 1849-1850 (1987) ISBN 1-55584-204-6

Sources

  • Baly, Monica E. and H. C. G. Matthew, "Nightingale, Florence (1820–1910)"; Oxford Dictionary of National Biography, Oxford University Press (2004); online edn, May 2005 accessed 28 October 2006
  • Bostridge, Mark (2008). Florence Nightingale: The Woman and Her Legend. London: Viking. ISBN 9780670874118.
  • Gill, G. The extraordinary upbringing and curious life of Miss Florence Nightingale Random House, New York (2005)
  • McDonald, Lynn ed., Collected Works of Florence Nightingale. Wilfrid Laurier University Press
  • Pugh, Martin; The march of the women: A revisionist analysis of the campaign for women's suffrage 1866-1914, Oxford (2000), at 55.
  • Sokoloff, Nancy Boyd.; Three Victorian women who changed their world, Macmillan, London (1982)
  • Webb, Val; The Making of a Radical Theologician, Chalice Press (2002)
  • Woodham Smith, Cecil; Florence Nightingale, Penguin (1951), rev. 1955

References

  1. ^ Florence Nightingale's birthplace with photo of commemorative plaque
  2. ^ Bibby, John. (1986) Notes towards a history of teaching statistics
  3. ^ Edward Chaney, "Egypt in England and America: The Cultural Memorials of Religion, Royalty and Revolution", in: Sites of Exchange: European Crossroads and Faultlines, eds. M. Ascari and A. Corrado (Rodopi, Amsterdam and New York, 2006), 39-74.
  4. ^ Oxford Dictionary of National Biography
  5. ^ History of Harley Street at Harley Street Guide (commercial website)
  6. ^ Gill, Christopher J.; Gill, GC (2005). "Nightingale in Scutari: Her Legacy Reexamined". Clinical Infectious Diseases. 40 (12): 1799–1805. doi:10.1086/430380. ISSN 1058-4838. PMID 15909269. Retrieved 2007-10-07. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); More than one of |last1= and |last= specified (help); More than one of |first1= and |first= specified (help)
  7. ^ Florence Nightingale: Measuring Hospital Care Outcomes
  8. ^ a b Florence Nightingale, Avenging Angel by Hugh Small (Constable 1998)
  9. ^ Cited in Cook, E. T. The Life of Florence Nightingale. (1913) Vol 1, p 237.
  10. ^ Nightingale, Florence (1974. First published 1859). "Preface". In … (ed.). Notes on Nursing: What it is and what it is not. Glasgow & London: Blackie & Son Ltd. ISBN 0-216-89974-5. Unknown parameter |ISBN-status= ignored (help); Check date values in: |year= (help).
  11. ^ Nightingale, Florence (1974. First published 1859). "Introduction by Joan Quixley". In … (ed.). Notes on Nursing: What it is and what it is not. Blackie & Son Ltd. ISBN 0397550073. Check date values in: |year= (help)
  12. ^ Florence Nightingale, the Woman and her Legend, by Mark Bostridge (Viking 2008)
  13. ^ Bostridge (2008)
  14. ^ In an 1861 letter, Nightengale wrote "Women have no sympathy. [...] Women crave for being loved, not for loving. They scream out at you for sympathy all day long, they are incapable of giving any in return, for they cannot remember your affairs long enough to do so. ... They cannot state a fact accurately to another, nor can that other attend to it accurately enough for it to become information.".
  15. ^ Institute of Our Lady of Mercy, Great Britain
  16. ^ Cannadine, David. "Ever Yours, Florence Nightingale: Selected Letters." The New Republic. 203.7 (August 13, 1990): 38-42.
  17. ^ Dossey, Barbara Montgomery. Florence Nightingale: Mystic, Visionary, Reformer. Philadelphia: Lippincott Williams & Wilkins, 1999.
  18. ^ "Miss Nightingale Dies, Aged Ninety". The New York Times. 1910-08-15. Retrieved 2007-07-21. Florence Nightingale, the famous nurse of the Crimean war, and the only woman who ever received the Order of Merit, died yesterday afternoon at her London home. Although she had been an invalid for a long time, rarely leaving her room, where she passed the time in a half-recumbent position, and was under the constant care of a physician, her death was somewhat unexpected. A week ago she was quite sick, but then improved, and on Friday was cheerful. During that night alarming symptoms developed, and she gradually sank until 2 o'clock Saturday afternoon, when the end came.
  19. ^ http://www.countryjoe.com/nightingale/joe_grave.jpg
  20. ^ Florence Nightingale: The Grave at East Wellow
  21. ^ Lewi, Paul J. (2006). Speaking of Graphics.
  22. ^ Cohen, I. Bernard (March), "Florence Nightingale", Scientific American, 250: 128–37 Check date values in: |date=, |year= / |date= mismatch (help) (alternative pagination depending on country of sale: 98-107. This quote p.107. Bibliography on p.114)
  23. ^ Cohen, I. Bernard (1984), p.107
  24. ^ Cohen, I. Bernard (1984), p.98
  25. ^ Gilbert, Sandra M. and Susan Gubar. "Florence Nightingale." The Norton Anthology of Literature by Women: The Traditions in English. New York: W.W. Norton, 1996. 836-837.
  26. ^ Florence Nightingale at Tentmaker.org. Accessed July 13, 2007.
  27. ^ Neeb, Kathy. Mental Health Nursing. 3rd. Philadelphia: F.A. Davis Company, 2006.
  28. ^ Florence Nightingale Declaration Campaign
  29. ^ Country Joe McDonald's Tribute to Florence Nightingale
  30. ^ http://www.florence.com.tr/tr/index.asp Florence
  31. ^ Università Cattolica del Sacro Cuore - The Rome Campus
  32. ^ http://www.gesi.it/MS%20bedside(e).pdf
  33. ^ Derby Guide: Florence Nightingale
  34. ^ Florence Nightingale
  35. ^ Commenwealth War Graves Commission Haidar Pasha Cemetery
  36. ^ Mark Bostridge, Florence Nightingale - The Woman and Her Legend
  37. ^ "Withdrawn banknotes reference guide". Bank of England. Retrieved 2008-10-17.
  38. ^ "Rare Nightingale photo sold off". BBC News. 19 November 2008. Retrieved 2008-11-19.
  39. ^ Air Mobility Command Museum: "C-9 Nightingale".
  40. ^ Air Force Link: "Historic C-9 heads to Andrews for retirement".

Further reading

External links

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