Florence Nightingale was a revolutionary nurse leader in her time. She was an activist for the “sick poor” (Monteiro, 1985, p. 181) who had the forethought, organization, planning, skills, knowledge, and determination to accomplish great strides in public health and nurse training. She was not just an activist for a specific gender or race, but she was an advocate for the general health and well-being of humanity. Her work still inspires nursing today and has laid the foundation for many nurse theories still relevant for what is now more than a hundred years after her death. History and Contributions
Florence Nightingale was born in 1820 to an upper-class family in England. Florence’s childhood years were spent bringing aid to the less fortunate. She left home at the age of thirty to begin a 3-year nurse training program in Kaiserswerth, Germany (Chitty & Black, 2011, p. 29). Florence is best known for her work in the Crimean War where she and a group of untrained women went to assist the wounded and sick soldiers in Scutari, Turkey. While in Scutari, her theory surrounding the impact that environment had on health began to take shape.
She used her understanding of the impact of environment on health, coupled with statistical evidence she gathered while caring for the soldiers, to bring change to the British Army (Chitty & Black, 2011, p. 30). Her experience during the Crimean War would prove to be invaluable to her later work in London. The Crimean War ignited a passion in Florence Nightingale to pursue the proper training for nurses. It was her belief that nursing could not be accomplished by well-meaning, upper-class women who came to bring aid to the “sick poor” (Monteiro, 1985, p. 184). In her words, “there is no such thing as amateur nursing” and “nursing was an art requiring an organized, practical, and specific training” (Monteiro, 1985, p. 184). In 1860, Florence began a nurses’ training program at St. Thomas’ Hospital in London.
Her training program was the first of many of its kind in England and in the United States (Chitty & Black, 2011, p. 30). Florence would go on to pursue social reform in London and Liverpool where workhouses housed infirmaries that were rampant with infectious diseases. In 1864, there were 1,200 “sick poor” being housed together in a Liverpool workhouse infirmary (Monteiro, 1985, p. 181). Florence was asked by William Rathbone, a wealthy merchant, to devise public policy that would address the conditions these “sick poor” were living in. Her first recommendation to Rathbone was that he start a training school for nurses so that the problem in Liverpool could have long-term attention from properly trained nurses.
Florence agreed to help and began with a questionnaire for all of the workhouses to assess the actual state that they were in. According to Florence, the questionnaire “revealed facts so shameful that they could not be ignored” (Monteiro, 1985, p. 182). Her plan involved dividing the sick into four categories and quarantining them from the rest of the workhouse inhabitants, establishing one administration over all the workhouses to maintain continuity, and raising funds through taxes to cover the expenses involved in caring for the “sick poor” (Monteiro, 1985, p. 182). While her plan was reasonable, it was met with political opposition in London and soon a leadership change would decline it’s acceptance into “Poor Law”. Later, the new leader, Gathorne Hardy, would write his own policy that somewhat resembled Florence’s.
His policy made it into law and brought forth the beginning of change in London. Liverpool, however, was enforcing Florence’s plan and was seeing positive results. One of the graduates of the St. Thomas nursing school, Agnes Jones, was placed as the Superintendent over the Liverpool workhouse infirmaries along with twelve other trained nurses to assist her. Florence would continue her pursuit of establishing the nurse’s proper role in public health and the nurse’s proper training in eleven writings that she authored until her last in 1897. Summary
Florence Nightingale had a central theme from the time of the Crimean War to her work in London and Liverpool: trained nurses were an absolute necessity and that the sick should be met where their sicknesses began, at home. She believed that teaching the poor to be clean and find assistance with sanitation would deter the many infectious diseases that were prevalent in her time. She taught others and she herself sought to teach them in their own environment, their homes. This would later be called Public Health Nursing. Not only did Florence Nightingale forge the way for nurse education but she also brought necessary focus to Public Health Nursing that is still impacting nurses and our communities today. In 1894 Florence is quoted as saying, “it is cheaper to promote health than to maintain people in sickness” (Monteiro, 1985, p. 185). Her words still ring true today. References
Chitty, K. K., & Black, B. P. (2011). The History and Social Context of Nursing. In M. Iannuzzi (Ed.), Professional Nursing: Concepts & Challenges (6th ed., pp. 29-30). Maryland Heights, Missouri: Saunders Elsevier. Monteiro, L. A. (1985, February). Florence Nightingale on Public Health. American Journal of Public Health, 75(2), 181-186. doi: http://ajph.aphapublicati