Teacher, nurse, statistician, author, advocate for health care and occupational health and safety
Nightingale was the major founder of the modern profession of nursing, and health care pioneer, who became famous for leading the first team of British women to nurse in war–the Crimean War of 1854-56.
While Nightingale was famous in her lifetime, and for a long time after it, she is little known today and often mis-represented. She wrote a lot! Not just her most famous book, Notes on Nursing; published in 1860, the same year that her training school opened.
Here are some key points on her work and legacy:
- Nightingale wanted nursing to be an independent profession; nurses would take medical instructions from doctors, but no doctor would hire, fire, discipline or promote a nurse, decisions for senior nurses.
- Her vision for the profession included a career path, with increases in salary and responsibility, and made nursing a well-paying profession. Giving superintendents power to hire, discipline, etc., was to remove it from doctors, then 100% male when nurses were 100% female, and an unspoken measure to prevent sexual harassment of vulnerable women nurses.
- Nightingale consistently argued for good salaries and working conditions for nurses, holidays of at least a month per year; decent pensions; good living conditions during training; and hospital design to save nurses’ energy for patient care. Hospitals should hire cleaners, and nurses ensure that the job was done.
- “Army nurses,” before Nightingale’s time, were recruited from among the wives and widows of privates and non-commissioned officers (doctors were always officers), were paid less than cooks and laundresses, and reported to a sergeant. They did not even speak to a doctor. The belief that Nightingale wanted nurses to be “subordinate to doctors” misses the point, for when her nursing school started, in 1860, women lacked even a high school education, let alone university. Doctors had university/medical qualifications.)
- Nightingale succeeded in improving the status of nurses, from being a “domestic” service occupation in the 1861 Census, to being grouped with “medicine” in 1901 In the army, nurses became “officers,” like doctors.
- She did pioneering work on occupational health and safety as early as 1858. In 1871, she published a pioneering study of maternal mortality post-childbirth, Introductory Notes on Lying-in Institutions. Throughout her life, she worked with doctors, architects, engineers and statisticians to achieve great reforms.
- Nightingale worked to turn the terrible workhouse infirmaries into real hospitals, calling for the same quality of care available to the rich also for the poor.
- Hand washing is the single most effective means of infection control known–Nightingale began urging it in 1860. Hospital architects are turning back to Nightingale for her insights on sunlight and gardens in healing.
- Her writing is now available in a 16-volume Collected Works of Florence Nightingale, collected from more than 200 archives world wide.
Don’t want a 16-volume series? See the 200-page paperback with highlights: Lynn McDonald, Florence Nightingale at First Hand (London: Bloomsbury 2010) and Florence Nightingale, Nursing and Health Care Today (New York: Springer, 2018) 267 pages.