Mr Malcolm Cantello, president; Mr Alan Lovell, chief executive;
Ms Christina McAnea, head, Healthcare team
Unison Centre
130 Euston Road
London NW1 2AY

September 25, 2012

Dear Mr Cantello, Mr Lovell and Ms McAnea

We are writing to propose a rethinking of the importance of Florence Nightingale for nursing, for which you, as a major union, play an important role. We were unhappy and somewhat puzzled by the unanimous decision made back in 1999 to “ditch” Nightingale as the most significant founder of nursing, not least of all for the reasons stated. We suspect that those who voted simply did not know what Nightingale said and did to establish the modern profession. We note that the negative statements made about her were repeated in 2007 (“Kick over the Statues”) and on 12 May 2010, International Nurses’ Day.We would be pleased to meet with you or some representatives to pursue these issues. We think that Michael Walker and Wendy Wheeler have a point that the problem may be more in the “interpretation” of Nightingale’s legacy than in the legacy itself. Re-examination of what exactly she said and did would, we believe, lead to quite a different impression (see Did You Know below). There is much in Nightingale’s work that is still relevant today, especially on the principles of public health care, priority to health promotion and disease prevention, concern for occupational health and safety of healthcare workers, good salaries and working conditions.We want also to correct the misunderstandings in circulation on key points regarding Mary Seacole. We do not at all oppose recognition of her for her work, but rather the according to her of false accomplishments, some of them, in fact, Nightingale’s. So much misinformation about Seacole is now in circulation that it would be difficult for even the most fair-minded inquirer to get the story straight. We give as an example the statement made by your then president on becoming a patron of the Seacole Campaign:When Mary Seacole nursed the sick and wounded on the frontline in the Crimea she did not ask for, or expect any reward. She did it for the British troops, who she loved and admired.

But Seacole did not nurse the sick and wounded on the frontline at all, contrary to what is frequently said. Her British Hotel was a restaurant and store for officers, with minimal service to the troops. Seacole was generous to ordinary soldiers, but this was extra, volunteer work (and commendable): her main occupation was “sutler” or “provision merchant,” for which she had a business partner. She invested in the British Hotel, using the proceeds from her previous business of supplying gold miners on their way out to the California Gold Rush.

The website for the “The Mary Seacole (1805-1880) Campaign ‘Turn her into stone'” contains a number of serious errors, including a false accusation that Nightingale rejected Seacole as a nurse:

• Hearing of the poor medical provisions for would soldiers during the Crimean War, Seacole, who arrived in London in 1854, applied to the War Office and relevant authorities,
  But Seacole was en route to London on business regarding her gold stocks when the first battle took place, and only then decided, after Nightingale and her nurses departed, that she wanted to go to (see her Wonderful Adventures p 74).
• “She was turned down by all, including one of Florence Nightingale’s nurses,” but Nightingale never heard that she had applied.
• “Later the British Government decided to permit women to travel to the affected area. A party of 38 nurses was chosen by Florence Nightingale. Mary Seacole was not included.” No, the group had already left and Seacole was hoping to go with the second lot of nurses; her exclusion had nothing to do with Nightingale.
• “Instead she borrowed money to make the 4000 mile journey by herself at the age of 50. She set up a store and hotel.” She did not borrow money but used the profits from her last business venture; the “store and hotel” was a restaurant and store, a “mess table” for officers (see WA p 81).
• “Mary Seacole distinguished herself treating battlefield wounded and nursing wounded soldiers from both sides while under fire herself.” Seacole never made such a claim; on 3 occasions she went on to the battlefield, post-battle, with refreshments for sale; she also assisted with first aid. She used the expression “under fire” in quotation marks, as did others-for anyone walking around in the camps was at some risk. On one of her battlefield excursions she mentioned assisting Russians (see p 157).
• The “transcript of a letter” from Sir John Hall cited in the website was not a transcript, but part of Seacole’s own memoir, for which no documented source is known, and it is very unlikely to have been written by Hall (see p 170).
• The excerpt from Russell (although he was not then “Sir”) is correct as far as it goes, but it misleadingly omits his other remarks about her work as a “sutler,” or supplier of provisions, her chief work (see viii).

We must wonder about a union that calls for equal dignity for all attacking someone for her race, class of origin and religion, as Unison’s rejection of Nightingale in 1999 seems to do, for her being “white, middle class and Protestant.” This is the more remarkable when you support Seacole, who was three quarters white, also middle class and Roman Catholic.

We would agree that there are other “founders” of nursing worthy of recognition-Nightingale herself particularly appreciated Mary Jones and Sarah Wardroper. The Collected Works of Florence Nightingale provides information on a number of other worthy leaders.

Nursing leaders of diverse backgrounds of course should be celebrated. Some examples (a start) of African, West Indian and South Asian pioneer nurses are given, with information on Seacole, at http://www.maryseacole.info.

Elizabeth Fry was an early promoter of nursing, but her organization was chiefly for private nursing for the wealthy in their homes. Nor did she promote the development of a profession which Nightingale did. Making her the “founder” of nursing we suspect would be a step backwards.

We look forward to exploring these important issues with you. One of us, Lynn McDonald, lives in Canada but will be in London in the spring; the other three are resident in London and could be available earlier. McDonald, as well as being the one most knowledgeable about Nightingale, is a former Canadian MP (of a sister party to the Labour Party) and a successful advocate on women’s and public health issues.

Yours sincerely

Did You Know?

• That Nightingale did pioneering work on occupational health and safety for nurses;
• That she 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; those decisions would be made by senior nurses;
• That Nightingale’s vision included a career path, with increases in salary and responsibility, through the ward sister to the superintendent or matron, which was a high paying job? That giving superintendents power to hire, discipline, etc., was to remove it from doctors, then 100% male when nurses were 100% female-it was an unspoken measure to prevent sexual harassment of vulnerable women nurses;
• While Nightingale wrote about “self sacrifice,” she 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;
• That Nightingale worked mightily to make nurses givers of patient care, instead of hospital cleaners; hospitals should hire cleaners and nurses ensure that the job was done; nurses could not be the cleaners themselves.
• That “nurses,” before Nightingale’s time were not what we would recognize as nurses. In the army they 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. Before Nightingale’s time they would not have even spoken to a doctor; they were subordinate to a sergeant!
  Thus the statement that Nightingale wanted nurses to be “subordinate to doctors” misses the point. When she started her nursing school in 1860, women did not even have a high school education, let alone university. Doctors, with university and medical qualifications, would never have accepted them as equals. Nightingale worked prodigiously to improve the status of nurses, and saw it rise. When she started, “nurses” were listed with “domestic” servants in the Census; by 1901 they were in “medicine.” In the army they became “officers,” like doctors;
• Did you know that Nightingale worked to upgrade the terrible workhouse infirmaries into real hospitals? That she held that the same high quality of care available to the rich should be also for the poor? Is this not a message still needed today?
• Did you know that Nightingale worked with other professionals- doctors, statisticians, engineers, architects-on health care reforms? A union wanting to encourage its members to think of policy and advocacy would find much that is relevant in her example.
• Did you know that the original Elizabeth Garrett Hospital, where the Unison Centre now lives after much rebuilding, was a women’s hospital on whose design Nightingale worked? That she contributed to the funding for the hospital, and helped raise money for it?

For more on what Nightingale actually said and wrote see: www.uoguelph.ca/~cwfn.