Florence Nightingale had an immense influence on nursing.
Before her intervention nursing was often regarded, at least in England, as 'a menial employment needing neither study nor intelligence' (DNB entry on Florence Nightingale). Although she was by no means alone in this, she helped to turn it into what she realised it must be, a respectable profession for capable women. (Although in many ways she was ahead of her time, she was sufficiently trapped in the culture of her day not to conceive of nursing as a respectable profession for men too.)
But how did this come about? Florence was born into a well-to-do family who had no need of employment. (She was named Florence because that was where she happened to be born, in Florence, in Italy) As she grew up she became increasingly frustrated at the kind of life young women in her social circle were expected to lead. She wrote about this in Cassandra. She felt that women had no chance of gaining a professional career or of exercising their talents. They were expected to give their time to social calls, or to dinner parties, and then to get married - to someone they had little real opportunity to get to know. She argued that women would only be truly fulfilled if they were able to work in spheres to which, she believed, they were suited. These were what we now think of as the 'caring' professions - nursing and social work. (We should notice again that she accepted the notion that men and women are fitted to different roles, and she did not argue for women becoming, for example, bank managers or engineers.)
In her early twenties Florence began visiting hospitals. In Egypt she met some of the Sisters of St Vincent de Paul who were nursing in Alexandria and recognised the value of their discipline, organisation and training. She gained further insight herself as a trainee nurse herself in 1851 in a Protestant institution at Kaiserswerth, near Dusseldorf although she claimed that 'the nursing was nil and the hygiene horrible'. She spent the next years visiting hospitals in London, Edinburgh, Dublin and Paris. Then in August 1853 she started work herself as the superintendent of the recently-opened Hospital for Invalid Gentlewomen in London.
This was only a few months before Britain became engaged in the Crimean War. The standard of nursing care provided for the British soldiers wounded at the front was abysmally poor. Florence Nightingale was asked by the secretary of state for war to go out to the Crimea and take control of this work. Her title was Superintendent of the Female Nurses in the Hospitals in the East. She took thirty-eight nurses with her, eighteen of them Roman Catholic or Anglican nuns.
Despite massive difficulties, including the lack of practical necessities and the resentment of both army officers and doctors, she steadily brought about a revolution, insisting on high standards of nursing care and sanitation. It has been said that she 'ruled, but at the same time she slaved' (DNB); in other words, although she took charge and gave orders, she also worked hard at the job of nursing herself. Since she insisted on remaining in control at night, she earned the name of the Lady of the Lamp.
Florence Nightingale returned to England only in 1856. She had already become a legend. Prior to her return, a fund had been established in her honour which she determined should be used to found a training school for nurses. The Nightingale School and Home for Nurses was founded at St.Thomas's Hospital, London, in 1860. The first students - or probationer nurses as they were called - began their course on 24 June. In the same year Florence Nightingale's handbook, Notes on Nursing, was published.
Meanwhile Florence Nightingale herself -although something of an invalid - was actively working for better standards of health care in the army. Her Notes on Matters affecting the Health and Efficiency and Hospital Administration of the British Army led in 1858 to the setting up of a Royal Commission. She then took up the cause of the welfare of the army in India and of the Indian people themselves, arguing in a series of papers and pamphlets for better sanitation and other health-promoting measures.
But good nurses needed good hospital buildings and Florence Nightingale had clear ideas on how hospitals and their wards should be designed. In the late 1850s she published a number of articles on the 'Sites and Construction of Hospitals' and in the 1860s advised on specific building projects. She had a major influence on the subsequent design of both civic and military hospitals.
A further concern for Florence Nightingale lay in the training of nurses for the specialist work of midwifery and in the care of women at the time they gave birth. At her instigation a training school for midwives was founded at King's College Hospital, London, in 1861. In 1871 she published Introductory Notes on Lying-in Institutions.
Florence Nightingale's understanding and ideas influenced the founding, in Liverpool, in 1861 of a system of District Nursing and, ultimately, to the widespread establishment of both District Nurses and Health Visitors.
In later years Florence Nightingale remained an invalid but she continued to take a keen interest in health and nursing and to give advice whenever it was sought. In 1907 she was awarded the Order of Merit by King Edward VII and in 1908 was given the Honorary Freedom of the City of London. She died on 13 August 1910 and was buried at East Wellow, Hampshire. A memorial service took place on the same day in St.Paul's Cathedral, London.
