Lo! in that house of misery,
A lady with a lamp I see,
Pass through the glimmering gloom,
And flit from room to room.
Thus were Henry Wadsworth Longfellow’s words in Santa Filomena about The Lady with the Lamp, the founding angel of modern nursing: Florence Nightingale.
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Born on May 12, 1820 to a wealthy British family, Florence Nightingale was named after the city of her birth; Florence, Italy.
The family moved back to England in 1821, where Nightingale would be educated by her father.
From a very young age, Nightingale rebelled against the expectations put upon someone of his stature. While her mother was interested in climbing the social hierarchy, Nightingale shied away from attention. This represented one of several reasons that she and her mother – whom Nightingale considered far too strict – did not get along well
Her interest lay instead in tending to the ill and poor people in neighbouring areas of her family’s two estates. She started her philanthropic activities at a remarkably young age, and by her mid-teens, Nightingale’s future, her “divine purpose” was clear: she would become a professional nurse.
The decision was tantamount to heresy. Nightingale’s parents expressly forbade her to consider it any further. She was expected to marry ‘a man of worth’, not work a menial job. At age 17, she turned down the first of several marriage proposals, declaring that her “moral…active nature…requires satisfaction, and that would not find it in this life”. Indeed, for the rest of her life, Nightingale would avoid romantic pursuits with men.
At age 18, Nightingale’s father took her on a tour of Europe. While in France they would meet Mary Clarke, the woman who would become one of the biggest early influences of the young girl’s life. She did not focus on her appearance, social status, or pleasing everyone, in stark contrast to Nightingale’s mother. She spent her time predominantly in the company of male intellectuals (Nightingale would be a rare exception when their friendship grew), saying that if she’d had the choice of being a women or a galley slave, then she would choose the freedom of the galleys. Mary Clarke championed the notion that women could nevertheless be equal to men, a startling revelation in the eyes of Nightingale.
Nightingale’s experiences in Europe, especially in the presence of Mary Clarke, helped her make the ultimate decision to reject her family’s firm grasp on her future, and finally enrol as a nursing student at the Lutheran Hospital of Pastor Fliedner in Germany.
Three years later she travelled through Italy, where she met Sidney Herbert, a former British Secretary of War who would become instrumental in helping Nightingale reform nursing practices in the coming years. From there, she crossed into Greece, then Egypt.
At Thebes, she claims being “called to God”. Fuelled by her divine experience, she returned to Germany in 1950 and began working in the Lutheran community of Kaiserswerth-am-Rhein, tending to the sick and poor. It was a turning point in both her career and life, resulting in her first published book, The Institution of Kaiserswerth on the Rhine, for the Practical Training of Deaconesses, etc. The book was released anonymously in 1951.
The following year, Nightingale took a nursing job at the Institute for the Care of Sick Gentlewomen in London, and so impressed her employers that she became a superintendent in a year. She worked hard to improve sanitation at a time when cleanliness was not understood as beneficial to a patient’s health. The hospital’s death rate would drop significantly as a result.
But it was a year later, in October 1854, that Nightingale’s skills as a nurse would really come into their own.
12 months had passed since the commencement of the Crimean War, which saw British and Russian forces fought for control of the Ottoman Empire. 18,000 troops had been interred in medical camps over that time, but conditions were poor, and women nurses were not being enlisted due to previous poor experiences. But when insight of the conditions these soldiers faced reached the British population, unrest caused the government to cry out for more medical support.
Nightingale answered the call.
She trained 38 volunteer nurses, including her aunt and friend Mary Clarke, and within a month they were stationed in Scutari, the modern-day’s Istanbul.
Nothing could have prepared the nurses for what they experienced. The hospital sat upon a cesspool. Pest scurried around the patients, who lay in pools of their own excrement on stretchers that lined the halls. Supplies were limited. Worse, officials from the armed forces treated the situation with indifference.
Still, the conditions did not cause Nightingale to waver. She scrubbed the hospital clean from floor to ceiling, then turned her attention to the injured. Nightingale gained the nickname The Lady with the Lamp, as she moved around the hospital by night, caring for and comforting patients.
“I am of certain convinced that the greatest heroes are those who do their duty in the daily grind of domestic affairs whilst the world whirls as a maddening dreidel.”
4077 soldiers died in the hospital over that winter, most due to illness caused by the conditions rather than directly from their wounds.
In March of 1955, a sanitary commission entered the camp in response to a letter Nightingale had written to The Times requesting the government improve conditions. Though Nightingale never took credit, her work cut the death rate by 66% at Scutari, and 90% in other hospitals such as Renkioi, a prefabricated model which were commissioned after Nightingale’s letter was published.
Nightingale returned to England at the end of the war to a hero’s welcome. The Queen celebrated her efforts by honouring her with an engraved brooch known as the Nightingale Jewel, and a prize of $250,000.
Humbled but disinterested in recognition of her achievements, Nightingale began to focus on her findings about how nutrition, airflow, the overworking of staff and lack of supplies had made a bad situation in the Crimea even worse. When completed, she released an 830-page report entitled Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army. The damning notes would inspire a Royal Commission for the Health of the Army in 1857, and forever change the sanitary conditions found in military hospitals.
A year after, Nightingale wrote Notes on Nursing for the education of aspiring practitioners. It is now considered the cornerstone of nursing curriculum. “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,” reads the introduction to the 1974 edition, written by Joan Quixley of the Nightingale Training School Nightingale established in 1860.
From the mid-1850s onwards, Nightingale would spend much of her time bedridden with depression and an unknown illness that would later be known as Crimean fever, related to the consumption of infected animals or their by-products. Still, remarkably, she remained prolific, dedicating the rest of her life promoting the nursing profession across the British Empire, and the United States,
Nightingale was awarded the Royal Red Cross in 1883, appointed a Lady of Grace of the Order of St John in 1904, and in 1907, became the first woman to be awarded the Order of Merit.
Florence Nightingale died at the age of 90, on 13 August 1910.
Her achievements were many, and indelibly crucial to modern nursing, not least of all to her pioneering efforts as a woman striking out against social expectation. “I attribute my success to this – I never gave or took any excuse.”
The legacy she left behind – cemented in literature, film, plays, on the walls of museums, the lobbies of hospitals, or the many monuments that stand around the world – will never be forgotten. As it did at night during her time at Scutari, her dedication and knowledge has lit the way to a better future for all.