essay on florence nightingale

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Florence Nightingale

By: History.com Editors

Updated: April 24, 2023 | Original: November 9, 2009

Florence Nightingale (1820-1910), known as “The Lady With the Lamp,” was a British nurse, social reformer and statistician best known as the founder of modern nursing. Her experiences as a nurse during the Crimean War were foundational in her views about sanitation. She established St. Thomas’s Hospital and the Nightingale Training School for Nurses in 1860. Her efforts to reform healthcare greatly influenced the quality of care in the 19 and 20 centuries.

Florence Nightingale: Early Life

Florence Nightingale was born on May 12, 1820, in Florence, Italy to Frances Nightingale and William Shore Nightingale. She was the younger of two children. Nightingale’s affluent British family belonged to elite social circles. Her mother, Frances, hailed from a family of merchants and took pride in socializing with people of prominent social standing. Despite her mother’s interest in social climbing, Florence herself was reportedly awkward in social situations. She preferred to avoid being the center of attention whenever possible. Strong-willed, Florence often butted heads with her mother, whom she viewed as overly controlling. Still, like many daughters, she was eager to please her mother. “I think I am got something more good-natured and complying,” Florence wrote in her own defense, concerning the mother-daughter relationship.

Florence’s father was William Shore Nightingale, a wealthy landowner who had inherited two estates—one at Lea Hurst, Derbyshire, and the other in Hampshire, Embley Park—when Florence was five years old. Florence was raised on the family estate at Lea Hurst, where her father provided her with a classical education, including studies in German, French and Italian.

From a very young age, Florence Nightingale was active in philanthropy, ministering to the ill and poor people in the village neighboring her family’s estate. By the time she was 16 years old, it was clear to her that nursing was her calling. She believed it to be her divine purpose.

When Nightingale approached her parents and told them about her ambitions to become a nurse, they were not pleased. In fact, her parents forbade her to pursue nursing. During the Victorian Era , a young lady of Nightingale’s social stature was expected to marry a man of means—not take up a job that was viewed as lowly menial labor by the upper social classes. 

When Nightingale was 17 years old, she refused a marriage proposal from a “suitable” gentleman, Richard Monckton Milnes. Nightingale explained her reason for turning him down, saying that while he stimulated her intellectually and romantically, her “moral…active nature…requires satisfaction, and that would not find it in this life.” Determined to pursue her true calling despite her parents’ objections, in 1844, Nightingale enrolled as a nursing student at the Lutheran Hospital of Pastor Fliedner in Kaiserwerth, Germany.

Florence Nightingale and Nursing

In the early 1850s, Nightingale returned to London, where she took a nursing job in a Middlesex hospital for ailing governesses. Her performance there so impressed her employer that Nightingale was promoted to the superintendent within just a year of being hired. The position proved challenging as Nightingale grappled with a cholera outbreak and unsanitary conditions conducive to the rapid spread of the disease. Nightingale made it her mission to improve hygiene practices, significantly lowering the death rate at the hospital in the process. The hard work took a toll on her health. She had just barely recovered when the biggest challenge of her nursing career presented itself. 

Florence Nightingale and the Crimean War

In October of 1853, the Crimean War broke out. The British Empire was at war against the Russian Empire for control of the Ottoman Empire . Thousands of British soldiers were sent to the Black Sea, where supplies quickly dwindled. By 1854, no fewer than 18,000 soldiers had been admitted into military hospitals.

At the time, there were no female nurses stationed at hospitals in Crimea. The poor reputation of past female nurses had led the war office to avoid hiring more. But, after the Battle of Alma, England was in an uproar about the neglect of their ill and injured soldiers, who not only lacked sufficient medical attention due to hospitals being horribly understaffed but also languished in appallingly unsanitary and inhumane conditions.

In late 1854, Nightingale received a letter from Secretary of War Sidney Herbert, asking her to organize a corps of nurses to tend to the sick and fallen soldiers in the Crimea. Nightingale rose to her calling. She quickly assembled a team of 34 nurses from a variety of religious orders and sailed with them to the Crimea just a few days later.

Although they had been warned of the horrid conditions there, nothing could have prepared Nightingale and her nurses for what they saw when they arrived at Scutari, the British base hospital in Constantinople . The hospital sat on top of a large cesspool, which contaminated the water and the hospital building itself. Patients lay on in their own excrement on stretchers strewn throughout the hallways. Rodents and bugs scurried past them. The most basic supplies, such as bandages and soap, grew increasingly scarce as the number of ill and wounded steadily increased. Even water needed to be rationed. More soldiers were dying from infectious diseases like typhoid and cholera than from injuries incurred in battle.

The no-nonsense Nightingale quickly set to work. She procured hundreds of scrub brushes and asked the least infirm patients to scrub the inside of the hospital from floor to ceiling. Nightingale herself spent every waking minute caring for the soldiers. In the evenings she moved through the dark hallways carrying a lamp while making her rounds, ministering to patient after patient. The soldiers, who were both moved and comforted by her endless supply of compassion, took to calling her “the Lady with the Lamp.” Others simply called her “the Angel of Crimea.” Her work reduced the hospital’s death rate by two-thirds.

In addition to vastly improving the sanitary conditions of the hospital , Nightingale created a number of patient services that contributed to improving the quality of their hospital stay. She instituted the creation of an “invalid’s kitchen” where appealing food for patients with special dietary requirements was cooked. She established a laundry so that patients would have clean linens. She also instituted a classroom and a library for patients’ intellectual stimulation and entertainment. Based on her observations in Crimea, Nightingale wrote Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army , an 830-page report analyzing her experience and proposing reforms for other military hospitals operating under poor conditions. The book would spark a total restructuring of the War Office’s administrative department, including the establishment of a Royal Commission for the Health of the Army in 1857.

Nightingale remained at Scutari for a year and a half. She left in the summer of 1856, once the Crimean conflict was resolved, and returned to her childhood home at Lea Hurst. To her surprise, she was met with a hero’s welcome, which the humble nurse did her best to avoid. The Queen rewarded Nightingale’s work by presenting her with an engraved brooch that came to be known as the “Nightingale Jewel” and by granting her a prize of $250,000 from the British government.

Florence Nightingale, Statistician

With the support of Queen Victoria , Nightingale helped create a Royal Commission into the health of the army. It employed leading statisticians of the day, William Farr and John Sutherland, to analyze army mortality data, and what they found was horrifying: 16,000 of the 18,000 deaths were from preventable diseases—not battle. But it was Nightingale’s ability to translate this data into a new visual format that really caused a sensation. Her polar area diagram, now known as a “Nightingale Rose Diagram,” showed how the Sanitary Commission’s work decreased the death rate and made the complicated data accessible to all, inspiring new standards for sanitation in the army and beyond. She became the first female member of the Royal Statistical Society and was named an honorary member of the American Statistical Association.

Florence Nightingale’s Impact on Nursing

Nightingale decided to use the money to further her cause. In 1860, she funded the establishment of St. Thomas’ Hospital, and within it, the Nightingale Training School for Nurses. Nightingale became a figure of public admiration. Poems, songs and plays were written and dedicated in the heroine’s honor. Young women aspired to be like her. Eager to follow her example, even women from the wealthy upper classes started enrolling at the training school. Thanks to Nightingale, nursing was no longer frowned upon by the upper classes; it had, in fact, come to be viewed as an honorable vocation.

While at Scutari, Nightingale had contracted “Crimean fever” and would never fully recover. By the time she was 38 years old, she was homebound and bedridden and would be so for the remainder of her life. Fiercely determined and dedicated as ever to improving health care and alleviating patients’ suffering, Nightingale continued her work from her bed.

Residing in Mayfair, she remained an authority and advocate of health care reform, interviewing politicians and welcoming distinguished visitors from her bed. In 1859, she published Notes on Hospitals , which focused on how to properly run civilian hospitals.

Throughout the U.S. Civil War , she was frequently consulted about how to best manage field hospitals. Nightingale also served as an authority on public sanitation issues in India for both the military and civilians, although she had never been to India herself.

In 1908, at the age of 88, she was conferred the merit of honor by King Edward. In May of 1910, she received a congratulatory message from King George on her 90th birthday.

Florence Nightingale: Death and Legacy

In August 1910, Florence Nightingale fell ill but seemed to recover and was reportedly in good spirits. A week later, on the evening of Friday, August 12, 1910, she developed an array of troubling symptoms. She died unexpectedly at 2 p.m. the following day, Saturday, August 13, 1910, at her home in London.

Characteristically, she had expressed the desire that her funeral be a quiet and modest affair, despite the public’s desire to honor Nightingale—who tirelessly devoted her life to preventing disease and ensuring safe and compassionate treatment for the poor and the suffering. Respecting her last wishes, her relatives turned down a national funeral. The “Lady with the Lamp” was laid to rest in Hampshire, England.

The Florence Nightingale Museum, which sits at the site of the original Nightingale Training School for Nurses, houses more than 2,000 artifacts commemorating the life and career of the “Angel of the Crimea.” To this day, Florence Nightingale is broadly acknowledged and revered as the pioneer of modern nursing.

Florence Nightingale: Saving Lives With Statistics. BBC. Florence Nightingale. The National Archives, UK.

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Florence Nightingale

Often called “the Lady with the Lamp,” Florence Nightingale was a caring nurse and a leader. In addition to writing over 150 books, pamphlets and reports on health-related issues, she is also credited with creating one of the first versions of the pie chart. However, she is mostly known for making hospitals a cleaner and safer place to be.

Florence Nightingale was born on May 12, 1820, in Florence, Italy. Although her parents were from England, she was born in Italy while they were traveling. Both Florence and her older sister Parthenope were named after the Italian cities where they were born. When they returned to England in 1821, the Nightingale family lived in two homes. They had a summer home in Derbyshire called Lea Hurst , and a winter home in Hampshire called Embley. Growing up in a wealthy family, Florence Nightingale was homeschooled by her father and expected to get married at a young age. However, when she was a teenager, Nightingale believed she received a “calling” from God to help the poor and the sick.

Even though it was not a respected profession at the time, Nightingale told her parents that she wanted to become a nurse. Her parents did not approve of her decision and wanted her to get married and raise a family. Nightingale still wanted to be a nurse and refused marriage. Eventually, her father allowed her to go to Germany for three months to study at Pastor Theodore Fliedner’s hospital and school for Lutheran Deaconesses. After finishing her program in Germany, Nightingale went to Paris for extra training with the Sisters of Mercy. By the time she was 33, Nightingale was already making a name for herself in the nursing community. She returned to England in 1853 and became the superintendent and manager of a hospital for “gentlewomen” in London.

When the Crimean War began in 1854, the British were unprepared to deal with the number of sick and injured soldiers. The lack of medical supplies, overcrowding, and unsanitary conditions caused many people to complain. Newspapers began to report about the terrible state of medical care. The Secretary of War, Sidney Herbert asked Nightingale to manage a group of nurses that would go treat the wounded soldiers. She agreed, and on November 4, 1854, Nightingale and 38 nurses arrived at the British camp outside of Constantinople. When they got there, the doctors were unwelcoming because they did not want to work with female nurses. However, as the number of patients increased, the doctors needed their help. The nurses brought supplies, nutritious food, cleanliness, and sanitation to the military hospital. They also provided individual care and support. Nightingale was known for carrying a lamp and checking on the soldiers at night, so they gave her the nickname “the Lady with the Lamp.” Within six months, Nightingale and her team transformed the hospital. The death rate went down from 40 percent to 2 percent because of their work.

When Nightingale returned from the war, she continued to improve the conditions of hospitals. She presented her experiences and her data to Queen Victoria and Prince Albert in 1856. This data was the reason they formed a Royal Commission to improve the health of the British Army. Nightingale was so skilled with data and numbers that in 1858 she was also elected as the first woman member of the Royal Statistical Society. In 1859, Nightingale continued to spread her healthier medical practices by helping to set up the Army Medical College in Chatham. That same year, she published a book called Notes on Nursing: What it is, and What it is Not . Her book gives advice on good patient care and safe hospital environments. As a result of her efforts during the war, a fund was set up for Nightingale to continue teaching nurses in England. In 1860, the Nightingale Training School at St. Thomas’ Hospital was officially opened. In her later years, Nightingale was often bedridden from illness. However, she continued to advocate for safe nursing practices until her death.

Although Florence Nightingale died on August 13th, 1910 at the age of 90, her legacy continues. Two years after her death, the International Committee of the Red Cross created the Florence Nightingale Medal, that is given to excellent nurses every two years. Also, International Nurses Day has been celebrated on her birthday since 1965. In May of 2010, the Florence Nightingale Museum at St. Thomas’ Hospital in London reopened to honor the hundredth anniversary of Nightingale’s death.

Fee, Elizabeth, and Mary E Garofalo. “Florence Nightingale and the Crimean War.” American journal of public health vol. 100, no. 9 (2010): 1591. doi:10.2105/AJPH.2009.188607

Reynolds-Finley Historical Library. “The Life of Florence Nightingale.” The University of Alabama at Birmingham. Accessed May 1, 2018. https://library.uab.edu/locations/reynolds/collections/florence-nightingale/life

The Florence Nightingale Museum. “Florence Nightingale Biography.” Accessed May 3, 2018. https://www.florence-nightingale.co.uk/resources/biography/?v=7516fd43adaa.

The National Archives. “Florence Nightingale.” September 05, 2018. http://www.nationalarchives.gov.uk/education/resources/florence-nightingale/.

Photograph:

http://www.nationalarchives.gov.uk/wp-content/uploads/2014/03/COPY_1_11_34_1866-e1402062188591.jpg

MLA - Alexander, Kerri Lee. “Florence Nightingale." National Women's History Museum. National Women's History Museum, 2019. Date accessed.

Chicago - Alexander, Kerri Lee. "Florence Nightingale." National Women's History Museum. 2019. www.womenshistory.org/education-resources/biographies/florence-nightingale.

National Geographic Kids. “Florence Nightingale Facts for Kids.” April 26, 2018. https://www.natgeokids.com/za/discover/history/general-history/florence-nightingale/.

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Florence Nightingale: The Lady with the Lamp

Florence Nightingale (1820-1910) was a legend in her own lifetime and one of the most famous women in British history. Her work in the Crimea set the standards for modern nursing. For the rest of her life, she continued to campaign for improved sanitary conditions in both military and civilian hospitals.

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Florence Nightingale at Scutari, 1856

Training and appointment

Born into a wealthy family, Florence overcame the narrow opportunities offered to girls of her station. In 1851, despite the disapproval of her family, she completed a course of nursing training in Germany.

Moved by newspaper accounts of soldiers' suffering in the Crimean War (1854-56), Florence answered a government appeal for nurses. She was soon appointed Superintendent of the Female Nurses in the Hospitals in the East.

The hospital and cemetery at Scutari, 1856

Arrival at Scutari

On 21 October 1854, Florence and her party of nurses left London. They crossed the Channel and travelled through France to Marseilles. From there they sailed to Constantinople (now Istanbul), arriving on 3 November.

At Scutari, near Constantinople, the conditions were dire. The dirty and vermin-ridden hospital lacked even basic equipment and provisions. The medical staff were swamped by the large number of soldiers being shipped across the Black Sea from the war in the Crimea. More of these patients were suffering from disease than from battle wounds.

'All were swarming with vermin, huge lice crawling all about their persons and clothes. Many were grimed with mud, dirt, blood and gunpowder stains. Several were completely prostrated by fever and dysentery. The sight was a pitiable one and such as I had never before witnessed...  'There has been somehow unaccountable neglect in the arrangements for this hospital. Until some hours after the arrival of the men there were neither stores, attendants nor the necessary refreshments on the spot. During this afternoon I attended single handed to the wounds and wants of 74 helpless men.' Assistant Surgeon Henry Bellew describing Scutari hospital - January 1855

Despite these conditions, the male army doctors didn't want the help of Florence and her nurses. At first, they saw her opinions as an attack on their professionalism. But after fresh casualties arrived from the Battle of Inkerman in November 1854, the staff were soon fully stretched and accepted the nurses' aid.

Florence and her nurses improved the medical and sanitary arrangements, set up food kitchens, washed linen and clothes, wrote home on behalf of the soldiers, and introduced reading rooms.

Florence Nightingale’s lamp, c1856

The Lady with the Lamp

Florence gained the nickname 'the Lady with the Lamp' during her work at Scutari. 'The Times' reported that at night she would walk among the beds, checking the wounded men holding a light in her hand.

The image of 'the Lady with the Lamp' captured the public's imagination and Florence soon became a celebrity. One of the main creators of the Nightingale cult was Henry Wadsworth Longfellow, who immortalised her in his poem 'Santa Filomena' .

'A Lady with a lamp shall stand. In the great history of the land, A noble type of good, Heroic Womanhood'. 'Santa Filomena' by Henry Wadsworth Longfellow - 1857

Florence and her nurses greatly improved the comfort of the men at Scutari. But, by February 1855, the death rate at the hospital had risen to 42 per cent. Florence mistakenly blamed the high number of deaths on inadequate nutrition, not on poor sanitation.

The unventilated building sat on top of a damaged sewer. The death rate only dropped after the sanitary commission repaired the sewers and improved the ventilation.

Florence Nightingale in the Military Hospital at Scutari, 1855

More help needed

In January 1855, Florence wrote to Lord Raglan, the British commander in the Crimea, pointing out deficiencies in medical arrangements for the sick and wounded at Scutari. She wrote about the lack of trained medical orderlies in the wards and pointed out that 'hundreds of lives may depend upon' addressing this situation.

Letter of Lieutenant-General Sir John Burgoyne on Florence Nightingale, 27 March 1855

Troubles and turmoils

Lord Raglan was sympathetic, but others were less enthusiastic. General Sir John Burgoyne believed that although 'the hospitals appear to me to be in excellent order' and the patients content, there was 'an under current of troubles and turmoils'.

He felt that Florence did 'not appear to be amiable in ordinary intercourse with her equals or superiors. She likes to govern, and bestows all her tenderness upon those who depend upon her'.

Florence sketched at the time of her illness, 1856

Crimean fever

On 2 May 1855, Florence left the hospital in Scutari in order to witness for herself the conditions of the army at Balaklava. Within a few days of her arrival in the harbour, she was struck down with 'Crimean fever'.

Although it was feared that she was near to death, Lord Raglan was able to telegraph London that she was out of danger by 24 May. However, her recovery was slow, hampered in part by her demanding schedule.

'During the greater part of the day I have been without food necessarily, except a little brandy and water (you see I am taking to drinking like my comrades in the Army)' Florence Nightingale writing to Sidney Herbert, Secretary at War, during her illness - 1855

On returning to her duties, the exertion of travelling to far-flung field hospitals took its toll on Florence's delicate health. She was given a mule cart, but this overturned one night. Colonel William McMurdo of the Land Transport Corps presented her with her Crimean carriage, which also served as an ambulance.

Model of the carriage used by Florence Nightingale in the Crimea, 1856

Florence was also a ground-breaking statistician. When she arrived at Scutari, the number of deaths was not being recorded appropriately. Her use of statistics cut through rumour and hearsay, while diagrams provided hard evidence in support of her recommendations for reforms in patient care.

Through data analysis, she found that soldiers were more likely to survive if they stayed in the hospitals at the front (which had a 12.5 per cent mortality rate) than if they were transferred to the hospital in Scutari (which had a 37.5 per cent mortality rate). In 1859, in recognition of her pioneering work, she was elected the first female member of the Royal Statistical Society.   The chart below, which Florence included in one of her books, allowed multiple data comparisons in one diagram. It clearly demonstrated that more soldiers had died in the Crimea in 1855-56 from disease (shown in blue) than from wounds (shown in red).

Nightingale Training School

Florence returned to England in August 1856. In the years that followed, she continued to campaign for the reform of nursing and for cleaner hospitals.

By 1859, well-wishers had donated over £40,000 to the Nightingale Fund. Florence used this money to set up the Nightingale Training School at St Thomas's Hospital on 9 July 1860.

Once the nurses were trained, they were sent to hospitals all over Britain, where they introduced her ideas. Florence also published two books, 'Notes on Hospital' (1859) and 'Notes on Nursing'   (1859), that laid the foundations of modern nursing practice.

The Nightingale Jewel given by Queen Victoria to Florence Nightingale in 1855

Recognition and adulation

Florence was showered with awards and decorations in recognition of her work. She became a national icon.

Her contemporary fame was reflected in the production of merchandise commemorating her achievements. Florence herself was publicity-shy and was appalled at the adulation she received. But this did not prevent the development of a whole industry based on her celebrity.

Queen Victoria herself awarded Florence a jewelled brooch, designed by her husband, Prince Albert. It was dedicated: 'To Miss Florence Nightingale, as a mark of esteem and gratitude for her devotion towards the Queen's brave soldiers.’

Florence Nightingale was the first of eight women to receive the Order of Merit.

The highly prestigious order's membership is limited to the sovereign and a maximum of 24 others at any one time..

Order of Merit awarded to Florence Nightingale in 1907

Bust presented to Florence Nightingale by men of the British Army in 1862

Florence later suffered from what is now known as Chronic Fatigue Syndrome. Despite being bedridden for many years, she still campaigned tirelessly to improve health standards.

She died on 13 August 1910 aged 90. Her relatives declined the offer of burial in Westminster Abbey. She was instead buried at St Margaret's Church in East Wellow, near her parents' home.

Florence Nightingale, 1860

Before Florence Nightingale, nursing was not considered a respectable profession. With the exception of nuns, the women who worked as nurses were often ill-trained and poorly disciplined. Most were working-class. Florence was determined to encourage educated, 'respectable' women into nursing.

Her work in the Crimea set the standards for modern nursing and helped transform its public image.

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Florence Nightingale

Florence Nightingale was a trailblazing figure in nursing who greatly affected 19th- and 20th-century policies around proper medical care. She was known for her night rounds to aid the wounded, establishing her image as the 'Lady with the Lamp.'

(1820-1910)

Who Was Florence Nightingale?

Part of a wealthy family, Florence Nightingale defied the expectations of the time and pursued what she saw as her God-given calling of nursing. During the Crimean War, she and a team of nurses improved the unsanitary conditions at a British base hospital, greatly reducing the death count. Her writings sparked worldwide health care reform, and in 1860 she established St. Thomas' Hospital and the Nightingale Training School for Nurses. A revered hero of her time, she died on August 13, 1910, in London.

Background and Early Life

Nightingale was born on May 12, 1820, in Florence, Italy, the city which inspired her name. The younger of two daughters, Nightingale was part of an affluent British clan that belonged to elite social circles. Her mother, Frances Nightingale, hailed from a family of merchants and took pride in socializing with people of prominent standing. Despite her mother's interests, Nightingale herself was reportedly awkward in social situations and preferred to avoid being the center of attention whenever possible. Strong-willed, she often butted heads with her mother, whom she viewed as overly controlling.

Nightingale's father was William Edward Nightingale (having changed his original surname, "Shore"), a wealthy landowner who would be associated with two estates—one at Lea Hurst, Derbyshire, and the other at Embly, Hampshire. Nightingale was provided with a classical education, including studies in mathematics along with German, French and Italian.

From a young age, Nightingale was active in philanthropy, ministering to the ill and poor people in the village neighboring her family’s estate. Nightingale eventually came to the conclusion that nursing was her calling; she believed the vocation to be her divine purpose.

When Nightingale approached her parents and told them about her ambitions to become a nurse, they were not pleased and forbade her to pursue appropriate training. During the Victorian Era, where English women had almost no property rights, a young lady of Nightingale's social stature was expected to marry a man of means to ensure her class standing—not take up a job that was viewed by the upper social classes as lowly menial labor.

In 1849, Nightingale refused a marriage proposal from a "suitable" gentleman, Richard Monckton Milnes, who had pursued her for years. She explained her reason for turning him down, saying that while he stimulated her intellectually and romantically, her "moral…active nature" called for something beyond a domestic life. (One biographer has suggested that the rejection of marriage to Milnes was not in fact an outright refusal.) Determined to pursue her true calling despite her parents' objections, Nightingale eventually enrolled as a nursing student in 1850 at the Institution of Protestant Deaconesses in Kaiserswerth, Germany.

Crimean War

In the early 1850s, Nightingale returned to London, where she took a nursing job in a Harley Street hospital for ailing governesses. Her performance there so impressed her employer that Nightingale was promoted to superintendent. Nightingale also volunteered at the Middlesex Hospital around this time, grappling with a cholera outbreak and unsanitary conditions conducive to the rapid spread of the disease. Nightingale made it her mission to improve hygiene practices, significantly lowering the death rate at the hospital in the process.

In October 1853, the Crimean War broke out. Allied British and French forces were at war against the Russian Empire for control of Ottoman territory. Thousands of British soldiers were sent to the Black Sea, where supplies quickly dwindled. By 1854, no fewer than 18,000 soldiers had been admitted into military hospitals.

At the time, there were no female nurses stationed at hospitals in the Crimea. After the Battle of Alma, England was in an uproar about the neglect of their ill and injured soldiers, who not only lacked sufficient medical attention due to hospitals being horribly understaffed but also languished in appallingly unsanitary conditions.

Pioneering Nurse

In late 1854, Nightingale received a letter from Secretary of War Sidney Herbert, asking her to organize a corps of nurses to tend to the sick and fallen soldiers in the Crimea. Given full control of the operation, she quickly assembled a team of almost three dozen nurses from a variety of religious orders and sailed with them to the Crimea just a few days later.

Although they had been warned of the horrid conditions there, nothing could have prepared Nightingale and her nurses for what they saw when they arrived at Scutari, the British base hospital in Constantinople. The hospital sat on top of a large cesspool, which contaminated the water and the building itself. Patients lay in their own excrement on stretchers strewn throughout the hallways. Rodents and bugs scurried past them. The most basic supplies, such as bandages and soap, grew increasingly scarce as the number of ill and wounded steadily increased. Even water needed to be rationed. More soldiers were dying from infectious diseases like typhoid and cholera than from injuries incurred in battle.

The no-nonsense Nightingale quickly set to work. She procured hundreds of scrub brushes and asked the least infirm patients to scrub the inside of the hospital from floor to ceiling. Nightingale herself spent every waking minute caring for the soldiers. In the evenings she moved through the dark hallways carrying a lamp while making her rounds, ministering to patient after patient. The soldiers, who were both moved and comforted by her endless supply of compassion, took to calling her "the Lady with the Lamp." Others simply called her "the Angel of the Crimea." Her work reduced the hospital’s death rate by two-thirds.

In addition to vastly improving the sanitary conditions of the hospital, Nightingale instituted an "invalid's kitchen" where appealing food for patients with special dietary requirements was prepared. She also established a laundry so that patients would have clean linens. as well as a classroom and library for intellectual stimulation and entertainment.

Recognition and Appreciation

Nightingale decided to use the money to further her cause. In 1860, she funded the establishment of St. Thomas' Hospital, and within it, the Nightingale Training School for Nurses. Nightingale became a figure of public admiration. Poems, songs and plays were written and dedicated in the heroine's honor. Young women aspired to be like her. Eager to follow her example, even women from the wealthy upper classes started enrolling at the training school. Thanks to Nightingale, nursing was no longer frowned upon by the upper classes; it had, in fact, come to be viewed as an honorable vocation.

Based on her observations during the Crimea War, Nightingale wrote Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army , a massive report published in 1858 analyzing her experience and proposing reforms for other military hospitals. Her research would spark a total restructuring of the War Office's administrative department, including the establishment of a Royal Commission for the Health of the Army in 1857. Nightingale was also noted for her statistician skills, creating coxcomb pie charts on patient mortality in Scutari that would influence the direction of medical epidemiology.

While at Scutari, Nightingale had contracted the bacterial infection brucellosis, also known as Crimean fever, and would never fully recover. By the time she was 38 years old, she was homebound and routinely bedridden, and would be so for the remainder of her life. Fiercely determined and dedicated as ever to improving health care and alleviating patients’ suffering, Nightingale continued her work from her bed.

Residing in Mayfair, she remained an authority and advocate of health care reform, interviewing politicians and welcoming distinguished visitors from her bed. In 1859, she published Notes on Hospitals , which focused on how to properly run civilian hospitals.

Throughout the U.S. Civil War, she was frequently consulted about how to best manage field hospitals. Nightingale also served as an authority on public sanitation issues in India for both the military and civilians, although she had never been to India herself.

In 1907, she was conferred the Order of Merit by King Edward , and received the Freedom of the City of London the following year, becoming the first woman to receive the honor. In May 1910, she received a celebratory message from King George on her 90th birthday.

Death and Legacy

In August 1910, Nightingale fell ill but seemed to recover and was reportedly in good spirits. A week later, on the evening of Friday, August 12, 1910, she developed an array of troubling symptoms. She died unexpectedly at around 2 p.m. the following day, Saturday, August 13, at her home in London.

Characteristically, she had expressed the desire that her funeral be a quiet and modest affair, despite the public's desire to honor Nightingale—who tirelessly devoted her life to preventing disease and ensuring safe and compassionate treatment for the poor and the suffering. Respecting her last wishes, her relatives turned down a national funeral. The "Lady with the Lamp" was laid to rest in her family's plot at St. Margaret's Church, East Wellow, in Hampshire, England.

The Florence Nightingale Museum , which sits at the site of the original Nightingale Training School for Nurses, houses more than 2,000 artifacts commemorating the life and career of the "Angel of the Crimea." To this day, Nightingale is broadly acknowledged and revered as the pioneer of modern nursing.

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• Name: Florence Nightingale
• Birth Year: 1820
• Birth date: May 12, 1820
• Birth City: Florence
• Birth Country: Italy
• Gender: Female
• Best Known For: Florence Nightingale was a trailblazing figure in nursing who greatly affected 19th- and 20th-century policies around proper medical care. She was known for her night rounds to aid the wounded, establishing her image as the 'Lady with the Lamp.'
• Science and Medicine
• Astrological Sign: Taurus
• Institution of Protestant Deaconesses at Kaiserswerth
• Nacionalities
• Death Year: 1910
• Death date: August 13, 1910
• Death City: London
• Death Country: United Kingdom

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CITATION INFORMATION

• Article Title: Florence Nightingale Biography
• Author: Biography.com Editors
• Website Name: The Biography.com website
• Url: https://www.biography.com/scientists/florence-nightingale
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• Publisher: A&E; Television Networks
• Last Updated: May 6, 2021
• Original Published Date: April 3, 2014
• All churches are, of course, only more or less unsuccessful attempts to represent the unseen to the mind.
• What the horrors of war are, no one can imagine.
• I use the word nursing for want of a better.
• Such education in women would indeed diminish the doctor's work—but no one really believes that doctors wish that there should be more illness, in order to have more work.
• It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm.
• Hospitals are only an intermediate stage of civilization, never intended at all even to take in the whole sick population.
• I think one's feelings waste themselves in words; they ought all to be distilled into actions, and into actions which bring results.
• I attribute my success to this: I never gave or took any excuse.
• Were there none who were discontented with what they have, the world would never reach anything better.
• Nursing in an art; and if it is to be made an art, it requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work.

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Florence Nightingale: a pioneer of hand washing and hygiene for health

Postdoctoral Research Fellow, Department of History, University of Nottingham

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Richard Bates works on the project 'Florence Nightingale Comes Home for 2020' ( www.florencenightingale.org ) at the University of Nottingham, headed by Professor Paul Crawford and Dr Anna Greenwood, funded by the Arts and Humanities Research Council.

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Florence Nightingale, who was born 200 years ago, is rightly famed for revolutionising nursing. Her approach to caring for wounded soldiers and training nurses in the 19th century saved and improved countless lives. And her ideas on how to stay healthy still resonate today – as politicians give official guidance on how best to battle coronavirus.

For example, although Nightingale did not fully subscribe to the idea that many diseases are caused by specific micro-organisms known as germs until she was in her sixties, in the 1880s, she was well aware of the importance of hand washing. In her book Notes on Nursing (1860), she wrote that:

Every nurse ought to be careful to wash her hands very frequently during the day. If her face, too, so much the better.

During the Crimean War (1853-1856) Nightingale had implemented hand washing and other hygiene practices in British army hospitals. This was relatively new advice, first publicised by Hungarian doctor Ignaz Semmelweis in the 1840s, who had observed the dramatic difference it made to death rates on maternity wards.

Nightingale’s attention to international medical research and developments was just one factor behind her ability to make effective interventions in public health. Like many public health experts of her age, Nightingale considered the home to be a crucial site for disease-preventing interventions. This was the place where most people contracted and suffered from infectious diseases. (The same is true today: in Wuhan’s coronavirus outbreak, around 75-80% of transmissions were reportedly in family clusters ).

Nightingale’s book, Notes on Nursing (1860) , was more of a public health instruction book than a nursing manual. It advised ordinary people how to maintain healthy homes – particularly women, in accordance with the worldview of the times. There was straightforward advice on everything from how to avoid excessive smoke from fireplaces (don’t let the fire get too low, and don’t overwhelm it with coal) to the safest material with which to cover walls (oil paints, not wallpaper).

Nightingale strongly counselled that people open windows to maximise light and ventilation and displace “stagnant, musty and corrupt” air. And she advocated improving drainage to combat water-borne diseases like cholera and typhoid.

In her view, all domestic interiors must be kept clean. Dirty carpets and unclean furniture, she wrote with characteristic bluntness, “pollute the air just as much as if there were a dung heap in the basement”.

Notes on Nursing also called upon the “mistress” of every building to clean “every hole and corner” of her home regularly, for the sake of her family’s health. But Nightingale also recommended a more holistic approach to health. She encouraged soldiers to read, write and socialise during their convalescence so they would not sink into boredom and alcoholism.

During her youth, Nightingale’s father had introduced her to a leading practitioner of statistics, then a brand new academic field, and paid for her to have a mathematics tutor. During and after the Crimean War, Nightingale seized on statistics as a way of proving the effectiveness of different interventions.

She went on to produce her famous diagrams , which demonstrated the high proportion of soldiers’ deaths caused by disease as opposed to battle wounds, and became the first woman admitted to the London Statistical Society in 1858.

Thereafter she designed questionnaires to obtain data on such questions as the sanitary condition of army stations in India, or the mortality rates of aboriginal populations in Australia. Her guiding principle was that a health problem could only be effectively tackled once its dimensions were reliably established.

In 1857, around a year after returning from the Crimean War, Nightingale suffered a severe collapse, now believed to have been caused by a flu-like infection called brucellosis . For much of her subsequent life, she was racked with chronic pain, often unable to walk or leave her bed.

Working from home

Having been declared an invalid, she imposed a rule of seclusion on herself because of pain and tiredness rather than from fears of contagion – a form of self-isolation that extended to her closest family (though she still had servants and other visitors).

During her first years of working entirely from home, Nightingale’s productivity was extraordinary. As well as writing Notes on Nursing, she produced an influential 900-page report on the medical failings during the Crimean War, and a book on hospital design.

This was in addition to setting up the Nightingale Training School for nurses at St Thomas’ hospital in London in 1860, and a midwifery training programme at King’s College Hospital in 1861, plus advising on the design of a number of new hospitals. Later in the 1860s, Nightingale proposed a reform of workhouse infirmaries to make them high quality taxpayer-funded hospitals; and also worked on sanitary and social reforms in India. All of this she accomplished without leaving her house (though government ministers sometimes came to her home for meetings).

Having said this, it is worth remembering that Nightingale’s was a privileged form of self-isolation. Her father’s fortune, derived from Derbyshire mining interests, meant she had no money worries.

She lived in a nice house in London with various assistants and servants to help, shop and cook for her, and had no children to look after. Her entire waking time could be devoted to reading and writing. So while this is an appropriate time to recall and celebrate the huge contribution Nightingale made to modern nursing and public health care, we shouldn’t feel too bad if we don’t quite live up to her high standards of isolated productivity.

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Florence Nightingale

Florence is probably the most influential English woman the world knows little about. She worked tirelessly to improve the health and sanitation of the British military and the civilians of England and British colonies. Her work in the Crimean war in Scutari became her most notable achievement and debut of her public life. She further initiated numerous reform agendas in the healthcare world. She remains a major point of influence in the nursing profession as the founder. Among other achievements, she literally changed the nursing profession to fit the women.

Introduction

Florence nightingale was born on the 12th day of May the year 1820 as a second child in Italy. Her parents, William and Frances nightingale were wealthy and respected citizens of the England. William Nightingale had even contested for a political position at some point in his life but lost. Florence began showing a lot of interest in intellectual things from an earlier age in her life. This made her father joyful and he heavily invested in her education. They lived in England at the Lea Hurst and Embley Park. Florence began showing an interest and passion for the needy and suffering despite living in a wealthy family. According to scholars who wrote her biographies, she displayed the characteristics of a sensitive and introspective person. Others described her as of a morbid and a strong perfectionist nature. This prompted her vision to improve the living conditions of people in the world. Her personality was also characterized by deep religious reflections. She always explained that she God had called her to offer help to the suffering. According to her, the highest honor resided in becoming a servant and coworker of God. This strong and intense drive to change the life of the human race landed her into the field of nursing.

Path to the Nursing Career

Despite her desire to help humanity, she began her professional career as a statistician. She however used her statistical prowess in demonstrating to the authorities the need for improving the health and sanitation of the people. Her efforts greatly contributed in the improvement of the health and sanitation of the British army, the civilian hospitals, workhouses and homecare. She further made efforts to improve the healthcare laws of England and India. She is finally credited with founding the profession of nursing. Nightingale began her work in hospitals in 1844. However, she did not advance her work at the hospitals for a period of nine years. This was because of the restrictions of the society that forbade women from taking the nursing profession.

Historical Era and Achievements

Nightingale lived in the era where she the British army was out fighting wars and building colonies. This prompted her appointment to the department war by Sidney Herbert, the secretary of war. She was charged with the responsibility of commanding a group of women on a mission to care for the wounded soldiers in the Crimean war in Scutari, Turkey. She found a horrible situation in the hospitals in Scutari; a situation that prompted the death of many of the wounded soldiers admitted in the hospitals. She immediately embarked on a reform agenda to improve the conditions of the hospital. Her work in the Crimean war proved the highlight of her achievements in the improvement of the nursing care.

During her work in the Scutari hospitals, she greatly improved the sanitary conditions of the military hospitals and the theatre in Crimean apart from nursing the sick and wounded. By the beginning of 1859, her reform agenda had taken the whole of the war office administration into action. This also saw the formation of the Nightingale fund that was basically used to improve health and sanitation.

She also successfully managed to reorganize the war office though after a long struggle with the anti-reformists such as Hawes. The death of her two min right hand officials in the war administration office ended the reform agenda. She finally managed to reorganize the office into four sub departments. The first sub department had the responsibility of ensuring the construction of barracks and the improvement thereof, upgrading of the drainage and ventilation system and improvement of barracks. The second sub commission was responsible the organization of the statistical issues of the army. This brought the excellence of the British army statistics. This has placed them as the army with the best statistical organization in the continent of Europe. The third sub commission had the responsibility of forming and organizing a medical school for the army. She directly nominated professors into the school and contributed in the formation of the curriculum.

The fourth sub-commission was charged with the responsibility of restructuring the medical department of the army. Their work span included the revision of hospital regulations and overseeing the promotion of medical department officers. They further worked towards the introduction of the sanitary code of the military into the army. She finally used the sub-commission to fight for the introduction of female nurses in the hospitals of the military. The establishment of recreational centers in the barracks and army posts also came through this sub commission.

Apart from the immense work she did at the military of the English army, Florence also worked towards the alleviation of health conditions of the civilian English people and the British colonies especially India. Her reform agenda worked for the good of the civilian hospitals and workhouses. She further spearheaded the establishment of the first professional nursing schools where the public could acquire knowledge on nursing and midwifery. She also notably wrote heavily on nursing and sanitation, literature that helped in the study and establishment of nursing.

Barriers and Obstacles She Faced

The dream of Florence Nightingale to serve as a nurse met reaction from both her family and the ethics of the profession. This is because the nursing career was only preserved for the men given that nursing was majorly practiced on war fronts. She however successfully managed to change this belief by serving as the first female nurse in the army. In addition, she became successful in the introduction of other female nurses in the military.

Florence also faced considerable opposition in the formation and implementation of her health and sanitation reform agenda in the war commission office. Hawes who served in the department as a sub commission head notably led the oppositions. His opposition nearly brought the reform agenda into a halt especially after the death of Herbert, the head of the war commission. However, the later death of Hawes and the installation of an ally of Florence into the war commission office helped in the revamping of the reforms.

The deaths of such people as Commissioner Herbert, Arthur Clough and George Lewis also became a barrier in the quest for change. This is because these people had upheld the reformations that Florence had introduced despite oppositions. Their death meant a loss of progress and caused much devastation for Florence Nightingale.

Global Impacts

Florence Nightingale first steps out as the mother and founder of the nursing profession. her numerous reforms in the health and sanitation of the British military and other entities provided for the subsequent reforms in other countries starting from the colonies of the British. She is credited with the formation of the first professional nursing and midwifery schools. The nursing profession also enjoys great resources and influence from her publications. Two of her most influential books include notes on nursing and notes on hospitals, all of which were published in 1859. The books greatly contributed in the introduction and perfection of health and sanitation in hospitals across the world. The book on notes on hospitals used statistics in tracing and explaining the origin of the high mortality rates. She cited reasons such as poor ventilation, poor drainage system and overcrowding in hospitals and health facilities.

The book on notes on nursing was largely for women. Its content had notes on how to provide nursing care to their families. Nonetheless, the book also held great significance and respect in the practice of professional nursing. This is because it had a wealth of information on hygiene, preventive medicine and care for the sick.

The experience on statistics and collection of data gave her the need to push for equal and uniform statistics on hospitals. This prompted her preparation of a model of statistical data collection forms for use in hospitals. Florence presented the model to the international statistical congress that was convened in 1860. The model also touted for the setting up of a mechanism of having uniform statistical in hospitals across the world. The congress made a positive response to the model by giving its approval. The congress further resolved to communicate the resolution to respective governments represented in the event. The works and publications of Florence on sanitation gained influence even in other social fronts such as workhouses and the housing sector. The constructions of barracks and infirmaries would soon change to feature the Florence Nightingale model. The livelihood and living conditions of both civilians and military personnel took a turn for the better. The health of the British colonies also received an improvement through her inputs.

In the words of the Lord Mayor of London on the 15th day of august 1910, Florence Nightingale was probably the greatest Englishwoman to have ever lived. The death of Florence Nightingale, which occurred in August 13th, 1910 met tears and sorrows. She probably serves as the only woman in the history of humanity to have influenced such a great movement in the world including the introduction of the nursing profession.

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Florence Nightingale - Nursing Theorist

Florence Nightingale is the most recognized name in the field of nursing. Her work was instrumental for developing modern nursing practice, and from her first shift, she worked to ensure patients in her care had what they needed to get healthy. Her Environmental Theory changed the face of nursing to create sanitary conditions for patients to get care.

Biography of Florence Nightingale

Florence Nightingale was born in 1820 in Italy to a wealthy British family. She was raised in the Anglican faith, and believed the God called her to be a nurse. This call came to her in February 1837 while at Embley Park.

She announced her intention to become a nurse in 1844. Her mother and sister were angry at her decision, but Nightingale stood strong. She worked hard to learn about nursing, despite society’s expectation that she become a wife and mother. In fact, she rejected a suitor because she thought it would interfere with her nursing career. In 1853, she accepted the position of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London. She held this position until October 1854. The income given to her by her father during this time allowed her to pursue her career and still live comfortably.

Though Nightingale had several important friendships with women, including a correspondence with an Irish nun named Sister Mary Clare Moore, she had little respect for women in general, and preferred friendships with powerful men.

She died in 1910.

Career of Florence Nightingale

Nightingale is best known for her pioneering work in the field of nursing. She tended to wounded soldiers during the Crimean War. She became known as the “Lady with the Lamp” because of her night rounds. While nursing soldiers during the war, Nightingale worked to improve nutrition and conditions in the wards. Many injured soldiers were dying from illnesses separate from their injuries, such as typhoid, cholera, and dysentery. Nightingale made changes on the wards or started the process by calling the Sanitary Commission. Her work led to a reduction in the death rates of injured soldiers from 42% to 2%. Nightingale believed the deaths were the result of poor nutrition, inadequate supplies, and the soldiers being dramatically overworked. After collecting evidence that pointed to unsanitary conditions as a major cause of death, Nightingale worked to improve sanitation in army and civilian hospitals during peacetime.

After the Crimean War, she established a nursing school at St. Thomas’ Hospital in London in 1860. The first nurses trained at this school began working in 1865 at the Liverpool Workhouse Infirmary. It was the first secular nursing school in the world, and is now part of King’s College London. Her work laid the foundation for modern nursing, and the pledge all new nurses take was named after her.

Nightingale wrote Notes on Nursing (1859), which was the foundation of the curriculum for her nursing school and other nursing schools. This short text was considered the foundation of nursing education, and even sold well to the public. She also wrote Notes on Hospitals , Notes on Matters Affecting the Health , and Efficiency and Hospital Administration of the British Army . Nightingale spent the rest of her career working toward the establishment and development of nursing as a profession, paving the way for nursing in its current form.

In 1883, Nightingale was given the Royal Red Cross by Queen Victoria. In 1907, she was the first woman to receive the Order of Merit. In 1908, she was given the Honorary Freedom of the City of London. International Nurses Day is celebrated on her birthday.

Some of Florence Nightingale’s works are:

Florence Nightingale’s Contribution to Nursing Theory: Environmental Theory

Florence Nightingale is attributed with establishing the modern practice of nursing. She also contributed to the field with nursing theories still used today. One of her nursing theories is the Environmental Theory , which incorporates the patients’ surrounding environment in his or her nursing care plan .

In this theory, the role of the nurse is to use the patient’s environment to help him or her recover and get back to the usual environment. The reason the patient’s environment is important is because it can affect his or her health in a positive or negative way. Some environmental factors affecting health according to Nightingale’s theory are fresh air, pure water, sufficient food and appropriate nutrition, efficient drainage, cleanliness, and light or direct sunlight. If any of these factors is lacking, it can delay the patient’s recovery. Nightingale also emphasized providing a quiet, warm environment for patients to recover in. The theory also calls for nurses to assess a patient’s dietary needs, document food intake times, and evaluate how the patient’s diet affects his or her health and recovery.

Determining a patient’s environment for recovery based on his or her condition or disease is still practiced today, such as in patients suffering from tetanus, who need minimal noise to keep them calm and prevent seizures.

For more detailed information: Nightingale’s Environmental Theory

See also: Nightingale’s Modern Nursing Theory

For more information about the life on Florence Nightingale:

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Florence Nightingale bicentennial: 1820–2020. Her contributions to health care improvement

Dinu i. dumitrascu.

1 Department of Anatomy, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

Liliana David

2 Department of Nursing, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

Dan L. Dumitrascu

3 2 nd Department of Internal medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

Liliana Rogozea

4 Department of the History of Medicine and Department of Nursing, Transilvania University, Brasov, Romania

In 2020 we celebrate the bicentennial of the birth of Florence Nightingale and 110 years from her death (1820–1910). This gives us the opportunity to remember her life and her achievements. She is mainly known for her contribution to the foundation of modern nursing in the British Empire and subsequently to the world. Besides her personal engagement in the Crimean War, she organized a professional training for nurses, wrote the first textbook on nursing (“Notes on Nursing”) and took public positions in favor of health care and philanthropic funding. She was a militant for the rights of the women and for social justice. She was a pioneer of medical statistics and hospital management. Her activity is acknowledged worldwide.

This year we celebrate one of the most famous health care providers of the world: Florence Nightingale. Beside representing the “mother” of modern nursing, she was very much engaged in improving the life of war victims, of women and of deprived persons. Considering the importance of this bicentennial, we review here her biography and her work and contributions to medical progress.

Florence Nightingale was born on May 12, 1820, in Florence, Italy. In her honor, this day will become, starting with 1965, the International Nurses Day. Her name was given by her parents in recognition of the city where they lived at that moment. Florence Nightingale left this world in London on August 13, 1910, after a very intense life filled with many accomplishments [ 1 ]. Her youth portrait is presented in figure 1 .

Florence Nightingale, lithographic reproduction of 1857 (private collection).

From the youngest age she developed a strong feeling of philanthropy and expressed the wish to help others. Therefore, she refused the common life path of ladies of that time, rejected advantageous marriage proposals and engaged in the study of nursery against the wish of her family [ 2 , 3 ]. Despite the wish of her parents she insisted and started nursing studies at the level of that time, in Germany. She chose Kaiserwerth, now part of Dusseldorf, where a well-known deaconry run by protestant nuns existed since 1836 thanks to the couple Theodor and Friederike Fliedner [ 4 ]. At that time, she could care for patients only in women rooms, while male patients were allocated to male care givers. At night female nurses were not allowed in rooms for male patients. She continued her training in nursing also in France [ 1 , 2 ]. Later she returned to England and since 1853 she worked in a home called the Institute for the Care of Sick Gentlewomen [ 5 ]. These early years of activity were in fact the prologue of her lifelong work, which started with the onset of the Crimean War.

Participation to the Crimean War and care of wounded and ill soldiers

The so-called Crimean War was in fact a pan-European war in which Russia was confronted with most major European powers contesting tsarist empire spread over Europe to the detriment of Ottoman Empire. The conflict started in 1853 with the occupation of Moldavia and Walachia by Russian troops and spread in Crimea, where the main and bloodiest battles were engaged until the end of 1856. The fights were intense and massive casualties were produced. The British Empire participated to the Crimean War and needed medical service for its army. Florence Nightingale travelled there together with her dedicated staff to care for the wounded on the battlefield and on field hospitals. She became famous for the lamp she always had with her to see the wounded during night, hence her nickname “the lady with the lamp”.

She was an example of enthusiasm and abnegation and motivated her staff (many of them nuns) to take care of those in need in the improvised hospital in Scutari, Turkey, where she worked. There she was able to reduce mortality to 10%. Beside the possibility to actively offer care and support to the victims of war, she drew a few conclusions: the need to organize a nursing system able to provide assistance during war but also during peace; the need to care and protect casualties of the war and prisoners of war. Indeed, everything was missing: hygiene regulations, medicines, skilled assistance, food [ 6 ].

In this respect her conception converged very much to that of Henri Dunant, the founder of the Red Cross in 1863, inspired by the terrible impressions of the Solferino battlefield that he visited just after the battle, in 1859.

It is well known that every prominent person has detractors, and the same happened to Florence Nightingale. A Jamaican nurse Mary Seacole claimed over Florence Nightingale the overhand of infirmary care and disputed her merits from the point of view of the negritude movement [ 1 , 7 ].

Founding of modern nursing

Her activity during the Crimean War was well reflected in the contemporary journals and increased the awareness of the need to launch an efficient nursing training and system. Florence Nightingale again was ahead of her time and created in London a nursing school in St Thomas Hospital. She also wrote the “Notes on Nursing”, probably the first textbook on nursing. For her activity she needed and received philanthropic funding.

Soon the Civil War started in the United Stated of America and Florence Nightingale served as an adviser for American nurses. She also trained the first American nurse Linda Richards (1841–1930).

In the following decades, her disciples became important disseminators of the training of Nightingale and contributed to the establishment of a quality nursing in the United Kingdom, which served as an example for other countries as well.

Despite a mysterious disease that disabled her now and again during the second half of the 19 th Century (maybe brucellosis?), she remained very much engaged in the care of ill people and in the education of nurses.

Contributions to surgery

Florence Nightingale did not have a direct surgical activity, but dealing with war injuries involves a lot of surgery. Her activity must have included hemostasis, wound cleaning and dressing, prevention of infection. As many health care providers of that time, she was long time not convinced by the existence of pathogenic germs; nevertheless, after the work of Pasteur and others became known, she was cautious in preventing the transmission of infections. She was decisive in the creation of the British Army Medical Service and thus her achievements are a corner stone for military surgery [ 8 ]. Therefore she is even now veneered for her personal commitment in war medical health care [ 9 ].

Other contributions

Beside nursing and military and civil healthcare she had important contributions to the healthcare system management, to medical statistics, to emancipation of women, for social equality [ 1 ]. She emphasized the importance of numbers, i.e. of statistics in healthcare providing: number of beds, number of patients, number of cases etc. [ 10 – 12 ]. These data served her to take decisions in regard to hospital administration and public health measures [ 13 , 14 ]. Her public interventions were always disseminated by journals and were influential for the public health policies of that time.

Cultural echoes

Not only in the United Kingdom, but throughout the world there are hospitals, streets, nursing schools who bear her name. The impact of the life and work of Florence Nightingale is largely reflected on different memorabilia: lithographs ( Figure 1 ), postcards, stamps ( Figure 2 ), coins, etc.

Stamp issued by United Nations Vienna office on 12 May 2020.

The Florence Nightingale Museum in London contributes to the perpetuation of the personality and achievement of Florence Nightingale. Figure 3 represents a painting from this Museum (published with the kind permission of the Museum director).

Nursing activity of Florence Nightingale in Scutari Hospital (Florence Nightingale Museum, photograph 2019; with permission of the Museum).

Echoes of Florence Nightingale’s activity in Romania

Most scholars of the history of medicine are familiar in Romania with this name. However, not many know in detail her biography. Unfortunately, there are no monographs dedicated to her to our knowledge.

Some papers about her are in the press, but for general information, not for those with advanced interest in her. Most of them were published in the observation of her bicentennial. One single medical paper indexed in the EBSCO database can be retrieved [ 1 ]. Her spirit is however reflected in some papers on nosocomial infections [ 15 ].

Conclusions

Florence Nightingale had an enormous contribution to the development of health care. She is indeed the founder of modern scientifically based nursing. Her achievement should be better reflected and disseminated by historians of medicine.

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Essays on Florence Nightingale

Florence Nightingale was a pioneering figure in the field of nursing and her impact on healthcare and society is undeniable. Writing an essay about Florence Nightingale is a great way to learn about her contributions to the medical field and the lasting impact she had on nursing practices. Whether you're writing an argumentative, cause and effect, opinion, or informative essay, there are plenty of interesting topics to explore when it comes to Florence Nightingale.

When choosing a topic for your essay on Florence Nightingale, consider her impact on healthcare, her contributions to nursing education, her role in the Crimean War, or her influence on public health policies. You could also explore her leadership and advocacy for sanitation and healthcare reform, as well as her lasting legacy in the field of nursing.

For an argumentative essay, you could explore topics such as "The Impact of Florence Nightingale's Nursing Practices on Modern Healthcare," "The Role of Florence Nightingale in Shaping Nursing Education," or "Florence Nightingale: A Pioneer for Women in Healthcare."

If you're writing a cause and effect essay, consider topics like "The Impact of Florence Nightingale's Sanitation Reforms on Public Health," "The Influence of Florence Nightingale's Work on Nursing Practices Today," or "The Consequences of Florence Nightingale's Advocacy for Healthcare Reform."

For an opinion essay, you might want to explore topics such as "Florence Nightingale: A Hero in Nursing History," "The Significance of Florence Nightingale's Contributions to Healthcare," or "My Personal Perspective on Florence Nightingale's Impact."

If you're writing an informative essay, consider topics like "The Life and Achievements of Florence Nightingale," "The Impact of Florence Nightingale's Work on Nursing Practices," or "The Legacy of Florence Nightingale in the Field of Healthcare."

Now that you have a topic in mind, let's take a look at an example essay on Florence Nightingale. For instance, a thesis statement for an essay on Florence Nightingale could be: "Florence Nightingale's innovative nursing practices revolutionized healthcare and laid the foundation for modern nursing education."

When writing the to your essay, you could start with a brief overview of Florence Nightingale's life and the impact she had on nursing and healthcare. For example, "Florence Nightingale, also known as the 'Lady with the Lamp,' was a trailblazing figure in the field of nursing and healthcare reform."

In the of your essay, you could summarize the key points of your argument and reflect on the lasting impact of Florence Nightingale's work. For example, "Florence Nightingale's dedication to nursing and healthcare reform continues to inspire and shape the practices of nurses and healthcare professionals around the world."

Florence Nightingale and Her Revolutionary Ideas

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Florence Nightingale and Her Impact on The Nursing Field

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Nurses and Holistic Care: a Perspective by Florence Nightingale

Florence nightingale: the lady of the lamp, the great nurse florence nightingale, how florence nightingale changed the nursing game, the embodiment of florence nightingale in "eminent victorians" by lytton strachey.

12 May 1820

13 August 1910 (aged 90)

Pioneering modern nursing, Polar area diagram

Florence Nightingale was born on May 12, 1820, in Florence, Italy. Nightingale’s affluent British family belonged to elite social circles. From a very young age, Florence Nightingale was active in philanthropy. By the time she was 16 years old, she decided to be a nurse.

In 1844, Nightingale enrolled as a nursing student at the Lutheran Hospital of Pastor Fliedner in Kaiserwerth, Germany. In the early 1850s, she took a nursing job in a Middlesex hospital for ailing governesses. She wanted to improve hygiene practices, significantly lowering the death rate at the hospital in the process.

In October of 1853, the Crimean War started. On 21 October 1854, she and the staff of 38 women volunteer nurses were sent to the Ottoman Empire. During that time, she was called “the Lady with the Lamp” and “the Angel of the Crimea.” Her work reduced the hospital’s death rate by two-thirds. The Queen rewarded Nightingale’s work by presenting her with an engraved brooch and by granting her a prize of $250,000 from the British government.

Nightingale decided to use the money to further her cause. In 1860, she funded the establishment of St. Thomas’ Hospital, and the Nightingale Training School for Nurses.

She died at Saturday, August 13, 1910, at her home in London. The "Lady with the Lamp" was laid to rest at St. Margaret's Church, East Wellow, in Hampshire, England.

"I attribute my success to this:—I never gave or took an excuse." "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."

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Florence Nightingale’s Contribution to Nursing Essay

Introduction, nightingale’s biography, nightingale’s ideas and innovations, the impact of florence nightingale’s activity.

Nursing has always contributed to the development and improvement of medicine, as some distinguished professionals have brought new and valuable ideas to the field. One such nurse was Florence Nightingale, who devoted herself to the study of war wounds and sacrifice. As a result of her extended analysis of military brutality, the nurse developed her statistics system, which later became widely used in hospitals.

First of all, it is necessary to begin with an analysis of the nurse herself and her biography. Florence Nightingale was born in 1820 and dedicated herself to nursing. Later, during the Crimean War, Florence began to develop the idea of incorporating social statistics into the medical service because she believed it could make it much easier for doctors to research casualties and injuries. She propagandized that the business of nurses is to save the wounded not only physically but also spiritually, for example, to care for their leisure time, organize reading rooms, and help establish correspondence with relatives (Nightingale, 2020). Florence Nightingale defined nursing as the maintenance of a person in such a condition that disease does not occur (Nightingale, 2020). In contrast, the care of the sick is helping the sick live a fuller and more satisfying life. Nightingale expressed a firm conviction that nursing as a profession is essentially distinct from the medical work and requires exceptional knowledge specific from that of physicians (Nightingale, 2020). In addition, Nightingale was a direct participant in the war, where she showed her professionalism and fearlessness.

As a result of her wartime activities, the nurse was inspired by the study of war sacrifice to show the inhumanity of war. Nightingale introduced pie charts to count deaths in the Crimean War and later distributed them to politicians (Kim & Mallory & Valerio, 2020). Above all, this idea was to unify the statistics collected by hospitals, such as the number of patients admitted to hospitals, the number who were cured, who were discharged as incurable, and the average time spent in the hospital (Kim & Mallory & Valerio, 2020). The effectiveness of this approach led to health care reform, the primary purpose of which was to actively introduce charts and statistics into medicine to obtain more reliable data. In addition to the idea of statistical data, Nightingale ensured that hospitals were equipped with ventilation and sanitation systems and that hospital staff were mandatorily trained.

Nightingale’s ideas gained widespread popularity in the nursing profession. Firstly, the reforms made it easier for nurses to gather and process the information needed to deal with actual illnesses and injuries (McDonald & PhD & LLD, 2017). Secondly, Nightingale’s enthusiasm and steadfastness encouraged many professionals to work for an idea rather than for profit, as seen in the nurse’s authority in her professional environment and the legends that began to build around her personality (McDonald & PhD & LLD, 2017). In the end, one of the psychological syndromes was named after the heroine, the essence of which is the emergence of the doctor’s love for the patient as a result of prolonged treatment (McDonald & PhD & LLD, 2017). Thus, Florence Nightingale’s contribution to nursing has been invaluable.

In conclusion, Nightingale is not only a professional but also a professional reformer. The nurse’s developments have made it easier and better to collect information about victims and illnesses, which is one of the core responsibilities of nurses. Finally, Nightingale set a high bar of professionalism for physicians that increased the number of quality specialists in nursing. Combining these factors allows us to judge Nightingale as one of the most significant figures for medicine and nursing history.

Nightingale, F. (2020). Florence Nightingale to her nurses: A selection from Miss Nightingale’s addresses to probationers and nurses of the Nightingale school at St. Thomas’s hospita l. Library of Alexandria.

McDonald, L., PhD, LLD (Hon). (2017). Florence Nightingale, Nursing, and health care today . Springer Publishing Company.

Kim. M., Mallory, C., Valerio, T. (2020). Statistics for evidence-based practice in nursing . Jones & Barlett Learning.

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How Florence Nightingale Paved the Way for the Heroic Work of Nurses Today

W hen Greta Westwood was 4 years old, she read a children’s book about Victorian nurse Florence Nightingale. Decades later, she still remembers being transfixed by the enduring image of the “Lady with the Lamp.” Westwood herself would go on to a distinguished nursing career of her own, starting out as a student orthopedic nurse in 1978. “From day one of putting the uniform on, I’ve never looked back,” she recalls.

Although she left Britain’s National Health Service in 2017 after nearly 40 years, Westwood has recently returned to her local hospital in Portsmouth, in the south of England, to help with the U.K.’s public health efforts in the coronavirus crisis . Westwood, who spoke to TIME on a busy Monday morning from the hospital, has been running psychological support sessions for nurses and midwives assisting patients with COVID-19 for the past six weeks.

That early image of Florence Nightingale, tending to wounded soldiers in the darkness with her lamp, has endured for so many nurses, for so many years, and takes on renewed significance as May 12 marks the 200th anniversary of Nightingale’s birth. It also marks International Nurses’ Day, commemorated in Nightingale’s honor. With nurses around the world on the front lines of a global pandemic, it’s a poignant time to reflect on how Nightingale’s legacy laid the groundwork for their heroic work in hospitals today. “It’s the trailblazing element I like about her,” says Westwood, who is also the CEO of the Florence Nightingale Foundation. “She never took no for an answer—anything was possible.”

Nightingale was born on May 12, 1820, to a wealthy aristocratic family in Italy, and grew up in England. As a teenager, she believed that she had heard a call from God encouraging her to help the sick and poor and felt a strong desire to become a nurse—although the profession was not seen as a respectable job at the time. Victorian social conventions also meant that women were generally expected to stay at home and run household affairs, not pursue careers; Nightingale turned down multiple marriage proposals because she felt it would interfere with her duty of caring for others. Her ambitions were particularly controversial given her upper-class background. But despite her family’s disapproval, she educated herself in arts and science and eventually gained some nursing experience at a Lutheran-run institution for the poor in Germany.

In March 1854 , Britain entered the Crimean War, fighting in an alliance against Russia. Newspaper reports detailed the devastating state of hospitals that cared for the wounded, and, in the face of public outcry at home, War Minister Sidney Herbert appointed Nightingale to lead a contingent of 38 volunteer nurses to a military hospital in Scutari, in modern-day Turkey, in the November of that year, to help wounded soldiers returning from the front lines.

Nightingale’s team was immediately confronted by nightmarish conditions. More soldiers were dying of diseases such as typhus, typhoid, cholera and dysentery than from battle wounds, and the hospital wards were overcrowded with rat and lice infestations.

“What greeted her there must have been horrendous in terms of the squalor,” says David Green, director of the Florence Nightingale Museum in London. “But she stayed until the end, and made sure she looked after the common soldier, not just the officer.”

Nightingale’s compassion set her apart from others, says Green, and she gained her famous moniker for checking in on her patients by lamplight, often writing letters to loved ones at home on their behalf. At that time, the army didn’t always inform families when soldiers were killed, but Nightingale felt a duty to do so. That sense of duty to patient and family has been on full display during the COVID-19 crisis, as nurses champion the need to be with patients until the very end , and have campaigned for iPads so relatives can communicate with loved ones. “That is so Nightingale, and that compassion really carries home,” says Green.

Nightingale’s time at Scutari prompted several innovations that she would develop in the later years of her life. Although the male doctors at the institution saw Nightingale’s suggestions as criticisms, she remained steadfast, taking several measures to improve sanitation and hygiene at the hospital, including washing the linens and towels, purchasing necessary kitchen supplies, and emphasizing hand-washing with soap and water, which was not widely practiced at the time. However, through 1855, the mortality rate at the hospital continued to rise, as Nightingale mistakenly believed that nutrition and supply problems were the main cause of the issue, rather than the sanitation problem. A Sanitary Commission found that the hospital was built on a sewer , meaning that the water supply was contaminated and helping to increase the spread of disease.

Nightingale returned to Britain in 1856 having learned from the experience. In the years that followed, she championed sanitary health—and cemented her status as a national hero.

For the next 50 years of her life, she prioritized the establishment of nursing as a respected profession. Her 1859 book Notes on Nursing is still regarded today as a pioneering text, was written in simple language intended for women nursing in the home to understand. One of her first tasks after returning from the war was to set up a training school for nurses in 1860, the first to exist in the world, which still runs today. “If you speak to any nurse about nursing, everybody comes to work to do their best for their patient. Through all those years even when she came back from Crimea, that was her purpose in life,” says Westwood.

Despite battling depression and being intermittently bedridden from 1857, Nightingale wrote thousands of letters campaigning for public health and workhouse reform, and used her influence to network with Queen Victoria and prominent politicians. It was also from her experience in Crimea that she learned about efficient hospital planning and design. In correspondence with other hospitals around the world, from Sydney to New York City, she shared her knowledge and the resources of the “Nightingale Nurses” that had been trained through her school.

Significantly, Nightingale backed up her campaigns with evidence, statistics and data visualizations that were easy to understand, using diagrams to show the effects of infection and mortality rates in the Crimean War. “She was the pioneer of the first pie chart,” says Westwood, comparing the public’s need for data during Nightingale’s time and our own. “When the Prime Minister or Chief Medical Officer do their briefings on the coronavirus today, we now see that data published as infographics. Nightingale got it that people wouldn’t understand the data unless she made it explicit and unquestionable.”

While her legacy has endured two centuries later, Nightingale’s bicentennial comes at a crucial time for nurses on the front lines, and a moment of financial challenge for the museum dedicated to her memory, due to its current closure. “It’s ironic that many of the field hospitals [in the U.K.] have taken her name,” says Green of the Florence Nightingale Museum, which houses almost 3,000 artifacts dedicated to her legacy, “but the thing that is always around to remind everyone of her might not be.”

For the Florence Nightingale Foundation, which was set up in 1934 to remember her legacy and actively supports nurses and midwifes through scholarship programs, their usual commemoration of Nightingale’s birthday is adapting to the current lockdown situation. Supported by The Crown actor Helena Bonham Carter, whose great-great-grandmother Joanna was Nightingale’s aunt, the Foundation is launching the Florence Nightingale White Rose Appeal , through which people worldwide can buy an e-white rose to help support nurses currently working on the front lines. Each rose bought will form part of an actual floral display at London’s Westminster Abbey once lockdown ends, to celebrate the contribution of nurses and midwives everywhere.

It’s quite a different bicentenary compared to what Westwood had envisaged, but the woman at its heart would not have shied away from the difficulty.

“Celebrations is a weird word at this time, because it is tinged with sadness—so many nurses have died, and we mustn’t forget that,” Westwood says. “But Florence would be so proud of what nurses have managed to achieve during this pandemic.”

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Honoring Our Heritage – Building Our Future

Winning essay – “bringing florence nightingale to the bedside of the critically ill patient”.

In celebration of the bicentenary of Florence Nightingale’s birth, the Nursing Archives Associates of the Boston University Libraries’ Howard Gotlieb Archival Research Center held an essay contest, open to nursing students enrolled at all levels of study— undergraduate, master’s and doctoral – and focused on Florence Nightingale’s influence on the evolution of nursing, both historical and contemporary. Although all Nightingale 2020 events were postponed due to the COVID-19 pandemic, we are proud to announce the winner of the Muriel A. Poulin Nursing Student Essay Contest.

The winning essay is titled “ Bringing Florence Nightingale to the Bedside of the Critically Ill Patient ,” written by Laura Beth Kalvas, MS, RN, PCCN, Graduate Fellow, The Ohio State University College of Nursing. Here is the essay:

In her Notes on Nursing (1969), Florence Nightingale argued that nature alone can cure the sick. Cautioning against an over-reliance on medical care, which could do nothing more than remove obstructions to the natural healing process, Nightingale encouraged nurses to put patients in the best possible conditions for nature to act upon them. Her environmental theory highlighted the importance of cleanliness, ventilation, limited noise, uninterrupted sleep, proper nutrition, and sunlight in promoting recovery of the sick (Hegge, 2013; Nightingale, 1969). Within this perspective, the role of the nurse was to provide an environment conducive to healing, support the patient in the healing process, and carefully observe the patient for signs of improvement or decline. Certainly when Nightingale cautioned against an over-reliance on medical care, she could little have imagined the treatments and technology available today, especially in the care of the critically ill. Yet her careful distinction between the practice of medicine and the practice of nursing remains relevant. In the complex critical care environment, where medical treatments are frequently lifesaving, what unique contribution does the nurse bring to the care of the critically ill patient? I would argue that the role of the critical care nurse remains the same; to put the patient in the best possible condition for nature to act upon them (Nightingale, 1969). Yet “so deep-rooted and universal is the conviction that to give medicine is to be doing something, or rather everything; to give air, warmth, cleanliness . . . is to do nothing” (p. 9), that this important aspect of nursing practice is easily undervalued. The phenomenon of pediatric delirium offers an interesting case study in the importance of high-quality nursing care in the modern intensive care unit. Delirium is a frequent, significant complication of critical illness consisting of acute changes in mental status that develop over a short period of time and fluctuate throughout the day (American Psychiatric Association, 2013). Up to 65.5% of children in the pediatric intensive care unit (PICU) experience delirium (Meyburg et al., 2017). Affected children exhibit signs of impaired attention, disorientation, agitation, hallucinations, and sleep/wake cycle disturbance (Holly et al., 2018). Children describe their delusional memories of the PICU as highly disturbing, including visual hallucinations of injured parents, monsters trying to eat them, and insects crawling on the walls (Colville et al., 2008). Furthermore, pediatric delirium is associated with poor clinical outcomes, including increased length of stay (Smith et al., 2017), cost of care (Traube et al., 2016), and mortality (Traube et al., 2017). Although delirium has only recently caught the attention of the pediatric critical care community (Kudchadkar, Yaster, et al., 2014), it is not a new phenomenon. Through her observations, Nightingale (1969) noted that lack of sunlight, excessive noise, and fragmented sleep were associated with delirium. Today’s pediatric critical care environment is characterized by excessive light and sound exposure and frequent nighttime caregiving (Al-Samsam & Cullen, 2005; Cureton-Lane & Fontaine, 1997). This environment likely contributes to the altered sleep patterns experienced by critically ill children (Kudchadkar, Aljohani, et al., 2014). Providing support for Nightingale’s (1969) early observations, we now know that these environmental exposures and resulting sleep disruption can impair cognitive function (e.g., attention, working memory, emotional regulation; Durmer & Dinges, 2005; Kahn et al., 2013) and disrupt the circadian rhythm of melatonin release, which has neuroprotective properties (Claustrat et al., 2005). Environmentally-induced circadian rhythm dysregulation is one hypothesized pathway to the cognitive changes observed in delirium (Maldonado, 2017), and sleep/wake cycle disturbances are often observed in children with delirium (Holly et al., 2018). Nurses are uniquely positioned at the bedside to prevent delirium through environmental modification and regulation of the circadian rhythm; interventions which place the patient in the best possible conditions for recovery (Nightingale, 1969). Sleep promotion interventions in the adult ICU are associated with a decreased incidence and duration of delirium (Kamdar et al., 2013; Patel et al., 2014). However, few researchers have considered the role of sleep in the development of pediatric delirium (Calandriello et al., 2018), and few pediatric critical care clinicians implement sleep-promoting interventions to prevent or manage delirium (Kudchadkar, Yaster, et al., 2014; Staveski et al., 2018). Nurse scientists are needed in the medically-dominated field of pediatric delirium research to highlight the important role of the critical care nurse in preventing and managing delirium (Balas et al., 2012). As a doctoral nursing student, my interest in pediatric delirium is driven both by Nightingale’s (1969) mandate to the nursing profession and the Human Response Model, a conceptual model for nursing that depicts the complex interplay between the patient, their environment, and their health (Heitkemper & Shaver, 1989; Shaver, 1985). My dissertation work focuses on the relationship between exposures in the pediatric critical care environment (i.e., light and sound exposure, caregiving patterns), sleep disruption, and delirium in young, critically ill children. I chose to focus on PICU environmental exposures and sleep patterns because they are inherently nurse-driven; as the primary bedside caregiver, the nurse determines the type of environment in which children receive treatment. This dissertation study will inform future large-scale stu dies of sleep disruption and pediatric delirium, as well as the design and implementation of sleep promotion interventions for the PICU. The validation of sleep promotion as an effective, nurse-driven, non-pharmacological delirium prevention method has the potential to improve the neurocognitive symptom management and clinical outcomes of survivors of pediatric critical illness. In my future work as a nurse scientist, I will continue to root my research in the ideals espoused by Nightingale in her Notes on Nursing (1969). My long-term career goal is to become a leader in improving the neurocognitive symptom management, clinical outcomes, and long-term health of critically ill children by optimizing the pediatric critical care environment. In today’s complex critical care setting, full of advanced treatments and lifesaving technology, let us never forget the unique role of the nurse: To place critically ill patients in the best possible intensive care environment to receive life saving treatment, heal, and promote long-term health. References Al-Samsam, R. H., & Cullen, P. (2005). Sleep and adverse environmental factors in sedated mechanically ventilated pediatric intensive care patients. Pediatric Critical Care Medicine, 6(5), 562–7. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association. Balas, M. C., Vasilevskis, E. E., Burke, W. J., Boehm, L., Pun, B. T., Olsen, K. M., Peitz, G. J., & Ely, E. W. (2012). Critical care nurses’ role in implementing the “ABCDE bundle” into practice. Critical Care Nurse, 32(2), 35–8, 40–7; quiz 48. https://doi.org/10.4037/ccn2012229 Calandriello, A., Tylka, J., & Patwari, P. (2018). Sleep and delirium in pediatric critical illness: What is the relationship? Medical Sciences, 6(4), 90. https://doi.org/10.3390/medsci6040090 Claustrat, B., Brun, J., & Chazot, G. (2005). The basic physiology and pathophysiology of melatonin. Sleep Medicine Reviews, 9(1), 11–24. https://doi.org/10.1016/J.SMRV.2004.08.001 Colville, G., Kerry, S., & Pierce, C. (2008). Children’s factual and delusional memories of intensive care. American Journal of Respiratory and Critical Care Medicine, 177(9), 976–982. https://doi.org/10.1164/rccm.200706-857OC Cureton-Lane, R. A., & Fontaine, D. K. (1997). Sleep in the pediatric ICU: an empirical investigation. American Journal of Critical Care, 6(1), 56–63. Durmer, J. S., & Dinges, D. F. (2005). Neurocognitive consequences of sleep deprivation. Seminars in Neurology, 25(1), 117–129. https://doi.org/10.1055/s2005-867080 Hegge, M. (2013). Nightingale’s Environmental Theory. Nursing Science Quarterly, 26(3), 211–219. https://doi.org/10.1177/0894318413489255 Heitkemper, M. M., & Shaver, J. F. (1989). Nursing research opportunities in enteral nutrition. The Nursing Clinics of North America, 24(2), 415–26. Holly, C., Porter, S., Echevarria, M., Dreker, M., & Ruzehaji, S. (2018). Recognizing delirium in hospitalized children: A systematic review of the evidence on risk factors and characteristics. American Journal of Nursing, 118(4), 24–36. https://doi.org/10.1097/01.NAJ.0000532069.55339.f9 Kahn, M., Sheppes, G., & Sadeh, A. (2013). Sleep and emotions: Bidirectional links and underlying mechanisms. International Journal of Psychophysiology, 89(2), 218–228. https://doi.org/10.1016/j.ijpsycho.2013.05.010 Kamdar, B. B., King, L. M., Collop, N. A., Sakamuri, S., Colantuoni, E., Neufeld, K. J., Bienvenu, O. J., Rowden, A. M., Touradji, P., Brower, R. G., & Needham, D. M. (2013). The effect of a quality improvement intervention on perceived sleep quality and cognition in a medical ICU. Critical Care Medicine, 41(3), 800–9. https://doi.org/10.1097/CCM.0b013e3182746442 Kudchadkar, S. R., Aljohani, O. A., & Punjabi, N. M. (2014). Sleep of critically ill children in the pediatric intensive care unit: A systematic review. Sleep Medicine Reviews, 18(2), 103–110. https://doi.org/10.1016/j.smrv.2013.02.002 Kudchadkar, S. R., Yaster, M., & Punjabi, N. M. (2014). Sedation, sleep promotion, and delirium screening practices in the care of mechanically ventilated children: A wake-up call for the pediatric critical care community. Critical Care Medicine, 42(7), 1592–1600. https://doi.org/10.1097/CCM.0000000000000326 Maldonado, J. R. (2017). Delirium pathophysiology: An updated hypothesis of the etiology of acute brain failure. International Journal of Geriatric Psychiatry, 1-30 https://doi.org/10.1002/gps.4823 Meyburg, J., Dill, M. L., Traube, C., Silver, G., & von Haken, R. (2017). Patterns of postoperative delirium in children. Pediatric Critical Care Medicine, 18(2), 128–133. https://doi.org/10.1097/PCC.0000000000000993 Nightingale, F. (1969). Notes on nursing: What it is and what it is not. Dover Publications, Inc. Patel, J., Baldwin, J., Bunting, P., & Laha, S. (2014). The effect of a multicomponent multidisciplinary bundle of interventions on sleep and delirium in medical and surgical intensive care patients. 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4 thoughts on “ winning essay – “bringing florence nightingale to the bedside of the critically ill patient” ”.

Laura, Congratulations on winning the essay contest and thank you many times over for a fabulous scholarly essay.

Laura – Congratulations and thank you! It is so important to continue to evolve Nursology’s unique perspective on health and illness.

Congratulations and many thanks to this wonderful post! Your sentence: “Yet her careful distinction between the practice of medicine and the practice of nursing remains relevant” is important, and the post is well substantiated with research.

If we really make this distinction, my suggestion is to use NURSING DIAGNOSES (e.g. risk for acute confusion/acute confusion) instead of, respectively in addition, the medical diagnosis delirium. Or sleep nursing diagnoses (e.g.Insomnia/Sleep deprivation/Disturbed sleep pattern) instead of sleep disruption. Nursing diagnoses describe nurses’ clinical judgement concerning a human response to health conditions/life processes…..and provide the basis for selecting nursing interventions to achieve outcomes for which the nurse has accountability (Herdman, & Kamitsuru, 2018; NANDA International nursing diagnoses: Definitions and classification 2018-2020. New York: Thieme).

Some nursing diagnoses need further validation and more literature research. Therefore, your contribution to the above mentioned ones would be appreciated for advancing the knowledge base of nursing, and to name and make nursing visible. Thanks so much!

Excellent essay Laura!! Thank you for sharing your contribution to the advancement of nursing knowledge!

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