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Opinions of Wednesday, 13 May 2020

Columnist: Gbande Sulleh

Bicentenary celebration of Florence Nightingale's history and legacy

The late Florence Nightingale The late Florence Nightingale

Who is Florence Nightingale?

Florence Nightingale was an English social reformer, statistician and pioneer of modern nursing. She was born on May 12, 1820, in Florence, Italy to Mr. William Shore Nightingale and Mrs.

Frances Nightingale. Florence was the younger of two children. Her parent belonged to elite social circles.

Florence’s parents were wealthy landowners who had inherited two estates one at Hampshire, Embley Park and the other in Lea Hurst, Derbyshire when she was just at age 5. Frances Nightingale her mother, hailed from a household of traders and took pride in mingling with people of projecting social standing.

In spite of her mother’s desire in social climbing, Florence was inversely awkward in social circumstances. She chose to avoid being the focus of courtesy whenever possible.

Resolute, Nightingale frequently rammed heads with her mother, whom she viewed as exceedingly controlling. Nonetheless, like countless daughters, she was enthusiastic to gratify her mother.

As she once wrote concerning her relationship with her mother “I think I am got something more good-natured and complying,” Florence Nightingale was brought up on the family estate at Lea Hurst. At a very tender age, Florence was active in charity, comforting the ill and poor people in the village bordering her family’s estate. And by age 16, it was evident to her that nursing was her calling.

Florence deemed this calling a divine purpose for her life. Her mother and sister were opposed to her chosen career, but Florence mounted a solid defense and worked hard to learn more about her craft despite the society’s expectation that she become a wife and mother.
Her education.

William Nightingale gave Florence a standard education, including studies in French, German, and Italian. Being home schooled by her parents and tutors, Florence gained excellence in Mathematics and philosophy. Resolute to pursue her true calling despite her parents’ objections, in 1844, Florence enrolled as a nursing student at the Lutheran Hospital in Kaiserwerth, Germany where she observed Pastor Theodor Fliedner care for the infirm and destitute.

Florence Nightingale and Nursing

In the early 1850s, Florence returned to London, and took a nursing job in a Middlesex hospital for ailing governesses. She extoled the virtues of a nurse and performed beyond expectation ad that impressed her employer that Nightingale was promoted to superintendent rank within just a year of being employed.

Her new rank proved challenging as Florence contended with a cholera outburst and unsanitary conditions conducive to the fast spread of the disease. Florence made it her focus to improve hygiene practices, expressively lowering the mortality rate at the hospital in the process. Her hard work took a toll on her health. She had just barely recovered when the major challenge of her nursing career surfaced.

Florence Nightingale and the Crimean War

The Crimean War broke out in October 1853. Russian Empire was at war against the British Empire for the control of the Ottoman Empire. Hundreds 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. And by 1854, Florence received a letter from Sidney Herbert, Secretary of War for Britain then, asking her to mobilize nurses to attend to the sick and fallen soldiers in the Crimea.

Florence rose to the occasions as it was her calling. She quickly assembled a team of 38 nurses from a variety of religious orders and sailed with them to the Crimea just a few days later to help. Sooner than later they arrived at Scutari, the British base hospital in Constantinople.

Her quick assessment of the situation revealed a lack of most basic supplies, such as bandages and soap due to a steady increase in the number of ill and wounded soldiers.

According to reports, even water needed to be rationed. Her observation showed that more soldiers were dying from infectious diseases like cholera and typhoid than from injuries incurred in battle. Florence made night rounds to minister onto her patients with a lamp given her the arcuate “the Lady with the Lamp.” With Others simply calling her “the Angel of the Crimea.” Florence and her team were able to reduce the mortality rate from 32% to 2%. And in 1856 she returned to London and queen Victoria awarded her with “Nightingale Jewel” and granted her a prize of $250,000 from the British government.

Florence Nightingale, Statistician

Queen Victoria supported Florence Nightingale to create a Royal Commission into the health of the army by employing leading statisticians of the time, thus, John Sutherland and William Farr, to analyze the death data of the arm. Their finding was horrifying: 16,000 of the 18,000 deaths were from preventable diseases not battle. However, it was Florence’s capacity to translate this data into a new visual format that really caused a sensation.

Thus, her polar area diagram, now termed as “Nightingale Rose Diagram,” exposed how the Sanitary Commission’s work lessened the death rate and made the complicated data accessible to all, thereby inspiring new canons for sanitation in the army and beyond. Florence became the first female fellow of the Royal Statistical Society and was named an honorary associate of the American Statistical Association.

Florence Nightingale’s Impact on Nursing

In 1859, Florence Nightingale wrote Notes on Nursing: “What it is and What it is Not” which is a book first published by Florence Nightingale in 1859 and in 1860, Florence establishment the first nursing school thus, St. Thomas’ Hospital, and within it, the Nightingale Training School for Nurses was founded.

She also propounded environmental theory in nursing with which she enumerated five components of the environment (pure water, pure air, good drainage system, good lighting ie. Sunlight and environmental cleanliness). In fact, she became known as the founder of modern nursing.

Florence became a symbol of community admiration. Songs, poems, and plays were written and dedicated in the heroine’s honor. Young women desired to be like her. During the U.S. Civil War, she was often consulted about how to superlative manage field hospitals.

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

Legacy of Florence Nightingale

Florence died on Saturday, August 13, 1910, at her home in London leaving a huge legacy in the field of nursing.

Legacy one – Empathy: At the Scutari Barrack Hospital Nightingale instituted the first patient library in anticipation of giving the soldiers under her care something to do other than drink. Her compassion for her patients could not afford her the luxury to sit and watch while the patients suffer.

While she was initially radicle by the military brass who insisted that the men their hero Wellington had referred to as “the scum of the earth” were incorrigible, they were astonished when in fact this act of empathy in action achieved the desired result.

Even long before Daniel Goleman coined the phrase “social radar” in his book Emotional Intelligence, Nightingale appreciated that awareness and empathy are central to quality patient care, active leadership, and to creating what Stallard calls a Connection Culture.

Legacy two – Commitment: Florence Nightingale had a calling and mission, not an occupation where wages precedes commitment. She neither inquire about pay nor benefits before leading her team of 38 nurses off to the Crimea. She endured working conditions that would be considered unbearable in today’s world.

Yet she never experienced “burnout,” and through devotion to her mission she changed the world of healthcare forever. Florence could easily have settled into a life of ease at her family’s country mansion; instead she chose a path of arduous commitment to caring for others.

Her legacy reminds us that caring for the sick is more than just a business, it’s a mission. The first duty of healthcare leadership is inspiring this commitment, beginning with our own examples.

Legacy three – Discipline: Nightingale was a disciplined pioneer of evidence-based practice. Her painstaking efforts to chart morbidity and mortality rates among soldiers at Scutari provided weight to her demands for better sanitary conditions first at military hospitals, and later in civilian institutions.

Nightingale proved that if you want to be effective, it’s not enough to know that you are right, you must be able to demonstrate that you are right with the facts. Through her discipline nature, she pioneered medical statistics.

Legacy four. Attitude: Like Maxwell rightly puts it, attitude is everything. Nightingale had an innate understanding that emotions are infectious, and would never have tolerated the complains, gossip, and other forms of lethal emotional negativity that are prevalent in many hospital breakrooms (and too often in public places). As some writers puts it, toxic emotional negativity is the emotional and spiritual equivalent of cigarette smoke, and in its own way just as harmful.

To promote a more positive and productive workplace culture, we must raise our attitudinal expectations and lower our tolerance for deviation from those expectations. Even in the horrendous circumstances that prevailed at Scutari, Nightingale insisted that people be treated with dignity.

Legacy five – Initiative: When told there was no money to repair a burned-out wing of the Scutari Barrack Hospital that was scheduled to receive hundreds of new casualties, Florence hired a Turkish work crew and before anyone could stop her, she had the wing refurbished.

The acid test of an “empowering” workplace is whether people, regardless of job title, can take the initiative to do the right thing for patients and coworkers without seeking permission or worrying about recrimination. Although she herself never used the words, “Proceed Until Apprehended” it would have been a pretty good description of Nightingale’s approach to getting things done. We must learn never to give or take any excuse but be initiative at work

Legacy six – Courage: Florence did not allow opposition from the British antiquated or the aristocracy views of imperious physicians and military leaders to prevent her from doing her work. When she ran into a brick wall, she found a way around or over. Our challenges today are different than those faced by Nightingale more than one hundred years ago, but the need for courage and perseverance is just as vital now as it was then.

Legacy seven – Loyalty: Nightingale was a team-builder who cared passionately about the nurses under her wing and the soldiers under her care. She was a demanding leader, but also showed unbending commitment to the people she led.

Upon her return to England from Scutari she personally endeavored to make sure that every nurse who had served with her there would find employment upon their return home. Her legendary loyalty to the soldiers she served was reflected in the fact that when she was buried, her coffin was accompanied by octogenarian veterans of the Crimean War honored their debt to the lady with the lamp.

Legacy eight – Humor: From reliable reports and pictorial evidence, Florence had a wonderful sense of humor and was often able to defuse tense situations with the light touch of laughter. If Florence could laugh in the hell-on-earth environment of the Scutari Barrack Hospital, then no matter what the world throws at us including COVID-19, we can’t forget the restorative and healing power of laughter.

Legacy nine – Contrarian Toughness: What would Florence Nightingale tell us about dealing with perennial crisis? She would say, we need to see opportunities where others see barriers. We need to be cheerleaders when others are moaning doom-and-gloom. We need to face problems with contrarian toughness because it’s in how we solve those problems that we differentiate ourselves from everyone else and in this pandemic of COVID-19, we must demonstrate this contrarian toughness.

Legacy ten – Aspiration: Florence Nightingale could have relaxed on her laurels, but she never did, rather, she continuously raised the bar. After proving that a more professional approach to nursing care would improve clinical outcomes, she helped found the first visiting nurses association, chartered the first modern school of professional nursing, and through her writing helped establish professional standards for hospital management. She remained active virtually until the end of her life at the age of 90.

In conclusion, 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.

GBANDE SULLEH

ASSISTANT LECTURER, UNIVERSITY OF HEALTH AND ALLIED SCIENCES

DEPARTMENT OF NURSING AND MIDWIFERY, HO