FLORENCE NIGHTINGALE

NURSE, RENEWER OF SOCIETY (12 AUGUST 1910)

 
The commemoration of Florence Nightingale is controversial. On the one hand, she doubted or denied many of the central articles of the Creed. On the other hand, she believed in God and devoted her life to His service as she understood it.

She was born in Florence on 12 May 1820 of upper-class English parents travelling through Italy, and named for her native city. ("Florence" was not an accepted first name at the time. Her sister was born in Naples and named "Parthenope," the Greek name for that city.) Florence was reared in the Unitarian Church, but later joined the Church of England.

In her diary, an entry shortly before her seventeenth birthday reads: "On February 7th, 1837, God spoke to me and called me to his service." She did not know what the service would be, and therefore decided that she must remain single, so as to have no encumbrances and be ready for anything. With this in mind, she rejected a proposal of marriage from a young man whom she dearly loved. She suffered from "trances" or "dreaming" spells, in which she would lose consciousness for several minutes or longer, and be unaware when she recovered that time had passed. (Could this be a form of petit mal epilepsy? No biographer of hers that I have read uses the word.) She found the knowledge that she was subject to such spells terrifying, and feared that they meant that she was unworthy of her calling, particularly since she did not hear the voice of God again for many years. In the spring of 1844 she came to believe that her calling was to nurse the sick. In 1850 her family sent her on a tour of Egypt for her health. Some extracts from her diary follow:

March 7. God called me in the morning and asked me would I do good for Him, for Him alone without the reputation.
March 9. During half an hour I had by myself in my cabin, settled the question with God.
April 1. Not able to go out but wished God to have it all His own way. I like Him to do exactly as He likes without even telling me the reason.
May 12. Today I am thirty--the age Christ began his mission.
Now no more childish things. No more love. No more marriage. Now Lord let me think only of Thy Will, what Thou willest me to do. Oh Lord Thy Will, Thy Will.
June 10. The Lord spoke to me; he said, Give five minutes every hour to the thought of Me. Coudst thou but love Me as Lizzie loves her husband, how happy wouldst thou be." But Lizzie does not give five minutes every hour to the thought of her husband, she thinks of him every minute, spontaneously.

Florence decided that she must train to be a nurse. Her family was horrified. In her day, nursing was done mostly by disabled army veterans or by women with no other means of support. It was common for nurses of either sex to be drunk on the job most of the time, and they had no training at all. It was common practice never to wash or change the sheets on a bed, not even when a patient died and his bed was given to a new patient. Florence was told to go to Kaiserswerth, Germany, to learn and train with the Lutheran order of Deaconesses who were running a hospital there. Back in England again, she used the influence of Sidney Herbert, a family friend and Member of Parliament, to be appointed supervisor of a sanatorium in London. Under her able guidance, it turned from a chamber of horrors into a model hospital. The innovations introduced by Miss Nightingale were, for their day, little short of revolutionary. She demanded, and got, a system of dumb-waiters that enabled food to be sent directly to every floor, so that nurses did not exhaust themselves carrying trays up numerous flights of stairs. She also invented and had installed a system of call bells by which a patient could ring from his bed and the bell would sound in the corridor, with a valve attached to the bell which opened when the bell rang, and remained open so that the nurse could see who had rung. "Without a system of this kind," she wrote, "a nurse is converted to a pair of legs."

While working in the poorer districts of London, Miss Nightingale encountered a Roman Catholic priest, Henry Edward Manning (later Cardinal Manning), who was working among the poor of London. She was impressed by the assistance he gave to many who had nowhere else to turn, and they became friends for life. She was greatly attracted by Roman Catholicism, but rejected much of its theology, and so reluctantly decided against joining it.

Then war broke out in the Crimea (in Russia, on the north edge of the Black Sea), and Sir Sidney Herbert, now Secretary of War, obtained permission for Florence to lead a group of 38 nurses there. Of these, 10 were Roman Catholic nuns, 14 were Anglican nuns, and the remaining 14 were "of no particular religion, unless one counts the worship of Bacchus." They found conditions appalling. Blankets were rotting in warehouses while the men did without, because no one had issued the proper forms for their distribution. The lavatories in the hospitals had no running water, and the latrines were tubs to be emptied by hand. But no one emptied them, since official regulations did not specify which department was responsible for doing so. The result was that the hospital had a foul stench that could be smelled for some distance outside its walls. Far more men were dying in hospitals of infection than of wounds. The chief concern of many of the Army doctors was that the nurses might usurp some of their authority. Florence gradually managed to win the doctors and other authorities over, and to reform hospital procedures, with spectacular results. Once the medical situation had ceased to be an acute problem, she turned her attention to other aspects of the soldiers' welfare. For example, most of them squandered all their pay on drink. She noted that there was no trustworthy way for them to send money home to their families, and she set up facilities for them to do so. First, she undertook to send money home herself for any soldier in the hospital that wanted it sent, and the soldiers brought in about 1000 pounds a month. She asked the authorities to set up an official service to do this, and they refused. By appealing to Queen Victoria herself, she overcame opposition to the idea, and the men sent home 71,000 pounds sterling in less than six months. She established with her own money a reading-room with tables for writing letters, and the men used it enthusiastically. She imported four schoolmasters to give lectures, and the halls were filled to overflowing. All this was done despite opposition from officers who said, "The men are hopeless brutes. You cannot expect anything from them."

At night, she would often patrol the wards, carrying a dim lamp, to make sure that all was well and no one was in need of help. She became famous as "the Lady with the Lamp."

In April 1856 the war was over, and by mid-July the hospital was emptied and her work in Crimea over. She returned to England a national hero, with a great welcome prepared for her; but she slipped into the country unnoticed and went to a convent that had supplied some of her nurses. There, she spent the day in prayer before coming out to face the public and beginning to lobby Parliament for suitable legislation. She wrote pamphlet after pamphlet, pointing out by pie charts, for example, that the major cause of deaths in the Army was not wounds caused by enemy action but disease caused by lack of proper sanitation. She is perhaps the first person to use pie charts and similar graphic devices to convey statistical information. She obtained the formation of an Army Medical Staff Corps and a Sanitary Commission to oversee military health conditions.

Throughout these efforts, she relied on the help of Sidney Herbert, insisting that he must work hard and long to get the legislation she needed through Parliament. When he protested that she was asking too much, she would not listen. His health broke, and he died in August 1861. Florence prayed God to raise him from the dead, explaining that she needed him for the job. When God failed to comply, her faith was badly shaken. She wrote a book called, Suggestions for Thought: An Address to the Artisans of England, in which she explained that God was less of a Person and more of a Cosmic Force than is generally supposed by Christians. (But note that she was working on this book before Sir Sidney died, and one cannot call it simply a response to his death.) Advance copies were given to a few friends, such as John Stuart Mill, who praised it highly. However, it was never published (I have not seen it, and neither the Library of Congress nor the National library of Medicine has a copy, nor any other library in the United States that I have been able to learn of), since Florence kept revising it -- arguably, because her beliefs on the nature of God were simply not internally consistent. Eventually, it seems, God spoke to her again and said, "You are here to carry out my program. I am not here to carry out yours." She wrote in her diary, "I must remember that God is not my private secretary."

Before his death, Sir Sidney had gotten her involved in Indian affairs. She served on the Indian Sanitary Commission. In May 1859, she decided that there were insufficient data available in England on conditions in the Indian Army, and she wrote to 200 military stations there, asking for copies of all regulations and all documents relating to the health and sanitary administration of the army. The reports that came back filled two vans. She read them all and summarized them for the Report of the Commission. Her conclusion was that the death toll from disease in the Indian Army was appallingly high (69 out of 1000 annually), and that this was largely due, not to the climate, but to lack of sanitation, and that preventive measures included sanitation not just for army posts but for neighboring villages and, in the long run, for all of India.

She was a friend of General Charles George Gordon, who captured the British imagination when he and his troops were beseiged at Khartoum in the Sudan, and finally captured and killed. After his death, Florence wrote to a friend that suffering, disappointment, and lack of success are the tribute which it is the soul's greatest privilege to present to God. In Gordon's death, she wrote, we see "the triumph of failure, the triumph of the Cross. With him, all is well."

She met the scholar Benjamin Jowett, who was translating Plato into English. They became fast friends, and she contributed to the translation. She also began an anthology of mystical writings, called "Notes from Devotional Authors of the Middle Ages, Collected, Chosen, and Freely Translated by Florence Nightingale." It was her contention that mystical prayer is not just for monks and nuns, but should form a part of the every-day life of ordinary persons.

Under the strain of ceaseless overwork, her own health broke, and she was an invalid for the latter half of her life. On Christmas Day when she was sixty-five, she wrote: "Today, O Lord, let me dedicate this crumbling old woman to thee. Behold the handmaid of the Lord. I was thy handmaid as a girl. Since then, I have backslid." She wrote a manual called Notes for Nurses, and a set of instructions for the matron in charge of training nurses, emphasizing the importance for a nurse of a schedule of daily prayer. A few years before her death, she was the first woman to receive the Order of Merit from the British government. She died at ninety, and, by her directions, her tombstone read simply, "F.N. 1820-1910".

Florence Nightingale died on 13 August 1910, and is commemorated on this day on the Lutheran Calendar. The Episcopal calendar commemorates Jeremy Taylor on 13 August, and accordingly has shifted the commemoration of Nightingale to 18 May. I am not sure of the significance of this date, but it is the date (or nearly) of the opening of the Nightingale Training School for Nurses in 1860. [Note: the current date in the Episcopal Church for her commemoration is 12 Aug.]

by James Kiefer