Martin Thomas - Florence Nightingale

In a well-attended September meeting, Martin Thomas gave members a detailed and thoughtful account of the life of nursing pioneer and social reformer Florence Nightingale, reminding us how extraordinary her achievements were for any era, let alone in a time when women had so little influence and standing.

Named after her place of birth in Italy, Florence Nightingale was born into the landed gentry.  Unusually for the time, her father was very supportive of her education.  She gained a grounding in mathematics and statistics that would prove useful later.

As a teenager, Florence knew she would not be following the usual path for a woman of her status: marriage (despite five proposals from very eligible suitors), children, a country house.  She believed she had a God-given purpose to help people and later declared her intention to become a nurse.  This was not well-received by her family because, as Martin explained, nurses were considered uneducated, promiscuous and partial to a drink or seven.  Despite the objections, Florence gained employment managing a women’s hospital, where she learned about nursing, management and administration.

In 1854, following the outbreak of the Crimean War, and with the backing of Sidney Herbert, a government minister, Florence travelled with a group of women to assist at the Scutari Barracks Hospital in Turkey.  There, she found the injured troops and the medical staff dealing with appalling conditions – no plumbing, no beds, and wards overrun with vermin.  Three major battles (Alma, Balaclava and Inkerman) soon overwhelmed the military hospitals with over 7,000 casualties, many suffering from cholera.  Around the same time, supply ships bringing winter supplies (including horses, food and 40,000 coats) were lost in a storm. 

Martin explained how Florence Nightingale tackled this overwhelmingly bad situation through several initiatives.  She focussed on essential nutrition, hygiene and sanitation, or “diet, dirt and drains”.  She ventilated the wards, spaced the beds, and segregated casualties with illnesses.  She introduced pastoral care, writing hundreds of letters to families of the dead, and assisting her patients in writing home.  She set up a banking system to assist in getting soldiers’ pay back to families. 

While adored by her patients, Florence clashed with officers, doctors, and nuns!  She was steadfast in her approach to running the wards and would not back down when challenged by those who considered themselves superior to her.

Martin told members how Florence Nightingale became widely known as the “Lady with the Lamp”.  The term was coined in a letter to The Times in February 1855, which described her making her nighttime rounds.  Also in 1855, Isambard Kingdom Brunel, using Florence Nightingale’s sanitary principles, designed prefabricated field hospitals, which were shipped out to Turkey in 50-bed units to be combined on site.

Florence’s schooling in mathematics and statistics was also employed during those early months.  Alongside the improvements that she instigated, her management of the wards was informed by meticulously collected mortality data, and, in just a few months, mortality rates fell from 42% to 2%.  Data collection was extended to satellite hospitals, where a surgeon with unprecedented survival rates was found, and his practice of putting surgical instruments in hot water identified as a factor.

Upon return, Florence Nightingale found out just how famous she had become.  Martin detailed how she used her continued influence with several MPs for the protection and advancement of women – reform of prostitution laws, women’s suffrage, and female participation in the workplace.  Her use of statistical methods in areas such as child malnourishment, and her administrative skills in introducing standardised death certificates, continued to benefit Victorian society.

One of her greatest achievements away from the battlefield was, using a £2mn government fund, establishing the Nightingale School of Nursing, and sending teams around the country and empire to set up more schools based on the same principles.  This improved the standard of nursing, the reputation of nursing and, for the first time, began to attract middle- and upper-class, educated women into the profession in numbers.  Her model was studied and implemented elsewhere in the world - in Sweden, the USA and Japan.

Florence Nightingale was the first woman to be admitted to the Royal Statistical Society in 1888, and the first female recipient of the British Order of Merit in 1907.  She declined a state funeral and was buried at the family plot in Hampshire in 1910.  She is not just memorialised around the UK, but around the world.