Aug. 13 is the 100th anniversary of the death of Florence Nightingale, a fitting time to see who she really was and what she really did.
Henry Wadsworth Longfellow wrote of her — in his 1857 poem “Santa Filomena” — as the Lady with the Lamp, who “flitted from room to room” kissing “speechless sufferers” in the “glimmering gloom.”
But Nightingale was far more than a devoted do-gooder. She was a radical and visionary health care reformer who revolutionized the organization of hospital care, promoted public health and pioneered the formal education of nurses.
Although she is best known for her work in nursing, today she is most relevant for her focus on patient safety.
For more than 40 years, from the battlefields of Crimea to her invalid bed in London, she waged a relentless campaign to improve health outcomes. “The very first requirement in a hospital,” she wrote is “that it should do the sick no harm.”
To protect patients from harm, she was a pioneer of health statistics and gathered data on infection and mortality rates. She used this data to develop scientific principles that covered everything from hospital design, sanitation, kitchens, diet and, importantly, the organization of care.
Her best-seller, “Notes on Nursing,” which remains in print today, was actually a manual on the prevention of infection and the management of symptoms. It guided everyone involved in the care of the sick, from households to hospitals. Through her efforts, hospitals began to transform themselves from dirty, chaotic and disease-ridden death traps into modern, safe and effective institutions.
Nightingale was also one of the first pioneers in public health. She was deeply concerned with what those in that field would now call the “social determinants of health.”
She was concerned about the impact of the environment on people’s well-being, and she firmly believed that better housing, sanitation and diet were fundamental to improving fitness. She also supported the development of home nursing to bring this message directly into the communities and houses of the poor.
One of her great disappointments was that she failed to convince the British government to bring clean water to India before railroads. Had she succeeded, cholera would not have cost the lives of millions of Indians in the 19th century, and the battle to reduce infant mortality would have been won a century ago.
Florence Nightingale was way ahead of her time. Not only nurses but doctors, hospital administrators and health care policymakers still have a lot to learn from this Victorian woman who spent 40 years in her bed and died in 1910.
Suzanne Gordon is editor of “When Chicken Soup Isn’t Enough: Stories of Nurses Standing Up for Themselves, Their Patients and Their Profession,” and Sioban Nelson is editor of “Notes on Nightingale: The Influence and Legacy of a Nursing Icon.” They can be reached at email@example.com.
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