This is National Nurses Week which has been expanded this year to National Nurses Month. As well it should be.
In 2001 the iconic heroes of 9/11 were
the firefighters—both the ones who
rushed into the twin towers after
the aircraft impacts and those
covered in ash and grief in the hours and days after the buildings collapsed. In war
time they have often been soldiers like
those who stormed the beaches of Normandy or raised the flag on Iwo Jima. In the aftermath
of earthquakes, floods, tornados and
other natural disasters they are the
rescuers searching frantically for survivors.
During the Coronavirus pandemic the iconic heroes were the nurses. Sure,
other got and deserved attention—first
responders, doctors and other medical
personnel, scientists seeking treatments or vaccines, and even other usually ignored essential workers including grocery
clerks, truck drivers and delivery
persons, custodians and cleaners. But nurses riveted our attention and sympathy
with their tireless devotion in the
midst of overwhelming chaos and suffering.
It is no accident that the
celebration of nurses is centered on the woman
often considered the mother of
the profession and its secular patron saint. Americans also look to a home grown inspiration.
Britain
and America each have iconic
nurse heroines. But other than sharing a common calling, horrific
experience in war, and a steely
determination, Florence Nightingale
and Clara Barton could not have been
more different.
Nightingale was the daughter of a wealthy landowner and member of the British ruling class.
Barton came from a struggling but respectable family of middling means. Nightingale struggled to gain acceptance for nursing
as a respectable occupation for gentle women. Spinster
Barton had no choice but to work
spending years as a school mistress
before volunteering without training
to serve the Civil War wounded.
Nightingale came from a family with Unitarian connections but was a devoted Anglican. Barton was raised a Universalist who had no religious affiliation in later life, but credited her ethic to
her childhood faith. Nightingale was interested in the professionalization of nursing, sanitation practices, and what we would now describe as holistic medicine. Barton cared about the amelioration of suffering and building a new
model of active charity and volunteerism.
Disabled
by illness and perhaps Post-Traumatic
Stress Disorder, Nightingale had to largely retire from active nursing and
administration within a few years of returning from the Crimean War and spent the rest of her
long life as a semi-invalid, writer, and researcher. She never embraced feminism, was in fact openly critical of it and cultivated the support and friendship of powerful men. Barton, although necessarily careful to curry support for the American Red Cross from the President
and Congress, was supportive of women’s suffrage.
But, of course, Nightingale’s famous
example inspired and motivated
Barton in her own career.
Florence Nightingale was named for
the city of Florence, then the
capital of the Duchy of Tuscany on
May 12, 1820. Her father, born William Shore, inherited a rich country estate from his mother’s
family and assumed their name, Nightingale.
In 1825 the family returned to
England where they took up residence
in a large and elegant new country home
on the familial estate, Lea Hall in Derbyshire. The following
year her father bought a second estate, Embley
Park, in Hampshire. Soon after he was appointed the High Sheriff of Hampshire. The family divided their years between the
two country seats.
Nightingale was home tutored, like most of her class, but benefited from parents
who allowed her to study deeply beyond
the narrow instruction usual for
women of her class and place. By here
late teens she was as academically
accomplished as most university
educated men.
Her mother, despite progressive social views and ardent abolitionism, was a Victorian
traditionalist when it came to the role of women. She strongly opposed young Florence’s announcement
that she was determined to find a career in
service, and particularly in nursing.
Women nurses were not unheard of. But other than Catholic and Anglican nursing orders, it was considered an unskilled job for the lowest
orders of society. Because they were required to come into close
physical contact with patients,
including men, it was assumed that they were degraded and likely to service
their charges sexually as
well. In fact, secular nurses were often
regarded as little more than prostitutes.
Despite her mother’s opposition, in
1844 Nightingale launched a round of visiting hospitals in London and
elsewhere, observing conditions and techniques, and eventually volunteering her services. She rejected
an ardent suitor, politician and poet Richard Monckton Milnes, for fear that marriage would interfere with
her calling. She continued her hospital
visits for 14 years, eventually attracting the attention and support of others.
In 1849 Nightingale undertook
extensive travels in Europe, Turkey, and Egypt. He mother probably
hoped the Grand Tour would divert her from her purpose. She was dead
wrong. She used the trip to make
visits to hospitals and study nursing techniques. She spent time with in Egypt she visited a convent of nursing sisters of St.
Vincent de Paul in Alexandria,
where she was impressed by the order and discipline that made their care superior to anything she had found in Europe.
Later on the journey she spent
considerable time at the Institute of
Protestant Deaconesses at Kaiserswerth
in Germany. The institute had been
founded for the care of the destitute
in 1833 and had grown into a training
school for women teachers and
nurses. She described the event as the turning point of her life. She returned to the Institute in 1851 for
four months of medical training—the
only formal nursing education she
ever received. She vowed to establish
similar training programs in England.
Her accounts of her experiences there, The Institution of Kaiserswerth on the Rhine, for the Practical
Training of Deaconesses, etc,
was her first major publication and
drew attention for her plans in England.
Nightingale’s
sister also published her extensive correspondence describing in
detail her experience in Egypt and “The
Orient” which showed her as a gifted
travel writer and astute observer of life and customs in other lands.
During
these travels Nightingale also made contact with important British political figures also traveling abroad,
especially Sidney Herbert, who she met in Rome. Herbert was a former Secretary at War in
the Tory government Sir Robert Peel and would be called back to
that post during the Crimean War.
He became a lifelong devoted friend and supporter of Nightingale.
Back home,
Nightingale resumed her round of hospital visits will arguing for opening
nursing to respectable women and for formal schooling for them.
In 1852
she finally got a position where she could put her ideas into practice
as the Superintendent of the Institute for
the Care of Sick Gentlewomen in London.
It may not have been tending to the poor as she one day hoped to do, but
it was a start. In her relatively short tenure at the
Institute, she inaugurated formal training for her nurses.
About the same time, probably against his wife’s wishes but bowing to the inevitable, Florence’s father settled an £500 annual income on her allowing her to live comfortably while pursuing her career.
What interrupted Nightingale’s new job was the onset of the Crimean War,
as foolish a major power conflict as was ever fought. France
under the newly minted Emperor
Napoleon III, Britain and Russia
chest bumped over the rotting but
still alive corpse of the Ottoman Empire. The immediate
cause of the war, Russia’s occupation
of Ottoman provinces along the Danube ostensibly in defense of Orthodox rights, was voided
when Austria threatened to join the coalition against the Tsar and
Russia withdrew its troops. Undeterred, the war went on anyway, fought
mostly in naval actions on the Black Sea beginning in 1853 and on the Crimean Peninsula with the siege of the port of Sevastopol beginning
in September of 1854. Large, stupidly led Ottoman, French, and British Armies slogged it out against stubborn Russian resistance, cholera, and
other epidemics.
Considered the first modern war because of the use of steam powered war ships, iron clad floating batteries, railroads, telegraph lines, and massed
artillery, the war quickly turned
into a charnel house. And for the first time reporters traveling with the armies got word back to London and
Paris by wire within hours of actual events.
Newspapers quickly filled
with grim stories.
Word also got back to England about
the suffering of the British wounded in comparison to the French, who had better organized medical services and hospitals. Nightingale offered her services and her
friend Herbert, back as Secretary at
War, quickly accepted the offer and promised her full support and
all of the supplies she needed.
Nightingale set sail for the war zone on October 21, 1854 in charge
of a hastily recruited force of
nurses including 10 Roman Catholic nuns, 8 Anglican Sisters of Mercy, 6 nurses from St. John’s Institute, and 14 from various other hospitals.
She declined the services of Mary
Seacole a Black Jamaican traditional
doctor. Seacole traveled to the
Crimea anyway at her own expense and
served valiantly near the front lines. Briefly
honored upon her return to England, her memory was virtually erased
as Nightingale’s reputation soared.
Florence’s group arrived early in
November 1854 at Selimiye Barracks in
Scutari, Istanbul, 250 miles across
the Black Sea from the Crimea. Thousands
of British wounded were warehoused
there with almost no support. This would
be Nightingales main base throughout
the war.
She found appalling conditions:
There were no vessels
for water or utensils of any kind; no
soap, towels, or clothes, no hospital clothes; the men lying
in their uniforms, stiff with gore and covered
with filth to a degree and of a kind no
one could write about; their persons
covered with vermin . . .
We have not seen a drop
of milk, and the bread is extremely
sour. The butter is most filthy;
it is Irish butter in a state of decomposition; and the meat is more like moist leather than food.
Potatoes we are waiting for, until
they arrive from France . . .
Nightingale appealed through correspondent
William Russell of the The Times for supplies and
assistance. The Times organized relief
drives and supplies began to trickle in by year’s end.
Despite improvements and the best
efforts of her overworked nurses,
death rates actually climbed in the
hospital in the months after Nightingales arrival due to sanitary conditions and overcrowding. Cholera, typhus,
and typhoid swept the wards. Over 4,000 men died there over the winter.
Meanwhile the government commissioned a prefabricated hospital
and dispatched it to the scene under the civilian
leadership of Dr. Edmund Alexander
Parkes. When it arrived and was set
up nearby, its death rates were less than 1/10th of those at Suctari under
Nightingale’s care.
In March of 1865 a Sanitary Commission arrived from home
which flushed the sewers at Suctari, after which deaths dropped sharply. Nightingale did not recognize the connection however, and credited the improvement to nutrition and nursing care.
Despite their limitations, Florence and her nurses worked tirelessly, none more so than their leader. In addition to her administrative duties, she spent much time in the wards. And because the prejudice against nurses persisted
among Army authorities, only
Nightingale was allowed on the wards
at night to aid the ill trained and sometimes brutal male orderlies. She visited bedsides carrying a lantern, earning her the nickname Lady of the Lamp among her charges.
Russell spread the word of her
service back home where she was hailed as
a hero. The Nightingale
Fund for the training of nurses was set up under the stewardship Herbert while
she was still abroad and an astonishing £ 45,000 was raised by 1859.
In May of 1855 Nightingale finally
made it to the Crimea, inspecting hospitals near the front at Balaclava. While there, she fell ill with “Crimea Fever”
and lay dangerously near death for
12 days. She returned to Suctari
weakened. But she resumed her duties and
even returned Balaclava in March of 1856, remaining there until after active fighting ceased on the peninsula and the hospitals there were closed in July.
In August Nightingale boarded a
French ship and returned privately
to England where she was hailed as a great heroine. She was introduced to Queen Victoria herself and presented
the monarch with a report on conditions. Her fame even crossed the Atlantic where
Henry Wadsworth Longfellow memorialized
her in Santa Filomena
Lo!
in that house of misery
A lady with a lamp I see
Pass through the glimmering gloom,
And flit from room to room.
In 1860 with money from the
Nightingale Fund the Nightingale
Training School at St. Thomas'
Hospital opened in London. Nurses
there were trained in a course of study designed
by Florence. She was, however, too ill
to accept the superintendency of the new school. She also raised money for the Royal
Buckinghamshire Hospital near her family home. But her days as an active nurse and
administer were over.
Nightingale busied herself with a close study of statistics from the various hospitals and medical facilities in
the war. What she discovered caused her
to dramatically re-assess her own
views. In 1859 she published her
findings in Notes on Matters affecting the Health, Efficiency and Hospital
Administration of the British Army in which she acknowledged the supreme
importance of sanitation in reducing hospital deaths. In 1859 an Army medical college was opened at Chatham and the first military hospital was established in Woolwich in 1861 following the advice laid out by Nightingale.
That was followed in 1860 with Notes
on Nursing which laid down the educational program adopted at the St. Thomas school and others throughout
Britain.
When the Sepoy Rebellion broke out in India
in 1857, Nightingale volunteered once more to go abroad. But her health would not permit it. Instead she undertook a deep study of India
and wrote many articles about the
sub-continent over the next several years, including a detailed proposal for digging wells in Indian villages.
Nightingale continued to write and
was honored time and again over the next decades. She participated
as far as she was able in events like the Queen’s Diamond
Jubilee.
Nightingale died in London, on
August 13 1910 at the age of ninety and
was buried in the family plot at East Wellow, Hampshire after an offer of internment
in Westminster Abbey was turned down by her family. Memorial services took place in St. Paul’s Cathedral.
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