Lessons from the life of Florence Nightingale

The presence of thousands of daughters of Florence Nightingale in the regions devastated by the great world war, and the great service to humanity which they have rendered, have turned the thoughts of many to that other battlefield where the great need of the world for trained nurses was first impressed on the hearts of the people--an impression never to be effaced while there are suffering human beings requiring skilled care and service.

Sixty odd years ago, at the outbreak of the Crimean war there were no women nurses to minister to those who had been wounded in the service of their country. Woman’s ministry was sorely needed but not wanted by those in active command of military affairs at the seat of war. It remained for Florence Nightingale to teach the world one of its greatest lessons--a lesson from which future generations will reap increasing benefits. When the Crimean war closed, the foundation was begun on which the structure of modern nursing was to be reared.

In every age, the world has had its heroes, and Florence Nightingale would have been the last to wish to give the impression that there were not many splendid women devoting themselves to the care of the sick long before she was born. They were not trained women according to modern ideals of training, but there were women of gentle birth and breeding, refined and accomplished who served the sick with singleness of heart and rare devotion. The world will always owe its debt of gratitude to the Roman Catholic Sisters and the Deaconesses of other churches, whose tender ministries to the sick in hospitals and home, did much to lessen the sum of human suffering in the years before Miss Nightingale’s great work was begun.

No one who reads the story of the beautiful life of Florence Nightingale can fail to be impressed with the fact that the dominant motive of that life was--SERVICE. It has been aptly said that one of the first and most important lessons that a nurse needs to learn, is to spell SELF with a little s. In this she has a worthy example for forgetfulness of self seems to have been characteristic of Florence Nightingale all through her life. Service to humanity--especially service to the sick and distressed part of humanity--seems to have made its strong appeal to her almost from childhood. Organization for service, education and training for service, plans for service in a hundred different ways--filled her life, and the story of her many-sided activities, as revealed by her official biographer--has been a surprise to those who have thought of her only in connection with nursing. While she will always be best remembered as the founder of modern nursing, her great efforts in improving sanitary conditions in India, in which she labored unceasingly for many years with officials in the War Department, and her work in behalf of reform in the management of workhouses in England, were closely interwoven with her work in behalf of better nursing for the sick. Her voluminous correspondence and her literary work seem in themselves to have been sufficient to occupy her full time, after her return from the Crimea.

The popular idea of Florence Nightingale has been drawn largely from the pen picture of Longfellow in Santa Filomena, but it is far from being a true picture of her life. To fully appreciate her character and influence one must study to some extent, not alone the social and sanitary conditions that prevailed in her earlier life, but the habits of thought and even the etiquette of the times, during which her chief work was being accomplished. Of these conditions her biographer says:

“Now that the fruits of Florence Nightingale’s pioneer work have been gathered, and that nursing is one of the recognized occupations for gentlewomen, it is not altogether easy to realize the difficulties which stood in her way. The objections were moral and social, in large measure rooted to conventional ideas. Gentlewomen, it was felt, would be exposed, if not to danger and temptations, at least to undesirable and unfitting conditions. ‘It was as if I had wanted to be a kitchen maid,’ Miss Nightingale herself said in later years. Nothing is more tenacious than social prejudice. But the prejudice was in part founded on very intelligible reasons and in part was justified by the level of nursing as an occupation at that time. It will suffice to say that though there were better-managed and worse-managed hospitals, yet there was strong evidence to show that hospital nurses had opportunities which they freely used, for ‘putting the bottle to their lips’ when so disposed, also that other evils were more or less prevalent.

“The more she heard of the worst, the more was Florence Nightingale resolved to make things better; but the more her parents heard, the greater and more natural was their repugnance. Somebody must do the rough pioneer work of the world; but one can understand how the parents of an attractive daughter, to whom their own life at home seemed to them to open many possibilities of comfortable happiness, came to desire that in this case the somebody should be somebody else.”

It is difficult to study her life without feeling that she was sent into the world especially to accomplish the great tasks to which in early middle life, her powers were chiefly devoted. It should, however, be always remembered that during this period others besides Miss Nightingale were making their contribution to better nursing and better sanitary conditions in hospitals, and in the world outside. Lord Lister, who ushered in the new era of antiseptic surgery, was seven years younger than Florence Nightingale. “He and she, each in the manner in which Nature or Providence fitted them, were simultaneously inaugurating the new era, he the foster father, she the foster mother of myriads of this generation and unthinkable millions of those who are to be. His methods demanded the trained nurse both for surgery and midwifery, both for the battlefield where life is destroyed, and for the lying-in room where it is ushered into separate existence. Her work was to provide the training and the principles, the ideals, the enthusiasm, and the tiniest, humblest details, whereby the modern nurse is made.”

Apart entirely from the generally undesirable type of women (there were many exceptions) found in charge of the care of the sick when Florence Nightingale began her work, were the generally undesirable conditions which existed before Lord Lister’s antiseptic methods were inaugurated in 1868. Erysipelas, gangrene, pyemia, and septicemia were common complications of surgery and the death rate of maternity patients in hospitals was appalling. A nurse who was one of the pioneers in improving the care of the sick, thus describes her experience when she entered for training in an English hospital:

“New methods of nursing as well as of surgery had to contend with tremendous difficulties in the way of bad buildings, bad ventilation, old-fashioned furniture, and lack of apparatus.

“The utensils, which in the hospitals of today are of white earthenware or enamel, were of exceedingly battered tin, almost entirely denuded of their original covering of black japan, and it was absolutely impossible to keep some of them clean and sweet. Smells abounded. I have seen a visiting surgeon run through a ward to escape them, and during my first week I was much puzzled by the existence of a horrible smell in one corner of the children’s ward. I privately investigated the floor and under the beds, but could find nothing to account for it, but discovered at last that it came from a patient--a child with a diseased bone of the face, a case which nowadays would be antiseptically treated and probably isolated.

“Under the old regime the nurses had, as a rule, no uniform dress, and cooked their own meals, which they bought for themselves, in the ward kitchens or scullery, and these conditions did not at once pass away.

“The antiseptic treatment of wounds was coming into general use, and the particular method of the moment, which had been advocated by Dr. Lister, was a sort of model steam-engine, which could be carried about and placed on a table or stand by the side of a patient’s bed. When a wound was to be attended to, before the dressings were removed a lamp in this apparatus was lighted. A strong spray of diluted carbolic acid then played over the wound the whole time it was being dressed, much to the discomfort of the doctors and nurses, whose hands would be stiff with the carbolic and their ears dulled with the constant hissing and fizzing of the machine. Everything was saturated with carbolic at that time, wool, bandages, lint, gauze, etc., but in the course of a few years this treatment was entirely superseded.

“Operations were comparatively free and easy performances. We nurses wore our ordinary dresses, and were kept busy washing sponges, which were used again and again, though they were boiled between the operation days. In the medical wards enteric cases were indiscriminately mixed with others, and tuberculosis patients stalked about and expectorated freely.”

Nurses of today, in common with the rest of the world, owe a greater debt of gratitude than most of them realize to Lord Lister who, by his surgical experiments, and his demand for trained nurses, helped so much in laying the foundations for the trained nursing of today. Other workers in the realm of bacteriology were aiding greatly in the remarkable developments which medicine and surgery were making in that period.

THE SPIRIT OF VOCATION.

An English writer, Miss Margaret Fox, in an address to nurses has called attention to the great need of the spirit of vocation in the nurses of today. “Look at it what way you will,” she states, “the fact remains that nursing is work demanding something more than mere business qualities, more than an active intelligence, more than even sympathy and kindness of heart. The latter, precious though it is, may be worn very threadbare in the constant daily contact with all sorts of unlovely natures suffering from every variety of trying ailment. Patients are not all grateful, or appreciative, and you will find some of them by no means ready to kiss your shadow as you pass on your rounds. Sometimes they are inclined to grumble because they do not immediately get all they want. Their disease may make them irritable, captious even, sometimes, repulsive. These people need more than ordinary everyday good qualities in a nurse. They need one who, over and above her professional ability, looks upon her work as a vocation, ‘a calling by the will of God.’ It was that spirit which made the best of the pioneers of other days what they were. Nursing was undertaken by them as a definite life-work. It cost them so much to enter upon it, that they were unlikely to throw it up without some very cogent reason. Work was not then considered so much a means to an end. It was the ultimate achievement. Nursing is a mission; and wherever it is done, it needs the same spirit of true vocation to do it well, and to persevere in spite of difficulties.