On a recent trip to England, I finally had the time alone to decide my own itinerary. Since it had long been on my bucket list, and it was only a short walk, I headed straight to the Florence Nightingale Museum. It is right at St. Thomas’ Hospital, where Florence opened the first school of nursing in 1860. The museum is nondescript and small on the outside, but it was wonderfully full of Florence’s life in the form of her correspondence, writings, statistical reports, and personal possessions.
As a nurse, I know about the origins of modern nursing and Florence’s abundant contributions. However, I came of age in nursing at a time when she was not nearly as appreciated as she is now, and perhaps even a bit dismissed as outdated. It was a time of nascent feminism and many advances in nursing, and we did not truly value the extraordinary achievements of this Victorian woman. We were the new generation of nurses who were obtaining graduate degrees, learning physical assessment, and exploring nursing theories. How could this woman, who lived in a male-dominated society and wrote about the importance of cleanliness, light, and food compete with our “advanced” skills and knowledge? I now recognize this attitude as supercilious, and a few hours with Florence at her museum solidified that feeling. I learned so much more about her and her time, all of which made my admiration and wonder explode.
Florence lived her early years in a life circumscribed by Victorian dictates and boundaries. Always a keen observer, she recognized that women had to live under oppression, and she felt trapped in a life of relative luxury and social duties. She raged against the suppression of middle- and upper-class women’s use of their innate energy and intelligence. She even wrote a semi-autobiographical novel, “Cassandra,” describing the era as the source of female powerlessness and hopelessness, and of the loss of dreams women inherently possessed.
Student nurses generally learn about Florence’s time in Crimea during the war (1854-1856). Florence and her small band of nurses were appalled and overwhelmed by the conditions that prevailed at the military hospital: an absolute lack of sanitation, ventilation, supplies, nutrition, fresh water, and basic care. Into this chaos, Florence brought order, but that order was on a level we might now call transformational change. She raised awareness of the need for clean water, bedding, bandages and floors, fresh air, and finally, nursing attention. It is extraordinarily hard for us to see now how revolutionary these things were at the time.
Considering the current state of world heath, Florence is even more relevant. I visited the museum before the COVID-19 pandemic, but now I hear her voice in the continual reminders for handwashing, physical distancing, and good nutrition.
Florence went on to establish the first nursing school, and that alone would have been enough for a lifetime achievement award. But she did so much more. Before my visit to the museum, I only peripherally knew of all her other extraordinary accomplishments, like:
- Briefing politicians and medical experts
- Consulting with architects around the world about hospital design
- Lobbing Queen Victoria and the British Parliament about healthcare reform
- Creating magnificent statistical graphics
- Pioneering quality improvement and possibly even shared governance
Florence was exceptionally well-known in her time, another fact I never realized. Her book, “Notes on Nursing,” was a best-seller in 1860! The first nurse, who focused on light, sanitation, and nutrition, was also the world’s first infection control practitioner, nursing educator and administrator, nurse researcher, nurse lobbyist, policy-influencer, and global nurse. She envisioned and pioneered healthcare innovation and quality improvement, becoming an internationally revered expert in the process. This is a start by any age’s standards; for a Victorian woman, it is nothing short of extraordinary.
Florence’s time in Crimea took its toll on her health, and the depiction of her later years is quite sad. She was reclusive and plagued with chronic illness, yet she remained an active advocate for patients, nursing, and healthcare. Even in poor health, when most would have turned inward, Florence continued her work as a reformer and leader.
Florence Nightingale, a Victorian woman living in a time of constriction and paternalism, focused her life’s work on identifying and meeting the basic needs of patients using methods that we now take for granted. In the process, she changed the world. My experience at the Florence Nightingale Museum drew me into her life and times and to the “big bang” of modern nursing. I had previously thought of her work as more like a seed, but it was indeed an explosion. I left the museum feeling closer to Florence, the nurse who altered history and gave me my life’s work. Thank you, Miss Nightingale and happy 200th birthday.
Katherine Kuren Black, MSN, RN-BC, is a Clinical Assistant Professor at Rutgers School of Nursing in Newark, New Jersey, USA. She is the president of Sigma’s Gamma Nu Chapter at Seton Hall University in New Jersey, USA.