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Celebration of the Life of Florence Nightingale, 2014

Celebration of the Life of Florence Nightingale

Derby Cathedral, May 17 2014
by Lynn McDonald

On the occasion of the blessing of a memorial plaque to Florence Nightingale, let us consider what her legacy was, as a woman of faith, a nurse, hospital reformer and pioneer of public health care. What did she accomplish and how did her faith shape that work?

Nightingale was at home in the secular world. It was God’s world and God ran it by laws, the laws of natural and social science. Our mission was in this real world—retreats were a good thing, Nightingale thought—but we should get back to work promptly.

While her work was grounded on her faith, stemming from her “call to service,” yet Nightingale insisted that her training school be secular. From its opening in 1860 it admitted pupils of any faith and none at all. Nursing was to be a profession based on knowledge and training, to serve the sick and injured, regardless of their religion, or lack of it.

Many leading nurses were motivated by a strong Christian faith, as Nightingale was. Her “addresses” to pupils and former pupils at her school contain many references to faith and some celebrate Christian heroes like the missionary David Livingstone. But nursing work itself was centred on the human body—how to prevent disease and promote health—and how to facilitate healing when sickness occurs.

Yet for Nightingale, Jesus was “the most important person that ever lived.” She kept a print of Christ crowned with thorns in her bedroom. She complained about a revision of the Bible for children for omitting some of the words of Christ on the cross, on what was “the most important day that ever was in the world.” The full account should be given, she said.

The cross of Christ had a “practical meaning,” for Christ “voluntarily” gave himself, not

in the vulgar sense … to appease the anger of a perfect Being—but in the sense of willingly incurring any and all sufferings which come in the way of helping to carry out God’s will and work.

Jesus was “the irreplaceable, precious one” who could not be spared:

Oh may we not try to be perfect (in giving) even as the Father in heaven is perfect—in giving Him our best, even as He gave us his best?

Jesus’s faithfulness and courage gave her courage in her own life, when she had tough times to face:

Should I say: “Father, save me from this hour?” And immediately, as it were recollecting himself, “but for this cause came I unto this hour.”

She found relevance in the Beatitudes, for nowhere did Christ say “Blessed are the fashionable, but blessed are the persecuted, that is, they who have to work against fashion and popularity.”

This she often had to do in her work: for ordinary soldiers (as opposed to officers), during the Crimean War and later back in peacetime England, and her work for civilian nursing, especially getting professional nursing in the workhouses, and her decades of work for the oppressed peasants in India.

Mentoring nurses was a holy duty for Nightingale. She told a young priest that no one could do much good to others who did not constantly keep them in mind—their “temptations, thoughts and wants.” She prayed that she would be able to say, as Jesus had, “of them that Thou gavest me I have lost none.”

Nightingale, in other words, was inspired in her care for her nurses by the example of Jesus.

Nursing is a respectable profession now, and what Nightingale had to do to get it established has long been forgotten. It was difficult to get doctors to accept nurses—some were enthusiastic—while others were positively hostile. It was difficult to get hospitals to pay nurses adequately and provide decent accommodation and food—yet nursing became the top-paying occupation for women in Nightingale’s time.

A new profession was created, with:

  • systematic training, mainly at the bedside, plus some academic, with a commitment to life-long learning to keep up with advances in knowledge—always with high ethical standards; how Nightingale would be proud and happy to see you today with your accomplishments!
  • professional-level nursing even in the workhouse infirmaries, meaning the best care possible—which became the vision of the National Health Service of 1948—not the minimal given to “charity” cases in the past;
  • health promotion as a key goal, as well as treatment when illness occurs;
  • an “environmental” approach to health care and nursing, meaning clean air, ventilation, adequate space, direct sunlight, clean water, clean bedding, clothing, walls and floors (to minimize the potential for cross-infection); and
  • advocacy for safe hospital design, at a time when hospital death rates were high.

We recognize also her support for:

  • women’s economic independence, the right to vote, hold property, be educated and join the professions;
  • for health promotion in India, including early steps towards self-government; and
  • her excellent research methods, from the collection and analysis of data, to their effective dissemination, with tables and charts, and policy implications.

All of these contributions, I suggest, are matters of ongoing relevance, especially as hospital-acquired infections kill large numbers, and hospital spending cuts jeopardize patient care.

As senior nurses increasingly take on policy roles, Nightingale’s example can inspire: she took on the greatest issues of her day and made a solid contribution.

As we become increasingly aware of environmental degradation and the climate crisis, her environmentalism can encourage us. She understood the connections between the biophysical environment and health, and navigated effectively between them.

Her faith helped her to do this, for God’s love for the world gave motivation, and her understanding of scientific order in the world gave method.

That she would dare to be so bold in her aspirations goes back to her belief in the greatness of God. Then her own direct experience of seeing good come out of evil during the Crimean War reinforced this confidence. She saw the terrible death rates from unsanitary conditions, as high as 40% of hospital admissions, brought to a new low of 2%, thanks to a thorough clean-up and the institution of adequate sanitary measures, consistent with the laws of nature/the laws of God.

Human ingenuity was capable of effecting such change—she saw it happen and assisted in the process. Believing that “we cannot expect too much from God” gave her confidence for the rest of her life to take on the great challenges for which we celebrate her now.

The Crimean War gave Nightingale her reputation, and the fund raised in her honour during it made her school possible. I think of her more as the researcher and health care advocate after the war, but we must also recognize her hands-on work during it—work she loved and never forgot.

She became the “Lady with the Lamp” thanks to newspaper reports of her gliding through the corridors and wards of the great Barrack Hospital, when the doctors had left for the night. As a Times dispatch said, when

silence and darkness have settled down upon these miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.

The lamp image was captured also by the volunteer chef, Alexis Soyer, who worked with Nightingale to improve nutrition. He saw

as we turned the angle of the long corridor … a faint light flying from bed to bed, like a will-o’-the-wisp flickering in a meadow on a summer’s eve … As we came nearer and nearer, the picture burst upon us. A dying soldier was half reclining upon his bed. Life, you could observe, was fast bidding him adieu.

Near him was a guardian angel, sitting at the foot of his bed, and most devotedly engaged pencilling down his last wishes … A watch and a few more trinkets were consigned to the care of the writer … It was then near 2 o’clock in the morning.

Approaching, I made inquiries of Miss Nightingale as to the complaint of her patient, when she replied, in French, that the poor fellow was given up by the doctors, and was not likely to get through the night, “so I have been engaged noting down his last wishes, in order to forward them to his relatives.”

So, let us celebrate Nightingale both as a nurse giving devoted care at the bedside and as the advocate for system change to ensure that the suffering she saw would not recur. On the anniversary of her birth, let us give thanks for the life, work, vision and faithfulness of Florence Nightingale, here in Derby Cathedral May 17 2014.

Contact: lynnmcd@uoguelph.ca

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