The Collected Works of Florence Nightingale
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Health Care as God’s Work

4. Health Care as God’s Work

Niagara Anglican, October 1999:15

Florence Nightingale worked to make nursing a respectable occupation for women when it most decidedly was not, when “nurses” were untrained hospital cleaners, ill paid and often drunk, notorious for stealing the patients’ food and liquor. Nightingale herself experienced a “call to service,” which she experienced as hearing a “voice,” indeed on many occasions, confirming the call and giving directions as to what she should do. She responded as Mary did, “Behold the handmaid of the Lord; be it done unto me according to Thy word.” She hoped that many women would answer that call to service. Nursing for her was always a “vocation” not a mere job.

Nightingale insisted that her own training school for nurses be secular, i.e. admit women regardless of religious affiliation, and provide nursing services rather than try for death bed conversions. Yet nurses needed the resources of God to do their work well, and her advice to nurses was heavily laced with religion.

Nightingale did not have a high opinion of conventional, drug-oriented medicine. God or nature cured and the care-giver’s role was rather to provide the right conditions. An unpublished note gives the advice: “Go to God’s infirmary and rest awhile.”

Nightingale’s faith led her to take the first steps to the establishment of a public health care system in Britain, with the institution of professional nursing services for the sick poor. A Christian philanthropist, William Rathbone, provided the money for the experiment. As she explained to her father, when a pauper becomes ill “he ceases to be a pauper and becomes brother to the best of us and as a brother he should be cared for. I would make this a cardinal principle in Poor Law relief.” The community at large was responsible for caring for our “fellow creature in suffering.”

Even more forcefully, Nightingale called philanthropy “humbug…love to mankind ought to be our one principle in the Poor Law.” She wanted quality care for all, not a two-tiered system of good care for those who could afford it and whatever charity provided for the rest.

Preventive medicine and health promotion were prominent in Nightingale’s conceptualization of a good health care system. Good nutrition and adequate housing were essential, as well as clean air and water. As God’s co-workers we needed to study the “sanitary laws” of the universe, to know what work was needed to be done. Nor were good intentions enough, but Nightingale gave frequent examples where people’s, notably Christians’, good intentions led to harmful results, as in the opening of a “foundling” institution resulting in increased numbers of babies being abandoned. God needed good statisticians and public administrators, not mere do-gooders (philanthropy is humbug!)

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