Nightingale, Florence (DNB12)

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NIGHTINGALE, FLORENCE (1820–1910), reformer of hospital nursing, born at the Villa La Columbaia, Florence, on 12 May 1820, was named after the city of her birth. Her father, William Edward Nightingale (1794–1874), was son of William Shore, long a banker at Sheffield; he was a highly cultured country gentleman of ample means, and a great lover of travel. When he came of age on 21 Feb. 1815 he assumed by royal sign-manual the surname of Nightingale on inheriting the Derbyshire estates of Lea Hurst and Woodend of his mother’s uncle, Peter Nightingale (d. unmarried 1803). On 1 June 1818 he married Frances, daughter of William Smith (1756–1835) [q. v.], a strong supporter of the abolition of slavery. The issue was two daughters, of whom Florence was the younger. Her elder sister, Frances Parthenope (d. 1890), so called from the classical name of Naples, her birthplace, married in 1858, as his second wife, Sir Harry Verney [q. v.], second baronet, of Claydon, Buckinghamshire.

Florence Nightingale’s first home was at her father’s house. Lea Hall, in Derbyshire. About 1825 the family moved to Lea Hurst, which Nightingale had just built. In 1826 he also bought Embley Park, in Hampshire, serving the office of high sheriff of that county in 1828. It became the custom of the famlly to spend the summer at Lea Hurst and the winter at Embley Park, with an occasional visit to London. Miss Nightingale enjoyed under her father’s roof a liberal education, but she chafed at the narrow opportunities of activity offered to girls of her station in life. She engaged in cottage visiting, and developed a love of animals. But her chief interest lay in tending the sick. Anxious to undertake more important responsibilities than home offered her she visited hospitals in London and the country with a view to finding what scope for activity offered there. Nursing was then reckoned in England a menial employment needing neither study nor intelligence; nor was it viewed as a work of mercy or philanthropy. Sidney Herbert, afterwards Lord Herbert of Lea [q. v.], and his wife were Miss Nightingale’s neighbours at Wilton House, not far from Embley Park. A close friendship with them stimulated her philanthropic and intellectual instincts. Her horizon was widened, too, by intercourse with enlightened members of her mother’s family, by acquaintance with Madame Mohl and her husband, and possibly by a chance meeting in girlhood with Mrs. Elizabeth Fry.

Miss Nightingale’s hospital visits seem to have begun in 1844, and were continued at home and abroad for eleven years. She spent the winter and spring of 1849–50 with friends of her family, Mr. and Mrs. Bracebridge, in a long tour through Egypt. On the journey from Paris she met two sisters of St. Vincent de Paul, who gave her an introduction to the house of their order at Alexandria, where she carefully inspected their schools and “Miséricorde.’ She recognised that the Roman Catholic sisterhoods in France, with their discipline and their organisation, made better nurses than she found in her own country (cf. Miss Nightingale, Letters from Egypt, privately printed). On her way back to England she paid a first visit (31 July to 13 Aug. 1850) to the Institute of Protestant Deaconesses at Kaiserswerth on the Rhine near Düsseldorf. The institute had been founded on a very humble scale in 1833 for the care of the destitute by Theodor Fliedner, protestant pastor of Kaiserswerth, and had since grown into a training school for women teachers and for nurses of the sick. The institution was run on the lines of poverty, simplicity, and common sense. A very brief experience of the Kaiserswerth Institute convinced Miss Nightingale of the possibilities of making nursing a "calling" for ladies and no mere desultory occupation. Next year she spent some four months at Kaiserswerth (July to October), and went through a regular course of training as a sick nurse. On her return to her home at Embley Park she published a short account of Kaiserswerth, in which she spoke frankly of the dullness of the ordinary home life of English girls. Late in life she wrote of her visits to Kaiserswerth, 'Never have I met with a higher love, a purer devotion, than there. There was no neglect. It was the more remarkable, because many of the deaconesses had been only peasants: none were gentlewomen when I was there.' There followed further visits to London hospitals, and in the autumn of 1852 she inspected those of Edinburgh and Dublin. Great part of 1853 was devoted to various types of hospitals at Paris. Late in the same year she accepted her first administrative post. On 12 Aug. 1853 she became superintendent of the Hospital for Invalid Gentlewomen, which was established in 1850 in Chandos Street by Lady Canning. Miss Nightingale moved the institution to No. 1 Upper (now 90) Harley Street. In 1910 it was resettled at 19 Lisson Grove, N.W., and was then renamed after Miss Nightingale.

In March 1854 the Crimean war broke out, and the reports of the sufferings of the sick and wounded in the English camps stirred English feeling to its depths. In letters to 'The Times' (Sir) William Howard Russell [q. v. Suppl. II], the correspondent, described the terrible neglect of the wounded, and the 'disgraceful antithesis' between the neglect of our men and the careful nursing of the French wounded. 'Are there no devoted women among us,' he wrote, 'able and willing to go forth to minister to the sick and suffering soldiers of the East in the hospitals of Scutari? Are none of the daughters of England, at this extreme hour of need, ready for such a work of mercy? Must we fall so far below the French in self-sacrifice and devotedness?' (cf. The Times, 15 and 22 Sept. 1854). On 14 Oct. Miss Nightingale offered her services to the War Office; but before her offer reached her friend, Sidney Herbert, then secretary of state for war, he himself had written to her on the same day, and proposed that she should go out to the Crimea: 'I receive numbers of offers from ladies to go out' (he told Miss Nightingale), 'but they are ladies who have no conception of what a hospital is, nor of the nature of its duties. . . . My question simply is, Would you listen to the request to go out and supervise the whole thing? You would, of course, have plenary authority over all the nurses, and I think I could secure you the fullest assistance and co-operation from the medical staff, and you would also have an unlimited power of drawing on the government for whatever you think requisite for the success of your mission.' Miss Nightingale made her plans with extraordinary speed. On 17 Oct. Lady Canning, who helped her in the choice of nurses, wrote of her, 'She has such nerve and skill, and is so gentle and wise and quiet; even now she is in no bustle or hurry, though so much is on her hands, and such numbers of people volunteer their services' (Hare's Story of two Noble Lives). On 21 Oct., within a week of receiving Herbert's letter, Miss Nightingale embarked for the Crimea, with thirty-eight nurses (ten Roman Catholic sisters, eight sisters of mercy of the Church of England, six nurses from St. John's Institute, and fourteen from various hospitals); her friends, Mr. and Mrs. Bracebridge, also went with her. Scutari was reached on 4 Nov., the eve of the battle of Inkerman. Miss Nightingale's official title was 'Superintendent of the Female Nurses in the Hospitals in the East'; but she came to be known generally as 'The Lady-in-Chief.'

Her headquarters were in the barrack hospital at Scutari, a huge dismal place, reeking with dirt and infection. Stores, urgently needed, had not got beyond Varna, or were lost at sea. '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.' One of the nurses, a week after arrival, wrote home, '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.' Sidney Godolphin Osborne went out to visit Scutari soon after Miss Nightingale's arrival, and in a report on the hospital accommodation described the complete absence of 'the commonest provision for the exigencies' of the hour (cf. Osborne's Scutari and its Hospitals, 1855). Miss Nightingale's difficulties are incapable of exaggeration. The military and medical authorities already on the spot viewed her intervention as a reflection on themselves. Many of her own volunteers were inexperienced, and the roughness of the orderlies was offensive to women of refinement. But Miss Nightingale’s quiet resolution and dignity, her powers of organisation and discipline rapidly worked a revolution.

Before the end of the year Miss Nightingale and her companions had put the Scutari barrack hospital in fairly good order. The relief fund organised by ‘The Times’ newspaper sent out stores, and other voluntary associations at home were helpful. In December Mary Stanley, daughter of the bishop of Norwich, and sister of Dean Stanley, came out with a reinforcement of forty-six nurses. Miss Nightingale quickly established a vast kitchen and a laundry; she made time to look after the soldiers’ wives and children, and to provide ordinary decencies for them. She ruled, but at the same time she slaved: it is said that she was on her feet for twenty hours daily. Although her nurses were also over-worked, she allowed no woman but herself to be in the wards after eight at night, when the other nurses’ places were taken by orderlies. She alone bore the weight of responsibility. Among the wounded men she naturally moved an ardent devotion. They christened her ‘The Lady of the Lamp.’ Longfellow in his poem, ‘Santa Filomena,’ tried to express the veneration which her endurance and courage excited.

But the battle for the reform of the war hospitals was not rapidly won. Early in 1855, owing to defects of sanitation, there was a great increase in the number of cases of cholera and of typhus fever among Miss Nightingale’s patients. Seven of the army doctors died, and three of the nurses. Frost-bite and dysentery from exposure in the trenches before Sevastopol made the wards fuller than before. The sick and wounded in the barrack hospital numbered 2000. The death-rate rose in February 1855 to 42 per cent. At Miss Nightingale’s persistent entreaties the war office at home ordered the sanitary commissioners at Scutari to carry out at once sanitary reforms. Then the death-rate rapidly declined until in June it had dropped to 2 per cent. The improved conditions at Scutari allowed Miss Nightingale in May to visit the hospitals at and near Balaclava. Her companions on the journey included Mr. Bracebridge and the French cook, Alexis Benoît Soyer [q. v.], who had lately done good service at Scutari. The fatigues attending this visit of inspection brought on an attack of Crimean fever, and for twelve days she lay dangerously ill in the Balaclava sanatorium. Early in June she was able to return to Scutari, and resumed her work there. To her nursing work she added efforts to provide reading and recreation rooms for the men and their families. In March 1856, when peace was concluded, she returned to Balaclava, and she remained there till July, when the hospitals were closed. She then went back for the last time to Scutari. It was not till August 1856 that she came home.

A ship of war was offered Miss Nightingale for her passage, but she returned privately in a French vessel and, crossing to England unnoticed, made her way quietly to Lea Hurst, her home in Derbyshire, although the whole nation was waiting to demonstrate their admiration of her. Queen Victoria, who abounded in expressions of devotion, had in Jan. 1856 sent her an autograph letter of thanks with an enamelled and jewelled brooch designed by the Prince Consort (Queen Victoria’s Letters, iii. 215), and the Sultan of Turkey had given her a diamond bracelet. In Sept. 1856 she visited Queen Victoria at Balmoral. ‘She put before us,’ wrote the Prince Consort, ‘all that affects our present military hospital system and the reforms that are needed: we are much pleased with her. She is extremely modest’ Sir (Theodore Martin, Prince Consort, iii. 503). In Nov. 1855, at a meeting in London, a Nightingale fund had been inaugurated for the purpose of founding a training school for nurses, the only recognition of her services which Miss Nightingale would sanction. By 1860 50,000l. was collected, and the Nightingale School and Home for Nurses was established at St. Thomas’s Hospital. Although Miss Nightingale’s health and other occupations did not allow her to accept the post of superintendent, she watched the progress of the new institution with practical interest and was indefatigable in counsel. Her annual addresses to the nurses, which embody her wisest views, were printed for private circulation. The example thus set was followed by other great hospitals, to the great advantage both of hospital nurses and of hospital patients.

In spite of the strain of work and anxiety in the Crimea, which seriously affected her health. Miss Nightingale thenceforth pursued her labours unceasingly, and sought to turn to permanent advantage for the world at large the authoritative position and experience which she had attained in matters of nursing and sanitation. She settled in London, and, although she lived the retired life of an invalid, she was always busy with her pen or was offering verbally encouragement and direction. In 1857, after publishing a full report of the voluntary contributions which had passed through her hands in the Crimea, she issued an exhaustive and confidential report on the workings of the army medical departments in the Crimea. Next year she printed ‘Notes on Matters affecting the Health, Efficiency and Hospital Administration of the British Army.’ The commission appointed in 1857 to inquire into the sanitary condition of the army set a high value on her interesting evidence. With her approval an army medical college was opened in 1859 at Chatham; a first military hospital was established in Woolwich in 1861; and an army sanitary commission was established in permanence in 1862. Everywhere her expert reputation was paramount. During the American civil war of 1862–4 and the Franco-German war of 1870–1 her advice was sought by the foreign governments concerned.

In regard to civil hospitals, home nursing, care of poor women in childbirth, and sanitation, Miss Nightingale’s authority stood equally high. In 1862, in Liverpool Infirmary, a nursing home was founded with special reference to district nursing, and was placed under the care of Agnes Elizabeth Jones (1832–1868), who had been trained at Kaiserswerth. In 1867, at the request of the poor law board, she wrote a paper of ‘Suggestions for the improvement of the nursing service in hospitals and on the methods of training nurses for the sick poor.’ Miss Nightingale had a hand in establishing in 1868 the East London Nursing Society, in 1874 the Workhouse Nursing Association and the National Society for providing Trained Nurses for the Poor, and in 1890 the Queen’s Jubilee Nursing Institute.

In 1857, on the outbreak of the Indian Mutiny, Miss Nightingale had written from Malvern to her friend Lady Canning, wife of the governor-general, offering in spite of her bad health ‘to come out at twenty-four hours’ notice, if there were anything for her to do in her line of business’ (Hare, op. cit.). She never went to India. But the sanitary condition of the army and people there became one of the chief interests of her later life. The government submitted to her the report of the royal commission on the sanitary state of the army in India in 1863, and she embodied her comments in a paper entitled ‘How People may live and not die in India,’ in which she urged the initiation of sanitary reform. She corresponded actively with Sir Bartle Frere, governor of Bombay, and in August 1867 was in constant communication with Sir Stafford Northcote, then secretary of state for India, as to the establishment of a sanitary department of the Indian government. With every side of Indian social life she made herself thoroughly familiar, exchanging views personally or by correspondence with natives, viceroys, and secretaries of state, and constantly writing on native education and village sanitation. She wrote to the ‘Poona Sarvajanik Sabha’ in 1889: ‘There must be as it were missionaries and preachers of health and cleansing, if any real progress is to be made.’ In other published papers and pamphlets she discussed the causes of famine, the need of irrigation, the poverty of the peasantry, and the domination of the money-lender. She urged native Indians to take part in the seventh international congress of hygiene and demography held in London in 1887, and to the eighth congress at Buda-Pesth in 1890 she contributed a paper on village sanitation in India, a subject which, as she wrote in a memorandum addressed to Lord Cross, secretary of state for India, in 1892, she regarded as especially her own.

Miss Nightingale wrote well, in a direct and intimate way, and her papers and pamphlets, which covered all the subjects of her activity, greatly extended her influence. Her most famous book, ‘Notes on Nursing,’ which first appeared in 1860, went through many editions in her lifetime.

Miss Nightingale, in spite of her withdrawal from society, was honoured until her death. Among the latest distinctions which she received was the Order of Merit in 1907, which was then for the first time bestowed on a woman, and in 1908 she was awarded the freedom of the City of London, which had hitherto only been bestowed on one woman, the Baroness Burdett-Coutts [q. v. Suppl. II]. She had already received, among many similar honours, the German order of the Cross of Merit and the French gold medal of Secours aux blessés militaires. On 10 May 1910 she was presented with the badge of honour of the Norwegian Red Cross Society.

She died at her house in South Street, Park Lane, London, on 13 Aug. 1910, at the age of ninety. An offer of burial in Westminster Abbey was in accordance with her wishes refused by her relatives. She was buried in the burial place of her family at East Wellow, Hampshire, on 20 August. Memorial services took place in St. Paul’s Cathedral, where the government was officially represented, at Liverpool Cathedral, and many other places of worship.

Miss Nightingale raised the art of nursing in this country from a menial employment to an honoured vocation; she taught nurses to be ladies, and she brought ladies out of the bondage of idleness to be nurses. This, which was the aim of her life, was no fruit of her Crimean experience, although that experience enabled her to give effect to her purpose more readily than were otherwise possible. Long before she went to the Crimea she felt deeply the ‘disgraceful antithesis’ between Mrs. Gamp and a sister of mercy. The picture of her at Scutari is of a strong-willed, strong-nerved energetic woman, gentle and pitiful to the wounded, but always masterful among those with whom she worked. After the war she worked with no less zeal or resolution, and realised many of her early dreams. She was not only the reformer of nursing but a leader of women.

After her death a memorial fund was instituted for the purpose of providing pensions for disabled or aged nurses and for erecting a statue in Waterloo Place. Memorial tablets have been fixed on her birthplace at Florence as well as in the cloisters of Santa Croce there.

A marble bust executed by Sir John Steell in 1862 and presented to Miss Nightingale by the non-commissioned officers and men of the British army was bequeathed by her to the Royal United Service Museum, together with her various presentation jewels and orders. A plaster statuette by Miss J. H. Bonham-Carter (c. 1856) (standing figure with lamp in right hand) is at Lea Hurst; of five replicas, one is at St. Thomas’s Hospital, another is at the Johns Hopkins Hospital School for Nurses, Baltimore, and the others belong to members of the family. Of two portraits in oils, one by Augustus Leopold Egg, R.A., executed about 1836, is in the National Portrait Gallery; another, by Sir William B. Richmond, R.A., dated about 1886, is at Claydon House. A chalk drawing by Countess Feodora Gleichen, made in 1908, is at Windsor Castle among portraits of members of the Order of Merit. Several water-colour and chalk drawings are either at Lea Hurst or at Claydon House: one (with Miss Nightingale’s mother and sister) by A. E. Chalon is dated about 1835; another is by Lady Eastlake; a third, dated about 1850, by her sister, Lady Verney, was lithographed. Others were executed by Miss F. A. de B. Footner in 1907. A picture of Miss Nightingale receiving the wounded at Scutari hospital in 1856 is by Jerry Barrett.

[M. A. Nutting and L. L. Dock’s History of Nursing (with bibliography of Miss Nightingale’s writings). New York, 1907, vol. ii., chaps. 3–6; The Times, 14–23 Aug. 1910; Burke’s Landed Gentry; Soyer’s Culinary Campaign, 1857; Lord Stanmore’s Lord Herbert of Lea, 1906; J. B. Atkins, Sir William Howard Russell, 1911; Martineau’s Sir Bartle Frere; Bosworth Smith’s Lord Lawrence, Trans. Seventh Intemat. Congress on Hygiene and Demography, 1887; Journal of the Poona Sarvajanik Sabha, 1889; private information.]

S. P.