Florence Nightingale, known as the Crimean War’s ‘Lady with the Lamp’ was a pioneering 19th-century nurse and social reformer.
Overcoming formidable family opposition and the straitjacket of Victorian society, she changed the face of military nursing and laid the foundations for modern hospital nursing and its elevation into a profession.
Here we look at her life and enduring legacy.
Florence came from a wealthy well-connected liberal-humanitarian family. Unusual for a Victorian, her father William Nightingale believed in women’s education. The sisters were clever and he personally educated them in modern and classical languages, history, philosophy and mathematics.
Despite her intellectual ability, Florence was still expected to conform to the social restraints of the 19th-century by making a good marriage, keeping home, and bearing children.
However, after visiting poor and sick villagers near her Derbyshire home, as well as successfully nursing her family and their servants during a flu epidemic, Florence found her vocation; a ‘divine calling’ she wrote. She told her parents she wanted to train as a nurse.
Florence’s parents were aghast. Nursing then was not a job for someone of her status. To them, it was on the level of being a servant or a cleaner. Nurses were associated with immoral behaviour. Hospitals were dirty and hazardous. They forbade her to pursue the idea.
Frustrated in her calling and with marriage out of the question, Florence suffered depression. But she was also strong-willed and driven. Over several years, she continued visiting the poor, as well as making fact-finding trips to London hospitals.
Early Nursing Experience
In the hope of distracting their daughter from her nursing ambition, her parents sent her on a chaperoned trip abroad. Florence was 30. In Rome, she met Sidney Herbert, MP and former cabinet minister, and his wife Elizabeth, both interested in social reform. They would become lifelong friends and future influential supporters.
In summer 1850, on her way back to England, Florence visited Kaiserwerth, a hospital and college, one of the earliest institutions for the proper training of nurses. It was transformational – confirming her belief that nursing could be a noble vocation for all women.
With her father’s reluctant support, Florence returned to Kaiserwerth the following year for four months training as a sick nurse.
On her return to England, Florence’s parents finally acquiesced to her calling – giving her a generous allowance of £500 a year (the equivalent of nearly £50,000 today).
Now fully independent, in August 1853 she became the superintendent of a private care home for ‘gentlewomen’ in London’s Harley Street. She took leave of absence the following year to the Middlesex Hospital, London, nursing victims of a cholera epidemic that had swept the capital.
Then came The Times newspaper’s shocking reports about the Crimean War. The course of Florence Nightingale’s life was about to radically change.
The Crimean War (1854-1856)
The Crimean War saw Britain, France and Turkey allied against Russia to resist her expansionist policies. The war was characterised by British military incompetence and the appalling suffering of allied soldiers.
The Crimean War was the first European conflict to be photographed, and the first to be reported on by a war correspondent able to transmit dispatches by electric telegraph. These would arrive at the newspaper the next day and, for the first time, the public were able to read about the realities of warfare as events unfolded.
To national outrage, reporter William Howard Russell sent back horrifying reports to The Times newspaper about the Army’s failings and the terrible neglect of the sick and wounded as a result of lack of nurses.
A dispatch in September 1854 asked: ‘Are there no devoted women…able and willing to minister to the sick and suffering soldiers…in the hospitals of Scutari…?’
Florence Nightingale immediately offered her nursing expertise. She was appointed Superintendent of the Female Nurses in the Hospitals of the East. Her old contact and friend, Sidney Herbert, now Secretary for War, promised her full assistance from medical staff in Scutari and authority over all the nurses.
Florence gathered together a team of 38 experienced nurses. They reached the British Army camp at Scutari on 4 November 1854.
The English General Military Hospital, Scutari, Turkey
Florence and her nurses were faced with appalling scenes. The hospital was filthy and vermin-filled. It was over-flowing with patients – hundreds of wounded soldiers had been shipped across the Black Sea from Sevastopol to Scutari hospital.
Many had infected wounds and were still covered in mud and blood. Others had fever, dysentery and cholera. They lay waiting for treatment, sometimes for days. Far more died in hospital than on the battlefields. Essentials such as medicine, food, and bedding were in short supply. The hospital was in chaos; staff were completely overwhelmed.
Florence and her team of nurses faced initial hostility and prejudice from the male hospital doctors and the military. But within a few months – having bombarded Sidney Herbert with requests for supplies and as a result of a relief fund organised by The Times – she brought order, hygiene, proper food and comfort to the wounded. They called her ‘the lady with the lamp.’
However, death rates continued to rise and it was not until a Sanitary Commission found that the hospital had been built on a now over-flowing open sewer and ordered remedial action that deaths dramatically fell. (This fall was wrongly attributed to Florence’s nursing practises).
In May 1855, Florence visited other hospitals in Balaclava, Crimea, hundreds of miles away from Scutari. She fell dangerously ill and, although near death, she recovered and continued her work at Scutari until the end of the war, but her health had been permanently impaired.
The Birth of a Legend
Florence, while still at Scutari, became a nursing celebrity, something she disliked intensely. Songs and poems were written about her. There was an insatiable demand for her image and an industry flourished producing hundreds of idealised depictions – paintings, lithographs, figurines, posters, mats, even paper bags.
When Florence returned to Britain at the end of the war in August 1856 – ill and exhausted and with a sense of having failed those who died – she slipped into the country incognito as Miss Smith to avoid any adulation, arriving unannounced at her family home at Lea Hurst, Derbyshire.
Nursing Becomes a Profession
Unwelcome as fame was to Florence, it gave her great power and influence. She enlisted the support of Queen Victoria for a Royal Commission to look into the health of the Army, including in India. She published a report on hospital design.
Using public money donated in her honour – the Nightingale Fund – Florence established the Nightingale Training School for nurses at St Thomas’s Hospital, London, opened 9 July 1860. Her qualified nurses staffed British hospitals, and spread the Nightingale nursing theories all over the world.
Florence never gave speeches or made any public appearances, but was a prolific writer. It is thought she may have written some 200 books, articles and pamphlets and around 14,000 letters.
She published ‘Notes on Nursing’ January 1860. It was a practical classic introduction to nursing for the general public, with an ahead-of-its-time holistic approach, aimed at helping ordinary women care for their families. It sold tens of thousands of copies and is still in print today.
From 1865, Florence settled in London. She was still only 45, but home-bound, intermittently ill and often bedridden. She remained a formidable and authoritative advocate of health care reform for the rest of her life, awarded honours from Britain and around the world, and often receiving distinguished visitors, such as politicians, while in bed.
She lived to be 90 and died in her sleep at her home, 13 August 1910.
There were moves to bury Florence in Westminster Abbey, but her family wanted her interned in the family grave close to their Embley Park home. This had been Florence’s express wish.
The four-sided monument carries her parents’ and sister’s inscriptions on three faces. On the fourth, is a small cross with the simple letters ‘F.N.’ and the words’ Born 1820. Died 1910.’
Honoured and Remembered
Florence Nightingale name remains high profile today. There are many memorials and plaques to her in Britain and abroad. Hospitals, wards, streets, buildings, stained glass windows, a museum and even an American Second World War Navy troop carrier have been named after her.
Girls were given her name. Her image has appeared on £10 notes and on postage stamps. Each year, International Nurses’ Day is celebrated on her birthday, 12 May.
Her Nightingale Training School for nurses endures, now called the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College, London. Established 160 years ago, it is the oldest nurse training facility in the world.
Florence Nightingale’s legacy lives on. During this year’s coronavirus pandemic, eight temporary NHS Nightingale Hospitals have been opened across the country for coronavirus patients; the first a 4,000 bed hospital created in nine days in the ExCel exhibition and convention centre, east London.
Written by Nicky Hughes
Header Image: Florence Nightingale on a ward round with her lamp, checking wounded soldiers at Scutari Hospital, Constantinople (now Istanbul), Turkey during the Crimean War, 1854-1856. Although Florence is popularly portrayed with the type of oil lamp pictured, she is thought to have used a Turkish fanoos – a concertinered paper or fabric hanging lantern containing a candle. © Wellcome Collection