Florence Nightingale was a nurse during the Victorian age in England, or to be more precise, she was the first real nurse. She was the first to define nursery as a profession (for a long time exclusively for women), and to define its rules and principles in her book Notes on nursing for the labouring classes (1868).
A member of the upper class, she was involved in charitable activities, and he worked as a volunteer in a small hospital in London, where she learnt how to manage and assist patients. The turning point in Florence Nightingale’s life was the Crimean War (1853-1856), when she went to the military hospital in Scutari, Turkey, at the head of a group of nurses.
Thanks to her strong attention to detail, she observed that in most cases British soldiers were not dying of wounds acquired on the battlefield, but of illness contracted in the hospital. She set up a system of daily observation and detailed record of data from every patient, tracking symptoms, reaction to cure, time and modality of death. In Notes on Nursing, she wrote that the most important characteristic of a nurse should be the ability to observe and record any changes in patient conditions. She was the first to apply statistics and scientific method to this context.
She invented a new graph called the rose chart or coxcomb, ancestor of the pie chart we all know, in which she represented “the causes of mortality of the Army in the East”.
The germ theory (stating that diseases are spread by microbes) was not widespread at that time, and it was thought that diseases spread through venomous particles in the air (the miasm theory). Nightingale realized that overcrowding, scars ventilation and scars hygiene were the major causes of death in the hospital. She reorganized the distribution of the beds, and gave precise instructions on how and how often nurses needed to wash their hands; she insisted that bandages and blankets had to be washed between patients.
In Nightingale’s theory, the environmental conditions were of primary importance to determine the health status of the patients and identified clean water, pure air, light, cleanness and an efficient drainage system as major factors. Her innovations contributed to a 20% decrease in mortality among soldiers.
Based on her experience during the Crimean War and in other hospitals, she wrote Notes on Hospitals (1863), where she described the ideal architecture of hospitals: pavilions branching out from a central hallway to maximize light and ventilation, and to minimize contact between patients with different diseases. For many years new hospitals were built according to her model.
Gifted with passion and ability in mathematics and statistics, she was the first woman to be admitted to the Royal Statistical Society in 1858.
Florence Nightingale’s contributions to statistics, epidemiology and infectious disease control were so important that the World Health Organisation declared 2020, the bicentenary of her birth, the International Year of the Nurse. At that moment, it could have been impossible to imagine that in 2020 nurses and all the healthcare workers were bound to have such a critical role and that the principles introduced for the first time by da Florence Nightingale would have been of extreme importance in the fight against the pandemic. To further celebrate this extraordinary figure, the National Health Service decided to name after Florence Nightingale the temporary hospitals built as an emergency response during the first months of the pandemic to face the huge number of hospital admissions.
Almost 170 years after the publication of Nightingale’s books, when the concept of a virus was pretty much unknown, we have kept ourselves safe by applying the concept that she had introduced: wash your hand, avoid crowded spaces, ventilate rooms.
Featured image: Florence Nightingale’s rose chart, Public domain, via Wikimedia Commons
Bibliography
Notes on Nursing for the Labouring Classes, Florence Nightingale; Harrison 18684
Notes on Hospitals, Florence Nightingale; Longman, Roberts, and Green 1863
Florence Nightingale’s Environmental Theory and its influence on contemporary infection control, Gilbert HA, Collegian 2020 https://10.1016/j.collegn.2020.09.006
Florence Nightingale’s lasting legacy for health care, Tye J, Nurse Leader 2020 https://doi.org/10.1016/j.mnl.2020.03.023
The art of medicine. Celebrating Florence Nightingale’s bicentenary, McEnroe N, The Lancet 2020 https://doi.org/10.1016/S0140-6736(20)30992-2
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