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Florence Nightingale on Public Health Care

Collected Works of Florence Nightingale, Volume 6

Lynn McDonald

Publication Year: 2004

This sixth volume in the Collected Works of Florence Nightingale reports Nightingale’s considerable accomplishments in the development of a public health care system based on health promotion and disease prevention. It follows directly from her understanding of social science and broader social reform activities, which were related in Society and Politics (Volume 5). Public Health Care includes a critical edition of Notes on Nursing for the Labouring Classes, papers on mortality in aboriginal schools and hospitals, and on rural health. It reports much unknown material on Nightingale’s signal contribution of bringing professional nursing into the dreaded workhouse infirmaries. This collection presents letters and notes on a wide range of issues from specific diseases to germ theory, and relates some of her own extensive work as a nurse practitioner, which included organizing referrals to doctors and providing related care.

Currently, Volumes 1 to 11 are available in e-book version by subscription or from university and college libraries through the following vendors: Canadian Electronic Library, Ebrary, MyiLibrary, and Netlibrary.

Published by: Wilfrid Laurier University Press

Series: Collected Works of Florence Nightingale

Title Page, Copyright Page

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pp. vii-viii

Acknowledgments are due first to the Henry Bonham Carter Will Trust for permission to publish Nightingale original manuscripts, and indeed for treating Nightingale material generally as being in the public domain. To the owners of Nightingale manuscripts thanks are due for their important role in...

Dramatis Personae

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pp. ix

List of Illustrations

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pp. x

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Florence Nightingale: A Précis of the Collected Works

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pp. xi-xiii

Florence Nightingale was born in Florence 1820, the second daughter of wealthy English parents taking an extended European wedding trip. She was raised in England at country homes, Lea Hurst, in Derbyshire, and Embley, in Hampshire. She was educated largely by her father, who had studied classics at Trinity...

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Introduction to Volume 6

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pp. 1-11

Nightingale’s work as a public health pioneer and reformer was prompted and nourished by her faith. She early interpreted her adolescent ‘‘call to service’’ as a call to nursing, but later understood it more broadly to be a ‘‘saviour,’’ meaning saver of lives, or healer. For this, administrative reform more than direct...

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Key to Editing

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pp. 13-16

All the manuscript material in the Collected Works has been carefully transcribed and verified (see the electronic text for a full description of the process). Remaining illegible words and passages are so indicated, with [illeg] or [?] inserted to indicate our best reading of the word or words in question. Dates for material...

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Notes on Nursing for the Labouring Classes

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pp. 17-162

The original Notes on Nursing: What It Is and What It Is Not was prompted by an 1858 letter from Edwin Chadwick to Nightingale encouraging her to think of ‘‘a change in the direction of your labour.’’ He had been asked to write this letter by her cousin Beatrice Lushington when Nightingale was discouraged. He explained...

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Colonial Sanitary Statistics and Aboriginal Depopulation

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pp. 163-201

By the late twentieth century residential schools for aboriginal children, in Canada at least, were condemned for the suppression of aboriginal culture, religion and language and numerous instances of physical and sexual abuse. In Nightingale’s day the issue was excessive illness and mortality, with the related fear of...

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‘‘Sick-Nursing and Health-Nursing’’

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pp. 203-220

Angela Burdett-Coutts (1814-1906) was England’s wealthiest heiress, a renowned philanthropist with a simple faith who acted on it to great effect. An acquaintance of Nightingale’s from the 1840s, she assisted her practically during the Crimean War. In 1893 Burdett-Coutts persuaded Nightingale to write an article on...

The Reform of Workhouse Infirmaries

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Workhouse Infirmaries in Nightingale’s Day

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pp. 223-230

It is difficult for us today to imagine the horrors of the workhouse infirmaries of Nightingale’s time. Material conditions were abysmal: overcrowding, poor ventilation, sooty air, shared beds or sleeping on the floor. Toilets and bathing facilities were scarce and poor. Infectious fever cases were mixed in with the rest of the inmates...

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The Liverpool Workhouse Infirmary

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pp. 231-325

That the Liverpool Workhouse Infirmary became the first to provide trained nursing services is thanks to the intervention of William Rathbone, the philanthropist who had, a few years earlier, instituted district nursing in Liverpool (related in a nursing volume). Nightingale was ready to respond with a plan in mind when...

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The Extension of Workhouse Nursing to Metropolitan London

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pp. 326-464

Even before trained nurses began staffing the Liverpool Workhouse Infirmary, in May 1865, media attention to a death from the absence of nursing at a London workhouse infirmary gave Nightingale the opportunity to raise the issue of reform there. To her friend, the Rev Mother Mary Clare Moore of Ber mondsey...

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Other Workhouse Infirmaries

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pp. 465-489

Nightingale continued to work on workhouse infirmary reform in various ways for the rest of her professional life. It was slow, piecemeal work depending on reformers in individual workhouses asking for her involvement. She was in touch with many nursing superintendents by letter, and invited them for occasional...

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The Extension of Nursing to Workhouse Infirmaries in Ireland

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pp. 490-506

Nightingale was involved in workhouse infirmary nursing in Ireland, initially in Belfast, then the south. An 1885 letter to a cousin’s son described a visit from ‘‘a young Irish lady who has actually undertaken 900 beds of the Belfast Workhouse Infirmary without a single trained nurse.’’ Nightingale also explained that she...

Public Health Issues, Rural Health and Nightingale’s ‘‘Caseload’’

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Nature, Disease, Germs and Contagion

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pp. 509-579

In this last part we return to the broad themes outlined in the introduction: Nightingale’s views on the nature of health and disease, the causes of disease (especially germ theory vs. contagion) and the role in health promotion of medicine, nutrition and preventive sanitary measures such as clean water and safe sewage...

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Rural Health

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pp. 580-622

Nightingale’s interest in the special problems of rural health stemmed from her own rural roots in Derbyshire, the Hampshire home and later stays at Claydon House. From Notes on Nursing for the Labouring Classes it should be clear that the sanitary conditions in which cottagers typically lived were poor. There was no...

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Medical Care of Employees, Former Employees and Tenants

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pp. 623-671

In Nightingale’s lifetime there was no state system for the provision of health care services nor well-organized provision through people’s place of employment. Medical and nursing care for ordinary working people was haphazard at best. Good employers paid for the care of their employees and their families; charitable...


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pp. 673-678


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pp. 679-684


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pp. 685-701

E-ISBN-13: 9780889205420
Print-ISBN-13: 9780889204461
Print-ISBN-10: 0889204462

Page Count: 714
Publication Year: 2004

Series Title: Collected Works of Florence Nightingale