Florence Nightingale on Public Health Care: Collected Works of Florence Nightingale, Volume 6

‘‘Sick-Nursing and Health-Nursing’’

‘‘Sick-Nursing and Health-Nursing’’ A ngela 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 nursing for the women’s section at the Chicago Exhibition, which was later published in Woman’s Mission. It takes up many of the themes of Notes on Nursing for the Labouring Classes, now thirty-two years later. There is some overlap with rural hygiene issues, on which Nightingale was working at the same time with Fred Verney (further below). Correspondence shows that Nightingale declined at first (there is a letter to her early in February 1893, with a draft note by Henry Bonham Carter declining.1 But her cousin strongly urged her to write the paper, ‘‘reiterating the principles of nurse training,’’ sent her some notes to help her and suggested that the registration issue ‘‘not take a prominent position’’2 (advice taken with a grain of salt). When she had agreed, he wrote her about the need to reserve copyright of the paper for publication in the U.K., that it might be reproduced as a review article or a pamphlet, and suggested that she contact Burdett-Coutts about this.3 Nightingale did go ahead, but found the whole thing ‘‘troublesome .’’4 She described to Bonham Carter arranging for ‘‘type-writers,’’ 1 Letter from Isabel Somerset 3 February 1893, Add Mss 45811 f236, draft note by Henry Bonham Carter 18 February 1893, Add Mss 45811 f238. A circular about the Chicago Fair and notes about Burdett-Coutts and the delegates appear in a letter from him 6 August 1892, Add Mss 47724 f120. 2 Letter 18 February 1893, Add Mss 47724 ff234-35. 3 Letter 31 March 1893, Add Mss 47724 ff255-56. 4 Letter to Henry Bonham Carter 22 March 1893, Add Mss 47724 f254. / 203 i.e., typists, to have the paper typed fast. Perhaps he helped with editing , or at least proofreading, as an excerpt from a letter of Nightingale ’s to him suggests. Source: From a letter to Henry Bonham Carter, Add Mss 47724 ff250-51 18 March 1893 With gratitude more than I can say I send you this indistinguishable ‘‘mass.’’ I am afraid it is irretrievably bad. It is intended to be: 1. Sickness—what is it? 2. Health—what is it? Nursing: training: discipline—what? 3. Necessities for a training school for sick nurses. Quain.5 4. Ditto for health missioners. Bucks. 5. Dangers. Interlude on private nursing. '' '' district '' . Summing up of danger. 6. Hopes, which I am afraid are too transcendental. 7. A (somewhat flightly) address to the United States on combination not independence and workshops not lectures. I could write out this summary if you wished it. It is too good of you to undertake this unsavoury job. Editor: Nightingale then explained her arrangement with ‘‘with typewriters , if they have it before 10 on Monday morning to let me have it typewritten by 6 on Monday afternoon (for Lady Burdett-Coutts) according to what you thought necessary’’ (f251). The material was of course much used (it will be referred to in a nursing volume). Nightingale’s opposition to the proposed scheme of the registration of nurses is clear, with the explanation that the qualities that make a woman a good nurse could not be ascertained by examination, ‘‘while the best nurse may come off worst’’ (below). There are such enduring themes as: ‘‘A good nurse must be a good woman’’; and ‘‘Hospitals are only an intermediate stage of civilization, never intended, at all events, to take in the whole sick population’’ (below). 5 Nightingale wrote the articles on nurse training and sick-nursing for Richard Quain’s Dictionary of Medicine. 204 / Florence Nightingale on Public Health Care Nightingale’s statement about the need for collective action to achieve good public health is here particularly strong. She called competition ‘‘each man for himself and the devil against us all’’ no less than ‘‘the enemy of health.’’ Co-operative work or ‘‘combination’’ was the antidote, ‘‘to secure the best air, the best food and all that makes life useful, healthy and happy’’ (below). There indeed was ‘‘no such thing as independence.’’ This was written at a time in which there was very...