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

Florence Nightingale: A Précis of the Collected Works

Florence Nightingale: A Précis of the Collected Works F lorence 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 College , Cambridge. At age sixteen Nightingale experienced a ‘‘call to service,’’ but her family would not permit her to act on it by becoming a nurse, then a lower-class occupation and thoroughly unthinkable for a ‘‘lady.’’ Lengthy trips to Rome and Egypt were allowed (1847-48 and 1849-50 respectively). Nightingale was finally permitted to spend three months at the (Protestant) Deaconess Institution in Kaiserswerth, near Düsseldorf, Germany, in 1851 and several weeks with Roman Catholic nursing orders in Paris in 1853. Her father gave her an annuity in 1853 to permit her to become the superintendent of the Establishment for Gentlewomen during Illness, Upper Harley Street, London. She left there in 1854 to lead the first team of British women nurses sent to war. The British Army was poorly prepared for that war and the death rate from preventible disease was seven times that from wounds. Nightingale’s work as a public health reformer effectively began on her return from the Crimean War in 1856. Recognized as a national heroine, she chose to work behind the scenes for structural changes to prevent that war’s high death rates from ever recurring. She began by lobbying to get a royal commission established to investigate the causes of the disaster and recommend changes. She herself briefed witnesses, analyzed data and strongly influenced the thrust of the report. Even before the report was finished Nightingale fell ill, it is thought, from the chronic form of brucellosis, the disease from which (again this is conjecture) she nearly died in the war. She spent most of the rest of her life as an invalid, confined to her room or her bed, / xi seeing people on a one-to-one basis, and making her influence by research and writing. It has become fashionable to speculate on the cause of Nightingale ’s later illnesses, or to propose psychiatric explanations, especially by authors content to use only secondary sources. An appendix in a later volume will both itemize this increasingly far-fetched literature and summarize information from relevant primary sources, including doctors’ letters and letters and notes by Nightingale and members of her family and friends. Nightingale was baptized in the Church of England and remained in it for the rest of her life, although often despairing of its paltry role for women, the minimal demands it made of its adherents generally and its social conservatism. Her experience of religious conversion in 1836 and call to service in 1837 (the latter specifically dated 7 February and frequently referred to) were both shaped by reading the work of an American Congregational minister, Jacob Abbott, notably The Corner-stone. Her faith was nourished by broad reading, from the medieval mystics, liberal theologians, the German historical school to contemporary sermons, popular devotional books, tracts and religious novels. The family had been largely Unitarian in earlier generations, but her paternal grandmother was evangelical Church of England. There is a strong Wesleyan element in Nightingale’s faith, for the family supported dissenting chapels in Derbyshire, and Lutheran influences date from the time at Kaiserswerth. God for Nightingale was a perfect Creator who made and runs the world by laws, which human beings can ascertain by rigorous, preferably statistical, study. With the knowledge thus gained we may then intervene for good, thus becoming God’s ‘‘co-workers.’’ Ongoing research is required, for human interventions, however well intentioned , may have negative unintended consequences. This approach appears in all the work Nightingale did, whether in health care or social reform more broadly. Public Health Care is the sixth volume in the Collected Works. The first volume, Life and Family, as well as introducing the Collected Works, gives an overview of Nightingale’s life, family correspondence and domestic arrangements. There are then three volumes relating her religious writing: Spiritual Journey (biblical annotations, sermons and private journal notes); Theology (essays, correspondence with a range of Roman Catholics and Protestants, notes from her diverse devotional reading and extracts from Catholic religious orders); and Mysticism xii / Florence Nightingale on Public Health Care and Eastern Religions (translations...