Special Sub-Topic: Going with the Flo - Florence Nightingale
|In 1837, when Florence was just 17 years old, she received a Christian divine calling to do God's work. What did she initially think she was meant to do?|
She was unsure. Initially, Florence was unsure of what He wanted her to do. She had an interest in caring for the homeless as well as tending the sick. It wasn't until she was 24 that she knew she must do nursing.
At the time nursing was not a respectable profession and required neither training nor intelligence. As a result, nurses were viewed as little more than prostitutes. Naturally, her family was horrified and angry about the idea. Florence was raised as an affluent young woman and as such, was expected to marry well and raise a family. But Florence rebelled against this and followed her desires to tend the poor and ill.
|Florence cared for poverty stricken people and soon became a leading advocate for improved medical care in the infirmaries. As much as she was against the idea of spending her life as a wife and mother, she was courted by and received a proposal of marriage from a well-connected gentleman. Who was this man?|
Richard Monckton Milnes. Richard Milnes, politician and poet, 1st Baron of Houghton, wished to marry Florence. However, she became torn between her calling and the wishes of her family, particularly those of her mother. In 1851 she finally rejected the Baron's advances, but the stress caused her to have a breakdown.
While recovering from this she met Sidney Herbert, another politician and Secretary at War. The two became life-long friends and this friendship became particularly important later on. Florence developed a strong relationship with Benjamin Jowett, and it is thought he also wished to marry her. However, Florence rejected him as well. Charles and Selena Bracebridge were travelling companions of Florence's during her time in Egypt and Greece and according to some reports, were also in the Crimea with Florence.
|Whilst touring around Greece and Egypt with friends, she met two St Vincent de Paul sisters. Through them she learned of a hospital and orphanage overseas where she might do some training. Where was this school?|
Germany. In England, around the time Florence first began tending to the sick; there were no training schools for nurses. So for the next eleven years she visited hospitals around Britain, gaining knowledge through experience. However, after hearing about this new hospital, Florence was determined to go there.
She travelled to Germany where she spent four months at the Institute of Protestant Deaconesses at Kaiserwerth. Whilst it was not formal training, she gained invaluable medical experience. Here, she was permitted to assist with operations, something unheard of and prohibited in England. She realised also that it was possible to make nursing into a vocation for ladies.
|After completing her four months training, Florence returned home. For the next eleven years she continued her hospital visits in England, Scotland and Ireland, during which time she consolidated her knowledge. Around this time she also was offered and accepted the post of superintendent at the Institute for the Care of Sick Gentlewomen. In which city was this hospital?|
London. Her first supervisory role was in Upper Harley Street in London in 1853, but it was not a paid position. By accepting this position, she finally won the approval of her family, and particularly, her father. He paid her a small allowance to live on while she continued her work. Within months she had transformed the Institute into a clean and efficient hospital.
"Sick Gentlewomen" roughly translated into "governesses who had outgrown their usefulness", so it is unsure how much actual medicine was practiced there.
Florence also worked in hospitals in Dublin and Edinburgh, but not in a supervisory capacity. After completing her training in Germany she travelled to Paris where she spent some time working at the Sisters of Mercy hospital.
|England went to war in 1854 and Florence answered the call to help. How did she hear the call?|
From "The Times" newspaper. The war correspondent of "The Times", William Russell, wrote of the appalling conditions and lamented the fact there were no nurses and few doctors to treat the thousands of injured soldiers. Florence read this and immediately wrote to her friend, Sidney Herbert offering her services. Shortly before Sidney received Florence's letter, he himself wrote to Florence to ask if she would go and supervise the military hospital there.
A few days later, Florence left for the war with a group of nurses and no real idea of what awaited them. Although she had been informed that there were ample supplies in the hospital, Florence followed her intuition and purchased food and equipment on the way.
|When Florence and her group of nurses arrived at the Barrack Hospital they were greeted with suspicion and resistance. The doctors thought their arrival was a negative reflection on their own efforts, so they initially refused the nurses access to the wards. How did the women fill their time?|
Washing and mending. The Barrack Hospital was in a pitiful state when Florence and her troop of nurses arrived. The buildings were in a state of disrepair and were filthy, there was little food for the wounded soldiers or the people caring for them, and there were no bandages. In fact, there were few supplies of anything, including basic equipment. There was not even an operating table.
Initially, Florence set her nurses to cleaning the walls and floors, washing and mending sheets, and making mattresses and bandages. A small hut nearby was soon transformed into a laundry and she arranged for the soldiers' wives and girlfriends who were in the area to work there.
|The hospital was crowded with soldiers injured in the Battle of Balaclava, but after the Battle of Inkerman began, they were inundated. Finally, the nurses were asked to help with the influx. However, the hospital wards were in appalling condition, and disease was rife. Florence immediately took charge and made many changes. Which of these options did Florence NOT undertake?|
Installing lighting. There were no clean clothes for the soldiers, so they were forced to lay in their filthy, bloody, vermin infested rags. There were few chamber pots in the building and the ones that were used were emptied into large tubs in the center of the building. These tubs were rarely, if ever, emptied. The smell would have been unbearable. Florence did not understand how disease and infection spread, but she had an aversion to dirt and was could see that more men died from dysentery, typhoid and cholera than from their injuries.
One of the biggest problems Florence faced was red tape. Deliveries were spasmodic, as officers required signed orders before they would accept supplies. After she wrote to Sidney Herbert she was granted the ability to cut through the tape and take delivery herself. Finally there were clothes, soap and medicine to enable the men to be cleaned and have their wounds dressed.
There was also little food and the kitchen was ill equipped to cater for the number of people requiring to be fed. Florence took to ordering vegetables from local growers, and her friend, Alexis Soyer came and took control of the kitchen, installing ovens for bread and making soups and stews for the thousands of patients. His greatest invention was the "Scutari Teapot" which held enough tea to serve fifty men at a time. Greater quantities of food began arriving after a plea in "The Times" stirred the public to donate money.
Florence also asked the war office for, and was granted, a team of men to flush out the sewers and improve ventilation in the hospital. Florence may not have understood the infection process, but in six months she was responsible for bringing down the mortality rate from 42% to almost 2%.
|Florence will always be affectionately known as "The Lady with the Lamp" for her care of the soldiers during the war. But which war was this?|
Crimean War. The Crimean War lasted from 1854 until 1856 and was caused by the contest over territories belonging to the failing Ottoman Empire.
At night the hospital wards were run by male orderlies, however, Florence insisted upon checking all the patients herself. She was impressed with the soldiers' bravery, and tended them gently and with dignity. In return, the soldiers treated her with the utmost respect. It has been said that the soldiers would kiss her shadow when it fell on their pillows, but this has not been substantiated. The soldiers first called her the lady with the lamp and this was subsequently reported in "The Times" where they also called her a "Ministering Angel". After the war she was immortalised in the poem: "Santa Filomena" by Henry Wadsworth Longfellow:
"Lo! In that hour of misery
A lady with a lamp I see
Pass through the glimmering gloom,
And flit from room to room."
|Florence returned to England after the war with strong thoughts on military hospital reform. Although she had the support of Queen Victoria and Lord Panmure of the War Office, women could not be appointed to the Royal Commission. Despite this, Florence had a very strong say in the overhaul of army military care. What was her role in the refurbishment of the establishment? |
She assisted with writing the commission's report. The Commission was to comprise ten men, but Florence was not permitted to select all of them. In the end, Florence managed to have six of her names on the final list, including that of Sidney Herbert. But her greatest triumph was vetoing the appointment of Sir John Hall. Sir John had been in the Crimea with Florence and was her greatest adversary. While Florence was in favour of using Chloroform (which was in plentiful supply) for the many amputations, Sir John didn't think it was necessary and would make the soldiers "soft".
Florence finished writing "Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army" around the time the Royal Commission was being appointed. The Chairman of the Commission, Sidney Herbert, had the task of writing the report. For this, he relied heavily on Florence's findings in Crimea and especially the statistical data she had collected. All of this was included in his report. Since Florence had such a great input into the Commission's report, it has been said that she actually wrote it herself.
The main message in Florence's "Notes" was that men were dying from neglect, rather than injuries sustained. The living conditions, food and clothing, awful medical treatment and lax practices needed to be addressed immediately. Florence was also instrumental in implementing the essential reforms. The report resulted in major improvements in military hospital care. It also led to the establishment of an Army Medical School.
Throughout her life, Florence was a prolific writer. On her return from the war she wrote two other textbooks: "Notes on Hospitals" and "Notes on Nursing", both of which dealt with sanitary techniques and treatment in medical facilities. She also collected data and statistics feeling that these were the best evidence to show the need for, and the results of, change. This practice continues to this day where the use of statistics, including outcomes, are proof of "Best Practice".
For her work in the Crimea and on medical reform, Florence was awarded many honours. She was the first woman ever to receive the Order of Merit, but was also bestowed the Royal Red Cross, the German order of the Cross of Merit, the French gold medal: Secours aux BlessÚs Militaires, the Badge of Honour from the Norwegian Red Cross Society, and the Honorary Freedom of the City of London.
|Even before Florence returned from war, she had become a national heroine for her care of soldiers and improvement in hospital conditions. A public fund was set up in London to raise money to establish a training school for nurses. Where did this school first open?|
St Thomas's Hospital, London. Florence did not welcome praise or accolades for her work, however she was delighted to have a proper training school for nurses open in London. At the time however, she was busy with the Army reform and Royal Commission, and was unable to organise the school program. This was left to Mrs Wardroper, a lady who, like Florence, had no formal training, but was fiercely passionate about cleanliness.
The first training school opened at St Thomas's in July 1860. Probationers were given lectures and instruction on the wards, but it was mainly practical nursing only. The lectures included very little anatomy and physiology. However, it wasn't long before other hospitals demanded trained nurses as well, and the school realised the nurses needed at least a basic understanding of anatomy.
Within a few years, Nightingale Nurses were employed as Matrons in Hospitals throughout England, Scotland and Ireland. It did not take long before they were as far away as America and Australia. Students also came from abroad to study under Florence's banner, much as Florence had travelled to Germany so many years before.
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