The Lady of the Lamp – And Much More Besides

Notes on Nursing, by Florence Nightingale Dr Sarah Preston, the professional librarian of the CLC team, writes: Probably the best known woman of the nineteenth century after Queen Victoria, Florence Nightingale died on 13 August, 1910. Her popular reputation was immortalised into the romantic figure of the ‘Lady of the Lamp’ gliding around the military hospitals of the Crimea. However there was a great deal more to her, and she was an obvious candidate for inclusion in the Cambridge Library Collection. As we have mentioned before, we have found many links between our nineteenth-century authors, most of whom seem to have known each other. Growing up, Florence knew historian Leopold von Ranke and Mrs Gaskell . Her mission to take a party of nurses to Scutari to improve matters in the military hospital was inspired by the Times reports on conditions there by W.H. Russell. She visited Queen Victoria at Balmoral, and the monarch was ‘much struck by her great gentleness and simplicity and wonderfully clear and comprehensive head’. The Queen’s support was crucial to Nightingale in getting many of her reforms adopted. The prefabricated hospital which was shipped out to Scutari (arriving after the war had ended!) was designed by Isambard Kingdom Brunel (whose ‘life’ we will be reissuing shortly). She had a regular and confidential correspondence for over thirty years with Benjamin Jowett, Master of Balliol College, Oxford, and colleagues in charitable work included J.S. Mill and Charles Dickens. Her portrait, never finished, was undertaken by G.F. Watts for his pantheon of important national figures.

Her Notes on Nursing reveals an extremely practical and sensible character, with little patience with stupidity (the book’s subtitle is What It Is, And What It is Not). This book was published in 1859 and expanded in the 1860 edition which we are reissuing. Aimed primarily at home nursing, but with many observations just as relevant to hospitals, it will strike a chord with NHS managers and staff today. Her emphasis on hygiene for both patients and nurses is especially timely given the current outbreaks of MRSA and other infections in hospitals.

Nightingale denied that her aim was to provide a manual to teach nursing: rather, she was suggesting issues which anyone attempting to nurse should have thought about. For her, most nursing was a matter of observation and common sense, which could not be taught, although the good habits could be developed in persons of suitable character. ‘Nursing’ had come to mean simply the administration of medicines, but she looked at it more holistically, by stipulating the circumstances in which a recovery could be made, or disease avoided, by means of fresh air, light, warmth, cleanliness, and correct diet.

At the time she was writing, 40% of children in London died before they reached their second birthday, mostly of preventable diseases, because of poor standards of living, hygiene and diet. Demands for a special Children’s Hospital were made, but Nightingale correctly makes the point that child mortality could be dramatically reduced by improvements to their home lives. Far more soldiers died in the Crimea through illness than in battle, and it was the need to prevent that waste of life which led to Nightingale’s greatest achievements. A Royal Commission was set up to investigate the health of the army, and she inundated them with questions and observations about provision of water, sewerage, ventilation and diet in barracks, and showing how these were directly related to death rates. The Commission accepted her recommendations, and her royal connections ensured they were implemented, leading to a 75% fall in deaths.

A keen mathematician, and aware of the necessity to back up arguments with statistics, Nightingale was the first women to become a Fellow of the Royal Statistical Society, and argued for a question in the national census about health, so that the relationship between living conditions and illness could be analysed. She was an advocate, very much in advance of her time, of collecting social statistics which could be used to plan and provide better social, educational and health services, very much in advance of her time. The popular idea of a crinolined lady with a vocation, quietly walking the aisles of hospital wards, does not do justice to the capable, energetic, farsighted and – when necessary – manipulative woman, who transformed health care from the Dickensian image of a gin-raddled Mrs Gamp to a profession for intelligent middle- and upper-class ladies. Reading her own words, written 150 years ago, has given me an entirely new picture of a famous, but usually rather one-dimensional, figure.

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4 Responses to The Lady of the Lamp – And Much More Besides

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