PDF | On Jun 1, , Hosein Karimi and others published Florence Nightingale: The Mother of Nursing. Florence Nightingale, who was called as “the lady with the lamp,” by the sick and injured at Crimean war, has laid down strong foundational principles in nursing. Her multitasked role contributed significantly toward the development of nursing profession into structured. Objective: To analyze the environmental theory of Florence Nightingale based on the model .. bacttemcocani.ml 5.
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On 4 November , Florence Nightingale arrived in Turkey with a group of 38 nurses from England. Britain was at war with Russia (the. Crimean War. The popular perception of Florence Nightingale as a romantic heroine ignores Florence Nightingale rose to fame for nursing the sick and wounded during the. Florence Nightingale – The Lady with the Lamp. Read the following text and then do the tasks which follow. Before the s nursing in England was classed.
Few of the numerous books, articles and chapters on her from any country at any time give more than cursory coverage to what she actually wrote — a pity because she was a fine writer, who told it like it is, with relentless concern for accuracy, often adding intriguing literary allusions and much humour.
The exaggerated praises of the adulatory books, many of them intended to inspire children, scarcely need refutation. They are long out of date and were probably never taken seriously. But the condescending and often derogatory second-hand books need to be answered. They have a significant and growing following. Two BBC films and using these books as sources have taken their hostile messages to large audiences.
Press stories based on the television films are yet a further step away from first-hand sources. Part of the problem of writing about Nightingale is that there is so much material, not only those all-too-numerous secondary sources on her, but her own letters more than 10, and reports, full books, articles, briefs, letters to the editor, chapters and pamphlets in more than archives worldwide.
I am the person who reads it all, as editor of the Collected Works of Florence Nightingale, of which the first 13 of the total 16 volumes have been published to The purpose of this book is to present Nightingale first hand as an author, systems thinker and pioneer public health reformer. The first chapter relates her family background and education, along with the core principles that guided her working life: her faith, politics, understanding of social science and statistics, and working style.
Chapters on her major areas of work follow, on social reform, women, war, public health, nursing, midwifery, workhouses, hospitals and India.
A final chapter comments on her lasting legacy. Nightingale in fact was always controversial. There were hostile, often sexist, comments on her even in her lifetime. But the real toppling from the pedestal occurred with the publication of a book by an Australian historian, F.
Smith, which gave the impression of being based on extensive research using primary sources. Clearly he missed most of the important archives, even the two largest for family P R E FA C E xiii letters, which did not stop him from making withering remarks about her family relations. More to the point, his extreme accusations turn out not to be based on the sources listed in his endnotes, when one takes the trouble to look them up. But it is odd that so many failed to wonder how such bizarre statements could be true.
Some of the most enthusiastic Smith followers were junior academic nurses who subsequently became prominent in their field. It seems that they never rethought their youthful endorsement of this unreliable work. Nursing history has always been an extremely rare and poorly funded specialty. Nursing faculties in recent decades have typically stopped giving even a cursory introduction to their most illustrious founder, if they ever did.
We look to the future, not to the past, nursing leaders say. Heroines became unfashionable in the late twentieth century, Nightingale not the least of them. She was particularly vulnerable as a Victorian, single, celibate woman of a privileged background.
That she was a radical thinker, a political liberal, with republican leanings no less, and a devout Christian believer with wide ecumenical and even inter-faith sympathies, seems scarcely to have been noticed.
Florence Nightingale: The Mother of Nursing
That she, as a nurse, led a team of male medical doctors and political figures to xiv P R E FA C E work for radical reforms in public health is similarly unknown.
Is it not time now to look at what she in fact wrote and did? She set to work on a page analysis of what went wrong, and succeeded, with her collaborators, in getting a royal commission to investigate and report publicly.
She did much of the behind-the-scenes work for it. Her report, which evidently was not read, cites clearly who did what and when, to address the problems, and who failed to act. Moreover, her page report cites a completely different hospital, at Koulali, as the one with the highest death rate, but these critics seem not to have read it. That BBC film also lacks ordinary common sense: since when have nurses or doctors been responsible for the faulty sewers and overflowing toilets of the hospitals to which they are sent?
Why did the army not send out their engineers when the defects were first reported? They, after all, had both the doctors and engineers who knew what was needed; Nightingale had access to neither.
She developed and sustained a superb network of experts to consult later, but that was after the Crimean War, indeed on the basis of her analysis of the mistakes of that war. Old-fashioned sexism continues to mar the portrayal of Nightingale. She was denounced in her lifetime for her pioneering analysis of maternal mortality post-childbirth, which was critical of doctors.
She was then supposedly rescued by her father, who persuaded her to reform civilian nursing to expiate her failures. Her father in fact thwarted her desire to work for years, and took little interest when she finally did become a nurse. He neither shared her ardent faith nor believed in her reform mission. Further, as material in this book will show, Nightingale was long and early determined to tackle nursing in regular hospitals, and would have started in the s if her family had allowed her to it was only on the strength of her Crimean War fame that she got the chance later.
Nightingale in fact claimed guidance from God for her great mission, not her earthly father. But perhaps it is too much to expect the Faith Department of the BBC, the unit that produced this film, to have a director or writer who might entertain that possibility.
If you want to read another book of sarcastic, sexist inferences, or one which shoots the messenger for bringing the bad news, read no further: this book is not for you.
If you want to discover Nightingale as she was to her collaborators, some of the greatest minds and boldest reformers of her age, and how she attracted them to work with her to realize her vision, this is. Whether or not she talked to God about her mission, as she claimed, is not for me to say. Wardroper c. She was raised in England at country homes in Derbyshire and Hampshire. She was educated largely by her father, William Edward Nightingale, who had studied classics at Trinity College, Cambridge.
Lengthy trips to Rome —48 and Egypt and Europe —50 were allowed. She had earlier —39 been taken on a long trip with her family, mainly to Italy and France. These European trips not only improved her language skills she was fluent in modern French, German and Italian , but exposed her to republican politics and Italian independence she was in Rome and France during the revolts of Its hospital, orphanage and teacher training gave women opportunities for serious work and she wanted to come back for a longer stay.
Her parents finally permitted her to spend three months there in , to get some practical experience, and then several weeks in with Roman Catholic nursing orders in Paris. In her father gave her an annuity to permit her to become the superintendent of a small hospital, the Establishment for Gentlewomen during Illness, Upper Harley Street, London. The British Army was poorly prepared for what became known as the Crimean War, and the death rate from preventable disease was seven times that from wounds.
The Barrack Hospital at Scutari, where Nightingale was stationed, was structurally unfit to be a hospital, had defective drains and had to be re-engineered by a team of visiting experts before the death rate could be brought down. It had not been intended for use as a hospital and should never have been used as one. Yet when it was inspected, by Dr John Hall, inspector general of hospitals, it was given a glowing report.
On her return from the war in August Nightingale set to work to ensure that the high death rates that had occurred there would never happen again. Recognized as a national heroine, she chose to use that renown to work behind the scenes for structural reforms, first in the army itself, then in the wider society. She began by lobbying to get a royal commission established to investigate the causes of the medical disaster and recommend changes. She herself briefed witnesses, analyzed data and strongly influenced the thrust of the report, despite falling ill before it was finished.
At the same time she wrote a page analysis of what went wrong, which she had printed for private circulation. Nightingale had only one relatively healthy year after the war. An invalid for the most part, she saw people on a one-on-one basis, making her influence through research and writing.
The illness was certainly painful and incapacitating, but Nightingale learned how to work around it, focusing her best hours on the projects that had the best prospect of saving lives. Her ardent and consistent liberal politics informed her social reform work. Her family and the Verney family, into which her sister married were strong Liberals.
Florence Nightingale and Irish nursing
Her brother-in-law was a Liberal MP, as were a number of cousins and family friends. Nightingale herself gave money to the Liberal Party and even wrote campaign letters for a small number of favoured especially progressive candidates.
The Liberal Party seemed to her to be the best political manifestation of these principles. As with the Church of England, the Liberal Party often failed to live up to them — she desperately wanted it to be as liberal on India as it was on Ireland.
She stuck with both church and party. Some days she could not see anybody, but usually she had interviews, sometimes several and sometimes lengthy ones, with nursing leaders, medical experts, politicians and Indian officials.
Many people who requested interviews with her over their concerns were turned down. People who did not get interviews, however, normally got letters in reply, sometimes with detailed advice as to what to do, and even a modest donation.
She always worked collectively, seeking advice and having her own questionnaires, draft articles and reports vetted by knowledgeable people.
Nightingale continued to produce papers and reports of various kinds well into her seventies. She did not do any serious writing in her eighties, when blindness and failing mental faculties gradually stopped her.
From she wrote only brief messages. Consistent with her wishes, the family declined an offer of burial at Westminster Abbey. This page intentionally left blank 1 The Making of Florence Nightingale The Nightingale parents returned to England in to raise their Italian-born daughters. They lived in great luxury, dividing their time between two country homes, Lea Hurst, in Derbyshire, and Embley Park, in Hampshire. The curriculum included modern languages, Latin and Greek, and constitutional history as well as the more conventional grammar, composition, English literature and music.
Nightingale loved the classics of her own language, frequently quoted Shakespeare and Milton, and read such contemporary novelists as Charles Dickens, Elizabeth Gaskell and Harriet Martineau. She read contemporary poets like Victor Hugo, and loved adventure stories. Numerous relatives on both sides visited for weeks at a time. The family enjoyed outings, picnics, musical performances and amateur theatre. When Embley underwent a major renovation in —39 the family took an month trip to France, Italy, Germany and Switzerland.
The stay in Florence included lessons in Italian, art, piano and singing. They went to the opera three times a week and Nightingale said she could have gone every night.
In Geneva she met refugees suffering poverty for their beliefs. The Italian historian Sismondi took her on long walks during which they discussed politics and economics.
The family returned to England in and the two sisters were formally presented at court. Normal life resumed, but Florence Nightingale had had her first taste of political struggle and would be a partisan of independence movements thereafter.
While still a girl she began to nurse sick relatives, servants and villagers. In , by then in her mid-twenties, she sought to learn nursing at nearby Salisbury Hospital.
Her mother and sister were vehemently opposed. Nursing was then an unskilled occupation, poorly paid and disreputable. The stereotype has nurses drinking too much and using coarse language, although Nightingale herself refuted the latter, though not the former. The years of lost opportunity continued to rankle in old age.
Both were taken with family friends, Charles and Selina Bracebridge, an older, childless, couple, who later accompanied her to Scutari in the Crimean War.
In Rome Nightingale not only visited art museums and churches, she did detailed sketches that developed skills she later applied to hospital design. She was especially moved by the beauty of the Sistine Chapel. Seeing it, she recounted to her sister, was like seeing heaven. Nightingale attended a great rally in the Roman Colosseum; she cheered the hoisting of the tri-colour flag at the Capitol.
But he would soon become reactionary on which more below. Nightingale would never visit India, but her time in Egypt gave her experience of a large and complex agrarian society, with radically different cultures and religions. She accepted the expert opinion that the ancient Egyptian religion was, for its priests, monotheistic — the multiplicity of gods was to placate the uneducated.
Different gods were in effect different aspects of the one God. The Christian trinity could be seen as a parallel of several Egyptian trinities. She wrote lengthy descriptive letters home from Egypt, which her sister later had printed for private circulation.
But the private diary Nightingale kept shows that the trip was a time also of anguished religious reflection. Nightingale had done a form of retreat while in Rome in There were also political insights.
Nightingale came to realize why only Moses, of all the Jews captive in Egypt, could lead them to Israel. When Nightingale was at the Kaiserswerth Deaconess Institution in and it was run by its founder, Pastor Theodor Fliedner, and his second wife, Caroline Fliedner.
But the atmosphere was serious and devout and she learned discipline and order. The nurses and patients came mainly from humble origins, which broadened her experience considerably.
She had an enormously enjoyable time with people who shared her deepest beliefs and were committed to pursuing their own calls.
Her meritocratic inclinations were reinforced. The family back in England attended the Church of England in Hampshire, a dissenting chapel but not Unitarian in Derbyshire. They did not attend Unitarian chapels after that. Nightingale remained in the Church of England for the rest of her life, although she often despaired of the paltry roles it accorded women, the minimal demands it made of its adherents in general and its social conservatism.
Ongoing research is required, for human interventions — however well motivated — could have negative unintended consequences. This approach appears in all the work Nightingale did. Her sources were the Belgian statistician L.
Florence Nightingale at First Hand: Vision, Power, Legacy
Quetelet on the conduct of research and the British philosopher John Stuart Mill on its philosophical grounding. As a young woman Nightingale considered conversion to Roman Catholicism, but did not seriously pursue this. Indeed she became increasingly critical of Catholicism over the years, identifying as a liberal, broad church member of the Church of England, and, more significantly, simply as a Protestant Christian.
She drew on a wide range of sources for spiritual nourishment, including Roman Catholics from the church fathers through the medieval mystics to the French, liberal Dominicans of her own age.
Wesleyan influences date from her own chapel attendance early in life, and an enduring respect for church reformer John Wesley.
She believed that God wanted people to work to change the world, not to pray to be spared the natural consequences of bad conditions. If that world is in advance of this, it must be. Do you believe that mortality, morality, health and education are the results of certain conditions which He has imposed?
Then you must believe that Houses of Commons, or similar institutions, are far more certain than churches to exist in all worlds till we become like God. At that time there were no effective means of contraception, so the very life and health of a wife was entirely subject to forces beyond her control. Wives were legally obliged to obey their husbands, whose conjugal rights were unlimited. Nightingale, however, was apparently heterosexual and seems to have regretted that her life would be without a husband and physical love.
She did not regret not having children, but rather took on motherly roles both with young soldiers and nurses. She refused him in but the two remained on good terms; he served for years on the Nightingale Trust, as did his son on his death. At age 30 Nightingale recorded the recognition that all her suitors had married although it seems two or more later turned up.
With the benefit of hindsight she later said that not marrying was one decision she never regretted. And that is a subject of joy. But a woman must be born into the family. If she were born into the world, it would be joy too. But what joy is there in her being born into the smallest of all possible spheres, which will exercise perhaps no single one of her faculties?
Her family socialized with the great landowners and nobility of her country, and when they travelled with multiple servants they were received by ambassadors and dukes. A long-term lease her father arranged in permitted her to settle down in one place. Yet she, like Jesus, never owned any property and always lived, after she left home, in rented, borrowed or leased accommodation.
It seems there were times when Nightingale was short of money, for she had to borrow from her lawyer. Otherwise she enjoyed the creature comforts of her class and age, and did not begrudge them to others. To ailing friends and colleagues she sent tempting food and drink to a dying nun she sent fresh eggs, jelly, beef juice, port and champagne. She maintained a staff of five or six. Her rooms were well furnished and with, for her era, unusually little clutter.
Consistent with her fanaticism for ventilation, her windows were curtainless. Visitors and biographers commented on the overall light and pleasant effect.
Surviving notes include recipes in her own hand. Nightingale was fastidious about housekeeping. Whether it is our fault I cannot say. She noticed and loved flowers. A steady stream of greenery flowed into her London home from Embley, much of which she relayed to hospitals. Her friend William Rathbone regularly sent her flowering plants. Nightingale was a believer in moderation in drink. Soldiers, she thought, should drink less and nuns more. How much she and her guests drank is not clear, but there are routine expenditures for beer and brandy recorded in her account books.
She supported cafes for soldiers, to give them options for socializing without recourse to alcohol. True, Nightingale was a formidable genius, heroine, intellectual, workaholic perfectionist; she was utterly faithful in her service and a brilliant writer, too.
She also had more normal human qualities: a temper, a wicked sense of humour and considerable style. She had few friends in the normal sense — rather her friends were her collaborators in some cause or other. These were real friends, however, who shared confidences and jokes as well as books and documents.
Nightingale was glad of the Turkish towels; she sent pheasant and partridge. Her team, at least the inner circle who were welcomed to her home, were well fed while they were at work. Other people were kept at a distance, with careful, often affectionate, correspondence — gifts, too — but not everyone got inside the door. Former pupils who became matrons went back to her year after year for advice and sympathy.
She gave them moral support and practical help in their crises, sent food parcels, flowers and books to cheer them up. There are numerous letters with money or a cheque, usually small amounts, with a supportive letter and the wish she could send more.
Serious disasters, like famine in India and the siege of Paris in the Franco-Prussian War, got larger donations, indeed concerted fundraising efforts. Nightingale was fiercely loyal to old friends and villagers around Lea Hurst.
To a woman she had taught in a class of adult mill girls in the s she sent food and clothing in her old age, obtained medical care for her and mourned her death in She corresponded with former tenants and employees, and had them visit on later occasional stays at Lea Hurst.
As a girl she was given music and art lessons. She attended concerts and was taken to the leading art museums of the Western world. In Notes on Nursing she observed that the music of wind instruments, including the human voice, had a soothing effect on invalids, but the piano did not.
Keen as she had been on the piano, when she was ill she found listening to it, even Mendelssohn, nerve-wracking. Nightingale loved architecture and had the opportunity to visit great churches, palaces, abbeys, temples and mosques. The subject of the Sistine fresco, The Last Judgment, is a gloomy one.
Yet she bought engravings of the ceiling in Rome and kept them in her rooms for the rest of her life. Joko Gunawan. She synthesized information gathered in many of her life experiences to assist her in the development of modern nursing. Nightingale viewed the manipulation of the physical environment as a major component of nursing care. She identified ventilation and warmth, light, noise, variety, bed and bedding, cleanliness of rooms and walls, and nutrition as major areas of the environment the nurse could control.
When one or more aspects are out of balance, the client must use increased energy to counter the environmental stress.
Actually, Nightingale did not invent or define the four major concepts nursing, human beings, environment, health used to organize nursing theory. They evolved from an analysis of nursing curricula Falco, Although we have applied our modern conventions to her framework, not all the concepts were addressed specifically by Nightingale.
The first is to ask the client what is needed or wanted. If the patient is in pain, ask where the pain is located. If the patient is not eating, ask when he or she would like to eat and what food is desired. Find out what the patient believes is wrong. Nurses must make the observations because client may be too weak or shy to make them.
Secondly, Nursing diagnoses are based on an analysis of the conclusions gained from the information in the assessment. Nightingale believed data should be used as the basis for forming any conclusion.
Nursing diagnosis reflect the importance of the environment to the health and well-being of the client.Statistics showed that in every thousand injured soldiers, the six hundred were dying because of communicable and infectious diseases 2. In late , Nightingale received a letter from Secretary of War Sidney Herbert, asking her to organize a corps of nurses to tend to the sick and fallen soldiers in the Crimea. In she was persuaded to accept the services of a secretary.
The Barrack Hospital at Scutari, where Nightingale was stationed, was structurally unfit to be a hospital, had defective drains and had to be re-engineered by a team of visiting experts before the death rate could be brought down.
The most basic supplies, such as bandages and soap, grew increasingly scarce as the number of ill and wounded steadily increased. She had contracted soldiers to alcohol, she endeavored to bring sition without consent from her and no new Crimean Fever. During her first winter at Scutari, 4, soldiers died there. The first is to ask the client what is needed or wanted.