Nightingale, Florence

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The founder of modern secular nursing, a social activist, and a pioneer in the use of social statistics, Florence Nightingale (1820–1910) was born on April 12 in Florence, Italy, the child of a wealthy, prominent English family. Given a classical education by her father, the serious, devout young woman was drawn to caring for the sick, but nursing was then a form of menial labor that was considered inappropriate for members of her social class. Nightingale persisted; for years she visited and gathered information on hospitals in England and abroad, sought training in Germany, and in 1853 became superintendent of a nursing home in London, where she undertook reforms to improve patient care.

After the start of the Crimean War (1854–1856) the public reacted with outrage to newspaper reports of the horrid conditions endured by British soldiers wounded in battle, and Nightingale was appointed to bring nursing care to the military. Arriving at the hospital in Scutari, Turkey, with a team of thirty-eight nurses, including fourteen Anglican and ten Roman Catholic sisters, she found overcrowding, filth, infestation, and disease. Far more soldiers were dying of cholera and typhus than were dying of their wounds. Against the objections of the hospital staff, Nightingale took firm administrative measures, set up sanitary kitchen and laundry facilities, and procured supplies with private funds. The death rate fell from 42.7 percent to 2.2 percent in six months. An international heroine at age thirty-six, Nightingale was immortalized by Henry Wadsworth Longfellow, as "a lady with a lamp" making her nightly rounds on the hospital wards, in his 1857 poem "Santa Filomena."

Nightingale used her Crimean experience to lobby for the reform of medical care in the army, publishing an 800-page book, Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army (1857). She included documentation that the death rate of army recruits in peacetime was nearly twice that of the comparable civilian population. Queen Victoria, to whom Nightingale had been presented as a debutante, supported her aims, as did friends in influential positions. Despite resistance within the bureaucracy, reforms followed. A Royal Commission for the Health of the Army was set up in 1857, and a similar commission was established for the army in India in 1859. Nightingale wrote Notes on Nursing (1859) and Notes on Hospitals (1859) and founded the Nightingale School of Nursing at St. Thomas's Hospital in London (1860). Nurse training programs based on her system were established during her lifetime in twenty countries, including a thousand in the United States alone.

Florence Nightingale was called the "Passionate Statistician" because her spirited campaigns for reform were anchored in carefully compiled data to convince those in power of the validity of her cause. Fascinated by mathematics since childhood, she found guidance in the social physics of Adolphe Quetelet (1796–1874), a Belgian astronomer and pioneer of sociology who developed the notion of the average man to show that observed regularities in the traits and behavior of groups could be characterized by the laws of probability. She devised graphic techniques to convey her politically explosive findings and was aided in her analyses by William Farr (1807–1883), a physician and the founder of British vital statistics. She urged the introduction ofstatistics into higher education and with the help of the scientist Francis Galton (1822–1911) sought to establish a university chair in statistics.

After 1857 Nightingale lived as an invalid and rarely left her home. According to a comprehensive biography (Dossey 1999), her disability was consistent with chronic brucellosis, an infection contracted in the Crimea, but equally significant was the central role of religion in her life. Much is revealed in Nightingale's journals and the thousands of letters she wrote. Since the age of seventeen Nightingale felt that she had been called by God for a special mission. Well versed in the tradition of Western mysticism, she was inspired by strong women such as Saint Catherine of Siena (1347–1380), Saint Catherine of Genoa (1447–1510) and Saint Teresa of Avila (1515–1582), whose intense spiritual lives found expression in service to humanity. In her daily life, coping with illness and engaged in widespread reform activities through her writing and personal contacts, she accommodated the contemplative's need for solitude, guided to the end by her inner vision. She died in London on August 13, 1910.

It was Florence Nightingale's mission to lessen human suffering through better healthcare and the prevention of disease. Her novel approach was the use of statistical evidence to show the way: quality data on which to base policies to serve the common good, with a call for the education of administrators as well as the public to help them understand. The study of statistics was for her a moral duty.

Bioethics;; Medical Ethics.

Cohen, I. Bernard. (1984). "Florence Nightingale." Scientific American 250 (3): 128–137. Article assessing Nightingale's contributions contains samples of her statistical graphics methodology

Dossey, Barbara Montgomery. (1999). Florence Nightingale: Mystic, Visionary, Healer. Springhouse, PA: Springhouse Corporation. A large-size, richly illustrated volume, a thoroughly researched biography that includes analysis of the spiritual motivation of Nightingale's life and work.

Kopf, E. W. (1916). "Florence Nightingale as Statistician." Journal of the American Statistical Association 15: 388–404. Reprinted in Studies in the History of Statistics and Probability, vol. 2, ed. M. G. Kendall and R. L. Plackett (1977). New York: Macmillan.

Nightingale, Florence. (1969). Notes on Nursing: What It Is and What It Is Not. New York: Dover. A manual of nursing care, revolutionary in its day.

Nightingale, Florence. (2002–2005). Collected Works of Florence Nightingale, 8 vols., ed. Lynn McDonald. Toronto: Wilfrid Laurier University Press. The first 8 in a projected series of 16 volumes.

Walker, Helen M. (1929). Studies in the History of Statistical Method, with Special Reference to Certain Educational Problems. Baltimore: Williams & Wilkins. Includes discussion of Nightingale's efforts to promote statistics education.

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