The Responsibilities of Florence Nightingale

Florence Nightingale became a legend known as "The Lady of the Lamp" due to her nursing of injured British servicemen during the Crimean War. During the Crimean War many men died as a result of their stay in the field hospitals. This led Florence Nightingale to become a health reformer and to campaign for better sanitary conditions in hospitals and for nursing to be recognised as a worthy profession for women.

Crimean war

• Florence Nightingale had read about the terrible conditions in the hospital in Scutari where British servicemen were dying not just from their injuries, but from disease and offered her services. Eventually the Secretary of State at War asked Florence to head a team of nurses and head for Scutari. Against initial resentment from the doctors in Scutari, Florence managed the hospital effectively by having it cleaned, toilets emptied regularly and constantly harassing the government for sufficient supplies. It was reported that Nightingale's attempts to sanitize the hospital led to a reduction in the mortality rate. Florence herself contracted an illness and nearly died, but she continued her work until the end of the war.

The Royal Commission

• With her profile high after the Crimean War, Nightingale received an audience with Queen Victoria whose support she got for the creation of a Royal Commission to investigate the failings of health care during the war. Nightingale lobbied for Commission members who would work at improving health care and submitted a detailed report on her findings. This report, "Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army," was 830 pages long and was privately circulated, though never published. Included in the report were statistical representations, known as Florence's "coxcombs," that showed where death rates were highest and the causes thereof. This work contributed towards Nightingale being the first female member of the Statistical Society.

Nightingale Foundation

• During the Crimean War, a fund totalling £44,000 was set up in Nightingale's name. The money went to open a school for nurses, the Nightingale School at St. Thomas'. Nightingale had to intervene in the 1870s as the school was not providing the students with adequate training and had a very high drop-out rate. Nightingale took a more personal interest and subsequently her nurses were being sent out as matrons to hospitals and workhouses across the country. The Nightingale Fund also funded a training scheme at King's College Hospital for midwives. The scheme closed in 1867, following acrimonious disputes between the hospital and the ecclesiastical order that ran the scheme. However, the training scheme and Nightingale's publication, "Introductory Notes on Lying-in Hospitals and Proposals for Training of Midwives," laid the foundations for further schemes that appeared at hospitals across the country.

Research and Campaign

• Despite continuous poor health and remaining bed-ridden for a good portion of her life after the Crimean War, Nightingale continued to research and campaign for improvements to public health. Nightingale published two books in 1859, three years after her return from the Crimea, "Notes on Nursing" and "Notes on Hospital," to push forward her reform ideas. In her lifetime Nightingale published over 200 books, reports and pamphlets. One of the areas in which Nightingale focused was the sanitary conditions in India. Nightingale sent out 200 questionnaires to stations in India and collated her results resulting in the paper "How People may Live and not Die in India'. The report highlighted the need for pure water supply and irrigation and focused on debt, poverty and famine. Before the report was published, Nightingale had sent instructions on how to improve the state of Indian barracks that were blocked by the India Office. Nightingale collated statistics and continued in her belief that the prevention of infection through cleanliness within hospitals was better than cures. She finally accepted Lister's theory on germs causing disease, and her approach complemented Lister's theory as good hygiene and sanitation practices removed germs.

Nightingale and Feminism

• Nightingale campaigned for women's right to own property and for educated women not to be restricted if they were undertaking worthwhile work. However, despite calls from activists lobbying for women to become doctors, she refused to back their cause, instead maintaining that there was plenty of opportunity for women in professions such as nursing, teaching and midwifery.