During these painful days of the coronavirus pandemic, we are more aware than ever of the importance of our healthcare workers. Doctors, nurses, and their assistants are the people we rely on for help with illnesses. But they do more than just help us as individuals. They also build knowledge and systems that improve the quality of healthcare for all of us. Often, they don’t get credit for these achievements. Nurses especially are apt to be remembered only for their gentle kindness, but not their other valuable work. Florence Nightingale is a good example of a woman who is remembered for all the wrong reasons.  

Born into an old-fashioned English family in 1820, Nightingale had to fight hard to get the education she wanted and to become a nurse. Her big chance to shine came when England blundered into the Crimean War in 1854. The British had not fought a war in decades and were confident they could defeat Russia which was threatening to block their access to India. It wasn’t until British troops reached the Crimea that their vulnerability to the climate and poor sanitary conditions was demonstrated. Before the battles had even started, 20 percent of the troops had come down with diarrhea, cholera, or dysentery. Hospital facilities were poor or non-existent.

At last Florence Nightingale had an arena in which her talents shone, although it was a difficult struggle to convince the authorities that she could help. Finally she was able to gather together a group of women who had some experience as nurses. They included lay nurses and both Roman Catholic and Anglican nuns. Florence left for the Crimea in October 1854 and established her headquarters in the hospital at Scutari. It was there that she proved her abilities as an executive, managing the delicate relationships between the army and the nurses, establishing methods of providing food and supplies for the hospital, and introducing sanitary measures that saved lives.

While she was in the Crimea, Florence’s fame as the “lady with the lamp” grew even though she did less and less nursing. She was essentially a manager and purveyor of supplies, but the public insisted upon viewing her as a gentle nurse who soothed poor, sick soldiers. The army officers and politicians who interacted with her were more realistic in describing her as a tough executive who fought to build a viable organization of hospitals.

When Florence returned to England in the summer of 1856, she had no intention of stepping back. The more she learned about health conditions among the troops, the more determined she became to change the situation. She pushed hard to get an official commission appointed and although she was not allowed to serve on the commission herself, it was her persistence that eventually brought it about. She labored relentlessly to write a report, which she eventually published as Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army. Founded Chiefly on the Experience of the Late War. Here her interest in statistics served her well. Realizing that people could visualize pictures better than rows of figures, she invented what she called her “coxcombs” to present the most important facts.

Florence Nightingale lived to be ninety years old and most of those years were devoted to improving public health. Like so many other women, her strengths have often been misunderstood. She is remembered as the sweet nurse tending soldiers, but her real achievement was far too “unwomanly” to be acknowledged while she was alive. It’s a shame that she is often misrepresented even now. There are several good biographies; one that I strongly recommend is Mark Bostridge’s recent Florence Nightingale: the Making of an Icon. After reading it, you’ll never feel the same about Victorian women and their lives.