Long-term readers of this blog will (I hope) remember the items on Florence Nightingale which we published during ‘lockdown’. At that time, we made a connection with the University of Nottingham where research was being undertaken to commemorate her bicentenary. They have now published a book “Florence Nightingale At Home”.
Dr Richard Bates has written to us again:
“I have recorded a lecture on Nightingale and 19th century hospitals for the education site Massolit. The lecture is aimed at GCSE / A level students. You can watch the opening section of the lecture on YouTube here: https://www.youtube.com/watch?v=bSReVEteV3o. The rest of the lecture is available via the Massolit website (you can get a free trial) – the link is in the blurb under the YouTube video.
If you would like to read some of our Salisbury Museum blogs on Florence again, just use the ‘Search’ box at top right, or click on any of the links below:
10 March ‘The Hero of Nursing Who Almost Has a Connection With Salisbury’
27 March ‘The Moment Salisbury ‘lost’ Florence Nightingale’
“Ahead of this year’s International Nurses’ Day (10 May), I am writing to draw your attention to two recently published academic articles by members of the ‘Nightingale Comes Home’ project. These articles are currently free to access.
Written by Richard Bates and Jonathan Memel, this article explores how Nightingale thought about who was responsible for funding and providing healthcare, and how her views evolved over time. It puts Nightingale’s views into the context of changing societal attitudes to healthcare in the 19th century, as Western societies moved from religious and philanthropic models of care towards greater state funding and involvement.
Published in the inaugural edition of the European Journal for the History ofMedicine and Health, this article is free to read via the link above. “
If there are any Florence Nightingale fans out there (and surely there are!) you may be interested that Richard Bates at Nottingham University sends us this:
Those who enjoyed the Florence Nightingale series of blogs last year will probably remember the work going on at the University of Nottingham to celebrate the 200th anniversary of her birth. We have received this from Dr Richard Bates:
Just a quick message to flag up that Dr Jonathan Memel from our Florence Nightingale project team will be giving a streamed talk next Tuesday (13 April) at 2.30pm on the theme of ‘Florence Nightingale and Health at Home’.
Our exhibition is currently scheduled to reopen in the week beginning 17 May in line with the wider reopening of museums and galleries on this date – we’ll be in touch nearer the time to confirm!
‘Museum Crush’ – a website that highlights the work and collections of all and any museums countrywide – has a delightful piece out this month. We can’t go and visit at the moment, but we can plan! Click on the blue to go there.
Mary Rose, Portsmouth
We can also donate. An alarming story is about the Florence Nightingale Museum. It lies within the grounds of St Thomas’ Hospital in London, and, like The Salisbury Museum, relies on income from visitors, especially foreign tourists. Like us, and many others, it is struggling.
Florence Nightingale, aged 34, soon after she returned from the Crimea
This email has come through from Nottingham University…
“As you probably know, 12 May is the date of Florence Nightingale’s bicentenary. It would, in normal times, have been marked with a variety of local and national events.
Instead, we are commemorating it ‘from home’. To this end, our Nottingham team has put together a web page with a variety of new and interesting materials, including:
An online exhibition, created by the Manuscripts and Special Collections team. It features some materials from our Lakeside Arts Centre exhibition, along with videos explaining some key items.
– and spend some time exploring the content! I’d also be grateful if you can share the link to the page far and wide – as you will hopefully agree, a lot of people have put work into producing some high-quality material.”
If you missed any of the recent articles on Florence Nightingale in The Salisbury Museum blog and would like to ‘catch up’, they are as follows:
10 March ‘The Hero of Nursing Who Almost Has a Connection With Salisbury’
27 March ‘The Moment Salisbury ‘lost’ Florence Nightingale’
Florence Nightingale is rightly famous for reforming nursing, even ‘inventing’ modern nursing, but it is arguable that her most important work was in ensuring the reform of army conditions. This took place during the last half of her life, after her return from the Crimea.
She returned from the Crimea essentially in mourning. Exhausted, she was ill, wracked with pains, unable to eat, unable to sleep. We might, today, call it Post Traumatic Stress Disorder. She was never fully fit again for the fifty or so years left of her life, often working from her bed or couch while people came to her. But she refused to forget the men. She described herself as “mother to 50 000”.
When she returned from the Crimea, she knew she had to strike while the iron was hot, while people still remembered what they had read in the Times, while her own name carried weight. Friends and family begged her to rest. Even Sidney Herbert wouldn’t engage with her at first, being concerned about her and feeling she was more than a little overwrought.
Tired, ill and frustrated, she refused to stop. Florence began visiting and advising on military hospitals (Haslar, Woolwich) and was consulted over the plans for the huge new military hospital on the Solent (Netley, near Southampton). She then began to be consulted on the plans for civil hospitals. She complete a one thousand page book of evidence on hospital administration for the Army, packed with the kind of facts and figures for which she, with her organised and mathematical mind, had become famous. This was presented to the Commission. The book included information about the appalling living conditions for the men and was able to show that death rates for those who enlisted were twice those of the population as a whole. And that was in peace time.
In August 1857 she collapsed completely, and she, herself, believed she was dying. She survived, and in the following months planned for the setting up of schools of nursing at St Thomas’ and King’s in London. and wrote ‘Notes on Nursing’* which, at 5 shillings, cost more than some workers earned in a week, but became a runaway best seller. It was translated into German, Italian and French. At a time when germ theory was still not understood, the book was a combination of her by now vast experience, common sense, practice, evidence-based theories and it called for care, a holistic approach, efficiency and discipline when looking after the sick or infirm.
Then came a very dark time for Florence. She lost possibly her greatest friend and ally when Sidney Herbert, ill for some time but still fighting in Parliament for the reforms that he and Florence knew were so important, died, at Wilton House in August 1861. She lost other important friends and allies through illness or their own family commitments and she collapsed again. This time she just wished she could die, but she carried on working.
She proposed necessary equipment for military hospitals, initiated hospitals for soldiers’ wives, revised lists for army rations, sent out instructions for dealing with yellow fever and cholera, produced diet sheets for troop ships. She lobbied for decent housing and married quarters as being the best defence against venereal disease which was rife amongst soldiers. She was asked for advice by the Union Army during the American Civil War, and would have assisted the South also but had no channel of communication.
She was asked to look into the conditions of the army in India. This involved literally tons in weight of paperwork being shipped to her rooms in London for her to read and it was clear all the old problems still existed, with a death rate from disease among the soldiers nearing 10%. In peace time. In some areas in India only one in five of the children of British soldiers survived to the age of five.
Florence produced two enormous volumes on the situation. For political reasons they were suppressed. A new Viceroy of India became her friend but he was unable to move things forward at that time, though there was considerable progress later. She became depressed, whereas in the past, challenges had always energised her. She began to self-isolate (an expression her biographer uses, writing in 1950), only having just enough energy to work. And she did, indeed, still work.
She began working – through correspondence initially – with a Mr William Rathbone, wealthy Liverpool ship owner (and, incidentally, Abolitionist) who was using his money to establish district nursing in Liverpool and sought Florence’s advice. Together, they also started to campaign for the improvement of workhouse conditions and the setting up of nursing homes for the poor. They didn’t get all they wanted but somehow managed to get an Act passed which meant that the sick, insane and also children in workhouses were to be housed separately from the able-bodied, and medical relief was effectively to come out of taxation rather than the parish.
Florence Nightingale was the first woman to be awarded the Order of Merit, bestowed by King Edward VII in 1907. She was by then blind, hardly aware.
She died in 1910. She had asked not to be given a state funeral, or to be buried in Westminster Abbey. She is buried at East Wellow, a few miles from Salisbury.
It is her birthday this week, on Tuesday 12 May.
*This is a comment from a medical professional on ‘discovering’ Florence’s ‘Notes on Nursing’:
“Neither in my own nursing education at the B.S.N. nor at the M.S.N. level, was it even suggested, much less required, that I read any of Florence Nightingale’s original writings. Even as a nurse educator for over 30 years, I did not require my students to read her writings either. After reading this book, I now believe it is a void in the education of a nurse not to read at least some of the writings of the founder of modern day nursing. Notes on Nursing would be an excellent choice. This book introduces holistic health, home health, alternative therapies, health prevention and maintenance, the role of women in nursing and in everyday life, nursingadministration, leadership, communications skills, mind/body and body/mind relationships. Her theory on the use of light, fresh air, warmth, cleanliness, quiet, and the proper selection and administration of diet is also well explored. – Anita S. Kessler, R.N., M.S.N., M.Ed.”
Florence Nightingale in the 1880s with nurses from St Thomas’s
The war in the Crimea dragged on. At the end of February 1855 a Commission was sent out to review conditions. Things were more orderly in the hospital at Scutari but the death rate still high. Eventually over 500 handcarts full of the foulest rubbish (including dead animals) were removed from the open privies. Old wooden furniture, which harboured rats, was removed and the walls limewashed. An unlikely hero, Alexis Soyer, famous French chef from the Reform Club in London, arrived. He was an odd figure but a genius with nutritious food and could produce it in bulk. He and Florence Nightingale became firm friends. At last the death rate began to come down. By May that year it was down to 5%.
But opposition to Florence Nightingale re-emerged as officials began to look for ways to avoid the blame for what had happened.
The soldiers meanwhile, loved her. When giving evidence to a later Commission back home they recorded that had she been in charge of the war, it would have been won much earlier. It was given in evidence that the men really did kiss her shadow as she tirelessly passed through the wards at night. She never allowed a man to die alone. She wrote letters for them. She frequently did not sleep for days at a time, dressing wounds, standing by men who were undergoing operations. She became ‘the lady with the lamp’ and described herself as ‘the mother of 50 000 children’.
In addition, she dealt with constant requests, gave endless advice, received and dealt with complaints and vexatious or openly hostile colleagues by day, and little water or food and cold and wet quarters at night. Somehow she managed, in the midst of all this, to continue sending home detailed private reports to Sidney Herbert, full of ideas as to how hospitals and the army could be reformed. These was to be the basis of her future work.
The provision of necessary ‘furniture’ with each bed was a Nightingale innovation
She became seriously ill but refused to go home. A sergeant wrote home that the men wept when they heard. “All their trust was in her”. Two leading military figures spitefully had her put on a ship for England but two other officials took her off and put her on a boat to the British Embassy villa in Turkey where she was able to convalesce.
At home she became famous and was lauded in popular songs, sent money and parcels from collections at home. Queen Victoria sent a brooch. The Staffordshire potteries produced a figure of her, wearing an unlikely flowered skirt, and red slippers. A lifeboat was named after her. Madame Tussaud modelled her in wax. A race horse was named after her…..
By the summer of 1856 she had been back at work for some time, the war was coming to a close and the numbers in hospital drastically reduced. She made sure her nurses were provided for and her family, army regiments and the government hoped to honour and fete her on her return. She was not interested in celebrity however, and she came home incognito via Marseilles, Paris, the Channel, Southampton and train to the family home in Derbyshire – Lea Hurst.
The family were in the drawing room. The housekeeper, at the front of the house, saw a lone figure in black walking up the drive, looked again, and rushed out to meet her.
Florence Nightingale was still only in her thirties…
‘Florence Nightingale Comes Home 2020′ is a project being run by Nottingham University. If you are interested in this, click here.
Lea Hurst is, today, a private home but does offer bed and breakfast to visitors, and the link to Nottingham University (above) allows a virtual tour.
Continuing the story of Florence Nightingale, her life and work…
As winter arrived, the men at the front, sick and wounded, still without supplies, had no shelter, were drenched by rain, stuck in mud, had no spare clothing, were eating dried peas and uncooked salted meat. They had to dig for roots to find fuel for fires. As they arrived at the hospital in Scutari everyone was totally overwhelmed, and, at last, everyone was called to help and the nurses set to work.
Bags were stuffed with straw to provide beds, thousands of them, but in the end the straw ran out and the men had to lie on bare boards, their heads on their boots. Conditions in the hospital defy description. The stench could be smelt outside the building. A violent storm wrecked every ship in the harbour, including the ‘Prince’, recently arrived with warm winter clothing and other stores.
Then, it started to snow.
Sidney Godolphin Osborne, another friend of Sidney Herbert, together with Augustus Stafford MP, who had come out to the Crimea to inspect matters, and a Mr Macdonald, who had come out to administer the monies raised by Times readers, joined FNs team. She ordered 200 scrubbing brushes and sacking to use as cloths. There followed 6 000 shirts, 2 000 socks and 500 pairs of drawers. Then nightcaps, slippers, towels, soap, spoons, bedpans, stump pillows… And screens. No washing had been done for five weeks. She persuaded the Engineer Corps to put boilers into a town house, paid for by the Times.
She made an ally of one of the doctors. He put into operation a wing of the hospital which had earlier been damaged by fire. It would accommodate another 1 000 men. FN engaged local workmen, and initially paid them herself.
Still, resentments, petty politicking and religious affiliations got in the way. Even some of FN’s own nurses, unsurprisingly perhaps, hated her. But she never wavered, even when, by January, there were 12 000 men in hospital and only 11 000 at the front and they were unable to bury their dead.
Her later work, largely unknown by people today, in helping to reform conditions for the British army, had started already. She wrote direct to Queen Victoria and asked that sick soldiers should be paid the same as wounded ones (they received less) and the Queen acted immediately. Florence fought bureaucratic nonsense such as the regulation that if a soldier had lost two blankets, he wouldn’t get a third.
At home, a Commission was announced to inquire into conditions. FN said later that this Commission “saved the British Army”. But meanwhile the horrors continued.
I started writing about Florence Nightingale for this blog in those halcyon days before the emergence of Covid 19. I was inspired by two things – that it is the two hundredth anniversary of her birth, and my belief that she is now a highly underrated British historical figure . I did not know how relevant her story was about to become, and could not have guessed how her name would re-enter our history.More next week.
NHS Nightingale Hospital, ExCel Convention Centre, London 2020
It was a mixed bag of women that Florence took with her to the Crimea. She had hoped to have forty but only managed 38. Each would receive around 60p a week, rising to £1 if satisfactory after a year and each had to agree to submit to Florence’s orders absolutely. They were to wear a very plain but practical uniform, and older women were preferred for several reasons. Some were nurses of the traditional kind, poor women, inclined to drunkenness but capable, while most were nuns or members in some way of religious institutions. Florence was non-sectarian about that. The contrast between nuns and the rest, one or two of whom considered themselves ‘gentlewomen’ , was a problem. The nuns tended to worry more about the men’s spirituality, while the ‘ladies’ didn’t think they had to empty bedpans. And the groups wouldn’t, at first, sit together for meals. Florence ate with the lower class women, one of whom later reported “We never had so much care taken of our comforts before. It is not people’s way with us.”
They travelled overland to Marseilles where FN organised supplies, then sailed on the ship ‘Vectis’. It was so rough that FN was confined to her cabin, even during a stop over in Malta.
‘Vectis’ 1853 – believed to to be the same ‘Vectis’ in which Florence Nightingale sailed to Turkey
They arrived at Scutari hospital. “..it’s not a building, its a town!”
They estimated four miles of beds. The building was dilapidated and filthy, walls running with water, a central courtyard a sea of mud, cavalry horses kept in the same building as the men. Drinking shops and brothels had been set up round about and 200 women -camp followers- were in the cellars, giving birth, or dying from cholera, or both.
A soldier was supposed to keep his pack with him, with a change of shirt and utensils for eating. Most had been lost. There were no supplies to replace these items. There were no facilities for FN and the women, apart from three rooms for them to share. Sidney Herbert demanded that the money raised by Times readers should be available to Florence and her party. The army, appalled at how this would reflect on them, maintained nothing was wrong…they froze her out.
In the end her plan was to wait until the doctors were so desperate that they had to ask for her help. All the while, the women slept on shelves, used a tin bowl for washing, eating and drinking and survived on a single pint of water for all of that each day. She kept her distance, and her nurses were instructed to do the same, to the point where the nurses nearly rebelled.
As the wounded came back from Balaklava, Florence was allowed in to the kitchens to make broth. Then, on 9 November, as biographer Cecil Woodham Smith describes it, the destruction of the British Army began.