At the time of the Crimean war between Russia, Turkey, Britain and France, a military hospital was a very grim place to end up in, reminiscent of a modern-day horror movie. The powers that were cared little about the quality of care the sick and wounded received, food was poor, hygiene was dismal and medicines were in short supply. Disease spread like wildfire, and those affected were more or less expected to either recover on their own or perish.
These were the conditions that greeted Florence Nightingale and a few dozen other volunteers trained by her, after crossing most of Europe to provide what aid she could. Despite the expectations of Victorian society and the desires of her family, andlargely self-educated as far as medicine was concerned, religious convictions led her to wade into a literal shambles to try to make a difference.
One of the most effective of the measures she took was to write to newspapers back in England describing the horrible conditions and death rates – at the time of her arrival, ten times as many soldiers died from preventable or treatable diseases as did from wounds sustained in fighting. One of the results of these letters was the design of a prefabricated hospital that would be manufactured in England and shipped to Turkey, eventually accommodating over a thousand patients and, more importantly, incorporating good drainage, sanitation and ventilation in its design. Once in use, patient deaths plummeted to 10% of what they had been. Newspaper coverage also caused the British government to send out a “Sanitary Commission” several months after Nightingale’s arrival, who helped to improve hospital and general hygiene further.
Some modern critics claim that her influence on government policy has been exaggerated, which may be true. However, in the midst of an unpopular, expensive and poorly managed war, her selfless actions provided a hero for the media and a nucleus for public opinion to adhere to.
Although Pasteur and others were proving that many diseases are caused or spread by microorganisms around the same time, basic precautions such as doctors and nurses washing their hands were not being taken until Nightingale started campaigning for them. She also identified poor nutrition, overcrowding and the general conditions in military hospitals as major causes of unnecessary deaths, which helped inform her work once she returned to Britain. Improvements in cleanliness both in hospitals and low-income housing are counted as some of her later achievements.
Although modern medicine is heavily evidence-based, Nightingale is credited with being one of the first medical professionals to use statistics, and especially visual representations of statistics, as a way to support her arguments. It’s highly unlikely that she could have swayed political figures as much as she did without techniques such as pie charts, which are today much better known than they were in Victorian times. Changes recommended by her with regard to things such as drinking water and building design are regarded as a major factor in improving British life expectancy by two decades during a time when effective medical treatment of major diseases was still not possible.
Establishment of Nursing as a Profession
Prior to 1855, female nurses were generally part of religious orders, with wide variations in the quality of their training. Other primary caregivers and midwives might have received no training at all, and could provide little more than comfort and folk remedies. At the same time, modern medical science was beginning to come into its own and best practices being developed.
Equipped with several thousand pounds from public donations, Nightingale established the first non-religious nursing school in Europe and possibly the world. Before this, nursing was hardly considered a profession a woman could follow, and certainly not a respectable one. Although her own health deteriorated not long after the nursing school bearing her name was organized, she wrote numerous books on health and nursing, often aimed at the public rather than fellow professionals, and devoted the rest of her life to improving the training of nurses. Graduates of the Nightingale Training School soon began spreading their knowledge to hospitals around Britain and North America.
Although some of her opinions would have horrified modern feminists, Nightingale’s effect on the modern medical profession is doubly impressive considering her gender and the times she lived in. The training center she helped established still bears her name, as does the highest award that is awarded to internationally outstanding nurses, as well as no fewer than four hospitals in Istanbul. Despite little scientifically proven information being available at a time, her skill at observation, her aptitude for convincing influential people of her viewpoints and sheer persistence arguably made her contribution to practical modern medicine greater than that of any scientist.