Saturday, 6 August 2011

Florence Nightingale

On 13th August, the Church of England commemorates Florence Nightingale. She was born in 1820 into a very well-connected, upper-class family, Unitarian and Abolitionist on her mother's side, Anglican and Latitudinarian on her father's. Her family knew most of the leading Tory and Whig politicians of the day.

When she was 17, she had what mystics call an 'audition'; she heard God speaking to her, calling her into His service. During her life, she had four further mystical experiences, but this audition, at the age of 17, was particularly interesting since, at the time, she had no knowledge of the mystical tradition and, in fact, came from two traditions that are peculiarly averse to mysticism. In later life, she undertook a learned study of mystics like Catherine of Sienna, Teresa of Avila and St John of the Cross, but, at 17, she had little background to help her interpret what God might be asking of her. Later, she said that she had an idea that this call involved turning her back on the conventional expectations that she would marry and live a life of comfort. It was a call to search for active ways in which to serve God. She had a hard time of it! Years later, she wrote, 'I would have given my all to the church but she would not have it; she sent me to teach children, but gave me no training.'

Florence had a hard time with her family, too. She had to fight her mother to continue with her maths studies, deemed unsuitable for a girl. When, in 1844, she anounced that she wished to nurse, her family was horrified, as horrified, she later wrote, as if she had announced her intention to turn to fraud and embezzlement! Eventually, she won their agreement, if not their favour. On her way back from a tour of Europe, she stopped at Kaiserwerth, in Germany, where she trained as a nurse with the Lutheran order of Deaconesses. When she returned to London, she briefly ran a hospital in Harley Street.

In doing all this, she flew in the face of the received wisdom of the time, arguing with her family, achieving a level of education that was thought unsuitable for a woman and introducing the concept of training into the world of nursing, which was largely, at that time, a job carried out by untrained women of the lower classes and ex-soldiers. Undoubtedly, she beacme a very competent nurse by the standards of her time. In England, she introduced cleanliness, decent food, call bells, proper sanitation and individualised care. At Scutari, during the Crimean war, she managed four miles of beds, each 18 inches apart. In today's terms she was something like the Chief Executive of a medium sized hospital trust with all the attendant problems of supply and all the frustrations of constantly changing government policies.

History has sentimentalized her as the 'Lady with the Lamp', a dedicated nurse, smoothing the fevered brows of dying men. Florence Nightingale's outstanding achievement, in fact, was as an administrator and statistician, not as a nurse. Her great contribution to nursing during the Crimean war was to persuade the Generals, by means of detailed statisical research, that 6 times the number of soldiers died of infection in military hospitals as of wounds acquired on the battle field; and then to make use of her family's political influence to improve sanitation and nutrition in British military hospitals. It was through her pioneering work in the use of graphs to represent statisical findings that she made possible advances in sanitation at Scutari and, after the war, in Britain and India. She invented a particular form of pie chart, known as the polar area diagram, which she used to illustrate seasonal causes of patient mortality at Scutari. She was a friend of the mathematicians Mary Somerville and Ada, Lord Byron's daughter and she beacme the first female member of the Royal Statistical Society. 

Historical biography has dealt her a poor hand in the way it has represented her solely as a nurse - the Lady with the Lamp who founded St Thomas's School of Nursing and lost her own health through overwork in the Crimea, becoming a chronic invalid and returning home to write a modest text book, 'Notes for Nurses.' She was so much more! A doggedly brilliant public health reformer, a deeply committed and devout, if unconventional, Christian and a considerable amateur theologian and classical scholar. In 1850-2, she wrote an 800 page work entitled, 'Suggestions for Thought to Searchers After Religious Truth' which includes her own theodicy, unique as a nurse's theory of evil and suffering. The work contains prophetic, radical and heterodox ideas. She believed passionately in education for all and in an educated electorate, predicting that, 'One day, women will take an active share in the affairs of state through parliamentary government'. She utterly eschewed the frivolous, leisured life of women of her class.

In 1850, she wrote in her diary, 'God called me this morning and asked me would I do good for Him? For Him alone, and without reputation.' When God called her, she did not vacillate, making plans haphazardly, saying 'yes' and 'no' at the same time. She single-mindedly sought out, found and followed her vocation. She trusted alone (and often she was very much alone) in God's faithfulness and in the 'Yes' of God that is found in Christ. She wrote, 'The promises of God are fulfilled in loving obedience.'     

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