Florence Nightingale

Abstract On her death in 1910, Florence Nightingale leftover a vast collection of reports, letters, notes and other written material. There ar numerous overtations that make use of this material, often highlighting Florences attitude to a particular issue. In this paper we gather a dumbfound of quotations and construct a dialogue with Florence Nightingale on the subject of statistics. Our dialogue rambles attention to strengthened points of connection between Florence Nightingales use of statistics and modern evidence-based approaches to medicine and public health.We offer our dialogue as a memorable way to draw the attention of students to the key role of info-based evidence in medicine and in the conduct of public affairs. 1. Introduction 1. 1 Who Was Florence Nightingale? Florence Nightingale (1820 1910), time to come referred to as FN, make remarkable use of her ninety years of life. She was the second of two daughters, born in England to wealthy and well-connected paren ts. There were varied ghostly influences. Her parents some(prenominal) came from a Unitarian apparitional tradition that emphasized deeds, not creeds.The family associated with the Church of England (Baly 1997b) when property that FNs father had inherited brought with it parochial duties. A further religious influence was her friendship with the Irish Sister Mary Clare Moore, the founding superior of the Roman Catholic Sisters of Mercy in Bermondsey, London. Her father supervised and took the major province for his daughters education, which included classical and modern languages, history, and philosophy. When she was 20 he arranged, at FNs insistence, tutoring in mathematics.These and other influences inculcated a strong sense of public duty, independence of mind, a fierce intellectual honesty, a radical and unconventional religious mysticism from which she found succour in her varied endeavours, and an unforgiving attitude both toward her construct got faults and toward tho se of others. At the age of 32, frust scored by her life as a gentlewoman, she found herself a position as Superintendent of a infirmary for spew out governesses. Additionally she cooperated with Sidney Herbert, a family friend who was by now a Cabinet minister, in several surveys of hospitals, examining defects in the working conditions of nurses.On the basis of this and related experience she was chosen, in 1854, to head up a party of nurses who would work in the hospital in Scutari, nursing wounded soldiers from the newly declared Crimean war. Her energy and enthusiasm for her task, the publicity which the Times gave to her work, the high regard in which she was held by the soldiers, and a national appeal for a Nightingale fund that would be used to help open up training for nurses, all contributed to make FN a heroine.There was a huge drop in mortality, from 43% of the patients three months after she arrived in Scutari to 2% fourteen months later, that biographers start out often attributed to her work. Upon her return to England at the end of July 1856 FN become involved in a series of investigations that sought to establish the reason for the huge death rate during the first winter of the war in the Crimea. Theories on the immediate cause abounded was it inadequate food, overwork, lack of shelter, or bad hygiene?In preparation for a promised Royal Commission, she worked over the relevant data with Dr William Farr, who had the title Superintendent of the Statistical Department in the Registrar-Generals Office. Farrs synopsis persuaded her that the worst affects had been in Scutari, where overcrowding had added to the effect of poor sanitation. Sewers had been blocked, and the camp around had been fouled with corpses and excrement, matters that were fixed before the following winter. The major problem had been specific to Scutari.FN did not have this information part she was in the Crimea. The data do however seem to have been readily available they were included in a report prepared by McNeill and Tulloch (1855). The aura of FNsvarious involvements, and perhaps residual effects from an illness that she had suffered while in the Crimea, in due course took their toll. A year after her return to England, she suffered a head-in-the-clouds breakdown, emerging from this personal crisis with views that were often remarkably different from those that she had held earlier.Of particular interest is a change from her demand that nurses should follow to the letter instructions from doctors, to her view that nurses ought, at heart their proper area of responsibility, to make their own autonomous judgments. wasted (1998, pp. 119 127, 178) has extensive and perhaps overly speculative comment on the reasons for the nervous breakdown, and an interesting analysis of ways in which her views changed. The data that showed that the high mortality was specific to Scutari were included in FNs 1858 report, but omitted from the 1857-1858 Royal Com mission report.It was feared that continuing and acrimonious attempts to cite blame would jeopardise ongoing efforts at army reform. FN, unhappy at this suppression of her evidence, sent copies of her report to a number of carefully chosen recipients, each(prenominal) time with instructions to keep it confidential. One of the recipients was the freethinking popular journalist Harriet Martineau. With FNs help, she wrote a book (Martinueau 1859), ostensibly based on information from public documents but using FNs confidential report for additional background information, that gave the facts as FN understood them.FNs biographers, perhaps relying too much on formal documents, have not until recently been mindful of these nuances. See Small (1998, p. 198 200) for further discussion is one of the first to recognise them. A comprehensive biography of FN, that get out do justice to the wide-ranging sympathies and interests of this remarkable woman and show how her views changed and dev eloped over time, has yet to be written. Small (see the note on his web site) and Baly (1997b, pp. 1-19) both draw attention to inaccuracies in earlier biographical accounts.Vicinus and Nergaard (1989) have much carefully documented biographical information. Among the numerous web sites that have material on FN note C. J. McDonald (2001) who emphasises connections between Nightingale and the experiences of soldiers in the Vietnam War L. McDonald (2002) who is leading a project to publish all Nightingales writings and Small (1998). Smalls web site has the data (from Nightingale 1858) that the Royal Commission suppressed. 1. 2 Hospitals and Hospital Nursing FN had remarkably radical views on hospitals and on hospital nursing. Both in 860 and in 1876, she describes hospitals (Baly 1997b, p. 25 Nightingale 1876) as an intermediate stage of civilisation. In 1867 she wrote (Baly 1997b, p. 21) my view you know is that the ultimate destination is the nursing of the be sick in their own h omes. I look to the abolition of all hospitals and workhouse infirmaries. But it is no use to talk about the year 2000. Consistent with these views, FNs Notes on Nursing (1859) are not intended as a manual to teach nurses to nurse, but are meant simply to give hints for thought to women who have personal charge of the health of others. It may thus seem ironic that, in her work with the Nightingale fund, FN was deeply involved in the development of hospital nursing training. She opposed the British Nurses Associations 1890 proposals to make nursing into an accredited profession (Baly 1997b, pp. 184-196). She noted that there was no widespread agreement on what constituted an adequate training or what the minimum qualification should be, and argued that a much longer experience was needed before a register could be contemplated. The qualities that were required in nurses were not amenable to test by public examination.FN did however see an important role for women medical overlords . She wanted women to take leading roles in midwifery and in the diseases of women and children, and to be as well or better trained for these tasks as the men who at that time had a professional monopoly. It was her view that There is a better thing than making women into medical men, and that is making them into medical women (Nightingale 1871). She looked to a time when, as had happened in France, women would be professors of midwifery.She set out the immediate steps that she thought would best achieve that end. FN worked relentlessly for reform, in the army, in the hospitals, and in public health. She was meticulous in researching the reforms that she proposed. Where, as often, data were unavailable or inadequate, she pressed for their collection. Data inadequacies are strong themes in her Notes on Hospitals and in her Introductory Notes on Lying-In Institutions, i. e. , on maternity institutions. She made strong, consistent and carefully argued cases for enlightened and data-ba sed public decision-making.This is not to say that FN was always correct in her judgments. In her next to final contribution to the dialogue, FN comments on a controversy that erupted following the publication of the third edition of her Notes on Hospitals. Her use of the term mortality percent for deaths per hundred beds per day, which she copied from Farrs report as Registrar-General, was unfortunate. As she seems to admit a page later in the Notes, these figures were not a goodness basis for comparing the sanitary states of different hospitals.Florence NightingaleI was in reality moved when Dr. Howe advised Florence that If you have a passion, the only way to satisfy it is to ensue it. Yes, you will only be satisfied in your life when you pursue your passion on something because if not, you will only regret it and in the end you werent able to help other people as well as yourself. Florence genuinely did not neglect Gods call to her and this really demonstrated the passionate side of her. Thanks to Dr. Howe, she found out that nursing is really her calling.I also admired Florences determination when she rejected Mr. Milnes and preferred to concentrate on her career. For me, to have a passion the same as her, espousal would really interfere with her ability to follow her calling. This is because it would really be difficult for Florence to manage a family when she is definitely drawn into helping other people. Florence is a good leader because she is understanding to the other nurses and all of them will really follow her orders.She is smart and knowledgeable in the proper health care. Florence has that magic in ameliorate and also she has a strong persona when she is dealing with dying patients. Furthermore, who knew how much prejudice there was against nurses before? It was really a terrible prejudice, considering nurses as undersize more than hangers-on and the prejudice in the army was shocking. The head doctors would prefer to see soldiers die th an let the nurses trained by Florence work in the military hospitals.Compared to nowadays, nurses are really respected and honoured because of the love and care they give to their patients. It is good to be reminded of the damages prejudice can cause and just how powerful it is as a social force The film was outstanding for me. The portrayal and the flow of the story were good. Jaclyn Smith was very good as Florence Nightingale. And the film really showed the complete compass point of Florence Nightingales works in the field of nursing.