Imagine if Florence Nightingale lived today
Nurses say the famous nurse would still be an avid advocate
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By Karen Schmidt, RN
EDITOR'S NOTE: Karen Schmidt, RN is a freelance writer.
It’s been almost 110 years since Florence Nightingale died — almost 11 decades of change and advancement of nursing as a profession.
“Nightingale said in the 1870s in her personal diary that it would take 100 to 150 years to see the kind of nursing she envisioned,” said Barbara Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC, international co-director for the Nightingale Initiative for Global Health in Neepawa, Manitoba, Canada, and Washington, D.C. Part of that visionary care, Dossey said, is happening in military and veterans’ care today. “We’re seeing a radical shift,” she stated, with holistic and integrative health programs emerging. “For example, the Total Force Fitness program that includes all elements of healing that reflects what was Nightingale’s deepest place of being.”

Total Force Fitness is a U. S. Armed Forces concept for holistically building and maintaining health, readiness and optimal performance. During the Crimean war, Dossey said, Nightingale saw men who were hopeless and had nothing to do, so she established canteens where they could read, learn and have conversations. That program became established in the military, and is an example of whole health system healing that has reflect Nightingale’s legacy, she said.
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Nightingale a soldier for veterans’ care
Yet Nightingale as a role model and inspiration is just as relevant today as she was in her lifetime. Four nurse scholars steeped in the life and vocation of “the founder of modern nursing” ardently agree her mission and mindset are as pertinent today as they were in the 1800s.
Louise Selanders, EdD, RN, FAAN, professor emerita, College of Nursing at Michigan State University, has a different perspective on the strides in veterans’ care. “I do think we have made something of an awareness of veterans’ care, but we haven’t been very active in solving the problems,” she said.
“That was one of her primary ways of getting problems solved: putting it in newspapers and magazines and talking about it with people who could do something about it,” she said.
Nightingale could be extraordinarily persistent and precise, always getting her facts straight before speaking out to advocate for change, Selanders said.
Caring for our soldiers and the military has been cyclical, according to Patricia D’Antonio, PhD, RN, FAAN, director of the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania School of Nursing in Philadelphia. “In the past five years, nursing has done a much better job of caring for our soldiers and the military, particularly in terms of traumatic brain injury, posttraumatic stress and substance abuse,” D’Antonio said. “[Nightingale’s] whole life was devoted to the health of the British Army and the soldiers; that was her overarching commitment.”
Always an advocate for the poor
Nightingale’s commitment to the care of soldiers was part of her greater vision of care for the poor, noted Lynn McDonald, PhD, professor emerita at the Department of Sociology and Anthropology, University of Guelph, Ontario, Canada, and editor of the 16-volume “The Collected Works of Florence Nightingale.”
Soldiers were among the poor people in her time, McDonald said. She worked tirelessly on health promotion and decent living conditions for soldiers and for the poor. “Today she would say the same thing — there needs to be equal access to quality care,” she said. “Nightingale would be unhappy today to see the enormous difference that wealth makes in healthcare. She would be impressed with the quality of care of the most privileged, but would wonder why we can’t provide it for everybody.”
McDonald said Nightingale’s vision grew out of her spiritual beliefs. She experienced a call from God at age 16 to serve the poor. “She was democratic in thinking that God was the god of all and he wanted the good of all,” McDonald said. ”This influenced her attitudes toward public healthcare.”
A champion for the climate and data analysis?
McDonald believes Nightingale would champion addressing the issue of climate change, if she were alive today. “She was qualitatively sophisticated, one of the first women fellows of the Royal Statistical Society,” McDonald said. “She was a great believer in going after the big issues, and today this would be climate change because it can cause the most [health] problems.” Dossey also thinks Nightingale would address environmental concerns such as clean air, water, housing — since these are health determinants that she addressed in her time — as well as social determinants such as poverty, education, family relationships and employment. “Nightingale would be very involved in the epidemiological roots of health issues today,” said D’Antonio. “She was dedicated to using data to identify problems and also solutions. She would be strongly supportive of data-based formulations of how to handle the pressing issues of our healthcare systems among patients, families and communities.”  
Today Nightingale would be in her element as a nurse researcher, as her commitment to data — along with her devotion to the health of soldiers — was the cause that animated her life, said D’Antonio. “She was an outstanding statistician and believed data was needed to drive decisions,” she said. Selanders agrees. “Deep down, she thought the answer to most of our problems was doing good research and finding the right people and the money [to solve the big issues],” she said. She also believes Nightingale would highly approve of university-based nursing education, and within nursing education, she would advocate for the teaching of nursing history. “We chronically miss the boat here,” Selanders said. “We worry so much about teaching the technical components, but we miss the big picture. We need to learn something about [nursing’s] history and how problems were solved.” Is Nightingale still relevant today? Absolutely.” D’Antonio said. “Every profession needs a founding story. Nightingale is relevant to anyone interested in healthcare, anyone interested in knowing the forces that shaped what healthcare is today.”
Little known Nightingale facts
The Lady with the Lamp, a nickname earned from Nightingale’s nighttime ward rounds during the Crimean War, changed healthcare in her time and ever since. Here are some more intriguing facts about the founder of our profession.
  • The Turkish candle lantern she carried in the Scutari Hospital during the war is still displayed in the Florence Nightingale Museum in London, which sits on the site of the training school. Among the more than 2,000 artifacts is Athena, Nightingale’s beloved pet owl.
  • Nightingale was the inspiration for Henry Wadsworth Longfellow’s poem, “Santa Filomena,” in which he wrote of her: “A noble type of good, heroic womanhood.”  
  • Following family tradition, Nightingale was named after the city of her birth, Florence, Italy.
  • Louise Selanders relates while Nightingale could seem extremely formidable, many people didn’t recognize her human side. “When getting ready to come home from the Crimean War, she brought home male orphan children who she thought would die at an early age. She saw that they were well taken care of once they got to London and someone could adopt them. She also brought a dog with her because she believed it would die if she didn’t do something for it.”
Linda Richards, the first professionally trained nurse in the U.S., was mentored by Nightingale during the 1870s.

Nightingale’s 75-page booklet, "Notes on Nursing: What It Is, and What It Is Not," was published in 1859 and is still in print. It has been one of the best-selling items in the Nightingale museum shop.
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