Nightingale's Lessons Still Apply

From patient care during the pandemic to everyday nursing, her influence is apparent even today

By Linda Childers
If Florence Nightingale, the British nurse best known as the founder of modern nursing, were alive today, she would be pleased to see how many of the hygiene practices she helped develop are still being used today to combat COVID-19.
Nightingale, who died in 1910, was known as a pioneer of hand-washing and also promoted good hygiene practices as a way to fight infection, says Beth Hundt, PhD, APRN, NP-C, ACNS-BC, Assistant Director of The Eleanor Crowder Bjoring Center for Nursing Historical Inquiry and Assistant Professor of Nursing at the University of Virginia School of Nursing in Charlottesville. In Hundt’s 2020 essay, “Reflections on Nightingale in the Year of the Nurse,” she states that in 1854, Nightingale and 40 of her nursing colleagues arrived at the British Medical Hospital in Scutari, Turkey, during the Crimean War and discovered that wounded and ill soldiers were being cared for in deplorable conditions.
Beth Hundt
“Nightingale knew the importance of keeping patients clean and fed,” Hundt said. “They scrubbed the facilities, bathed patients, and she solicited donations to ensure nurses had the supplies they needed to properly care for patients. As a result, mortality at the hospital dropped from 33% to 2%.” Hundt says Nightingale also was passionate about hospital reform, looking beyond patient care to identify structural problems at the hospital that affected optimal patient care. In a letter Nightingale wrote in 1860, she stressed how patient health depends on the environmental conditions in which they recover. “She noted how there was a sewage system directly under the hospital floors and a deficiency of fresh air and light,” Hundt said. “She secured funding to fix the floors and believed that patients should be cared for in areas that featured better ventilation and sanitation.” Nightingale’s lessons in the areas of environment, data, education, and patient-centered care continue to be relevant to nurses today, said Hundt. “Many of Nightingale’s ideas surrounding hospital reform and hygiene continue to be discussed today with COVID-19,” Hundt said. “Today, we rely on evidence-based medicine, and in her 1858 book, “Notes on Hospitals,” Nightingale documented her findings on patient care and backed them with data.”
Following in Nightingale’s Footsteps
Susan B. Hassmiller, PhD, RN, FAAN, RWJF Senior Adviser for Nursing; Director, Campaign for Action and Senior Scholar-In-Residence; and Senior Adviser to the President on Nursing at the National Academy of Medicine, was a recipient of the 42nd Florence Nightingale Medal, nursing’s highest international honor. She received the medal in 2009 in a ceremony in Washington, D.C. In 2010, Hassmiller decided to learn more about Nightingale’s life and work by embarking on a Florence Nightingale study tour to London’s Embley Park (Nightingale’s childhood home) and Turkey.
Susan B. Hassmiller
“Nightingale’s lessons for me are both personal and universal,” Hassmiller said. “She felt it was her life’s mission to give back through a nursing career and did everything she could to support this mission through education and connections.” Hassmiller said that Nightingale formed many partnerships throughout her life to complete the work she set out to do. She notes that seeking partnerships outside of nursing is a great lesson for today’s nurses who want to make an impact. “From working with military officials to business ‘men,’ to royalty, to builders (she designed hospitals), she relied on and adhered to evidence to inform her decisions and methodically tracked her work and the work of her nurses,” Hassmiller said. “She was a woman in a man’s world and knew she could not simply say, ‘this is the way it should be.’ She let the evidence stand for itself.”
She was a woman in a man’s world and knew she could not simply say, ‘this is the way it should be.’ She let the evidence stand for itself.
— Susan B. Hassmiller, PhD, RN
Hassmiller says Nightingale also was extremely savvy when it came to communicating and disseminating the results of her research. “She needed more support and supplies to do her work in Crimea and could not depend on the military officers stationed there, who were jealous of her,” Hassmiller said. “Therefore, she wrote home to England about her results, which became a groundswell of support for her, and she was able to secure more support. She arrived home to a hero’s welcome and used her written evidence to form the basis of her other works.” Hassmiller notes that Nightingale helped professionalize nursing by establishing Great Britain’s first training school for nurses, St. Thomas’ Hospital in London. Before Nightingale, nurses learned primarily from experience, rather than through training and education. “Her students received training in the best standards of care at the time,” Hassmiller said. Nightingale also was an advocate for her patients, offering her voice to improving public health for the sick and the poor. “Her strengths include a reliance on evidence to improve care and partnerships from a variety of influencers to advance her agenda,” Hassmiller said. “After she criticized the Poor Laws in the United Kingdom, Parliament took steps to improve the country’s workhouses by developing separate sections for the sick to live, bringing trained nurses to care for the sick, and starting oversight boards.”
About the Author
Linda Childers is a freelance writer.
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