Florence Nightingale - Her Contributions



Statistics and sanitary reform

Florence Nightingale exhibited a gift for mathematics from an early age and excelled in the subject under the tutorship of her father. Later, Nightingale became a pioneer in the visual presentation of information and statistical graphics. She used methods such as the pie chart, which had first been developed by William Playfair in 1801. While taken for granted now, it was at the time a relatively novel method of presenting data.

Indeed, Nightingale is described as "a true pioneer in the graphical representation of statistics", and is credited with developing a form of the pie chart now known as the polar area diagram, or occasionally the Nightingale rose diagram, equivalent to a modern circular histogram, to illustrate seasonal sources of patient mortality in the military field hospital she managed. Nightingale called a compilation of such diagrams a "coxcomb", but later that term would frequently be used for the individual diagrams. She made extensive use of coxcombs to present reports on the nature and magnitude of the conditions of medical care in the Crimean War to Members of Parliament and civil servants who would have been unlikely to read or understand traditional statistical reports. In 1859, Nightingale was elected the first female member of the Royal Statistical Society. She later became an honorary member of the American Statistical Association.

Her attention turned to the health of the British army in India and she demonstrated that bad drainage, contaminated water, overcrowding and poor ventilation were causing the high death rate. She concluded that the health of the army and the people of India had to go hand in hand and so campaigned to improve the sanitary conditions of the country as a whole.

Nightingale made a comprehensive statistical study of sanitation in Indian rural life and was the leading figure in the introduction of improved medical care and public health service in India. In 1858 and 1859, she successfully lobbied for the establishment of a Royal Commission into the Indian situation. Two years later, she provided a report to the commission, which completed its own study in 1863. "After 10 years of sanitary reform, in 1873, Nightingale reported that mortality among the soldiers in India had declined from 69 to 18 per 1,000".

The Royal Sanitary Commission of 1868–9 presented Nightingale with an opportunity to press for compulsory sanitation in private houses. She lobbied the minister responsible, James Stansfeld, to strengthen the proposed Public Health Bill to require owners of existing properties to pay for connection to mains drainage. The strengthened legislation was enacted in the Public Health Acts of 1874 and 1875. At the same time she combined with the retired sanitary reformer Edwin Chadwick to persuade Stansfeld to devolve powers to enforce the law to Local Authorities, eliminating central control by medical technocrats. Her Crimean War statistics had convinced her that non-medical approaches were more effective given the state of knowledge at the time. Historians now believe that both drainage and devolved enforcement played a crucial role in increasing average national life expectancy by 20 years between 1871 and the mid-1930s during which time medical science made no impact on the most fatal epidemic diseases.

Literature and the women's movement

“Nightingale's achievements are all the more impressive when they are considered against the background of social restraints on women in Victorian England. Her father, William Edward Nightingale, was an extremely wealthy landowner, and the family moved in the highest circles of English society. In those days, women of Nightingale's class did not attend universities and did not pursue professional careers; their purpose in life was to marry and bear children. Nightingale was fortunate. Her father believed women should be educated, and he personally taught her Italian, Latin, Greek, philosophy, history and – most unusual of all for women of the time – writing and mathematics.”

While better known for her contributions in the nursing and mathematical fields, Nightingale is also an important link in the study of English feminism. During 1850 and 1852, she was struggling with her self-definition and the expectations of an upper-class marriage from her family. As she sorted out her thoughts, she wrote Suggestions for Thought to Searchers after Religious Truth. This was an 829-page, three-volume work, which Nightingale had printed privately in 1860, but which until recently was never published in its entirety. An effort to correct this was made with a 2008 publication by Wilfrid Laurier University, as volume 11of a 16 volume project, the Collected Works of Florence Nightingale. The best known of these essays, called "Cassandra", was previously published by Ray Strachey in 1928. Strachey included it in The Cause, a history of the women's movement. Apparently, the writing served its original purpose of sorting out thoughts; Nightingale left soon after to train at the Institute for deaconesses at Kaiserswerth.

"Cassandra" protests the over-feminization of women into near helplessness, such as Nightingale saw in her mother's and older sister's lethargic lifestyle, despite their education. She rejected their life of thoughtless comfort for the world of social service. The work also reflects her fear of her ideas being ineffective, as were Cassandra's. Cassandra was a princess of Troy who served as a priestess in the temple of Apollo during the Trojan War. The god gave her the gift of prophecy; when she refused his advances, he cursed her so that her prophetic warnings would go unheeded. Elaine Showalter called Nightingale's writing "a major text of English feminism, a link between Wollstonecraft and Woolf."

Theology

Despite being named as a Unitarian in several older sources, Nightingale's own rare references to conventional Unitarianism are mildly negative. She remained in the Church of England throughout her life, albeit with unorthodox views. Influenced from an early age by the Wesleyan tradition, Nightingale felt that genuine religion should manifest in active care and love for others.[57][58] She wrote a work of theology: Suggestions for Thought, her own theodicy, which develops her heterodox ideas. Nightingale questioned the goodness of a God who would condemn souls to hell, and was a believer in universal reconciliation – the concept that even those who die without being saved will eventually make it to Heaven. She would sometimes comfort those in her care with this view. For example, a dying young prostitute being tended by Nightingale was concerned she was going to hell and said to her 'Pray God that you may never be in the despair I am in at this time'. The nurse replied "Oh, my girl, are you not now more merciful than the God you think you are going to? Yet the real God is far more merciful than any human creature ever was or can ever imagine."

Despite her intense personal devotion to Christ, Nightingale believed for much of her life that the pagan and eastern religions had also contained genuine revelation. She was a strong opponent of discrimination both against Christians of different denominations, and against those of non-Christian religions. Nightingale believed religion helped provide people with the fortitude for arduous good work, and would ensure the nurses in her care attended religious services. However she was often critical of organized religion. She disliked the role the 19th century Church of England would sometimes play in worsening the oppression of the poor. Nightingale argued that secular hospitals usually provided better care than their religious counterparts. While she held that the ideal health professional should be inspired by a religious as well as professional motive, she said that in practice many religiously motivated health workers were concerned chiefly in securing their own salvation, and that this motivation was inferior to the professional desire to deliver the best possible care.

Source - Wikipedia - https://en.wikipedia.org/wiki/Florence_Nightingale