Home Current Issue Previous Issues Published Ahead-of-Print Collections Podcasts Videos For Authors Journal Info
Skip Navigation LinksHome > March 2009 - Volume 20 - Issue 2 > Florence Nightingale: Founder of Modern Nursing and Hospital...
Epidemiology:
doi: 10.1097/EDE.0b013e3181935ad6
Vignette

Florence Nightingale: Founder of Modern Nursing and Hospital Epidemiology

Winkelstein, Warren Jr

Free Access

Florence Nightingale is revered as the founder of modern nursing. Her substantial contributions to health statistics are less well known. She first gained fame by leading a team of 38 nurses to staff an overseas hospital of the British army during the Crimean War.1 Newspaper reports of unsanitary conditions at the military hospital had aroused the public, and the Secretary of War responded by appointing a team of nurses to address the situation. The Secretary was a friend of Nightingale's and knew her leadership skills. Nightingale and her team arrived in Turkey in November 1854. They found hospital conditions were far worse than reported. The wards were vastly overcrowded, patients were covered with rags soiled with dried blood and excrement, the water supply was contaminated, and the food inedible. Sewage discharged onto floors of wards and dead animals rotted in the courtyards. According to Nightingale, the hospital case-fatality rate during the first months after her arrival was 32%.2

Although Nightingale did not accept the concept of bacterial infection, she deplored crowding and unsanitary conditions. She put her nurses to work sanitizing the wards and bathing and clothing patients. Nightingale addressed the more basic problems of providing decent food and water, ventilating the wards, and curbing rampant corruption that was decimating medical supplies. She had to overcome an inept and hostile military bureaucracy, which she did in part by paying for remediation from private sources, including her own funds. She also kept careful statistics. Within 6 months, the hospital case fatality had dropped to 2%.

When Nightingale returned to London 3 years later, she was a national hero. However, within a few more years she had become an invalid herself (suffering at age 40 from what may have been chronic fatigue syndrome). Although she lived as a recluse for the next 50 years, she continued to exert substantial influence on nursing and public health through letters, books, conference presentations, and personal persuasion.3

She was skilled in mathematics and far ahead of her time in understanding the importance of health data. She argued (unsuccessfully) that Parliament should extend the 1860 census to collect data on sickness and disability, and she advocated for the creation of a Chair in Applied Statistics at Oxford University. The Royal Statistical Society acknowledged her contributions to health data by electing Florence Nightingale to membership—the first woman to be so honored—and the American Statistical Association made her an Honorary Member.

Back to Top | Article Outline

REFERENCES

Figure. Florence Nig...
Figure. Florence Nig...
Image Tools
1. Cook E. The Life of Florence Nightingale. New York: The Macmillan Company; 1942.

2. Vandenbroucke JP, Vandenbroucke-Grauls CM. A note on the history of the calculation of hospital statistics. Am J Epidemiol. 1988;127:699–702.

3. Nightingale F. Notes on Hospitals: Being Two Papers Read Before the National Association for the Promotion of Social Science at Liverpool, in October1858: With Evidence Given to the Royal Commissioners on the State of the Army in 1857. London: John W Parker and Son, West Strand; 1859.

Cited By:

This article has been cited 1 time(s).

Journal of Neurosurgical Anesthesiology
Victorian Water Pumps and Anesthetic Neurotoxicity
Kalkman, CJ; Peelen, L
Journal of Neurosurgical Anesthesiology, 21(4): 283-285.
10.1097/ANA.0b013e3181b6ee0e
PDF (67) | CrossRef
Back to Top | Article Outline

© 2009 Lippincott Williams & Wilkins, Inc.

Twitter  Facebook

Login

Article Tools

Images

Share