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When I was researching Florence Nightingale for The lady with the lamp, the fourth ‘Carly Mills, Pioneer Girl’ book, I had no idea that modern medicine was about to face challenges not unlike those routinely encountered by practitioners in Florence’s day. The Covid-19 pandemic has reminded us that medicine doesn’t have all the answers. It has also reminded us of the value of infection control and, most significantly, of the debt we owe to the nursing profession. In the 162 years since Florence Nightingale first published her seminal text Notes on Nursing, much has changed – but, surprisingly, a good deal hasn’t.
In The lady with the lamp, Carly Mills and her friends Dora and Simone travel back in time to serve with Florence as nurses in the military hospital at Scutari during the Crimean War. The differences they notice between life ‘now’ and ‘then’ are striking. They face daily horrors: rampant disease, lice, squalor, corsets, gender discrimination and full chamber pots. Germ theory hasn’t been invented, and decent sewerage systems are something most people can only dream of. Medicines are mostly ineffective, and survival depends on good nursing and good luck.
Carly’s story is (obviously!) fictional, but I’ve based her adventures with Florence on actual events. Through their adventures, I’ve tried to bring Florence’s personality and remarkable contribution to nursing and public health to life. Working alongside Florence, the girls learn of her strength and courage, and have their eyes opened to attitudes and nursing practices of her day.
Florence Nightingale first published Notes on Nursing in 1859, three years after she returned from the Crimea. It makes fascinating reading. Without the benefit of modern scientific research, Florence based her advice on her observations. Some of these instructions no longer apply (‘A slop pail should never be brought into a sick room’) and others have evolved thanks to modern medicine (‘True nursing ignores infection, except to prevent it. Cleanliness and fresh air from open windows, with unremitting attention to the patient, are the only defence a true nurse either asks or needs’). The historical context, too, has changed since then. In 1859 Florence wrote, ‘… do you know that one in every seven infants in this civilized land of England perishes before it is one year old? That, in London, two in every five die before they are five years old? And, in the other great cities of England, nearly one out of two?’
But for the most part, Florence’s advice is as sound and relevant today (putting aside the quaint prose and Victorian attitudes!) as it was when written. She advocates for fresh air, light, warmth, peace, reassurance and cleanliness, along with ‘wise and humane management’. In her understanding of the interconnections of mind and body, she was ahead of her time.
When Carly Mills and her friends first meet Florence Nightingale, she is a young woman from a wealthy family trying to find purpose in life. Her parents have forbidden her from becoming a mathematician (maths not being respectable for a woman!) but, to her mother’s dismay, she has set her heart on a nursing career. In their second meeting, the girls travel with Florence and her nurses to the Crimea. Florence has been sent to take charge of the Scutari military hospital, where rates of death from disease and starvation amongst soldiers are sky-high.
After the war, Carly and her friends meet Florence again, back in London. She has been studying the statistics, and has discovered to her horror that death rates in her hospitals were the highest of all. Carly’s fictional adventures throw light on the true story: that poor sanitation was largely to blame. But rather than hide her findings, Florence is determined to publicise them. History shows that Florence’s findings inspired her to spend the rest of her life advocating for improved sanitation and public health. Though she is best known for her work in the Crimea, her most valuablework was undoubtedly done after the war.
Florence once said, ‘How very little can be done under the spirit of fear.’ She clearly lived by her words; her courage was remarkable. How frightening it must have been to rebel against the expectations of her family and class as she did. How terrifying to set off to war in a foreign land and do daily battle against prejudice, appalling conditions, disease and death. And how difficult it must have been to acknowledge her failures and turn them around for the public good.
Florence was loved by her patients for her kindness and respect for them as people regardless of their class. An intelligent, pious woman, she showed true humility and courage throughout her life. She is widely known as ‘the mother of modern nursing’, and many of her lessons still have relevance today. These last 18 months of pandemic have demanded sacrifice, courage and perseverance from nurses all around the world. They have shown that the consideration and respect for humanity that Florence Nightingale so ardently advocated are alive and well.
‘I attribute my success to this: I never gave or took an excuse.’
‘Live life when you have it. Life is a splendid gift – there is nothing small about it.’
Article by Jane Smith.
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