Florence Nightingale | English nurse | Britannica.com Florence Nightingale Alternative Title: Lady of the Lamp Florence Nightingale William Bligh Florence Nightingale, byname Lady with the Lamp (born May 12, 1820, Florence [Italy]—died August 13, 1910, London, England), foundational philosopher of modern nursing , statistician, and social reformer. Nightingale was put in charge of nursing British and allied soldiers in Turkey during the Crimean War . She spent many hours in the wards, and her night rounds giving personal care to the wounded established her image as the “Lady with the Lamp.” Her efforts to formalize nursing education led her to establish the first scientifically based nursing school—the Nightingale School of Nursing, at St. Thomas’ Hospital in London (opened 1860). She also was instrumental in setting up training for midwives and nurses in workhouse infirmaries. She was the first woman awarded the Order of Merit (1907). International Nurses Day , observed annually on May 12, commemorates her birth and celebrates the important role of nurses in health care.

Florence Nightingale at the Barrack Hospital in Scutari (Üsküdar), writing letters for … © Photos.com/Thinkstock Family ties and spiritual awakening Florence Nightingale was the second of two daughters born, during an extended European honeymoon, to William Edward and Frances Nightingale. (William Edward’s original surname was Shore; he changed his name to Nightingale after inheriting his great-uncle’s estate in 1815.) Florence was named after the city of her birth. After returning to England in 1821, the Nightingales had a comfortable lifestyle, dividing their time between two homes, Lea Hurst in Derbyshire , located in central England, and Embley Park in warmer Hampshire , located in south-central England. Embley Park, a large and comfortable estate, became the primary family residence, with the Nightingales taking trips to Lea Hurst in the summer and to London during the social season. Florence Nightingale, c. 1870. Perry Pictures/Library of Congress, Washington, D.C. (LC-USZ62-5877) Florence was a precocious child intellectually.

Her father took particular interest in her education, guiding her through history , philosophy , and literature . She excelled in mathematics and languages and was able to read and write French , German , Italian , Greek , and Latin at an early age. Never satisfied with the traditional female skills of home management, she preferred to read the great philosophers and to engage in serious political and social discourse with her father. As part of a liberal Unitarian family, Florence found great comfort in her religious beliefs. At the age of 16, she experienced one of several “calls from God.” She viewed her particular calling as reducing human suffering. Nursing seemed the suitable route to serve both God and humankind. However, despite having cared for sick relatives and tenants on the family estates, her attempts to seek nurse’s training were thwarted by her family as an inappropriate activity for a woman of her stature. Nursing in peace and war Britannica Stories Scientists Ponder Menopause in Killer Whales Despite family reservations, Nightingale was eventually able to enroll at the Institution of Protestant Deaconesses at Kaiserswerth in Germany for two weeks of training in July 1850 and again for three months in July 1851.

There she learned basic nursing skills, the importance of patient observation, and the value of good hospital organization. In 1853 Nightingale sought to break free from her family environment . Through social connections, she became the superintendent of the Institution for Sick Gentlewomen (governesses) in Distressed Circumstances, in London, where she successfully displayed her skills as an administrator by improving nursing care, working conditions, and efficiency of the hospital. After one year she began to realize that her services would be more valuable in an institution that would allow her to train nurses. She considered becoming the superintendent of nurses at King’s College Hospital in London. However, politics, not nursing expertise, was to shape her next move. Florence Nightingale, c. 1850. British Culture and Politics In October 1853 the Turkish Ottoman Empire declared war on Russia, following a series of disputes over holy places in Jerusalem and Russian demands to exercise protection over the Orthodox subjects of the Ottoman sultan. The British and the French, allies of Turkey, sought to curb Russian expansion. The majority of the Crimean War was fought on the Crimean Peninsula in Russia .

However, the British troop base and hospitals for the care of the sick and wounded soldiers were primarily established in Scutari ( Üsküdar ), across the Bosporus from Constantinople ( Istanbul ). The status of the care of the wounded was reported to the London Times by the first modern war correspondent, British journalist William Howard Russell. The newspaper reports stated that soldiers were treated by an incompetent and ineffective medical establishment and that the most basic supplies were not available for care. The British public raised an outcry over the treatment of the soldiers and demanded that the situation be drastically improved. Florence Nightingale, the “Lady with the Lamp,” at the Barrack Hospital at Scutari … Cassell & Company/Library of Congress, Washington, D.C. (LC-DIG-pga-00466) Britannica Lists & Quizzes Editor Picks: Exploring 10 Types of Basketball Movies Sidney Herbert, secretary of state at war for the British government, wrote to Nightingale requesting that she lead a group of nurses to Scutari. At the same time, Nightingale wrote to her friend Liz Herbert, Sidney’s wife, asking that she be allowed to lead a private expedition.

Their letters crossed in the mail, but in the end their mutual requests were granted. Nightingale led an officially sanctioned party of 38 women, departing October 21, 1854, and arriving in Scutari at the Barrack Hospital on November 5. Not welcomed by the medical officers, Nightingale found conditions filthy, supplies inadequate, staff uncooperative, and overcrowding severe. Few nurses had access to the cholera wards, and Nightingale, who wanted to gain the confidence of army surgeons by waiting for official military orders for assistance, kept her party from the wards. Five days after Nightingale’s arrival in Scutari, injured soldiers from the Battle of Balaklava and the Battle of Inkerman arrived and overwhelmed the facility. Nightingale said it was the “Kingdom of Hell.” In order to care for the soldiers properly, it was necessary that adequate supplies be obtained. Nightingale bought equipment with funds provided by the London Times and enlisted soldiers’ wives to assist with the laundry. The wards were cleaned and basic care was provided by the nurses. Most important, Nightingale established standards of care, requiring such basic necessities as bathing, clean clothing and dressings, and adequate food.

Attention was given to psychological needs through assistance in writing letters to relatives and through providing educational and recreational activities. Nightingale herself wandered the wards at night, providing support to the patients; this earned her the title of “Lady with the Lamp.” She gained the respect of the soldiers and medical establishment alike. Her accomplishments in providing care and reportedly reducing the mortality rate to about 2 percent brought her fame in England through the press and the soldiers’ letters. (Investigations by historians in the 20th century revealed that the mortality rate at Barrack Hospital under Nightingale’s care was actually much higher than had been reported—the British government had concealed the actual mortality rate.) Florence Nightingale in a hospital ward at Scutari (Üsküdar) during the Crimean War. Day & Son./Library of Congress, Washington, D.C. (LC-USZC4-10261) Connect with Britannica Facebook Twitter YouTube Instagram Pinterest In May 1855 Nightingale began the first of several excursions to Crimea; however, shortly after arriving, she fell ill with “Crimean fever”—most likely brucellosis , which she probably contracted from drinking contaminated milk.

Nightingale experienced a slow recovery, as no active treatment was available. The lingering effects of the disease were to last for 25 years, frequently confining her to bed because of severe chronic pain. On March 30, 1856, the Treaty of Paris ended the Crimean War. Nightingale remained in Scutari until the hospitals were ready to close, returning to her home in Derbyshire on August 7, 1856, as a reluctant heroine. Homecoming and legacy Although primarily remembered for her accomplishments during the Crimean War, Nightingale’s greatest achievements centred on attempts to create social reform in health care and nursing. On her return to England, Nightingale was suffering the effects of both brucellosis and exhaustion. In September 1856 she met with Queen Victoria and Prince Albert to discuss the need for reform of the British military establishment. Nightingale kept meticulous records regarding the running of the Barrack Hospital, causes of illness and death, the efficiency of the nursing and medical staffs, and difficulties in purveyance. A Royal Commission was established, which based its findings on the statistical data and analysis provided by Nightingale.

The result was marked reform in the military medical and purveyance systems. In 1855, as a token of gratitude and respect for Nightingale, the Nightingale Fund was established. Through private donations, £45,000 was raised by 1859 and put at Nightingale’s disposal. She used a substantial part of these monies to institute the Nightingale School of Nursing at St. Thomas’ Hospital in London, which opened in 1860. The school formalized secular nursing education, making nursing a viable and respectable option for women who desired employment outside of the home. The model was taken worldwide by matrons (women supervisors of public health institutions). Nightingale’s statistical models—such as the Coxcomb chart, which she developed to assess mortality—and her basic concepts regarding nursing remain applicable today. For these reasons she is considered the foundational philosopher of modern nursing. Coxcomb chart Open Door policy Nightingale improved the health of households through her most famous publication, Notes on Nursing: What It Is and What It Is Not, which provided direction on how to manage the sick. This volume has been in continuous publication worldwide since 1859.

Additional reforms were financed through the Nightingale Fund, and a school for the education of midwives was established at King’s College Hospital in 1862. Believing that the most important location for the care of the sick was in the home, she established training for district nursing, which was aimed at improving the health of the poor and vulnerable . A second Royal Commission examined the health of India, resulting in major environmental reform, again based on Nightingale’s statistical data. Florence Nightingale was honoured in her lifetime by receiving the title of Lady of Grace of the Order of St. John of Jerusalem and by becoming the first woman to receive the Order of Merit . On her death in 1910, at Nightingale’s prior request, her family declined the offer of a state funeral and burial in Westminster Abbey . Instead, she was honoured with a memorial service at St. Paul’s Cathedral , London. Her burial is in the family plot in St. Margaret’s Church, East Wellow, Hampshire.

King's College London - Florence Nightingale Famous King's People Florence Nightingale Florence Nightingale (1820-1910) founded the world's first professional school of nursing at St Thomas' Hospital in 1860 - the direct ancestor of the current Florence Nightingale School of Nursing & Midwifery at King's. Life and work Born into a wealthy family, Nightingale was determined to enter nursing despite its low status at this time. She gained nursing experience in Germany and France and ran a nursing home for gentlewomen in Harley Street, London. In 1854 she left for the Crimea with 38 nurses and sisters. Her major achievement in the Crimea was to organise the barracks hospital at Scutari, introducing proper discipline among the nurses and better sanitation. She became known as 'the lady of the lamp'. A new nursing school In 1855 a public subscription was launched and raised over £50,000 (over £2.6 million today). Nightingale decided to use this to found a nursing school.

Due to ill-health, she was unable to run the school, but oversaw its in the new St Thomas' Hospital building and gave instructions for every aspect of training. From the beginning, her aim was that Nightingale nurses should go on to found training schools in Britain and throughout the world. Nightingale, Florence - Massachusetts General Hospital, Boston, MA MGH Department Affiliation: School of Nursing Alumnae Nightingale, Florence Catalog Number: 31 Florence Nightingale (1820-1910) worked as a nurse at the Institute of Protestant Deaconesses in Kaisersworth, Germany. In 1852, she was appointed Superintendent of the Institution for the Care of Sick Gentlewomen in Distressed Circumstances in London. In 1854, when Britain was fighting the Crimean War, Sir Sidney Herbert, Secretary of War, obtained approval to appoint Miss Nightingale the Superintendent of the Female Nursing Establishment in Turkey. Later that year, she was the leader of a group of 38 nurses who left London for the Barracks Hospital in Scutari.

The nurses improved the meals provided to the injured and cared for the approximately 12,000 casualties in the hospital. Meanwhile in England, the Nightingale Fund was established to help British soldiers. In 1860, Nightingale founded the Nightingale School for Nurses, based out of St. Thomas' Hospital in London. Her book, Notes On Nursing, published in 1860, was a seminal work in the development of the nursing profession. In 1897, at Queen Victoria's Diamond Jubilee celebration, Nightingale was acknowledged for her influence in the progress of nursing as a distinct profession. Today, Nightingale is considered by many to be the founder of modern nursing. The Massachusetts General Hospital School of Nursing was created in 1873 and was patterned according to the principles established by Florence Nightingale. The MGH still commemorates her through the Florence Nightingale Award, which honors nurses for their outstanding contributions to nursing and their devotion to caring for others. “Nursing is an Art; the finest of the Fine Arts... The goal of nursing is to put the patient in the best condition for nature to act upon him, primarily by altering the environment".

-Florence Nightingale If you have any additional information on any of the items on this website that you would like to share with us or if you believe that any of the information we have provided may be inaccurate, please e-mail mghhistory@partners.org . Florence Nightingale: The School for Nurses The School for Nurses Sometimes Florence Nightingle would take the entire class of nurse probationers from the Nightingale Training School at St. Thomas Hospital on holiday outings to Lea Hurst. This photo was taken on such a day with an older Miss Nightingale and Sir Harry Verney, who was active in the school and the Nightingale Fund which supported the school independent of the hospital. The Badge of the Nightingale Training School. Introduced by Dame Alicia Lloyd Still in 1925, its design is taken from the eight-pointed cross of the Knights of the Hospital of St. John of Jerusalem. Its four arms symbolize the Cardinal Virtues -- Prudence, Temperance, Justice and Fortitude -- and the points represent the Eight Beatitudes which spring from the practice of those virtues. The color blue was chosen as being the color of the ribbon of the Order of Merit of Miss Nightingale.

The inclusion of the Tudor rose, fleur-de-lis and the shield with the sword of St. Paul afford a link with the Hospital coat of arms. The center of the design portrays the head of Miss Nightingale in relief, with the words, "Schola Sancti Thomae." To be a good nurse, one must be an improving woman; for stagnant waters sooner or later, and stagnant air, as we know ouselves, always grow corrupt and unfit for use. Is any one of us a stagnant woman? -- Address to the Probationers (students) of the Nightingale Training School at St. Thomas's Hospital, London, 1872. FN wrote many addresses to the students but never delivered any in person. The normal time the students spent in training was one year. The students lived in private rooms with a common social room in a special area of the Hospital. They attended classes and the sick at St. Thomas. There might be 20-30 students in a yearly class. There were two kinds of probationers.

A Lady, an upper class woman with some education could purchase the opportunity to attend the school; a common class woman could serve as student and receive expenses plus a small amount of money upon completion and placement in an institution or home. They all wore a uniform and were under charge of a Matron and an assistant. Miss Nightingale had students upon graduation visit her in her South Street apartment. This was a very cherished moment for few people met her face to face after the Crimean War. And always the student would leave with a gift of food or clothing or something FN felt she needed. FN kept extensive notes on all the students including "character." In fact it was the issue of character that caused her to oppose "certification" of nurses and a "registrar." History of the school. ~~~ Around 1990 when I first visited the newly opened Florence Nightingale Museum in London I picked up the below information. Graduates of the school were once called "Nightingales," but no longer. --CJM, March, 1999 The enclosed notes are an attempt to chart the spread of the Nightingale influence up to 1910. Much more research needs to be done if the map is to grow.

Migration Of Nurses Trained In The Nightingale School THE BRITISH ISLES: Miss Ella Pirrie, Lady Superintendent Children�s Hospital Belfast Board of Guardians� Sanitorium, Whiteabbey Miss Hamilton Miss Alice Fisher Matron, followed by Miss Lovesy, Matron Cambridge: The Kent and Canterbury Hospital Miss J Gardiner, Matron, & staff of Nightingale Nurses Edinburgh: The Royal Infirmary Miss Barclay, Matron, & staff of 13 Nightingale Nurses, followed by Miss Pringle, Matron and Miss R.

Williams, Asst Matron Lincoln: Miss Merryweather & 3 of the first set of probationers and 1 of the second set Workhouse Infirmary Miss Agnes Jones & staff of 12 followed by Mrs Kidd, Asst Superintendent; Miss Louisa Freeman, Superintendent London: Miss Maria Machin Matron & Superintendent of Nursing; Miss Helen Blower; Asst Matron; Miss Isla Stewart St Mary�s Hospital Paddington Miss Rachel Williams The Misses Mary & Elizabeth Merryweather followed by Miss Mary Pyne St Marylebone Infirmary Miss Vincent (Matron) -- Training for Workhouse nursing sponsored by the Nightingale Fund St Pancras Workhouse Infirmary Miss Torrance, Matron, and 9 Nightingale Nurses Netley: Miss Deeble, Matron, & staff of 10 Nightingale Nurses Newcastle-upon-Tyne: Miss Freeman & 6 Nightingale Nurses Wolverhampton: Between 1879 and 1895 matrons trained in the Nightingale School were appointed to: The Cardiff Infirmary Dublin: City of Dublin Hospital "...Sister S (Sister Ophthalmic) elected as Matron of the City of Dublin Hospital" -- Letter from

 Miss Gordon, Matron, St.

Thomas� to FN Fever Hospital Miss Ramsden, Matron; Miss Maria Mitchell (Theatre Sister) CANADA: Montreal: Montreal Hospital 1875 Miss Maria Machin, Matron, with 4 nurses, 2 more sent later. Experienced great difficulties & returned 1878 UNITED STATES OF AMERICA: Philadelphia: Philadelphia General Hospital 1884 Miss Alice Fisher, Matron -- set up the first School of Nursing, 1885; Miss Edith Horner, Associate Chief Nurse Hospital of the University of Pennsylvania Miss Charlotte Hugo appointed Superintendent 1886 -- set up a new Nurses Training School with a staff of Nightingale Nurses -- Mrs Horrocks (Night Superintendent), Misses Bellamy, Swallwell and Adams AUSTRALIA: Sydney: Sydney Hospital 1867 Miss Lucy Osborn appointed Lady Superintendant; Miss Turiff, Asssistant, & Nightingale Nurses: Barker, Blundell, Chant and Miller FIJI: 1892 Miss Frances Webberburn, Matron.

Commenced a nurse training programme in 1892 for European nurses The Nightingale School: Foreign Probationers The Nightngale Fund Committee accepted probationers from other countries with the stipulations that they should be preparing for some constructive nursing work in their own countries and have sufficient command of English to understand the instruction. DENMARK: A Danish nurse, Henriette "Henny" Tscherning (1853-1932) trained in the face of family opposition, qualifying in 1878. She visited the Nightingale School at St Thomas� Hospital in London in 1883 and returned to Denmark where she made a very considerable contribution to nurse education and founded the Danish Nursing Association. FINLAND: Baroness Sophie Mannerheim (German born) entered the Nightingale School as a probationer in 1899 and spent 3 years at the Queen�s Institute for District Nursing. Returned to Finland to become Matron of a large Surgical Hospital at Helsingfors (Helsinki) where she set up a preliminary training school. President of the International Council of Nurses 1922-25. Died in 1928.

SWEDEN: Emily Carolina Rappe joined the Nightingale School for training in 1866. She returned to Sweden to take up a post at a new hospital at Uppsala and later became Inspector of Nursing Schools. Was awarded the Gold Medal for "distinguished services". GERMANY: In 1868 the German Crown Princess, Queen Victoria�s eldest daughter, sent Fraulein Fuhrmann to the Nightingale School; she later directed a nursing institution in Berlin. In 1872 two probationers trained and returned to set up a nurse training institution in Darmstadt. The Grand Duchess of Baden sent Frau von Cornberg from Baden. Miss Nightingale maintained close links with the Institution of Kaiserswerth on the Rhine. FRANCE: Bordeaux (Association Florence Nightingale, Bagatelle) Montpellier (Papers by Dr Anna Hamilton, Faculty of Medicine, Montpellier Nightingale Nurses Serving Abroad: EGYPT: TEL-EL-KEBIR Miss Nightingale in her Letters to Probationers refers to two sisters serving on a Hospital Ship and others who volunteered for Egypt, 1882.

WITH DR LIVINGSTONE: In a letter to probationers dated 1874 Miss Nightingale writes: "Some of us knew him (Dr Livingstone); one of our Probationers was with him and his wife, who died in 1862, and Bishop Mackenzie, at their Mission Station in Africa..." TRANSVAAL: Lady Makins (nee Kirkland) entered the Nightingale School after her first husband, General Fellowes, died in 1879. Florence Nightingale selected her to accompany Sir Frederick Roberts� force to the Transvaal in February 1881. Later served in Egypt and in the South African War. Royal Red Cross 1884. ZULU WARS: Edith Horner was a member of a Nursing Unit sent from England to South Africa to care for British wounded. Royal Red Cross.

BOER WAR: Miss Gordon, Matron of St Thomas Hospital, to Florence Nightingale: "...Nurse McL...to a convalescent home for officers." Wars: Miss Nightingale was consulted on the care of the wounded in connection with the American Civil War, the Army in India, the Franco-Prussian War, campaigns in Egypt and the Sudan, and the South African War. She had a direct influence on the drafting of the Geneva Convention 1864. Jean Henri Dunant,founder of the International Red Cross, 1872, paid tribute to her work. Bibliography: The Hospital: A Social and Architectural History John D Thompson and Grace Goldin Yale University Press 1975 The History of the Philadelphia General Hospital School of Nursing Stephanie A. Stachniewicz RN MS NHa & Jean K.

Axelrod Privately printed by The Alumni Association of the School of Nursing Philadelphia General Hospital 1978 Booklet printed to celebrate the inauguration of the Tower Unit 1987 One Hundred Years of Caring 1873-1973 The Royal Belfast Hospital for Sick Children Privately printed 1973 Compilied in 1975 by her great-niece Alicia C Percival Privately printed Cathedral College and Hospital: An Account of the Chaplaincy of the Royal Hampshire Country Hospital 1(?)36-1986 Cyril Moxley Data from the Medical Library, Royal Hampshire County Hospital Ms Margaret Skellern From Circle The Magazine for the West Lambeth Health Authority, Issue , 1983 -- report on a visit from the High Commissioner for Fiji to St.

Thomas Hospital God Bless You, My Dear Miss Nightingale Letters from Emmy Carolina Rappe to Florence Nightingale 1867-1870, edited by Bertil Johansson Published bAlinquist & Wiksell International, Stockholm 1977 Paper by Dr Anna Emilie Hamilton presented and published under the auspices of the Faculty of Medicine of Montpellier, 1900 Florence Nightingale�s Letters to Probationers The Nightingale Training School Centenary 1860-1960 Private publication for the Nightingale Training School 1960 The Voice of Florence Nightingale on Advocacy The Voice of Florence Nightingale on Advocacy Patrick C. Crane, MSN, RN Abstract Modern nursing is complex, ever changing, and multi focused. Since the time of Florence Nightingale, however, the goal of nursing has remained unchanged, namely to provide a safe and caring environment that promotes patient health and well being. Effective use of an interpersonal tool, such as advocacy, enhances the care-giving environment. Nightingale used advocacy early and often in the development of modern nursing.

By reading her many letters and publications that have survived, it is possible to identify her professional goals and techniques. Specifically, Nightingale valued egalitarian human rights and developed leadership principles and practices that provide useful advocacy techniques for nurses practicing in the 21st century. In this article we will review the accomplishments of Florence Nightingale , discuss advocacy in nursing and show how Nightingale used advocacy through promoting both egalitarian human rights and leadership activities. We will conclude by exploring how Nightingale’s advocacy is as relevant for the 21st century as it was for the 19th century. Citation: Selanders, L., Crane, P., (January 31, 2012) "The Voice of Florence Nightingale on Advocacy" OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 1. DOI: 10.3912/OJIN.Vol17No01Man01 Key words: Florence Nightingale, advocacy, nursing, profession Nursing has never been simple. Early care stressors included exposure to the elements and a lack of knowledge as to how to treat serious injuries or diseases.

Through ensuing generations, environmental conditions have improved and science has provided effective treatment pathways. However, other complexities, including societal acceptance of the profession, gender discrimination, and educational and regulatory disarray, have created a multifaceted and complicated backdrop against which nurses continue to provide the most basic of human interventions: caring. One of the most effective tools that [Nightingale]employed was advocacy, both for individuals and for the nursing collective. In the nineteenth century, one woman, because of her religious convictions and profound vision of the potential of nursing, altered the status of nursing from that of domestic service to that of a profession ( Nightingale, 1893/1949 ; Nightingale, 1895a ). This woman, Florence Nightingale, utilized intellect, personal motivation, available opportunities, and the strength of her own persona to create a permanent professional transformation ( Bostridge, 2008 ; Cook, 1913 ; Dossey, 2000 ). One of the most effective tools that she employed was advocacy, both for individuals and for the nursing collective.

The purpose of this article is to explore Nightingale’s use of advocacy as a tool and to identify the continuing value of her conceptual and practical advocacy strategies for the nursing profession in the 21st century. In this article we will review the accomplishments of Florence Nightingale, discuss advocacy in nursing, and show how Nightingale advocated both through promoting egalitarian human rights and through her leadership activities. We will conclude by exploring how Nightingale’s advocacy is as relevant for the 21st century as it was for the 19th century. Who Was Florence Nightingale? On May 12, 1820, Florence Nightingale was born as the second of two daughters to English parents. As a young woman, she displayed exceptional intellect, learning multiple languages and being particularly capable in mathematics ( Bostridge, 2008 ). Nightingale seemed to be most comfortable in the solitary activities of reading, writing in her journals, and attempting to discern purpose in her life. She deeply believed that she had a God-given purpose to better mankind, but the route to achieving this goal was unclear ( Calabria & Macrae, 1994 ; Cook, 1913 ).

...her lifetime of work and her passion for improving healthcare provided nursing with a foundational philosophy for practice. As a young woman, Nightingale wished for meaningful work and began to imagine herself caring for others, defying her parents’ desire that she marry into a socially prominent family. On at least three occasions she declined proposals, indicating that she could not pursue her own goals as a married woman ( Gill, 2004 ; Nightingale, 1859a/1978 ). By the age of 17 she had discerned that she had a Christian duty to serve humankind. By the age of 25 she had identified nursing as the means to fulfill this mandate ( Gill, 2004 ). When she was 30 years old, she was permitted two brief periods of instruction in nursing at Kasiserswerth, a Protestant institution in Germany ( Bostridge, 2008 ; Nightingale, 1851 ). This experience helped her to understand the essential components of basic nursing, hospital design, and personnel administration. Of even greater consequence was Nightingale’s perception that formalized education was a necessary component of nurse preparation ( Nightingale, 1851 ).

In 1852 Nightingale was offered the superintendency of a small hospital on Harley Street in central London ( Verney, 1970 ). During her twelve months in this position, she developed effective administrative skills, identified appropriate qualifications for those employed as nurses, and affirmed her belief that egalitarian and competent care were basic human rights for all people ( Selanders, Lake, & Crane, 2010 ; Verney, 1970 ). As Nightingale was preparing to leave the Harley Street position, she was appointed by the Victorian government to lead a group of thirty-eight women to Ottoman, Turkey, to provide nursing care for British soldiers fighting the Crimean War ( Bostridge, 2008 ; Woodham-Smith, 1983 ). Nightingale’s singular motivation was to improve the plight of the wounded. She stated, “...I did not think of going to give myself a position, but for the sake of common humanity” (as cited in Goldie, 1987 , p.21). Her administrative skills allowed her to negotiate the male worlds of both the military and medicine.

She successfully solved the issues of supply purveyance, resolved interpersonal squabbles between nursing factions, and designed care modalities in the face of massive overcrowding, incompetence, uncaring physicians, and a military structure that was outdated and inept. In a letter to her uncle, Nightingale stated that the Purveyor had intentionally withheld supplies for his own gain, noting, “This little Fitzgerald [Purveyor] has starved every hospital when his store was full- & not, as it appears from ignorance, like some of the honorable men who have been our murderers, but from malice prepense.” (Nightingale, March 6, 1856, as cited in Goldie ( 1987 , p. 225). On her return from the Crimea, Nightingale worked tirelessly to develop nursing as an essential and educated component of healthcare. On her return from the Crimea, Nightingale worked tirelessly to develop nursing as an essential and educated component of healthcare. Her establishment of the Nightingale School in London in 1860, and the distribution of trained nurses abroad established the basis for nursing education worldwide ( Baly, 1986 ; Godden, 2010 ).

Through the support of Queen Victoria and Prince Albert she was able to design improvements for the British military and establish public health standards in India ( Dossey, 2000 ; Mowbray, 2008 ). Additionally, her lifetime of work and her passion for improving healthcare provided nursing with a foundational philosophy for practice ( Selanders, 2005a ). Nightingale remained actively concerned with the development and behavior of the Nightingale nurses educated at the Nightingale School until her death in 1910 at age 90. Between 1872 and 1900, she wrote a series of thirteen letters to the Nightingale nurses that both documented the progress nursing made in the late nineteenth century and warned nurses that they must remain current, competent, and caring. In 1897, she wrote of the danger of relying on words over actions: “There is no doubt that this is a critical time for nursing... ...There is a curious old legend that the nineteenth century is to be the age for women and has it not been so? Shall the twentieth century be the age for words?

God forbid.” ( Dossey, Selanders, Beck, & Attewell, 2005 , p. 283). Advocacy in Nursing ...advocacy has not always been a clear expectation in nursing...Early nursing education emphasized conformity and a position subservient to the physician. Advocacy has been defined as an active process of supporting a cause or position ( Illustrated Oxford Dictionary, 1998 ). However, advocacy has not always been a clear expectation in nursing. Seminal documents in the development of the American nursing curriculum, such as Nursing and Nursing Education in the United States ( Goldmark, 1923 ) and A Curriculum Guide for Schools of Nursing ( National League of Nursing Education, 1937 ), do not explicitly mention advocacy. Early nursing education emphasized conformity and a position subservient to the physician. Isabel Hampton Robb, an early leader in the development of American nursing education, encouraged obedience as the primary activity of the nurse.

In 1900 Robb stated: Above all, let [the nurse] remember to do what she is told to do, and no more; the sooner she learns this lesson, the easier her work will be for her, and the less likely she will be to fall under severe criticism. Implicit, unquestioning obedience is one of the first lessons a probationer must learn, for this is a quality that will be expected from her in her professional capacity for all future time.... ( Hamric, 2000 , p. 103). While Nightingale expected obedience in following the rules and medical direction, her intent was to allow nurses the autonomy of purpose to advocate for patients and the profession (Nightingale, 1893). It is probable that she would have disapproved of Robb’s emphasis on obedience. The term ‘advocacy’ was first utilized in the nursing literature by the International Council of Nurses in 1973. The term ‘advocacy’ was first utilized in the nursing literature by the International Council of Nurses in 1973 ( Vaartio & Leino-Kilpi, 2004 ).

Today the American Nurses Association (ANA) states that high quality practice includes advocacy as an integral component of patient safety ( ANA, n.d. ). Advocacy is now identified both as a component of ethical nursing practice and as a philosophical principle underpinning the nursing profession and helping to assure the rights and safety of the patient. Nurses are seen as advocates both when working to achieve desired patient outcomes and when patients are unable or unwilling to advocate for themselves. Since 1973 advocacy has been considered a major component of nursing practice - politically, socially, professionally, and academically. Despite the seeming lack of a professional focus on advocacy before the early 1970s, it is argued that Nightingale implicitly laid the foundation for nurse advocacy and established the expectation that nurses would advocate for their patients. Nightingale and Advocacy Nursing is now recognizing how [Nightingale's] ideas and techniques can be useful in the 21st century. The scope of Nightingale’s effect on nursing and her utilization of advocacy as a functional principle, like the profession itself, is complex. Nightingale did not directly address the concept of advocacy. She did, however, demonstrate advocacy in exceptional ways throughout her lifetime.

We know of Nightingale’s actions, thoughts, and motivations through her correspondence. At least 13,000 letters remain in public archives and private collections. She was the shadow author for a number of official government documents relating to healthcare in the military and the subcontinent of India ( Bostridge, 2008 ; Mawbray, 2008 ). Some of her most insightful writings, such as those found in Suggestions for Thought ( Calabria & Macrae, 1994 ), were published privately, thus controlling the distribution to friends and colleagues. However, they are now publically available. The volumes Nightingale published for public consumption, including Notes on Hospitals ( 1859b/1982 ) and Notes on Nursing: What it is and what it is not ( 1860/1982 ), specifically outline the role of the nurse and the environment in which care should occur ( Selanders, 2005b ). Nightingale was a singular force in advocating for as opposed to with individuals, groups, and the nursing profession. Her expressions of advocacy grew with age, experience, and public acceptance of her as both nurse and expert.

Her significant contributions include her advocacy for egalitarian human rights and for advocacy in her leadership roles. Nursing is now recognizing how her ideas and techniques can be useful in the 21st century. Advocacy Through Promotion of Egalitarian Human Rights As a young woman, Nightingale became acutely aware of the unequal status and opportunity provided to men as compared to women in English society. Stark ( 1979 ) described the social structure: Victorian England was a country in the grip of an ideology that worshipped the woman in the home. Women were viewed as wives and mothers, as potential wives and mothers, or as failed wives and mothers. The woman who was neither wife nor mother was called the “odd woman” or the “redundant woman” (p. 4). In Nightingale’s frustration, she wrote the lengthy essay Cassandra ( 1859/1979 ), named after the tragic Greek mythological figure who, although able to predict the future, was not believed, and therefore, was powerless.

As a part of this diatribe, she compares the perceived value of a woman’s activity to that of a man: Now, why is it more ridiculous for a man than a woman to do worsted work and drive out everyday in a carriage?... Is man’s time more valuable than woman’s? or is it the difference between man and woman this, that woman has confessedly nothing to do? ( Nightingale, 1859a/1979 , p. 32). Nightingale’s first significant demonstration of advocacy for individuals came as she was superintendent of the Hospital for Gentlewomen in Distressed Circumstances. On one hand, assuming the superintendency of this institution had to have been extremely daunting for a woman of 32 entering her first employment. The hospital was a newly acquired facility in poor condition with inadequate furnishings and a poorly trained staff. She reported that in the first month of occupancy she had experienced a gas leak with small explosions, a fight between workmen in the drawing room, a drunken foreman, and the death of 5 patients ( Verney, 1970 ).

On the other hand, it was the opportunity to participate in a healthcare situation under her control that allowed her to create and utilize environmental and patient care standards that were to become foundational to the development of modern nursing ( Selanders, 2005a ). Nightingale did have the general support of the Ladies’ Committee, the body to whom she reported. Her first major concern, however, was a policy held by the Committee stating that only individuals who were members of the Church of England would be admitted to the institution. Nightingale could not accept this position, perhaps because of her liberal Unitarian upbringing and her deeply rooted beliefs in the value of individuals without respect to religious preference. In a private note to her close friend and ally, Mary Clarke Mohl, she airs her frustration, indicating she would leave the post if this disagreement could not be resolved: From committees, charities, and schism, from the Church of England, from philanthropy and all deceits of the devil, good Lord deliver us. My committee refused me to take in Catholic patients; whereupon I wished them good morning, unless I might take Jews and their Rabbis to attend to them. ( Verney, 1970 , p. viii).

Eventually, she won the battle with the Committee so that patients of all faiths – or no faith – were equally admitted to the hospital ( Verney, 1970 ). The importance of this event cannot be overlooked in Nightingale’s development as a social reformer and healthcare advocate. She won this encounter partially through logical persuasion, but also because of her status as a ‘lady’ – a person of the upper class. This allowed her to meet the committee members on equal social footing. Use of personal position and social acquaintances, logic and debating skills, and the development of statistical evidence were tools she would refine and employ over the next fifty years. This immediate victory helped her to retain her moral convictions and to move forward as an advocate for women and nursing ( Selanders, Lake, & Crane, 2010 ). Nightingale next turned her attention to the development of care standards for patients, including the right to a peaceful death. The chronically and the mentally ill were often ignored by staff. Those determined to be ‘malingerers’ and the dying did not meet the criteria for admission ( Scott, 1853 ).

Nightingale, however, accepted these patients and allowed them to remain as long as she believed that they were benefiting from care despite staff objections. For a staff member to refuse to work to Nightingale’s standard resulted in dismissal, signaling the application of administrative standards of care. This is explicitly demonstrated in her May 15, 1854, report to the Governors when she wrote, “I have changed one housemaid on account of her love of dirt and inexperience, & one nurse, on account of her love of Opium & intimidation” ( Verney, 1970 , p. 28). ...Nightingale never wavered from the idea that a basic human right was high-quality patient care provided by a dedicated nursing staff. Nightingale advocated for patients on a larger stage during her 20 months in Scutari and the Crimea. These nurses were individually selected for their ability to nurse, the likelihood that they would accept authority, and the expectation that they would remain for the duration of the conflict. Ultimately, many of those selected did not fulfill these criteria. However, Nightingale never wavered from the idea that a basic human right was high-quality patient care provided by a dedicated nursing staff.

Following her return to England she established similar operating principles at The Nightingale School at St. Thomas’ Hospital. Nightingale again insisted that probationer students be admitted without respect to religious preference ( Bostridge, 2008 ). The development of educational standards in a tightly controlled environment began to elevate nursing as a respectable profession that provided women with meaningful employment ( Adern, 2002 ). Advocacy Through Leadership Leadership was one of Nightingale’s innate qualities. During her fifty productive years, she continually benefited from the cumulative experiences of Harley Street, Scutari, the Crimea, and her interactions with government officials in determining the potential of nursing. Her education, social stature, extensive range of acquaintances, and international travel provided essential context, opportunity, and a public voice. Her major contributions to the profession had evolved from leadership of a few at Harley Street and in the Crimea to the professional collective. She was able to explore the potential of a refocused nursing, as opposed to remodeling the status quo. One of Nightingale’s central themes was the importance of nursing’s role in the management of the patient environment.

One of Nightingale’s central themes was the importance of nursing’s role in the management of the patient environment ( Nightingale, 1859b/1982 ). For much of Nightingale’s life she believed in miasmatism, the idea that foul odors caused disease ( Selanders, 2005c ). While this was an inaccurate theory, it did focus attention on the role of the environment in relation to illness. The deplorable conditions at Scutari reinforced this viewpoint, and led to her advocating for the importance of an appropriate environment for the patient both internally and externally. She began her Notes on Nursing ( 1860/1982 ) by stating that the incidence of disease is related to “...the want of fresh air, or of light, or of warmth, or of quiet or of cleanliness...” (p. 5). All of these factors are viewed as being within the purview of nursing. Although there is dispute as to the degree that the death rate was reduced in the Crimea, it is undeniable that there was a specific link between the state of the environment and the death rate ( Small, 1998 ).

Nightingale was also a supporter of the sanitation movement in London. She joined forces with reformers, such as Farr and Chadwick, in advocating for permanent improvements in public health ( Selanders, 2005c ). This emphasis was later extended to her environmental work in India ( Mowbray, 2008 ). ...she envisioned the extension of nursing as the essential force which would meet the growing healthcare needs in sectors outside of the hospital. A second major outcome/theme of Nightingale’s leadership was the establishment of the Nightingale School at St. Thomas’ Hospital in London. She advocated for educated nurses who had a knowledge base and a specific role in healthcare. Further, she envisioned the extension of nursing as the essential force which would meet the growing healthcare needs in sectors outside of the hospital. This resulted in the development of nursing in the military, midwifery, poor law nursing (care of paupers), and nurse visiting (public health nursing) ( Baly, 1986 ). This role expansion created a full range of services in and out of the hospital and across the life span, thus further expanding the role and autonomy of the nurse.

Nightingale’s continuing complaint from adolescence and into adulthood concerned the strict social mores relative to women and work outside of the home. Nursing actually served to begin to change the location of women’s work from the home into a formal workplace. Two factors contributed to the success of this change. The first was that nursing education under the Nightingale model took place in a tightly controlled environment that included a nurses’ home with a matron who functioned as parent and guardian ( Baly, 1986 ). This allowed families to agree to send their daughters to nursing school, as nursing education was deemed to be in safe surroundings. The second factor was that nursing was initially viewed as domestic work that had been transplanted into the hospital, thus extending the typical woman’s sphere ( Selanders, 2005d ). Nightingale, Advocacy, and 21stCentury Leadership Nightingale’s lasting legacy is a composite of her accomplishments and her vision of what can and should be undertaken by the profession. She wrote prolifically and demonstrated methods that were effective. Her lessons have become the roadmap for future generations.

Perhaps the most significant and enduring of Nightingale’s contribution to nursing is learned not by reading one document, but rather by synthesizing the entire body of literature that she wrote regarding nursing. From this body of literature can be extracted nursing’s foundational philosophical base ( Selanders, 2005a ). The Table summarizes the major referents defined by Nightingale as essential to nursing practice, education, and research.

Table: Nightingale’s Philosophical Referents for Professional Nursing The general nature of nursing: Nursing is defined as a unique profession that is both art and science The basic nursing activity is the alteration of the internal and external nursing environment Nursing is autonomous within the defined scope of practice Nursing is collaborative with all other healthcare professions The goal of nursing is to foster health within the patient Individuals are complex, holistic beings The power of nursing comes from decision-making activities based on empirical observation of the patient The practice of nursing should not be limited by gender, spiritual beliefs, or values The nurse should be allowed to develop to the maximum of his or her potential The nature and value of nursing education: Nursing has specialized educational requirements with theoretical and clinical components Nurses should be educated by nurses who specialize in education Nurses should have a grounding in basic sciences Nursing education should be controlled by the school, not the hospital Students are to be regularly evaluated and apprised of this evaluation during the course of the education The nature of nursing research: The most basic element of research is empiricism The nurse should be the primary investigator of nursing phenomena Statistics provide the basis for logical and factual argument Nightingale understood the value of and the methods for achieving visionary leadership.

She repetitively utilized techniques which have been developed as the stairstep leadership development model ( Figure ). This paradigm blends the ideas of Nightingale with the current leadership terminology of Burns ( 1978, 2003 ), who identified the relative merit of leadership outcomes, with the ‘novice-to-expert' concept of Benner ( 2000 ) which focuses on the necessity of building leadership skills. The goal of this stairstep leadership development model is to identify a progression of stages through which individuals achieve positive leadership behaviors over time. This model does not assume that an individual holds a formal leadership position in order to demonstrate leadership; rather, it assumes that all nurses are leaders by virtue of assuming the role of nurse. The ultimate goal of this model is that leaders and followers achieve a mutually defined goal with collective purpose and long-term effectiveness ( Selanders, 2005d ). ...transformational leaders seek to create long-term or permanent change through the mutual identification of goals between individuals and the organization. The first three steps of the model identify the progression from novice nurse to someone who is experienced in a specific realm of nursing. This is consistent with Benner’s ( 2000 ) model.

This progression may be repeated multiple times as the nurse moves from position to position. Additionally, it supports the idea that leaders are developed rather than the belief that some have innate leadership capabilities while others do not ( Broome, 2011 ). Expected outcomes of the model are that an individual ultimately will assume the characteristics of either a transvisionary or transformational leader. Burns ( 1978 , 2003 ) has defined these levels. Transactional leaders tend to exchange valued commodities, such as exchanging work for pay. This is often coercive in nature, and while perhaps effective for the short term, does not achieve long-term results. Conversely, transformational leaders seek to create long-term or permanent change through the mutual identification of goals between individuals and the organization. This is effective in achieving change that has lasting value. Transvisionary leadership is an appropriate goal when the leader...envision[s] a new or unusual change that may not be fully understood by constituents. Transvisionary leadership is an appropriate goal when the leader is able to envision a new or unusual change that may not be fully understood by constituents. This is effective in setting insightful goals within an organization that is experiencing new initiatives and outcomes.

This is the mode that Nightingale innately chose to use out of necessity when moving nursing from a disorganized and ill-conceived occupation to a profession. A transvisionary leader relies on both expert power and opportunity to achieve results. As the leader attains effective outcomes and the goals become recognized as sound and accepted, the leadership style may move from the transactional to the transformational mode ( Selanders, 2005d ). Summary Nightingale demonstrated that advocacy is what gives power to the caring nurse. Nursing has never been simple, nor is serving as a patient advocate. However, nursing has embraced advocacy as a professional construct. Advocacy includes a complex interaction between nurses, patients, professional colleagues, and the public. Nightingale’s experiences in nursing demonstrated to her the value of advocating for nurses and patients. She embraced an egalitarian value system and utilized leadership techniques to create change in nursing. Nightingale demonstrated that advocacy is what gives power to the caring nurse. Authors E-mail: selander@msu.edu Dr. Louise C. Selanders is a professor in the College of Nursing at Michigan State University (MSU) and Director of the MSU Nursing Master’s Program.

She has extensive teaching experience in undergraduate, graduate, and lifelong education programs. Each summer, she coordinates and teaches a study abroad program in England which emphasizes the historical origins of modern, western nursing as applicable to modern practice. Dr. Selanders is internationally recognized as a Nightingale historian and scholar. She is co-author of Florence Nightingale Today: Healing, Leadership, Global Action, which received the 2005 American Journal of Nursing Book of the Year Award. She holds degrees from MSU, East Lansing, MI; Adelphi University, Garden City, NY; and Western Michigan University, Kalamazoo, MI. Patrick C. Crane , MSN, RN E-mail: Patrick.crane@hc.msu.edu Patrick Crane is an instructor at the Michigan State University (MSU) College of Nursing in East Lansing, MI. He currently teaches both in the MSU undergraduate nursing curriculum and in a study abroad course in London, England. This course focuses on the history of nursing, as well as the education and regulation of nurses in the United Kingdom as compared to nurses in United States.

He has earned both his BSN and MSN from MSU and is currently a Doctor of Nursing Practice student at Wayne State University in Detroit, Michigan. He has addressed the role of Nightingale in the development of contemporary nursing practice through publications and presentations at national and international conferences. References Adern , P. (2002). When matron ruled. London: Robert Hale. American Nurses Association. (n.d.). Advocacy. Retrieved from: Baly , M. (1986). Florence Nightingale and the nursing legacy. Kent, England: Croom Helm. Benner , P. (2000). From novice to expert: Excellence and power in nursing practice. Upper Saddle River, NJ: Prentice-Hall. Bostridge , M. (2008). Florence Nightingale: The woman and the legend. London: Penguin. Broome , M. (2011). Leadership: Old concept, new visions. Nursing Outlook, 59, pp. 253-255. Burns , J.M. (1978). Leadership. New York: Harper Torchbooks. Burns , J.M.

(2003). Transforming leadership: A new pursuit of happiness. New York: Grove Press. Calabria , M & Macrae, J. (Eds.). (1994). Suggestions for thought by Florence Nightingale: Selections and commentaries. Philadelphia: University of Pennsylvania Press. Cook , E. (1913).The life of Florence Nightingale. (Vol 1). London: Macmillan and Co. Dossey , B.M. (2000). Florence Nightingale: Mystic, visionary, healer. Springhouse, PA: Springhouse. Dossey , B., Selanders, L., Beck, D., & Attewell, A. (2005). Florence Nightingale today: Healing, Leadership, Global Action Silver Spring, MD: American Nurses Association. Gil l, G. (2004). Nightingales: The extraordinary upbringing and curious life of Miss Florence Nightingale. New York: Ballantine Books. Goldie , S. (Ed.) (1987). “I have done my duty”: Florence Nightingale in the Crimean War 1854-56.

Manchester, UK: Manchester University Press. Goldmark , J. (1923). Nursing and nursing education in the United States. New York: MacMillan. Godden , J. (2010). The dream of nursing the empire. In S. Nelson & A.M. Rafferty (Eds). Notes on Nightingale: The influence and legacy of a nursing icon. London: ILR Press. Hamric , A. (2000). What is happening to advocacy? Nursing Outlook, 48, 103-4. Illustrated Oxford Dictionary. (1988). Advocacy. New York, NY: Oxford University Press. Mowbray , P. (2008). Florence Nightingale and the Viceroys. London: Haus Books. National League of Nursing League of Nursing Education. (1937). A curriculum guide for schools of nursing. New York: National League of Nursing Education. Nightingale , F. (1851). The institution of Kaiserswerth on the Rhine. London: London Ragged Colonial Training School. Nightingale , F.

(1859a/1978). Cassandra. In R. Strachey. The cause. London: Virago, pp. 395-420. Nightingale, F. (1859b/1982). Notes on hospitals: Being two papers read before the National Association for the promotion of Social Science at Liverpool in October, 1858. London: John W. Parker and Son. Nightingale, F. (1860/1982). Notes on nursing: What it is and what it is not. London: Harrison. Nightingale, F. (1893/1949). Sick nursing and health nursing. In I. Hampton (Ed.), Nursing the Sick – 1893 (pp. 24-43). New York: McGraw-Hill. Nightingale, F. (1895a). Nursing: Training of. In R. Quain (Ed). A Dictionary of Medicine (pp. 231-2374). New York:; D. Appleton and Company. Nightingale, F.

(1895b). Nursing the sick. In R. Quain (Ed). A Dictionary of Medicine (pp. 237-244). New York:; D. Appleton and Company. Scott , J. (1853, July 23). Benevolent institutions: Establishment for gentlewomen during illness. The Pen, 80. Selanders , L. C. (2005a). Nightingale’s foundational philosophy for nursing. In D.B. Dossey, L.C. Selanders, D.M. Beck & A. Attewell. Florence Nightingale today: Healing, leadership, global action (pp.66-74). Silver Spring, MD: American Nurses Association. Selanders , L. C. (2005b). Leading through theory: Nightingale’s Environmental Adaptation Theory of Nursing Practice. In D.B. Dossey, L.C. Selanders, D.M. Beck & A. Attewell. Florence Nightingale today: Healing, leadership, global action. Silver Spring, MD: American Nurses Association. Selanders , L.C. (2005c).

Florence Nightingale, dirt and germs. In D.B. Dossey, L.C. Selanders, D.M. Beck & A. Attewell. Florence Nightingale today: Healing, leadership, global action (pp. 107-113). Silver Spring, MD: American Nurses Association. Selanders , L.C. (2005d). Social change & leadership: Dynamic forces for nursing. In D.B. Dossey, L.C. Selanders, D.M. Beck & A. Attewell. Florence Nightingale today: Healing, leadership, global action (pp. 81-89). Silver Spring, MD: American Nurses Association. Selanders , L., Lake, K. & Crane, P. (2010). From charity to caring: Nightingale’s experience at Harley Street. Journal of Holistic Nursing. 28, 284-290. Small , H. (1998). Florence Nightingale: Avenging angel. London: Constable and Co. Stark , M. (1979). Cassandra: An essay by Florence Nightingale.

New York: The Feminist Press. Vaario , H. & Leino-Kilpi, H. (2004). Nursing advocacy – A review of the empirical research 1990-2003. International Journal of Nursing Studies, 42, 705-714. Verney , H. (1970). Florence Nightingale at Harley Street: Her reports to the Governors of her nursing home 1853-4. London: W.P. Griffith & Sons Ltd. Woodham-Smith , C. (1983). Florence Nightingale 1820-1910. New York: Atheneum. © 2012 OJIN: The Online Journal of Issues in Nursing Article published January 31, 2012 Related Articles Florence Nightingale opens the first school for nurses at the St. Thomas hospital in London | South African History Online South African History Online Home » Florence Nightingale opens the first school for nurses at the St. Thomas hospital in London Florence Nightingale opens the first school for nurses at the St.

Thomas hospital in London Florence Nightingale Florence Nightingale Image Source: Friday, 15 June 1860 Florence Nightingale was a revered English nurse, writer and statistician. Nightingale chose to become a nurse over the popular role of wife and mother. Though her family was against it, they could not change her mind. She believed that she had been called by God to pursue a nursing career. Nightingale gained popularity during the Crimean war where she cared for wounded soldiers. In 1860 she established a nursing school at St Thomas Hospital in London. It was the first professional nursing school in the world. The nursing school is now part of King’s College London where nursing graduates take the Nightingale pledge, so named in her honour. References: King's College London - About About the Faculty About The Florence Nightingale Faculty of Nursing & Midwifery is the direct descendant of the Nightingale Training School established at St Thomas’ Hospital in 1860. We are the world’s first school of nursing. We develop leading-edge nurses and midwives of tomorrow – practitioners, partners, and leaders in their field.

The Faculty is ranked as the number one faculty for nursing in the UK (QS World University Rankings 2015/16). We have 200 staff and nearly 3,000 students, and are spread across four departments: Child and Family Health; Midwifery and Women's Health; Adult Nursing; Mental Health Nursing. We also have a strong postgraduate research programme, with activities that meets the needs of a wide range of healthcare professionals seeking continuing professional development. We are at the forefront of health services, policy and evaluation research. Located in the heart of London on the south bank of the River Thames, our programmes meet the needs of individuals seeking to become nurses, midwives or to continue professional development after registration. The Faculty is one of nine within King's College London, one of the top 20 universities in the world (2015/16 QS World University Rankings) and a prestigious Russell Group University. King's is also the fourth oldest university in England.

Question: The Florence Nightingale School of Nursing was founded in 1860 at which London institution?
Answer: St Thomas' Hospital