Address given at A Service to Commemorate the Life of Florence Nightingale 8th May 2013

8 May 2013 at 18:00 pm

Mark Bostridge, author of Florence Nightingale: The Woman and Her Legend

A hundred and thirty-four years ago, in the summer of 1879, Florence Nightingale came here to Westminster Abbey to attend the funeral of a former Viceroy of India, Sir John Lawrence. Nightingale had long suffered from a painful and crippling disease, probably chronic brucellosis, but she was determined to pay her respects to a man she had held in the highest esteem. Although Lawrence had failed to introduce female nursing to India, he had succeeded in making sanitary improvements, according to Nightingale’s prescription, which had significantly reduced the high mortality from disease among British troops. To Nightingale, Lawrence had been nothing less than a hero and she proclaimed him as such. Besides, she’d been struck by the piercing blueness of his eyes, and had hung a picture of him in a room at her house in South Street.

Hero-worship: for good and ill, we all succumb to it at some point in our lives. For more than one and a half centuries now, the world has been hero-worshipping Florence Nightingale, transforming her into a legendary figure, one of that select band of historical characters who are instantly recognisable. In the course of the twentieth century and beyond, Nightingale has also offered an inevitable and irresistible target for attack, denigrated on account of her gender, her class, even her colour.

Why do we continue to commemorate the life and work of Florence Nightingale? She is one of those great Victorian polymaths who defy easy categorization. Yes, she was the founder of professional nursing, a reformer of army medical services, and an expert in hospital construction. But she was also a pioneer in the use of statistics, believing that the world is ruled by numbers; an innovator in the visual presentation of health data; an influential feminist, even though she might not have recognised herself as such; a radical theologian, whose autobiographical persona expresses a desire for a simple inscription, ‘I Believe in God’, on her gravestone; an early campaigner for health promotion, as well as for the prevention of disease; and much more.

Nightingale wasn’t the sentimental figure of myth – ‘all that ministering angel nonsense’, as she once referred to the cult that had built up around her name – but rather a hardworking professional, who, decades prior to the foundation of the NHS, designed a blueprint for an integrated health system. And when we talk today of safeguarding our National Health Service from ideologues of a variety of political persuasions, we should recall Nightingale as a significant precursor of the NHS. For decades, post-Crimea, up to the final years of her long working life, Nightingale was striving to introduce trained nurses to Victorian workhouses, those terrible pits of human suffering and degradation, emphasising the principle, as she did so, of what she considered to be one of the pre-eminent duties of the state: the provision of a high standard of health care for those sections of the population who are unable to pay for it.

As a mere writer and layman, looking in at the world of modern health care from the outside, I am constantly struck by Nightingale’s relevance to the problems we face today. In 2010, I remember reading a consultative document issued by the Department of Health, Liberating the NHS. There, amidst all the bland civil service speak, was one sentence that stood out. It was Nightingale’s, a quotation from the 1863 edition of Notes on Hospitals: ‘It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm.’ That ability to say what you mean, in a way that can be understood, let alone be acted on, remains a surprisingly rare one among the higher echelons of power in Britain today.

Then, only the other day, I came across a study produced at the University of Leeds, which demonstrated that the old Nightingale doctrine of large, open wards, with open windows providing a constant source of ventilation, was right all along. Closing or blocking off hospital windows does indeed increase the risk of infection.

When it comes to the difficulties faced by the nursing profession in 2013, it’s impossible to imagine Nightingale countenancing the two major obstacles, which make it more difficult for modern nurses to deliver safe patient care: chronic understaffing, and the heavy burden placed on nurses by the demands of excessive paperwork, which sometimes prevents them from being at the patient’s bedside. And as one of the great whistleblowers of history, Nightingale would surely have supported a nurse’s right and duty to raise the alarm about anything that puts a patient’s safety in jeopardy.

To Florence Nightingale, nursing was an art. More than 150 years has passed since she made that definition, years in which the range of responsibilities and tasks undertaken by nurses has grown more scientific and technical than even Nightingale could have envisaged. But the root of all good nursing remains the same: empathy and understanding, the ability to place oneself in the position of a sick man, woman, or child, and in large or small measures, do what you can to alleviate their suffering.

The language in which Nightingale couches her ideas sometimes appears too religiose for our more secular age. However, what brings a unity to her life and work is her overriding purpose: to save lives. Her work, like the work of many of you here today, is ultimately a reflection of a more perfect world in which we are all called upon to serve one another.

In a moment you will watch the time-honoured tradition of a lamp, representing the one used by Nightingale at Scutari, being processed to the High Altar. We don’t in fact know whether Florence Nightingale attached much importance to the system of lighting she employed at her hospital during the Crimean War, though, of course, it cemented her popular image as the Lady with the Lamp. But I’d ask you this evening to look at that lamp, not as a symbol perpetuating a simplistic, outdated legend, but as an image of the best of modern nursing, shining the light of humanity into some of the darker and lonelier corners of human experience.

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