Lessons from Florence Nightingale
Some weeks ago I visited the city of Istanbul, Turkey. I went there to absorb a different culture, taking in the sights, the people, and the food. Walking the streets, however, I happened upon a link to the past and to the West which left me with a renewed perspective on health and medicine. I looked around this huge, grand building and learned that it was the Selimiye Army Barracks, which was built in the early 1800's. During the Crimean War, it served as a military hospital for the British Army. While chivalrous and brave soldiers were likely housed there over the years performing noteworthy acts, the building is known for the work of a single, non-military female, Florence Nightingale. Even today, Nightingale's work and philosophy serve as a reminder to us who work within and who are subject to medical services.
Florence Nightingale was born into a life of privilege. As she matured, it was clear that she swam against the stream of her social expectations. She considered the spectacle of such a life, including the reception of suitors, a waste of her time. She was drawn to the service of others. Despite her family's objections, she pursued nursing.
She soon found herself in a foreign land, serving British soldiers in Turkey. She grew quickly intolerant of the red tape, status quo, and plain lack of common sense present in the military operation in caring for its sick and wounded. She told her superiors, "Give me blankets, food, and medicine. Give me more help. I do not care for your systems and your regulations, but I do care for your sick." And care for the sick she did. When the simple necessities of clean bandages and blankets were not provided, she purchased them with her own money. She worked tirelessly, keeping conditions clean and spirits high in the sick wards despite the obstacles of tradition and overwhelming needs.
The data proves well the merit of Nightingale's efforts. Before her changes were instituted, the mortality rate was 70% in the hospital. By the time she left, that number had dropped to 5%. It was even postulated by her observers that she made the soldiers of Crimea healthier than the civilian population of England.
What Made Her Great?
The assets that allowed Florence Nightingale to make history are those same qualities that led her to buck the system of the day and those which brought her to the field of nursing. She was not bound by conformity. When she looked around and saw something wrong with the status quo, she spoke up and did what she felt was right. This spanned her refusal to play the helpless female as a teenager, to challenging the authority of the British military as a nurse. She followed her moral compass. She could not stand helpless as people suffered. Finally, she used her common sense - she did what she felt was right despite the fact that others thought contrary.
Lessons from Florence
We live in an age where everyone has an opinion. This holds true as we tend to our health and utilize healthcare services. Follow your own compass. If it doesn't make sense, question it. If it does, and if it offers something better, pursue it. Focus on simple, common sense approaches to making your life and health better.
To conclude, the following are Nightingale's "Notes on Nursing Which Apply to the Art of Caring." Ask yourself if these qualities were in place with the last hospital experience you had.
- Observe the sick. (How much time did the doctor spend with you?)
- Never let a patient be waked out of his sleep. (Tell this one to a third shift nurse tasked with documenting vital signs.)
- Avoid unnecessary noise. (What would Florence think of the beepers and alarms of monitoring systems used in hospitals today?)
- View and sunlight are matters of first importance to the sick.
- Leading questions are useless or misleading.
- Obtain accurate information.
- Be confidential.
- Children are much more susceptible than grown people to noxious influences.
Florence Nightingale Museum, Istanbul Turkey
Advice to the Healer: On the Art of Caring, Richard Colgan, M.D.