Florence Nightingale (1820-1910)
 known as “The Lady With the Lamp,” was a British
nurse, social reformer and statistician best known as the
founder of modern nursing. Her experiences as a nurse
during the Crimean War were foundational in her views
about sanitation. She established St. Thomas’s Hospital
and the Nightingale Training School for Nurses in 1860.
Her efforts to reform healthcare greatly influenced the
quality of care in the 19 and 20 centuries.
Florence Nightingale: Early Life
 Florence Nightingale was born on May 12, 1820, in
Florence, Italy to Frances Nightingale and William
Shore Nightingale. She was the younger of two children.
Nightingale’s affluent British family belonged to elite
social circles. Her mother, Frances, hailed from a
family of merchants and took pride in socializing with
people of prominent social standing. Despite her
mother’s interest in social climbing, Florence herself
was reportedly awkward in social situations. She
preferred to avoid being the center of attention
whenever possible. Strong-willed, Florence often
butted heads with her mother, whom she viewed as
overly controlling. Still, like many daughters, she was
eager to please her mother. “I think I am got something
more good-natured and complying,” Florence wrote in
her own defense, concerning the mother-daughter
relationship.
 Florence’s father was William Shore Nightingale, a
wealthy landowner who had inherited two estates—one
at Lea Hurst, Derbyshire, and the other in Hampshire,
Embley Park—when Florence was five years old.
Florence was raised on the family estate at Lea Hurst,
where her father provided her with a classical education,
including studies in German, French and Italian.
 From a very young age, Florence Nightingale was
active in philanthropy, ministering to the ill and poor
people in the village neighboring her family’s estate.
By the time she was 16 years old, it was clear to her that
nursing was her calling. She believed it to be her divine
purpose.
 When Nightingale approached her parents and told
them about her ambitions to become a nurse, they were
not pleased. In fact, her parents forbade her to pursue
nursing. During the Victorian Era, a young lady of
Nightingale’s social stature was expected to marry a
man of means—not take up a job that was viewed as
lowly menial labor by the upper social classes.
 When Nightingale was 17 years old, she refused a
marriage proposal from a “suitable” gentleman,
Richard Monckton Milnes. Nightingale explained her
reason for turning him down, saying that while he
stimulated her intellectually and romantically, her
“moral…active nature…requires satisfaction, and that
would not find it in this life.” Determined to pursue her
true calling despite her parents’ objections, in 1844,
Nightingale enrolled as a nursing student at the
Lutheran Hospital of Pastor Fliedner in Kaiserwerth,
Germany.
Florence Nightingale and Nursing
 In the early 1850s, Nightingale returned to London,
where she took a nursing job in a Middlesex hospital
for ailing governesses. Her performance there so
impressed her employer that Nightingale was promoted
to the superintendent within just a year of being hired.
The position proved challenging as Nightingale
grappled with a cholera outbreak and unsanitary
conditions conducive to the rapid spread of the disease.
Nightingale made it her mission to improve hygiene
practices, significantly lowering the death rate at the
hospital in the process. The hard work took a toll on her
health. She had just barely recovered when the biggest
challenge of her nursing career presented itself.
Florence Nightingale and the Crimean War
 In October of 1853, the Crimean War broke out. The
British Empire was at war against the Russian Empire
for control of the Ottoman Empire. Thousands of
British soldiers were sent to the Black Sea, where
supplies quickly dwindled. By 1854, no fewer than
18,000 soldiers had been admitted into military
hospitals.
 At the time, there were no female nurses stationed at
hospitals in Crimea. The poor reputation of past female
nurses had led the war office to avoid hiring more. But,
after the Battle of Alma, England was in an uproar
about the neglect of their ill and injured soldiers, who
not only lacked sufficient medical attention due to
hospitals being horribly understaffed but also
languished in appallingly unsanitary and inhumane
conditions.
 In late 1854, Nightingale received a letter from
Secretary of War Sidney Herbert, asking her to
organize a corps of nurses to tend to the sick and fallen
soldiers in the Crimea. Nightingale rose to her calling.
She quickly assembled a team of 34 nurses from a
variety of religious orders and sailed with them to the
Crimea just a few days later.
 Although they had been warned of the horrid conditions
there, nothing could have prepared Nightingale and her
nurses for what they saw when they arrived at Scutari,
the British base hospital in Constantinople. The
hospital sat on top of a large cesspool, which
contaminated the water and the hospital building itself.
Patients lay on in their own excrement on stretchers
strewn throughout the hallways. Rodents and bugs
scurried past them. The most basic supplies, such as
bandages and soap, grew increasingly scarce as the
number of ill and wounded steadily increased. Even
water needed to be rationed. More soldiers were dying
from infectious diseases like typhoid and cholera than
from injuries incurred in battle.
 The no-nonsense Nightingale quickly set to work. She
procured hundreds of scrub brushes and asked the least
infirm patients to scrub the inside of the hospital from
floor to ceiling. Nightingale herself spent every waking
minute caring for the soldiers. In the evenings she
moved through the dark hallways carrying a lamp while
making her rounds, ministering to patient after patient.
 The soldiers, who were both moved and comforted by
her endless supply of compassion, took to calling her
“the Lady with the Lamp.” Others simply called her
“the Angel of Crimea.” Her work reduced the hospital’s
death rate by two-thirds.
 In addition to vastly improving the sanitary conditions
of the hospital, Nightingale created a number of patient
services that contributed to improving the quality of
their hospital stay. She instituted the creation of an
“invalid’s kitchen” where appealing food for patients
with special dietary requirements was cooked. She
established a laundry so that patients would have clean
linens. She also instituted a classroom and a library for
patients’ intellectual stimulation and entertainment.
Based on her observations in Crimea, Nightingale
wrote Notes on Matters Affecting the Health,
Efficiency and Hospital Administration of the British
Army, an 830-page report analyzing her experience and
proposing reforms for other military hospitals operating
under poor conditions. The book would spark a total
restructuring of the War Office’s administrative
department, including the establishment of a Royal
Commission for the Health of the Army in 1857.
 Nightingale remained at Scutari for a year and a half.
She left in the summer of 1856, once the Crimean
conflict was resolved, and returned to her childhood
home at Lea Hurst. To her surprise, she was met with a
hero’s welcome, which the humble nurse did her best
to avoid. The Queen rewarded Nightingale’s work by
presenting her with an engraved brooch that came to be
known as the “Nightingale Jewel” and by granting her
a prize of $250,000 from the British government.
Florence Nightingale, Statistician
 With the support of Queen Victoria, Nightingale helped
create a Royal Commission into the health of the army.
It employed leading statisticians of the day, William
Farr and John Sutherland, to analyze army mortality
data, and what they found was horrifying: 16,000 of the
18,000 deaths were from preventable diseases—not
battle. But it was Nightingale’s ability to translate this
data into a new visual format that really caused a
sensation. Her polar area diagram, now known as a
“Nightingale Rose Diagram,” showed how the Sanitary
Commission’s work decreased the death rate and made
the complicated data accessible to all, inspiring new
standards for sanitation in the army and beyond. She
became the first female member of the Royal Statistical
Society and was named an honorary member of the
American Statistical Association.
Florence Nightingale’s Impact on Nursing
 Nightingale decided to use the money to further her
cause. In 1860, she funded the establishment of St.
Thomas’ Hospital, and within it, the Nightingale
Training School for Nurses. Nightingale became a
figure of public admiration. Poems, songs and plays
were written and dedicated in the heroine’s honor.
Young women aspired to be like her. Eager to follow
her example, even women from the wealthy upper
classes started enrolling at the training school. Thanks
to Nightingale, nursing was no longer frowned upon by
the upper classes; it had, in fact, come to be viewed as
an honorable vocation.
 While at Scutari, Nightingale had contracted “Crimean
fever” and would never fully recover. By the time she
was 38 years old, she was homebound and bedridden
and would be so for the remainder of her life. Fiercely
determined and dedicated as ever to improving health
care and alleviating patients’ suffering, Nightingale
continued her work from her bed.
 Residing in Mayfair, she remained an authority and
advocate of health care reform, interviewing politicians
and welcoming distinguished visitors from her bed. In
1859, she published Notes on Hospitals, which focused
on how to properly run civilian hospitals.
 Throughout the U.S. Civil War, she was frequently
consulted about how to best manage field hospitals.
Nightingale also served as an authority on public
sanitation issues in India for both the military and
civilians, although she had never been to India herself.
 In 1908, at the age of 88, she was conferred the merit
of honor by King Edward. In May of 1910, she received
a congratulatory message from King George on her
90th birthday.
Florence Nightingale: Death and Legacy
 In August 1910, Florence Nightingale fell ill but seemed to
recover and was reportedly in good spirits. A week later, on
the evening of Friday, August 12, 1910, she developed an
array of troubling symptoms. She died unexpectedly at 2
p.m. the following day, Saturday, August 13, 1910, at her
home in London.
 Characteristically, she had expressed the desire that her
funeral be a quiet and modest affair, despite the public’s
desire to honor Nightingale—who tirelessly devoted her
life to preventing disease and ensuring safe and
compassionate treatment for the poor and the suffering.
Respecting her last wishes, her relatives turned down a
national funeral. The “Lady with the Lamp” was laid to rest
in Hampshire, England.
 The Florence Nightingale Museum, which sits at the site of
the original Nightingale Training School for Nurses, houses
more than 2,000 artifacts commemorating the life and
career of the “Angel of the Crimea.” To this day, Florence
Nightingale is broadly acknowledged and revered as the
pioneer of modern nursing.
 Florence Nightingale
 byname Lady with the Lamp, (born May 12, 1820,
Florence [Italy]—died August 13, 1910, London,
England), British nurse, statistician, and social reformer
who was the foundational philosopher of modern
nursing. 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.
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 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
 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.
 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.
 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.)
 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 of Florence Nightingale
 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.
 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.
 Florence Nightingale
 was a trailblazing figure in nursing who greatly
affected 19th- and 20th-century policies around proper
medical care. She was known for her night rounds to
aid the wounded, establishing her image as the 'Lady
with the Lamp.'
Who Was Florence Nightingale?
 Part of a wealthy family, Florence Nightingale defied
the expectations of the time and pursued what she saw
as her God-given calling of nursing. During the
Crimean War, she and a team of nurses improved the
unsanitary conditions at a British base hospital, greatly
reducing the death count. Her writings sparked
worldwide health care reform, and in 1860 she
established St. Thomas' Hospital and the Nightingale
Training School for Nurses. A revered hero of her time,
she died on August 13, 1910, in London.
Background and Early Life
 Nightingale was born on May 12, 1820, in Florence,
Italy, the city which inspired her name. The younger of
two daughters, Nightingale was part of an affluent
British clan that belonged to elite social circles. Her
mother, Frances Nightingale, hailed from a family of
merchants and took pride in socializing with people of
prominent standing. Despite her mother's interests,
Nightingale herself was reportedly awkward in social
situations and preferred to avoid being the center of
attention whenever possible. Strong-willed, she often
butted heads with her mother, whom she viewed as
overly controlling.
 Nightingale's father was William Edward Nightingale
(having changed his original surname, "Shore"), a
wealthy landowner who would be associated with two
estates—one at Lea Hurst, Derbyshire, and the other at
Embly, Hampshire. Nightingale was provided with a
classical education, including studies in mathematics
along with German, French and Italian.
 From a young age, Nightingale was active in
philanthropy, ministering to the ill and poor people in
the village neighboring her family’s estate. Nightingale
eventually came to the conclusion that nursing was her
calling; she believed the vocation to be her divine
purpose.
 When Nightingale approached her parents and told
them about her ambitions to become a nurse, they were
not pleased and forbade her to pursue appropriate
training. During the Victorian Era, where English
women had almost no property rights, a young lady of
Nightingale's social stature was expected to marry a
man of means to ensure her class standing—not take up
a job that was viewed by the upper social classes as
lowly menial labor.
 In 1849, Nightingale refused a marriage proposal from
a "suitable" gentleman, Richard Monckton Milnes, who
had pursued her for years. She explained her reason for
turning him down, saying that while he stimulated her
intellectually and romantically, her "moral…active
nature" called for something beyond a domestic life.
(One biographer has suggested that the rejection of
marriage to Milnes was not in fact an outright refusal.)
Determined to pursue her true calling despite her
parents' objections, Nightingale eventually enrolled as
a nursing student in 1850 at the Institution of Protestant
Deaconesses in Kaiserswerth, Germany.
Crimean War
 In the early 1850s, Nightingale returned to London,
where she took a nursing job in a Harley Street hospital
for ailing governesses. Her performance there so
impressed her employer that Nightingale was promoted
to superintendent. Nightingale also volunteered at the
Middlesex Hospital around this time, grappling with a
cholera outbreak and unsanitary conditions conducive
to the rapid spread of the disease. Nightingale made it
her mission to improve hygiene practices, significantly
lowering the death rate at the hospital in the process.
 In October 1853, the Crimean War broke out. Allied
British and French forces were at war against the
Russian Empire for control of Ottoman territory.
Thousands of British soldiers were sent to the Black
Sea, where supplies quickly dwindled. By 1854, no
fewer than 18,000 soldiers had been admitted into
military hospitals.
 At the time, there were no female nurses stationed at
hospitals in the Crimea. After the Battle of Alma,
England was in an uproar about the neglect of their ill
and injured soldiers, who not only lacked sufficient
medical attention due to hospitals being horribly
understaffed but also languished in appallingly
unsanitary conditions.
Pioneering Nurse
 In late 1854, Nightingale received a letter from
Secretary of War Sidney Herbert, asking her to
organize a corps of nurses to tend to the sick and fallen
soldiers in the Crimea. Given full control of the
operation, she quickly assembled a team of almost three
dozen nurses from a variety of religious orders and
sailed with them to the Crimea just a few days later.
 Although they had been warned of the horrid conditions
there, nothing could have prepared Nightingale and her
nurses for what they saw when they arrived at Scutari,
the British base hospital in Constantinople. The
hospital sat on top of a large cesspool, which
contaminated the water and the building itself. Patients
lay in their own excrement on stretchers strewn
throughout the hallways. Rodents and bugs scurried
past them. The most basic supplies, such as bandages
and soap, grew increasingly scarce as the number of ill
and wounded steadily increased. Even water needed to
be rationed. More soldiers were dying from infectious
diseases like typhoid and cholera than from injuries
incurred in battle.
 The no-nonsense Nightingale quickly set to work. She
procured hundreds of scrub brushes and asked the least
infirm patients to scrub the inside of the hospital from
floor to ceiling. Nightingale herself spent every waking
minute caring for the soldiers. In the evenings she
moved through the dark hallways carrying a lamp while
making her rounds, ministering to patient after patient.
 The soldiers, who were both moved and comforted by
her endless supply of compassion, took to calling her
"the Lady with the Lamp." Others simply called her
"the Angel of the Crimea." Her work reduced the
hospital’s death rate by two-thirds.
 In addition to vastly improving the sanitary conditions
of the hospital, Nightingale instituted an "invalid's
kitchen" where appealing food for patients with special
dietary requirements was prepared. She also established
a laundry so that patients would have clean linens. as
well as a classroom and library for intellectual
stimulation and entertainment.
Recognition and Appreciation
 Nightingale remained at Scutari for a year and a half.
She left in the summer of 1856, once the Crimean
conflict was resolved, and returned to her childhood
home at Lea Hurst. To her surprise she was met with a
hero's welcome, which the humble nurse did her best to
avoid. The previous year, Queen Victoria had rewarded
Nightingale's work by presenting her with an engraved
brooch that came to be known as the "Nightingale
Jewel" and by granting her a prize of $250,000 from the
British government.
 Nightingale decided to use the money to further her
cause. In 1860, she funded the establishment of St.
Thomas' Hospital, and within it, the Nightingale
Training School for Nurses. Nightingale became a
figure of public admiration. Poems, songs and plays
were written and dedicated in the heroine's honor.
Young women aspired to be like her. Eager to follow
her example, even women from the wealthy upper
classes started enrolling at the training school. Thanks
to Nightingale, nursing was no longer frowned upon by
the upper classes; it had, in fact, come to be viewed as
an honorable vocation.
 Based on her observations during the Crimea War,
Nightingale wrote Notes on Matters Affecting the
Health, Efficiency and Hospital Administration of the
British Army, a massive report published in 1858
analyzing her experience and proposing reforms for
other military hospitals. Her research would spark a
total restructuring of the War Office's administrative
department, including the establishment of a Royal
Commission for the Health of the Army in 1857.
Nightingale was also noted for her statistician skills,
creating coxcomb pie charts on patient mortality in
Scutari that would influence the direction of medical
epidemiology.
Later Life
 While at Scutari, Nightingale had contracted the
bacterial infection brucellosis, also known as Crimean
fever, and would never fully recover. By the time she
was 38 years old, she was homebound and routinely
bedridden, and would be so for the remainder of her life.
Fiercely determined and dedicated as ever to improving
health care and alleviating patients’ suffering,
Nightingale continued her work from her bed.
 Residing in Mayfair, she remained an authority and
advocate of health care reform, interviewing politicians
and welcoming distinguished visitors from her bed. In
1859, she published Notes on Hospitals, which focused
on how to properly run civilian hospitals.
 Throughout the U.S. Civil War, she was frequently
consulted about how to best manage field hospitals.
Nightingale also served as an authority on public
sanitation issues in India for both the military and
civilians, although she had never been to India herself.
 In 1907, she was conferred the Order of Merit by King
Edward, and received the Freedom of the City of
London the following year, becoming the first woman
to receive the honor. In May 1910, she received a
celebratory message from King George on her 90th
birthday.
Death and Legacy
 In August 1910, Nightingale fell ill but seemed to
recover and was reportedly in good spirits. A week later,
on the evening of Friday, August 12, 1910, she
developed an array of troubling symptoms. She died
unexpectedly at around 2 p.m. the following day,
Saturday, August 13, at her home in London.
 Characteristically, she had expressed the desire that her
funeral be a quiet and modest affair, despite the public's
desire to honor Nightingale—who tirelessly devoted
her life to preventing disease and ensuring safe and
compassionate treatment for the poor and the suffering.
Respecting her last wishes, her relatives turned down a
national funeral. The "Lady with the Lamp" was laid to
rest in her family's plot at St. Margaret's Church, East
Wellow, in Hampshire, England.
 The Florence Nightingale Museum, which sits at the
site of the original Nightingale Training School for
Nurses, houses more than 2,000 artifacts
commemorating the life and career of the "Angel of the
Crimea." To this day, Nightingale is broadly
acknowledged and revered as the pioneer of modern
nursing.
 12 May 1820
She was born in Italy to William Edward Nightingale and
Frances “Fanny” Nightingale. She had one sister. Florence
was born into a rich, well-connected British family.
Florence was raised at Lea Hurst where she received
classical education which included German, Italian and
French. By the time she reached 16, Florence, who always
had a very keen interest in philanthropy and caring for the
sick, knew her calling was nursing. She believed without
doubt that this was her divine calling.
1837
Whilst in the gardens of her family home in Embley,
Hampshire, Florence heard the voice of God calling her to
do his work, but at this time had no idea what the work
would be.
1839
Presented to Queen Victoria
1842
Introduced to Richard Monckton Milnes
1843
Decides to work in hospitals
1844
Declines wedding proposal of Milnes
1844
Pursuing a career in nursing was looked down upon by the
society at that time, especially for someone with an affluent
background. After much opposition, Florence announced
her decision to enter the field in 1844.
1845
Seeks training at Salisbury Infirmary; parents object
1850 July
Florence returns from her trip to Italy, Egypt, Greece and
Germany where she visited Pastor Theodore Fliedner’s
hospital and school for deaconesses at Kaiserswerth near
Dusseldorf.
1847
Visits hospitals in Italy and observes Catholic sisters
fulfilling nursing duties
1850
Visits Kaiserwerth Institution in Germany
1851
Returns to Kaiserwerth and joins in active nursing duties
1851 – 1853
Florence returns to Kaiserswerth for three months nursing
training which then enabled her to take up post as
Superintendent of the Establishment for Gentlewomen
during illnesses at number one Harley Street in 1853.
1853
 She enrolled herself as a student at the Lutheran
Hospital of Pastor Fliedner in Kaiserwerth, Germany.
She then worked hard to educate herself in the art and
science of nursing.
 On her trips to Egypt and Paris, she realized that
disciplined and well- organised nuns or sisters made
better nurses than women in England. When she
returned home she started visiting hospitals in London,
Edinburgh and Dublin. In 1853, she was appointed
Superintendent of the Hospital for Invalid
Gentlewoman.
Becomes Superintendent of the Institution for the Care of
Sick Gentlewomen in Distressed Circumstances
1853 October
The Crimean War broke out. A large number of British
soldiers were sent to the front and by 1854 around 18000
soldiers were injured and admitted into military hospitals.
Nightingale received a letter from Secretary of War, Sidney
Herbett - both eventually became very good friends -
requesting assistance from her nurses to tend to the soldiers.
She assembled a team of more than 30 nurses and sailed to
Crimea immediately.
The condition of the soldiers there was much worse than
expected. When they reached Scutari, the soldiers were in a
horrible state due to the lack of proper sanitation and
unhygienic surroundings. The medicine supply was little
and the death rate was on an all-time high.
Nightingale quickly got to work and tried to lower the death
rate. Apart from the basic sanitary precautions, she also
improved the quality of their stay in the hospital.
1854 March
Britain, France and Turkey declare war on Russia. British
medical facilities for the wounded are criticised by The
Times. Florence recruited to oversee the introduction of
female nurses into the military hospitals in Turkey.
1854 November
 Florence arrives in Scutari – a suburb on the Asian side
of Constantinople – with 38 nurses. Initially the doctors
did not want their help but within ten days fresh
casualties arrived from the Battle of Inkermann and the
nurses were fully stretched.
 Florence also wrote home on behalf of the soldiers and
acted as banker – sending the men’s wages home to
their families. She also introduced reading rooms in the
hospital.
 Mary SeacoleMary Seacole arrived in London and
offers her services to Mrs Elizabeth Herbert (wife of
Sidney Herbert, Secretary at War), who was in charge
of recruiting a second group of nurses to join Florence
in Scutari, but is rejected.
1854
 Crimean War begins; appointed Superintendent of the
Female Nursing Establishment of the English General
Hospitals in Turkey; arrives at Scutari on the Crimean
War front
1855
 Contracts Crimean Fever and almost dies
 Mary Seacole funds her own passage to the Crimea. She
also purchases medicines and home comforts that
would be useful for the military. Florence and Mary
meet and see much of each other in Balaclava.
 In 1855, the Nightingale fund was set up to open up a
training school for nurses. By 1860, �50,000 had been
collected and The Nightingale School and Home for
Nurses was established at St. Thomas Hospital. She
could not be the superintendent because of her
‘Crimean fever’ but she closely watched the progress of
the institution.
 1855 November for the next 30 years she wrote a letter to the students
 To show the nation’s gratitude, a public subscription giving advice and encouragement. On completion of
was organised to enable Florence to continue her their training, Florence gave them nurses books and
reform of the civil hospitals of Britain. invited them to tea.
1856 1897
 Crimean War ends; returns to England; declines  Diamond Jubilee of Queen Victoria includes exhibition
wedding proposal of Sir Harry Verney of Florence Nightingale’s nursing contributions
1856 March 1883
 The war was over. An estimated 94000 men were sent  In recognition of Florence’s hard work, she received the
to the war front, out of which almost 4000 died of battle Royal Red Cross from Queen Victoria.
wounds, 19000 died of diseases and 13000 were 1907
invalidated out of the Army.  Florence receives the Order of Merit – becoming the
1856 August first woman to receive it.
 Florence returned from the Crimean War, four months 1910 13 August
after the peace treaty was signed, and she hid herself  Florence dies at her home at 10 South Street, Mayfair,
away from the public’s attention. in the West End of London and was buried at St
 Florence returned to England as a national hero but she Margaret’s East Wellow, near her parent’s home,
was deeply shocked by the mass death that took place Embley Park in Hampshire.
right before her eyes because of poor sanitation.
Therefore, she was determined to begin a campaign that
would improve the quality of nursing in military
hospitals. She started investigating before the Royal
Commission on the Health of the Army and that
resulted in the formation of the Army Medical College.
1856 November
 Florence took a hotel room in London which became
the centre for the campaign for a Royal Commission to
investigate the health of the British Army.
1857
 When the Indian Mutiny broke out in 1857, she wished
to come to India and help improve the sanitation
facilities. Even though she could never come, she
played an instrumental role in getting a Sanitary
Department established by the Indian government.
 Even when she was resting at home, she was still very
much active in reforming and improving the health care
system, interviewing politicians and distinguished
visitors from her bed.
1859
 Publishes Notes on Hospitals and Notes on Nursing
1860
 For her contribution to Army statistics and comparative
hospital statistics in 1860 Florence became the first
woman to be elected a fellow of the Statistical
Society.Florence Nightingale
 Florence established the Nightingale Training School
for Nurses at St Thomas’ Hospital, London. Florence’s
best known work Notes on Nursing was published –
this is still available today and has been translated into
eleven languages. In total Florence published 200
books, reports and pamphlets during her lifetime.
1861
 Assists U.S. in organizing soldiers’ hospitals in Civil
War
1865
 Settles in her Mayfair home in London
1872
 Florence devotes closer attention to the organisation of
the Nightingale Training School and almost annually