1. Miracle, Vickie A. RN, EdD, CCRN, CCNS, CCRC, Editor-in-Chief, DCCN

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I recently read a book by Barbara Montgomery Dossey entitled, Florence Nightingale: Mystic, Visionary, Healer.1 I freely admit to being a fan of Ms Nightingale. I have written several papers for classes about her work. In my early years as a nurse, I must admit I considered her to be a footnote in the history of nursing. As I have learned more about her, I realize I was wrong. She is so much more than a footnote.


Many of us think of Ms Nightingale as a founder of nursing and do not realize that many of her teachings are as appropriate today as they were in the 1800s. Although this editorial is by no means a complete review of her works as portrayed in the book, I do hope to provide a glimpse into her philosophy and show the applicability of her work in today's turbulent health care climate.


Florence Nightingale decided to become a nurse at a young age. She was an unhealthy child and spent many days indoors. It was during these trying times in her young life that she felt a calling to become a nurse (not a popular career choice then). I also see nursing as a calling. The majority of nurses do not work for the money but rather as desire to help others.


Ms Nightingale was a pioneer in the women's movement. She made inroads into many places that were only open to men at the time. She was a true philanthropist giving of her time and money to help others. Nurses today do the same thing. Think of how many nurses volunteered to help after the tragic events of 9/11/01. Many of us help during other disasters, and others serve as volunteers for local charities and service organizations.


The beginning of nurses' notes can be attributed to Ms Nightingale. She kept extensive notes about her patients: observations, treatment modalities, responses to treatment, sleep patterns, and emotional needs. These notes became invaluable to the care of her patients. Nurses today keep detailed notes about our patients. Other healthcare professionals in making treatment decisions often use these notes.


Florence Nightingale was a nurse researcher. Her practice was based on assessment of the effects of various nursing interventions. She kept detailed reports on her patients and used statistics to support her findings. She actually provided quarterly reports and made changes as necessary to improve patient care. She was the first quality assurance nurse.


Nursing care plans can be traced to Ms Nightingale. She developed measurable outcomes and monitored her patients as they achieved these outcomes. I believe that if open-heart surgery was done in her day, those patients would have been up and moving the next day.


Florence Nightingale had a vision concerning how hospitals should be designed in a manner to provide compassionate and effective patient care. She was the first nurse administrator and had wonderful leadership skills. She developed what she called, "the art and science of nursing." She believed in the same principles we practice everyday for our patients: 1) the need for a quiet environment; 2) proper nutrition; 3) adequate ventilation and warmth; 4) cleanliness; 5) the need to see outdoors; 6) the skillful observation of patients; and 7) proper positioning and ambulation.


She was a teacher. At a time when nursing was not considered an honorable profession, Florence Nightingale did everything she could to change that perception. Young women came to her for an education. Through her efforts, nursing became a respectable career choice.


Florence Nightingale also dealt with bureaucracy. Yes, they had red tape then, too. She constantly had to negotiate for supplies, medications, and equipment. She learned to delegate responsibility. At the time, she realized men were more likely to get what they needed, so she used this to her advantage. She recruited men to serve as her delegates in obtaining the necessary supplies. This allowed her more time to spend with her patients, up to 20 hours a day, sometimes in very primitive sites. She made the best of what she had. Today, we make the same choices. We try to do the best we can with what we have for our patients.


Florence Nightingale has earned her spot in the history of nursing as well as history in general. She was a truly remarkable woman who could accomplish many things with very few resources. I truly hope that all of us have a little bit of Florence in us. We make nursing a great career and profession. So when you are tired, complaining of poor working conditions, long hours, short staffing, and other issues, remember what Florence Nightingale went through. Your work will seem lighter.




1. Dossey BM. Florence Nightingale: Mystic, Visionary, Healer. Springhouse, Pa: Springhouse Corporation; 2000. [Context Link]