1. Fulton, Janet S. PhD, RN, ACNS-BC, ANEF, FCNS, FAAN

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Today is the first day of spring, the vernal equinox in the northern hemisphere, a day where light and dark are equal. The arrival of spring is a recognized symbol of hope, a rebirth of the earth, a time of awakening from the long slumber of winter. This spring is different. We are on the cusp of the COVID-19 pandemic. Our daily routines, educational programs, national and personal economics, and valued social relationships are disrupted. Every day we learn more about the virus. Every day more cases are diagnosed; more deaths are reported.


On November 5, 1854, on the day of the Battle of Inkerman in the Crimean War, Florence Nightingale and 38 nurses arrived at the British military hospitals in Scutari, then the Ottoman Empire. The hospital wards were dark and crowded, filled with stale air, rank odors, fleas, rats, and other vermin. Sanitation was poor, food in short supply, and clean bedding and bandages scarce. More men were dying of infectious diseases than of battle wounds. The nurses faced epidemics of typhus, cholera, and ever-present dysentery.1 They had no diagnostic laboratories to identify the infections. No antibiotics, antipyretics, antidiarrheals, or antiemetics. No gloves, no masks.


For Nightingale, the responsibility of nurses was to put patients in such as state as to have no disease or to recover from disease.2 The contemporary interpretation of this responsibility has been to answer the question: What can and should nurses do to promote health, prevent illness, and aid recovery from disease. Nightingale's answer was "proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet."2(p1) The basics then, the basics now. Space between patients. Clean water. Clean bedding. Sleep. Nourishing food. Fresh air. Warmth. Sanitation. Healing requires a healing environment.


Let us remember that nurses are descended from a long line of intelligent, ingenious, compassionate, tenacious, and indefatigable women and men. For decades, we have met the public need for health promotion, disease prevention, illness recovery, and compassionate death. We care for the sick and dying. We support the well to stay well. We will continue to be compassionate, tenacious, and indefatigable in caring for persons and communities during this pandemic. Yet at the same time, we must create a healing environment for ourselves. We must, above all else, care for ourselves and each other. The days ahead will be difficult. We must lift each other up so that we may be lifted up. This spring is different.



The author thanks Mary Madeline Rogge, Texas Tech University, Health Sciences Center, for her inspirational words that are incorporated in this editorial.




1. Cohen IB. Florence Nightingale. Sci Am. 1984;250(3):128-137. [Context Link]


2. Nightingale F. Notes on Nursing. London: Harrison and Sons; 1859. [Context Link]