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Florence Nightingale's Revolution from Home

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What would Florence Nightingale say or recommend to us today? Most of Florence's life and work was actually done as a "Remote/Stay-at-Home Nurse" when she became bedridden at the young age of 38 years old until she died when she was 90 years old. From her bed she was able to still use her advocacy skills, her political connectedness, her passion for public health, and her endless desire to think outside of the box to make huge lasting changes in healthcare. She would take the interconnected technology we have today and run with it.

Specializes in Case Management, Pediatrics, Behavioral Health. Has 8 years experience.

Florence Nightingale, the first Work-from-Home Nurse and political whisperer

Florence Nightingale's Revolution from Home

I remember in Nursing School learning about Florence Nightingale’s role in the Crimean War - what she did to help establish safe sanitation practices, and that she was a tremendous advocate who worked tirelessly for her patients.  However, it was not until this year that I learned that the bulk of Florence’s life and career took place at her home, starting at the age of 38.  She had become homebound and bedridden due to contracting Crimean fever and suffering from its after-effects until the time of her death at 90 years of age.  According to the “History” documentary on Florence’s life [see Florence Nightingale], she continued to work tirelessly from her bed  - writing articles and books, interviewing politicians, and consulting as an international expert on sanitation best practices. This added up to almost 50 years of continued work that she conducted from home – our first “Remote/Work from Home” Nurse, if you will.

A few other interesting things I learned about her this year was that she was a renowned statistician who developed new ways of visualizing data that was convincing to even the layperson (also a good work from home position), that she enlisted fewer sick hospital patients to help clean the hospitals from top to bottom during the Crimean War (making nursing a communal effort), and that she created a holistic model for patient recovery by establishing the first hospital kitchen (“the Invalid’s Kitchen”) that could accommodate patient’s dietary needs and make more appealing food (as well as a laundry system so patients could have clean linens, and a classroom and library for intellectual stimulation and entertainment) (https://www.history.com/topics/womens-history/florence-nightingale-1).

So when I think about our modern problem of compromised patient care and inadequate staffing, where nurses are overworked and underpaid -- and apply Florence’s advocacy skills, her political connectedness, her passion for public health, and her endless desire to think outside of the box (ie enlisting fellow patients to help clean a hospital during war-time) -- there are several things she might do today.  She might work with our national political leaders to convince them to formally identify our current healthcare status as an “emergent healthcare crisis”, requiring all available medical resources to be accessed immediately.  She might convince the US government to deploy military medical personnel to all hospitals in need until the healthcare crisis stabilizes.  She would help develop a joint military-civilian healthcare team, with the full force of the federal government behind it, including its funding and medical resources.  This would solve both our Staffing and pay crises (the military budget is currently 54% of our national budget, so the money is already there), which would then also have the trickle-down effect of improving patient care. [See “National Priorities Project” for the US governmental budget breakdown statistics]

Since Florence was a statistician, I think she would also be very excited about all of our current technology (both medical and non-medical), and push for it to be used to its fullest capacity.  If we have Nurses who are unable to work in a hospital setting for any number of reasons, she would *find* a way to make sure they could work from home if they so choose.  She would not view work-from-home options as a hurdle to healthcare – she would view it only as an incredibly valuable asset.  She would deploy public health nurses, research nurses, and statisticians to be working from home around the clock – whenever they are able to work without hurting their health (I think Florence would have learned at this point that overwork is unhealthy, as she was forced to work from home for decades due to poor health that she contracted while working). 

I also think that Florence would be taking our emerging mental health crisis very seriously, especially since she seemed to recognize that all healing required holistic care (as evidenced by her advocacy for high-quality on-site food, laundry, and educational/entertainment resources).  I think she would argue that we wouldn’t be able to solve our healthcare problems without incorporating high-quality mental health supports throughout the entire healthcare system’s structure.  She may advocate for all patients to be assigned a bedside advocate from the moment that they arrive at the hospital.  A bedside advocate would be there to help make sure the patient’s voice is always heard (regardless of race, sexual orientation, ethnicity, etc.), and that mental health support is always present.  She may also advocate for a huge overhaul of our current hospital food system, to make sure the food options are clean, high-quality, whole foods promoting physical and mental wellness.  As a public health nurse with a passion for statistics, she would find creative ways of convincing the US government that all health (and healthcare costs) would dramatically improve if serious preventative measures were put in place.  Since she enlisted less sick patients to help clean the hospitals during the Crimean war, she may also advocate for more community support and engagement throughout all of these above-mentioned overhauls – enlisting restaurants and food services to support hospitals and patients at home.  She might also ensure that patient’s hearts and minds continue to be stimulated as an aid to recovery by creating a coalition of artists and healthcare providers so that there would always be live music or any form of art accessible to any of the patients.

I also think Florence would think deeply about what it means to be home with an illness, as she was home for over 40 years with her own illness.  She may advocate for people from every walk of life to visit homebound patients who could tolerate it.  She may even recognize that a lot of good healthcare services can be provided at home, and work with politicians to develop a national strategy to help patients be treated at home when the hospitals are overwhelmed, or when it was in the best interest of the patient to stay home.

Overall, I think Florence today would really push politicians to finally buy in to the age-old concept that an ounce of prevention is worth a pound of cure.  I think she would know it to be an uphill battle to convince them of this wisdom, but that she wouldn’t give up, and certainly would not take “No” for an answer. 

Susannah Marshall has been a Registered Nurse since 2013, and is board certified in case management as well as in psychiatric nursing. When she isn't tango dancing or travelling, she enjoys playing with her baby nephew and writing children's stories.

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21 Comment(s)

JBMmom, MSN

Specializes in Long term care; med-surg; critical care. Has 9 years experience.

Thank you for sharing this interesting piece, I was unaware of how long she was homebound and how it affected her career. 

kittyboxers, BSN, RN

Specializes in Author, Psych, Palliative. Has 44 years experience.

Inspirational! Thanks so much for writing such an interesting piece!

pattithenurse

Specializes in School Nursing/Pediatrics. Has 30 years experience.

This article is fantastic, and so relevant to today! I had no idea that Flo had a post viral illness that kept her bedridden for all those years.  Well done!

Curious1997, BSN

Specializes in Psych, Medical. Has 13 years experience.

Great article, but I doubt perspectively factual. 

If you know the UK well you would realize that Florence is the equivalent of say a Hillary Clinton or Elizabeth Warren re position in our society. Born into a prominent wealthy family with excellent govt connections, she was a product of  'Influencing' in her time. I absolutely doubt that she was the first nurse to organize anything, since wars happened thousands of years before her and people had been caring for the afflicted since then. 

The English were the rulers of the world then and simply rewrote history to their best interests. There were many cultures and nations practicing sanitary conditions over the centuries, notably the Indians and the Arabs. Ayurvedic practices are rifed with the same principles Florence espoused. 

Full props to her for the excellent job she did during her time, but it's also important to remember and contextualize the subject matter and recognize the propaganda we are fed. Ours is a profession of science and therefore facts! Subjective information should be disgarded. 

londonflo

Specializes in oncology. Has 44 years experience.

5 hours ago, Curious1997 said:

I absolutely doubt that she was the first nurse to organize anything, since wars happened thousands of years before her and people had been caring for the afflicted since then. 

Sound evidence to back this up?

 

5 hours ago, Curious1997 said:

Born into a prominent wealthy family with excellent govt connections, she was a product of  'Influencing' in her time. 

Did Hillary or Elizabeth Warren use their connections to develop a health care system...BTW what did they really develop in health care? Hillary was a flop at reinventing health care in the 90s. She bailed. 

Curious1997, BSN

Specializes in Psych, Medical. Has 13 years experience.

27 minutes ago, londonflo said:

Sound evidence to back this up?

 

27 minutes ago, londonflo said:

How about logic? 

 

Did Hillary or Elizabeth Warren use their connections to develop a health care system...BTW what did they really develop in health care? Hillary was a flop at reinventing health care in the 90s. She bailed. 

 

Don't want to argue with you man. Either you know history or you don't. She came back after the Crimean war a well known personality which since she was bedridden or housebound, parlayed using her formidable intelligence into expressing her ideas. See the connection with Hillary and Warren? Intelligent well known women predating influencers! 

Whenever you read anything, use your imagination re the time period and the context of the times. Economics, politics and how history may have influenced the outcome. You will learn that there's nothing new re human reactions even when new technology is involved! Same old behaviors! 

londonflo

Specializes in oncology. Has 44 years experience.

1 hour ago, Curious1997 said:

See the connection with Hillary and Warren? Intelligent well known women predating influencers! 

No I don't see any connection.

1 hour ago, Curious1997 said:

Either you know history or you don't

I presented at Oxford regarding Florence. I know  the history I speak about.

1 hour ago, Curious1997 said:

Don't want to argue with you man.

If you can't back up your claims,  your reply is a loser stance. If you can't argue against facts.....

Regarding her innovation in economics, this is a good read:

https://thisisstatistics.org/florence-nightingale-the-lady-with-the-data/

 

 

londonflo

Specializes in oncology. Has 44 years experience.

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Curious1997, BSN

Specializes in Psych, Medical. Has 13 years experience.

9 hours ago, londonflo said:

No I don't see any connection.

* You don't understand the concept of influencers? 

9 hours ago, londonflo said:

I presented at Oxford regarding Florence. I know  the history I speak about.

* Really? Do you know it contextually? 

9 hours ago, londonflo said:

If you can't back up your claims,  your reply is a loser stance. If you can't argue against facts.....

Regarding her innovation in economics, this is a good read:

https://thisisstatistics.org/florence-nightingale-the-lady-with-the-data/

* I look at the big picture framework of anything I read as well as applying logic. Economics applied in many disciplines, long before Florence came along. Do you think for example that she compiled that data single handedly? It's a collection from many sources, (incl historical data from many cultures and previous campaigns), made sense of to prove a point to get a better outcome. Isn't that what her father's profession was? 

I consider loser stances, from people who don't evaluate the information they read. Her brilliance lie in her tenacity of her passion and using her influence to effect change, despite her debilities in a period of stodgy men, who probably patronized her contributions because of misogyny and bureaucracy! I doubt you would know about the royal societies at the time and how they regulated patronage and information. It might be a good place for you to begin if you are to understand some of the context! 

9 hours ago, londonflo said:

 

If your knowledge of history is based on that link, I rest my case. 

londonflo

Specializes in oncology. Has 44 years experience.

10 hours ago, Curious1997 said:

* You don't understand the concept of influencers? 

I understand "influencers" Are you thinking you are one?

 

On 6/20/2021 at 5:43 AM, Curious1997 said:

If you know the UK well you would realize that Florence is the equivalent of say a Hillary Clinton or Elizabeth Warren re position in our society.

Are saying HC and EW were influenced by Nightingale?

10 hours ago, Curious1997 said:

Do you think for example that she compiled that data single handedly? It's a collection from many sources, (incl historical data from many cultures and previous campaigns), made sense of to prove a point to get a better outcome.

No one had compilated it and analyzed it before. Data collection without analysis is worthless. She directed the collection and analysis of data.  She presented her findings.

The Napoleonic wars gave poor data to extrapolate from.  And there is no record of the collection and analysis of the data from the Napoleonic Wars.. How many were lamed or died? 

10 hours ago, Curious1997 said:

I look at the big picture framework of anything I read as well as applying logic.

Looking at the BIG picture allows you to look at the facts, factual anomalies  and make an erroneous conclusion.  

From what I have read here you are an expert on Real Estate, Psych Nursing and Politics. Your posts show you do not have any historian skills. 

 

Quote

* Really? Do you know it contextually? 

Studying history requires that one know ....the context.  Tell me your knowledge base...., especially if it substantial to support your claims. I look forward to it.

londonflo

Specializes in oncology. Has 44 years experience.

On 6/20/2021 at 11:22 AM, Curious1997 said:

Whenever you read anything, use your imagination re the time period and the context of the times. Economics, politics and how history may have influenced the outcome

I don't need to use my imagination....I read primary resources. Gone to Oxford and read the primary sources, analyzed them and wrote a comprehensive paper and presentation.  

13 hours ago, Curious1997 said:

I consider loser stances, from people who don't evaluate the information they read.

I have evaluated the  primary sources and information, the time in which it was written and the outcome of the dissemination of the facts.

13 hours ago, Curious1997 said:

I consider loser stances, from people who don't evaluate the information they read.

umm, like you? Give us the facts you have used to evaluate FN claims and work.

 

13 hours ago, Curious1997 said:

I doubt you would know about the royal societies at the time and how they regulated patronage and information. It might be a good place for you to begin if you are to understand some of the context

My knowledge base is deep and thorough. You are making jumps in your understanding of the conceptual basis of history.. that may be okay for a blowhard ......but I do wish you good luck in your real estate business, travel throughout the world and attending concerts with back stage passes! You have no experience, education and credentials as a scholar. Stay in your own lane

SusannahM, BSN, RN

Specializes in Case Management, Pediatrics, Behavioral Health. Has 8 years experience.

Hi all! Thank you so much for reading my article! I would like to ammend my opening statement to include the word "help" -- so instead it would read: 

"I remember in Nursing School learning about Florence Nightingale’s role in the Crimean War - what she did to *help* establish safe sanitation practices, and that she was a tremendous advocate who worked tirelessly for her patients".

I will also add this statement was written to be perceived as purely anecdotal (from my experience with my professors in nursing school), and not intended to be stated as fact. So sorry for the confusion!

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

Very interesting! I also did not know how long she was homebound. Impressive that she was still so influential. Great article. 

I think continuing to praise Florence Nightingale can be a "yes, and" situation. Yes, she did a lot for nursing and infectious disease, and deserves recognition. And, many women of color also did a lot for nursing and are only recently being recognized. Harriet Tubman and Sojourner Truth were both nurses. The podcast Good Nurse Bad Nurse featured black nurses in its "good nurse" segment for all of 2020... that's 52 influential black nurses! Highly recommend. 

Curious1997, BSN

Specializes in Psych, Medical. Has 13 years experience.

4 hours ago, londonflo said:

I don't need to use my imagination....I read primary resources. Gone to Oxford and read the primary sources, analyzed them and wrote a comprehensive paper and presentation.  

I have evaluated the  primary sources and information, the time in which it was written and the outcome of the dissemination of the facts.

umm, like you? Give us the facts you have used to evaluate FN claims and work.

 

My knowledge base is deep and thorough. You are making jumps in your understanding of the conceptual basis of history.. that may be okay for a blowhard ......but I do wish you good luck in your real estate business, travel throughout the world and attending concerts with back stage passes! You have no experience, education and credentials as a scholar. Stay in your own lane

You really need to look into controlling your emotions. Many detrimental physiological effects when you don't. I will take your advice and stay in my lane. Too many overly emotional people in the other lanes. Thank you for the excellent advice. 

londonflo

Specializes in oncology. Has 44 years experience.

27 minutes ago, Curious1997 said:

You really need to look into controlling your emotions. Many detrimental physiological effects when you don't.

Please don't concern yourself with my emotional or physical health.  In fact, attributing my facts to 'emotions' shows immaturity/old world views (are you from the 1950's?) or an inability to counter facts because of a poor knowledge base of Florence Nightingale and/or the use of primary sources. A suggestion from me would be to read "Nursing What it is and What is not" by Florence Nightingale. A groundbreaking book of how nursing concepts can be used to benefit patients.

https://store.doverpublications.com/048622340x.html

For less than $10.00 you will learn about her theories of the care of the sick.

Best wishes for your educational journey.

 

londonflo

Specializes in oncology. Has 44 years experience.

2 hours ago, LibraNurse27 said:

And, many women of color also did a lot for nursing and are only recently being recognized.

Don't forget Mary Seacole! She also was a strong nurse during the Crimean War who set up hospitals.

https://en.wikipedia.org/wiki/Mary_Seacole

londonflo

Specializes in oncology. Has 44 years experience.

3 hours ago, SusannahM said:

I will also add this statement was written to be perceived as purely anecdotal (from my experience with my professors in nursing school), and not intended to be stated as fact. So sorry for the confusion!

It is a fact.  For an overall look at the life of Florence Nightingale, I recommend this book: "Florence Nightingale" by Mark Bostridge. There is much more to Florence than the 'Lady with the Lamp'.