Graduating from lantern to flashlight.

[AutumnApple]

Florence Nightingale. AKA: The Lady with the Lamp

Born on the 12th of May, 1820.

Adored by nurses and the general public alike. Her story of going from privileged status to a nursing career, as she followed a "calling", is the stuff movies are made of. She dedicated herself nursing in a way few in history can match, going as far as declining to marry a man she loved (who her family thought highly of as well, as the story goes) because it would have interrupted following her calling. She also served as a nurse during the Crimean War, and it is well documented that the health of wounded soldiers improved dramatically as a result.

The body of theory Florence contributed to nursing continues to be our foundation. From the Environmental Theory which is explained in "Notes on Nursing: What it is, what it is not" to her assertions that nursing requires specific education, her contributions are many.

To summarize: The Lady with the Lamp paid her due to be respected as a nurse and a nursing theorist.

Believe it or not though, this article is not about Florence Nightingale per se. It's about all of us who have followed her and what we've (not) done to continue on the path she set us on. I have a problem with how Florence continues to be the one, lone poster child for nursing theory. Jean Orlando did create the Nursing Process Theory in 1958, but unlike Nightingale her work remains hidden within the profession of nursing. Most of the general public have never heard of her. I have a problem with this in part because I believe Nightingale's theory hurts the profession as much as it helps it and (more so) because I am of the opinion that we should be well beyond the point in which her theory is the only widely accepted nursing theory.

One must understand, Nightingale's theory emphasized subservience to those who have medical education. Yes, this means accepting that we are beneath or less valuable than doctors. While I am not one who enjoys the Doctors vs. Nurses drama, this strikes a nerve with me. It seems to be an indirect contrast to her view point that nursing requires a specific education. If we truly are receiving a specific education, then we are neither above nor bellow anyone outside our ranks. It's comparing apples to oranges.

And this point highlights why I think our profession has outgrown using Nightingale as the theoretical (no pun intended) spokesperson for our profession. The general public is in love with her story, most notably the ascetic qualities of it, not her theory. Take note of the things people complain about right here on this very site. Poor compensation due to an expectation to do our duties "for the calling", lack of respect from other healthcare team members (and employers, and patients), a high turnover/burnout rate. The ascetic values placed on us by people outside the profession are the catalyst for all of this.

In the end, we are left with a spokesperson for our profession whose values and beliefs promote qualities that have a negative effect on the profession. And this is the point of the article. Why does she continue to be the primary focus when nursing theory is discussed? Because none who have followed her (note Nightingale's birth date for a complete understanding of how pathetic this is) have contributed enough to build upon her works.

What little we have produced to build upon nursing's body of theory is not accepted outside our ranks. This is partially because modern nursing theory lacks Nightingale's ascetic values, which are very important to those who wish to keep us in our place. But (everything that comes before *but* doesn't count) that accounts for only a small portion of the explanation of why we are where we are. The primary reason is because the majority of what we produce, theory wise, is pure garbage.

Sure, we have nursing care plans (considers vomiting in mouth), and we have nursing diagnosis (vomits in mouth) but the rest of what we have to say about our own profession is either heavily influenced by outsiders (employers, government run BON) or mostly borrowed (business leadership, psychology). None of this develops respect for our profession.

As I said, I have a problem with Florence Nightingale being the poster child for nursing theory. Not because I don't think she produced sound, reasonable theory but because I think she should be one of many who have done so. It's hard to take nurses seriously when the proclaim "Nursing is a profession" considering that we have not.

Some steps I propose to achieve this:

• Correct our thinking and let others follow: We continuously refer to people in history as nurses who did not perform nursing. Back in the day when *nurses* ran circles through churches doing chores but weren't allowed to touch patients is the perfect example. How is this nursing? These women (it was only women then) were even expected to provide *sexual relief* to patients. Today, we would not call these people nurses, so stop referring to them as such when discussing our history. They'd be called housekeeping, dietary and a few other things.
  
• Do away with corporate driven "book keeping" style nursing theory like nursing care plans and diagnosis. Produce theory that better represents us as a profession. If it's truly better than what already exists, people will naturally follow our lead.
  
• Develop more of a comradery within the profession. Doctors, lawyers, truck drivers and law enforcement all have it. Why not us. For our theory to be taken seriously, we must first act like people worthy of being taken seriously. That is not going to happen if we continue to focus on bringing each other down. We need to remember who the real enemy is.
  

I'm sure there is even more we can do, but this would be a start at least. Then perhaps we can start to graduate from The Lantern to a flashlight or something.

[RNperdiem, RN]

I love nursing history. Interestingly the way Florence Nightengale is portrayed says as much about the time as about the person.

I think if there was a movie being made today about Florence Nightengale, it would show more the political activist, non-conforming woman, statistician that she was.