What Would Florence Say if She Could See Us Now

What would she think if she saw us now?

Florence Nightingale was a daughter of privilege with a well-rounded education in languages and the arts and with connections to high society of her time. She was able to see beyond her class and use her relationships for the greater good.  Her approach to nursing was a public health approach. She understood that illness and disease were as much, if not more the result of social and economic inequities such as lack of sanitation and pure water, of underprivilege and poverty as they were infections. She demonstrated this in her work in the Crimea which reduced infections and mortality ( by ⅔) by having able soldiers scrub the floors and walls of the hospitals and bathing soldiers found lying in their own waste. 

Florence Nightingale’s understanding of what constitutes good health and what the root causes of bad health are informed by her combined approach to achieving health through social reform and data collection. Florence collected data and set the foundation for evidence-based treatment and prevention. In a study she did for the army she determined that 16,000/18,000 men died from preventable diseases during the Crimean War and not on the battlefield This comprehensive approach continues to guide good practice and public health.

There is a direct connection between scrubbing the walls and floors in the Crimea in 1852 to the recent plugging of the rodent holes in the walls of a Harlem building (Harlem Children’s Zone Asthma Initiative) to reduce the incidence and prevalence of severe asthma in the children living in the building.

What would she see if she saw us now?

She would see us true to her words: “What nursing has to do….is to put the patient in the best condition for nature to act upon him”.

Prevention is a primary principle of Nursing care-from proning Covid patients, to protocols for prevention of pressure sores to neonatal monitoring and beyond. 

“ Building trusting relationships with patients”

She would see nurses who cared for so many during Covid and who in the end, literally, were the ones with the patients. She would see those same nurses fight for the supplies they needed to care for their patients just as she fought for brushes to scrub the floors of Scutari in 1852.

What would she see if she saw us now?

A profession of women and men- 4million alone in the US who are the bedrock of health care, whose skills range from hospital bedside, critical care, extended care, ambulatory care, home care, nurse researchers, mental health nurses and beyond.

She would see that the nursing process still holds: she arrived in Scutari, assessed the situation, took charge, implemented her plan, and had the data to make permanent changes that benefited thousands. Nursing practice continues on these principles.

She would see nurses answering the call to war as she did- through every War since The Crimean. 

She would see a grateful public beloved to Nursing- from small-town America to large urban areas and best expressed by President Biden based on his personal and family experiences on the eve of his inauguration.

There is no nobler profession.

She would be proud

She would be satisfied with the health care system in her own country- the UK. A national Health System that serves all.

However, I feel she would be less satisfied with the United States which has no system and grave inequalities in health care delivery, access and affordability- though somewhat improved with the Affordable Care Act but not in every state. Nothing exposed the inequities in our health system more than the Covid pandemic as was evident in the distribution of vaccines, vaccinations, access to care and and increased mortality in underserved and underprivileged communities.

Florence would find the greatest challenge to Nursing’s future in the fact that there is still no standard for education and level of entry and that fact, despite being beloved by the public, continues to undermine Nursings’ credibility with doctors, other professionals and health care administrators. I believe she would fight for standardization in order to achieve the credibility necessary for an equal voice and a seat at the table to advocate for critical issues that impact patient care: the resources to provide excellence in care, safety, optimal pt/staff ratios.

May the words from “lady with the lamp” continue to illuminate us: