Notes on Nursing: What It Is, and What It Is Not/Florence Nightingale

FLORENCE NIGHTINGALE.




Florence Nightingale will be, through all time to come, the representative nurse par excellence. In her case it is a special calling, in virtue of natural capacity, moral and intellectual at once. She did not set out from any chosen starting point. She did not propose to earn her own salvation by a life of good works. She was not incited by visions of a religious life in a favored monastic community. She did not aspire to take in hand a department of human misery, in order to extinguish it, and then look about to see what particular misery it should be. She does not appear to have had any plans relating to herself at all. Nor was she overtaken by the plague in a village; nor did she overtake a fever in a village in the course of her travels, like her representative sisters of an earlier time; nor did she do the work of the occasion, and reenter ordinary life as if nothing had happened. Her case is special and singular in every way.

Her childhood and youth where very much like those of little girls who have wealthy parents, and carefully chosen governesses, and good masters, and much travel — in short, all facilities for intellectual cultivation by study and extended intercourse with society, at home and abroad.

The peculiarity in the case of herself and her nearest relatives seems to be their having been reared in an atmosphere of sincerity and freedom, — of reality, in fact, — which is more difficult to obtain than might be thought. There was a certain force and sincerity of character in the elder members on both sides of the house which could not but affect the formation of the children's characters; and in this case there was a governess also whose lofty rectitude and immaculate truthfulness commanded the reverence of all who knew her.

In childhood a domestic incident disclosed to the honest-minded little girl what her liking was, and she followed the lead of her natural taste. She took care of all cuts and bruises, and nursed all illness within her reach; and there is always a good deal of these things within the reach of country gentry who are wealthy and benevolent. For the usual term of young-lady life, Florence Nightingale did as other young ladies. She saw Italy, and looked at its monuments; she once went to Egypt and Greece with the Bracebridges; she visited in society, and went to court. But her heart was not in the apparent objects of her life — not in travel for amusement, nor in art. In literature, books which disclosed life and its miseries, and character with its sufferings, burnt themselves in upon her mind, and created much of her future effort. She was never resorted to for sentiment. Sentimentalists never had a chance with her. Besides that her character was too strong, and its quality too real, for any sympathy with shallowness and egotism, she had two characteristics which might well daunt the sentimentalists — her reserve, and her capacity for ridicule. Ill would they have fared who had come to her for responsive sympathies about sentiment, or even real woes in which no practical help was proposed; and there is perhaps nothing uttered by her, from her evidence before the Sanitary Commission for the Army to her recently published "Notes on Nursing," which does not disclose powers of irony which self-regardant persons may well dread.

Such force and earnestness must find or make a career. She evidently believes, as all persons of genius do, that she found it, while others say she made it. Philosophy will hereafter reconcile the two in her case and many others. As a matter of fact, while other young ladies were busy, and perhaps better employed than usual, in enjoying the great exhibition, she was in the Kaiserwerth Institution, on the Rhine, going through the training for nursing, and investigating the methods of organization there and elsewhere.

The strongest sensation she perhaps ever excited among her personal acquaintance was when she undertook to set up the Sanitarium in Harley Street, and left home to superintend the establishment. Her first work there was chiefly financial; and the powers of administration she manifested were a complete justification of what she had done in leaving her father's house to become what people called the matron of a charity. At first common-minded people held up hands and eyes as if she had done something almost scandalous. Between that day and this they must have discovered that she could exalt any function, and that no function could lower her. She rectified the accounts, paid the debts, and brought all round; and she always had leisure to help and comfort the sick ladies in the house. At one time, I remember, there was not a case in the house which was not hopeless; but there was no sign of dismay in Florence Nightingale. She completed her task, showing unconsciously by it how a woman as well as a man may be born to administration and command.

By a sort of treachery only too common in the visitors of celebrated people, we have all seen the letter of Mr. Sidney Herbert, in 1854, entreating Miss Nightingale to go — accompanied by her friends the Bracebridges, who are familiar with life in the East — to Turkey, to minister among the sick and wounded of our army. How soon she was ready, and how she and her band of nurses went, and were just in time to receive the wounded from Inkermann, no Englishman forgets. No man of any nation concerned will ever forget her subsequent services. She had against her not only a chaos of disorder in which to move, and a hell of misery around her to relieve, but special difficulties in the jealousy of the medical officers, the rawness of the nurses so hastily collected, and the incompatibilities of the volunteer ladies who started on the enterprise with her or after her. On the state of the hospitals it can, I hope, never be necessary to enlarge again. We all know how, under her superintendence, places became clean and airy, and persons cleanly, clothed, fed, and afforded some chance of recovery from maladies or wounds. While history abides, the image of Florence Nightingale, lamp in hand, going through miles of beds, night by night, noting every patient as she went, and ministering wherever most wanted, will always glow in men's hearts; and the sayings of the men about her will be traditions for future generations to enjoy.

She was prostrated by the Crimean fever at Balaklava, and carried up to the hospital on the cliffs till she began to mend, when she was taken to sea. She would not come home, because her work at Scutari was not finished. She remained there till the end of the war; by which time she and her military and medical coadjutors had shown what hospitals may be, and how low the rate of mortality of an army may be reduced, even in time of war.

She has never recovered from that fever; and for some years she has been confined by severe and increasing illness. Not the less has she worked, steadily and most efficiently. She cannot fulfil her aim — of training nurses in an institution of her own, and thus raising up a body of successors. The grateful people of England supplied the means, without her knowledge or desire, which was the same thing as imposing a new service upon her. She wished to decline it when she found how little likely her health was to improve. Her letter to the trustees of the fund must be fresh in all memories, and the reply of the trustees, who satisfied her that the money was accumulating, and the plan and the public able and willing to wait. If she could not do this particular work, she has done many others. Her written evidence before the Sanitary Commission for the Army is a great work in itself. So are various reforms urged on the military authorities by her and her coadjutors, and now adopted by the war office. Reforms in the Indian army are about to follow. The lives thus saved no one will attempt to number; and the amount of misery and vice precluded by her scientific humanity is past all estimate.

Her "Notes on Nursing," prepared and issued in illness and pain, are the crowning evidence of what she is, and can do. Hitherto we have, I trust, appreciated and honored her acts; now we are enabled to perceive and appreciate her mind. It was as certain before as it can ever be that she must have acquired no little science, in various departments, to produce the effects she wrought; but we see it all now.

We see also, much more clearly than ever, her moral characteristics. I will not describe them when they can be so much better seen in her "Notes on Nursing." Any one who reads those Notes without being moved in the depths of his heart will not understand the writer of them by any amount of description; and those who have been so moved do not need and will not tolerate it. The intense and exquisite humanity to the sick, underlying the glorious common sense about affairs, and the stern insight into the weaknesses and the perversions of the healthy, troubled as they are by the sight of suffering, and sympathizing with themselves instead of the patient, lay open a good deal of the secret of this wonderful woman's life and power. We begin to see how a woman, any thing but robust at any time, may have been able, as well as willing, to undertake whatever was most repulsive and most agonizing in the care of wounded soldiers and crowds of cholera patients. We see how her minute economy and attention to the smallest details are reconcilable with the magnitude of her administration, and the comprehensiveness of her plans for hospital establishments, and for the reduction of the national rate of mortality. As the lives of the sick hang on small things, she is as earnest about the quality of a cup of arrowroot, and the opening and shutting of doors, as about the institution of a service between the commissariat and the regimental, which shall insure an army against being starved when within reach of food. In the mind of a true nurse nothing is too great or too small to be attended to with all diligence; and therefore we have seen Florence Nightingale doing and insisting upon the right about shirts and towels, spoon-meats, and the boiling of rice, and largely aiding in reducing the mortality of the army from nineteen in the thousand to eight, in times of peace.

In the spirit and tone of this book we see, too, how it is that, with all her fame, we have known so little of the woman herself. Where it is of use to tell any piece of her own experience, she tells it; and these scraps of autobiography will be eagerly seized upon by all kinds of readers; but, except for the purpose of direct utility, she never speaks of herself, more or less, or even discloses any of her opinions, views, or feelings. This reserve is a great distinction in these days of self-exposure, and descanting on personal experiences. It is the best possible rebuke to the egotism, or the sentimentality, which has led several ladies to imagine that they could be nurses, without having tried whether they could bear the discipline. Her pure, undisguised common sense, and her keen perception of all deviations from common sense, may have turned back more or fewer women from the nursing vocation; but this is probably an unmixed good; for those who could be thus turned back were obviously unfit to proceed. She is the representative of those only who are nurses; that is, capable of the hardest and highest duties and sacrifices which women can undertake from love to their race.

In the end she will have won over far more than she can have (most righteously and mercifully) discouraged. Generations of women for centuries to come will be the better, the more helpful, and the more devoted for Florence Nightingale having lived; and no small number of each generation will try their strength on that difficult path of beneficence which she has opened, and on which her image will forever stand to show the way. Ingleby Scott.


THE JEWEL PRESENTED TO MISS NIGHTINGALE,
BY QUEEN VICTORIA.