Cropped from a Nightingale Panorama

Deva-Marie Beck, PhD, RN
Extract from the publication Florence Nightingale Today:  

Florence Nightingale began her work at a neighbourhood hospital in London and established her career during the Crimean War. She published a little book that is still in print, often quoted by nursing students and frequently cited in the nursing literature. Later, she oversaw and inspired the growth of a school that would become a cornerstone for modern nursing education. These examples are like well-worn cameos cherished as keepsakes — stories told about the beginnings of modern nursing, as it is practiced, even now, more than a century later.

In the Crimea, Nightingale carried a lamp to illumine her rounds during night shifts at Scutari hospital in Constantinople. Her lamp was a simple cylinder, wrought with an open metal framework to carry one lighted candle. It was covered with a thin parchment to keep the flame from blowing out as she walked along the drafty passages and to keep the firelight from being too bright in the soldiers’ eyes. Later, several men wrote home about how much her nightly rounds meant to them. This story caught fire in the hearts and minds of families who worried about their sons and husbands on a battlefield far away. Her flame became a metaphor — first for her exemplary caring during a deeply-troubled period — and, then, for the illumination her insights have brought to later times. The candle carrying her legacy is still lit, illuminating these treasured stories about her life.   

Thus, Nightingale became the most often-named nurse in human history.  But these stories have been cropped from a much larger panorama of her fifty-year career. Beyond her own neighborhood and her country’s battlefield, Nightingale took nursing much further still, to villages and cities around the world, to the halls of leadership and to behind-the-scenes discussions that would shape the history of human health in far-reaching ways. Although she wrote one famous, oft-cited book, she also wrote 20 others, 100s of monographs and articles, and at least 14, 000 letters now cataloged in private collections around the world (McDonald, 2000).

Together, Nightingale’s books, articles, monographs, and letters comprise an opus of written contributions — not just for the evolving field of nursing, but also for several interrelated health promotion disciplines — rarely matched by any of her 19th century contemporaries, male or female, in any field (Dossey, 2000). Her tremendous body of work is, just now, becoming available to 21st century readers. 

This larger Nightingale panorama — that she called nursing — has remained essentially hidden, left nearly invisible beside that album of familiar stories about her career. In her extensive review of nursing history, Dolan (1968) has touched upon this Nightingale panorama and its import, calling Nightingale "one of those rare and gifted people who transcend the period of their own existence and whose plans and accomplishments represent the thinking of a much later period in history" (Dolan, 1968, p. 211). She suggested that the Nightingale panorama be brought out again, to be studied — beside her better-known stories — for relevance to exemplary caring in today’s deeply-troubled time. The light shining from Nightingale’s well-known life can spread — across the field of her lesser-known work — to further illuminate the health issues faced today. 

The early 21st century has become — like others before it — both the best and worst of times. Current health care issues are complex — dynamic with successful developments, and fraught with significant risk. As a global thinker, Nightingale would have loved 21st century globalization and the challenge of our issues. She would have been keen to learn about emerging trends. She noted cultural, social and economic concerns, particularly how these relate to human health and to the discipline of nursing.  Her own writing urged nurses to progress in our practices, to continue to think outside the box of our established domains.  

As Nightingale’s panorama is unfolded, her wider blueprint becomes visible. In support of the nursing premises already well- established, Nightingale’s insights continue to detail her call for excellent, comprehensive care of sick and injured individuals. Yet, her own nursing career also encompassed the earth, demonstrating excellent, comprehensive care for humanity.

Like the larger millennium time we live in, contemporary nursing is at a crossroads. Despite the difficulties nurses face today, we can struggle along, as nurses have before. Or, we can pause to consider and to create what nursing could become. Nightingale’s world needed her. Our world needs nursing. The wide-range of things she learned can widen the range of choices nurses can take — to bring each of our nursing practices, with whatever we each choose to do, to humanity’s needs. This chapter introduces the idea that nurses can, like Nightingale, become global visionaries for the health of humanity. As we stand at our own crossroads, her light can help us see.