Chapter 4

Florence Nightingales Legacy of

Caring and Its Application
Developed by Bonnie Pope (2010)
Updated by D. Gullett (2014)

Copyright 2015. F.A. Davis Company

On completion of this chapter, students will be

able to:
1. Summarize significant events in Nightingales life that led her to
nursing and influenced the development of her Philosophy of nursing.
2. Discuss the influence of Nightingales spirituality on her practice of
nursing.
3. Compare and contrast the medical milieu of the 1800s with the
medical milieu of today.
4. Discuss the impact of Nightingales feminist view within the context of
her work.
5. Discuss Nightingales conception of nursing and analyze the
elements of Nightingales Theory of Nursing.

Copyright 2015. F.A. Davis Company

Introducing the Theorist: Florence Nightingale

Founder of modern nursing
Authored Notes on Nursing: What Nursing Is and What Nursing Is Not (Nightingale, 1859)
Wrote over 20,000 letters in her lifetime to persons of power in Great Britain advocating for nursing as a
profession
Born in 1820 in Florence, Italy, the city she was named after
Left a legacy of humanism, liberal thinking, and love of speculative thought due to her fathers influence
Her father believed in educating women

Copyright 2015. F.A. Davis Company

Introducing the Theorist

(continued)

Florence and her sister studied

Music; grammar; composition; modern languages; Ancient Greek
and Latin; constitutional history and Roman, Italian, German, and
Turkish history; and mathematics

Travel also played a part in Nightingales education

Visited Germany
First acquaintance with Kaiserswerth, a Protestant
religious community that contained the Institution for the
Training of Deaconesses
Hospital school, penitentiary, and orphanage

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Nightingale Returned in 1851

Against much family opposition

Stayed from July through October
Participated in nurses training
In 1852, Nightingale visited Ireland, touring hospitals and
keeping notes on various institutions along the way.
1853 Nightingale took two trips to Paris
Hospital training with the sisters of St. Vincent de Paul,
an order of nursing nuns.
In August 1853, she accepted her first official nursing post

Copyright 2015. F.A. Davis Company

Spirituality
A few months before her seventeenth birthday,
Nightingale recorded in a personal note that she
had been called to Gods service.
It took 16 years, from 1837 to 1853, for
Nightingale to actualize her calling to the role of
nurse

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For Nightingale: No Conflict Between Science and

Spirituality

In her view, science was necessary for the

development of a mature concept of God
Nursing should be a search for the truth, a
discovery of Gods laws of healing and their
proper application

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Crimean
War
Provided the stage
to actualize
her foundational
beliefs
Rooting forever in her mind certain truths
Drawn closer to those suffering injustice
In the Barracks Hospital of Scutari, Nightingale
acted justly and responded to a call for nursing
from the prolonged cries of the British soldiers
(Boykin and Dunphy, 2002, p 17).
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Nightingale
Appointed to head a contingent of nurses to the
Crimean War
Provide help and organization to the deteriorating
battlefield situation

It was a brave move

Medicine and war were exclusively male domains
To send a woman was risky

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Crimea Experiences
Cemented her views on disease and contagion
Strengthened her commitment to an
environmental approach to health and illness

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 Nursing became a science when Nightingale

Introducing
the Theory
identified
the laws of nursing,
also referred to as
the laws of health or nature

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Goal of Nursing
Analysis and application of universal laws
would promote well-being and relieve the
suffering of humanity
Used the presentation of statistical data to prove
her case that the costs of disease, crime, and
excess mortality was greater than the cost of
sanitary improvements

Copyright 2015. F.A. Davis Company

Goal of Nursing
Assisting the patient in his or her retention of
vital powers by meeting his or her needs
Putting the patient in the best condition for
nature to act upon (Nightingale, 1860/1969)
Voice of Florence Nightingale

Copyright 2015. F.A. Davis Company

Assumptions

Nursing is separate from medicine

Nurses should be trained

Florence was trained for just 3 months in Germany to become a
nurse
The environment is important to the health of the patient
The disease process is not important to nursing
Nursing should support the environment to assist the patient in
healing
Research should be used through observation and empirics to
define the nursing discipline

Copyright 2015. F.A. Davis Company

 Nursing is both an empirical science and an art

Assumptions
Nursings concern is with the person in the
environment
The person is interacting with the environment
Sick and well are governed by the same laws of
health
The nurse should be observant and confidential

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Health

Viewed as an additive process

Result of environmental, physical, and psychological
factors, not just the absence of disease

Diseasereparative process of the body

To correct a problem and could provide an opportunity
for spiritual growth

Copyright 2015. F.A. Davis Company

 The laws of health, as defined by Nightingale,

Environmental Components of
were those to do with keeping the person and
Health
the population healthy

Clean air
Pure water
Efficient drainage
Cleanliness
Light

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Patient
At the center of the Nightingale Philosophy
Her philosophy of nursing incorporates a holistic
view of the person
Someone with psychological, intellectual, and spiritual
components

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Nurse
Defined as any woman who had charge of the personal health of
somebody,
Whether well, as in caring for babies and children, or sick, as an
invalid (Nightingale, 1860/1969).

Copyright 2015. F.A. Davis Company

Nightingale on Women
Assumed that all women, at one time or another in their lives, would
nurse.
All women needed to know the laws of health.
Following the Crimean War, from August 1857 to 1880, Nightingale
suffered several bouts of significant illness. On Christmas 1861, a
neurological attack left her unable to walk and she remained
bedridden for six years. Nightingale became her own patient.
The nature of Nightingales illness has never been confirmed by
medical researchers
After her death medical opinion favored the diagnosis of
neurasthenia, an obsolete term denoting a symptom complex
now associated with psychosomatic illness

Copyright 2015. F.A. Davis Company

Nursing

Nursing proper, or sick nursing, was both an art and a science

Required organized, formal education to care for those
suffering from disease
Nursing was service to God in relief of man
Nursing activities served as an art form through which
spiritual development might occur
Nightingales ideas about nursing, health, the environment, and
the person were grounded in experience
She regarded ones observations as the only reliable means of
obtaining and verifying knowledge.

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Nightingales Legacy for 21st Century Nursing Practice

Caring
Activism
Research

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References
Boykin, A., & Dunphy, L. M. (2002). Justice-making: Nursings call. Policy,
Politics, & Nursing Practice, 3, 1419.
Nightingale, F. (1860/1969). Notes on nursing: What it is and what it is not. New
York, NY: Dover.

Copyright 2015. F.A. Davis Company