Florence Nightingale (1820–1910) was a nurse, a social reformer, a statistician and a pioneer of information design.
Featuring artwork & words by Dr. Eleonora Adami, Sci-Illustrate Stories. Set in motion by Dr. Radhika Patnala.
Early years and call to nursing
Florence Nightingale was born on 12 May 1820 into a wealthy British family in Tuscany, Italy, and was named after the city of her birth.
Florence received a liberal and humanitarian upbringing, influenced by the progressive mindset of her father, who had her study classical literature, philosophy as well as mathematics, something very uncommon for women at the time.
In 1838, when Florence was 18 years old, her father took the family on a sort of Grand Tour of Europe, at which point two fundamental things happened: i) Florence started displaying a specific inclination towards recording and analysing information and data, which she put to great use later in life, and ii) she was introduced to the Parisian hostess Mary Clarke, who had a big influence on the young Florence. This woman, with whom she deeply bonded despite the 27-years age difference, was cultured and independent and embodied the idea that women could be equals to men.
When in Thebes, Egypt, she experienced a “call to God” as recorded in her diary: “God called me in the morning and asked me would I do good for him alone without reputation.” Indeed, Florence struggled with the restrictions and the expectations of an upper-class marriage for a woman of her rank in Victorian England and decided instead to devote her life in service of others, by becoming a nurse, an occupation (not even a proper profession!) deemed well beneath her social status.
Later in 1850, she visited the Lutheran religious community at Kaiserswerth-am-Rhein and received four months of medical training, which formed the basis for her later care.
Three years later, she became superintendent of a London’s women’s hospital.
In 1853, Crimea was about to be set aflame by a military conflict between Russia and an alliance of the UK, France, the Ottoman Empire and Sardinia.
When reports got back of the horrible conditions for the wounded at the military hospital near Constantinople, Florence and a staff of 38 volunteer nurses were sent to help.
When they arrived, they found overcrowded wards, overworked medical staff, medicines in short supply, poor hygiene, lack of administrative oversight. She reported that ten times more soldiers were dying from infections and illnesses such as typhus and cholera, than in the battlefields.
Involving the sanitary commission and making improvements on ventilation/hygiene herself, Florence helped reach a reduction of -40% in the death rate, although she never took credit for it. This experience deeply influenced her later career, when she advocated good sanitary living conditions as of utmost importance.
A parallelism with advocacy for good hand hygiene, ventilation and physical distancing during the currently unfolding Covid-19 outbreak infallibly comes to mind. As it is evident today, communicating medical, epidemiological data clearly is essential for effective measures to be understood and then put into action. Florence recognized the importance of communicating data effectively and put her natural proclivity for statistics to good use.
She made extensive use of graphics, especially polar area diagrams (now also known as Nightingale Rose diagram), to present reports on the medical care conditions to members of the parliament and others who were unlikely to read traditional statistical documentation. Her graphs were bold, explanatory and demanded a call for action and she explained them in layman terms.
In this form, printed Tables & all in double columns I do not think anyone will read it. None but scientific men ever look into the Appendix of a Report. And this is for the vulgar public.
One of her most famous plots, besides the one included above (yes it was hers!), is perhaps the one where she summarises the effectiveness of the measures implemented in Crimea in terms of deaths/1000 people, comparing the hospitals in the war zone to death rates in London (the inner circle) in the same years. The comparison to the situation in London resonated with people!
In 1855, the Nightingale Fund for training nurses was established in recognition of her contribution and Florence became known as “the lady with the lamp” from an excerpt in a report in The Times:
She is a “ministering angel” without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow’s face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds.
Cited in Cook, E. T. The Life of Florence Nightingale. (1913)
The transformation of nursing
The fund was used to establish a training school, now called Florence Nightingale School of Nursing and Midwifery and part of King’s College London. She wrote several publications and a book, Notes on Nursing (1859), that served as the cornerstone of the school’s curriculum and it’s considered today a classic introduction to nursing.
“The book was the first of its kind ever to be written. It appeared at a time when the simple rules of health were only beginning to be known, when its topics were of vital importance not only for the well-being and recovery of patients, when hospitals were riddled with infection, when nurses were still mainly regarded as ignorant, uneducated persons. The book has, inevitably, its place in the history of nursing, for it was written by the founder of modern nursing”.
Joan Quixley on the 1974 edition of the book
Florence was stubborn and undoubtedly came from a position of privilege, which she exploited for a greater good, in constant opposition to an elite class of doctors and Army officers, who were refractory to change (and admission of incompetence in some cases). Florence was a civilian, with her own funds, who did not have to answer to military hierarchies. Naturally, many resented her. In spite of this, her influence was far-reaching and her studies on sanitation, years before germ theory was finalised by Pasteur and Lister, helped introduce new standards of care and public health service in Indian rural areas. Between 1858–59 she lobbied for the establishment of a Royal Commission to work on sanitary reforms in India. In 1873, she reported that mortality among British soldiers in India had greatly diminished (from 69/1000 to 18/1000).
Florence went on dedicating her life to the transformation of nursing into a proper profession and was engaged in the field of hospital planning, even during her bed-ridden years. By 1882, her mentees had become employed at several leading hospitals throughout Britain and even Australia. She became the first recipient of the Royal Red Cross and in 1907 she was the first woman to be awarded the Order of Merit.
Florence died in 1910 at the age of 90.
1820 — Born in Florence, Italy
1838 — Traveling across Europe
1850 — Medical training in Kaiserswerth-am-Rhein
1853–54 — Superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London
1854–1856 — Caring for the sick and wounded during the Crimean War
1855 — Florence Nightingale School of Nursing and Midwifery, now part of King’s College London, was founded.
1859–1st ed. of Notes on Nursing was published.
1858 — onwards — Engaged in promoting sanitary reforms at various levels.
1910 — Dies aged 90.
Refs / If you want to know more:
Florence Nightingale - Wikipedia
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About the author and artist
DR. ELEONORA ADAMI
Content editor and contributing artist
Women in Science, Sci-Illustrate Stories
Eleonora is a proud descendant of ancient Romans. Besides that, she is currently a postdoctoral research fellow at Duke-NUS in Singapore, working in the cardiovascular and metabolic diseases area. She has a biotechnology (BSc) and functional genomics (MSc) background, and has obtained her PhD in molecular biology and genetics in Germany before going to the far east.
Eleonora thinks of herself as a carrier pigeon, always on the go, trying to find new adventures and challenges. Ok, maybe pigeons are not very adventurous, but they were once useful to deliver important messages. One of the messages she likes to bring across is that we need more art in scientific practices. Creative thinking benefits both disciplines.
A passion for illustration has always accompanied her and percolates in her scientific work. She started the collaboration with the Sci-Illustrate team after attending their course on scientific illustration.
About this series:
Not enough can be said about the amazing Women in Science who did and continue to do their part in moving the world forward.
Every month, through the artwork & words of the Sci-Illustrate team, we will bring to you profiles of women who touched our hearts (and brains) with their scientific works, and of many more who currently hold the flag high in their own fields!
-Dr. Radhika Patnala, Series Director