1. The Crimean War

The Crimean War (1853-1856), was fought between Russia on one side and Turkey, France, Britain, and Sardinia on the other side. Although militarily insignificant, it was politically important. The war rose from a dispute over protection of the holy places in Palestine, then under Ottoman Turkish rule. By weakening Russia and by making the Italian question one of general European concern, it furthered the success of national movements in Italy, Germany, and the Balkans, and led to the reorganization of the European state system. The Turks declared war against Russia in October 1853. Britain and France feared Russian domination of the route from the Black Sea to the Mediterranean, and so choose to help Turkey. When a Turkish fleet was destroyed by Russia, French and British fleets sailed into the Black Sea; their armies went to Crimea in September 1854 and laid siege to Sebastopol for a year. In autumn 1855 and early in 1956, Russia accepted peace terms. Most to the losses on both sides resulted from hunger, exposure and disease during the siege. Russia blindly stumbled, to destroy the myth of Russian military might and to set free in Central Europe the forces of liberal nationalism [1].

2. Nightingale’s Own Campaign

The Crimean War, Was the first war to take place in the era of steamships and telegraph. “The Time” newspaper despatched a correspondent to cover the war, and he sent back a graphic description of Scutari Military Hospital, which was overcrowded, had blocked sewers, no blankets, no bandages and no trained nurses. Sydney Herbert, a cabinet minister who was a friend of Nightingales, asked Florence to go to Scutari and recognize it, which she did.

Florence took contingent of Catholic, Anglican, secular and trained nurses with her to the Scutari Military Hospital to care for the British wounded in the Crimean War. She found conditions in the overcrowded military hospitals appalling: miles of dirty beds, no facilities or equipment with which to care for or properly feed the soldiers and a mortality rate which at times reached over 40 per cent [2].

She not only offered aid and comfort, but restructured many military hospital services, waging her own war on disorganization and dirt. Together with others, her efforts paid off handsomely. When Nightingale’s party first arrived at the Scutari base camp in November 1854, the soldiers there were suffering a 60 per cent death rate. But at the end of the period of her reorganization of the hospitals there and at Balaclava, the mortality rate dropped just to over one per cent, with an overall drop in British military hospitals from 42 per cent to 2.2 per cent. While many factors contributed to this drop, the cleaning and scrubbing she organized undoubtedly helped. From her time at least, the cleansing and whitewashing of up-to-date hospital interiors left its own chemical scent on the staff and inmates [3]. Although most of her hours were spent in organizing, directing, and writing, the soldier quickly responded to her obvious concern for their welfare: “we lay there by the hundreds; but we could kiss her shadow as it fell and lay our heads on the pillow again content [4]”.

Figure 1. Florence Nightingale founded the modern secular school of nursing

Even though she was received with suspicion and confronted with every practical and administrative difficulties, she instituted reforms and won the veneration of the troops, who called her the “Lady with Lamp [5]”. Intense opposition to her by local military officials evaporated gradually in the face of ever-increasing casualties and deaths. Despite of the opposition of the military doctors, she had the hospital hygienic, well run and successful before she left it. The death rate fell from over 40 per cent to just 2 per cent. Not all of the opposition to Nightingale was merely personal. Even on the 20th century, several leaders of nursing believe that her focus on beside care to the virtual exclusion of more scientific methods of teaching and practicing is too narrow. Curiously, she was not convinced that bacteria caused disease and continued to hold the ancient belief in “miasmas” as responsible. But she preached the necessity for cleanliness and observed clearly that the separation of maternity patients from sick people in a hospital was essential to their safe care. Miss Nightingale’s tenets are still cogent: “The art is that of nursing the sick. Please mark, not nursing sickness.... This is the reason why nursing proper can only be thought at the patient’s beside and in the sick room or ward. Lectures and book are valuable accessories [6]. ” She also believed that, Nursing... ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet and diet [7].

On her return to England (1856), she refused all public honors, but pressed vigorously for further reforms in civil and military nursing [8].

She had many rebuffs and disappointments along with her successes. When secretary of War Sidney Herbert about to die in 1861, he said to his wife. “poor Florence, poor Florence, our joint work unfinished [9].”

Figure 2. Florence Nightingale’s work in the mid-19th century nursing had been the province of religious orders and untrained nurses that some of them were unkind, lazy, and unhygienic, drunken, with bad reputation

3. More about Florence Nightingale

Florence Nightingale (12 May, 1820-1910), British pioneer of nursing and hospital reforming, born in Florence while her wealthy parents were visiting Italy. She reacted strongly against the pleasure-loving society that admired her girlish charm and wit. In 1837, she developed a strong sense of vocation. She decided to devote her life to nursing, then a despised and undisciplined occupation carried on by ignorant and often delinquent nurses in filty, fever-ridden hospitals [10]. Many of them were lazy, unkind, unhygienic, drunken, and often stole from their charges. They earned nursing a very bad reputation. Florence’s parents opposed her plans, but she persisted. When she was 24, began her campaign in 1844. She had already refused to marry some very eligible suitors. It took her seven years to convince her parents of her intentions.

Figure 3. A pair of moccasins which Nightingales wore in Crimean War

In 1851, she went to a small hospital run by a religious organization in Germany for her training. Thanks are due to her prolific letters and the saving of them by her family and friends, there is plenty information about Florence Nightingale’s activities.

She returned London in 1853, to become superintendent at a hospital for “sick gentlewomen,” and found it a badly run nursing staff. Nightingale set about training them as disciplined, dedicated nurses. In the same year Britain entered the Crimean War; cadualties were horrific. She persuaded her friend, the war minister, to allow her to take a team of nurses to the badly run military hospital in “Losküdar” (Scutari). She took 38 nurses^* to Scutari’s dark, dirty, rat-infested Barrack Hospital [11]. At the hospital they had to work very hard. Miss Nightingale herself worked harder than other nurses. Every night she walked around the wards with a lamp. The patients were very pleased to see her. The soldiers knew that Florence and her team are working hardly for them, and called her the “The Lady with the Lamp.” Despite of the opposition of military doctors, she had the hospital hygienic, well run and successful before she left it. The mortality rate fell from forty per cent to just 2 per cent.

In 1856, when she returned to England, the British public were so grateful that they raised 50,000 pounds to found the Nightingale School of Nursing [12] and home for training nurses at St. Thomas’s Hospital in London (1880). Her efforts greatly improved and raised the standards and prestige of nursing. For the last years of her life, she was a semi-invalid, often bedridden, yet her home was visited by many outstanding people and she was an indefatigable letter writer [13]. Eventually she died in 13 August 1910 in Park Lane, London, England.

4. Conclusions and Impact

Some 2000 years ago, wounded Roman soldiers were cared for by auxiliary soldiers and slaves. With the spread of Christianity, monks and nuns cared for the sick. Most nursing took place at home and was haphazard. In the 18th and 19th centuries public hospital were established, but even then the nurses were mostly untrained, and ill-paid women. Catholic and Protestant groups began to train nurses. In 1836, a priest Theodor Fliender (1800-1864), and his wife founded a three-year training course for nurse-deaconesses in Germany. English Quaker and prison reformer, Elizabeth Fry (1780-1845), visited them and, back in England, helped found the Institute of Nursing, which improved the standards [14] of “caring for the sick.” But it was Florence Nightingale, the most outstanding figure in the history of nursing who dedicated her life to nursing at a time when it was shunned by other English gentlewomen of her class. She also travelled all over the world, taking her ideas about nursing with her, to found nursing schools and to change the image of nurses worldwide. Miss Nightingale’s brilliant success raised the social standing of nursing as a profession and stimulated movements for the teaching and training the nurses in Great Britain and throughout the world. The opening of her nursing school in London, marked the beginning of the transition of nursing from an art practical by dedicated but untrained workers to a profession whose members are trained in the basic medical sciences and are capable of administering the complex procedures of modern medicine [15].

Figure 4. Nightingale revolutionized standards of cleanliness and patient care. Today the nurses play an important role in the curing of the patients

Figure 5. Nightingale’s statue, in London Road, Derby

Figure 6. The plaque for Florence Nightingale, South Street, Mayfair

Note

∗ She took 14 trained nurses and 24 nuns with her because there were more suitably trained nuns than there were nurses.