Reflections on Florence

1 May 2010

So what does Florence Nightingale mean to nurses working today? Nursing Review asks nursing leaders what they remember or use from Nightingale’s teachings and how relevant they believe these to be in the 21st century 

One saying I love of Florence is that nursing is both an art and a science:

“Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts.”

This is still very relevant today. Because of the intimate nature of the art, the articulation still challenges us today.  Florence had a passion for data and this is an aspect of nursing that has the potential for growth.

Anita Bamford-Wade 
Joint Head of Nursing
Auckland University of Technology

Florence Nightingale didn’t ‘invent’ nursing nor did she work in isolation. She extended further the work of nurses before her, she worked closely and in collaboration with colleagues, she was supported by a network of champions and auxiliaries and was often in conflict with authority and, at times, even with those seeking to achieve the same objectives as her. Does this sound familiar?

I do believe we can take some of Florence’s personal attributes and apply them as she did 150 years ago to affect the delivery of quality health care. Demonstrate commitment, even in the face of adversity, foster professional relationships with individuals whose skillsets complement yours and learn from them in order that your patients might benefit. Be aware that you don’t work in isolation, others are watching and emulating you; be a quality role model irrespective of your level of experience. Don’t be afraid to challenge decisions or behaviours that you believe not to be in the best interests of those you nurse, it’s a matter of integrity. Carry out your duties with compassion and dedication but stand up and be counted as Florence did to effect positive change in nursing.

Maree Sheard
Director of Nursing Services
New Zealand Defence Force

The things I remember and use from the teachings of Florence Nightingale are the concepts of prevention, holistic health, compassion and commitment to patient care.

I think her original teachings are relevant in that she was the founder of modern nursing and an early pioneer of infection control and epidemiology.

Toni Dal Din
Director of Nursing
Hutt Valley DHB

 

The key thing that I remember in relation to question one is the recommendation that nurses put the patient in the best position/right environment for promoting healing.

Other very significant and relevant contributions were her modeling of strong leadership, her astute use of political connections and the beginnings of evidence-based practice. She demonstrated courage and proactive responsiveness to the important public health issues of her day and  collected figures to support her causes, effectively disseminating her ideas in writing.

Perhaps less useful were the strict discipline and her reluctance to support national registration, yet she had rationale for these.

Deb Spence
Joint Head of Nursing
Auckland University of Technology

 

The key thing I remember from Florence Nightingale’s teachings is the bedside empathy and compassion she showed. The understanding of kindness and touch, even in times when she couldn’t help, was all that these wounded soldiers wanted. The vision of the nurse with the lamp comes to mind. The basic/core nursing cares were an intrinsic requirement under Florence’s teaching.

And we still refer to Flo as being our first researcher and auditor.

I believe these teachings remain relative today, however perhaps we have lost them along the way with the advent of technology. We are however trying to regain the ‘basic nursing cares’ back into practice through programmes like hourly rounding, etc. We still use her teachings today to show that nurses can make changes that impact on health.

Denise Kivell
(DON) and senior nursing team
Counties Manukau DHB

Nightingale envisaged the breadth and essence of nursing in ways we struggle to maintain. She understood social determinants of health, the relevance of epidemiology and the synonymous nature of nursing and health.

Jenny Carryer 
Professor of Nursing
Massey University 

Nursing was a small segment of Nightingale’s interest in managing health and sickness. In fact it is her research techniques and her use of principles now commonly used in epidemiology, which I think were extremely important. She had a very definite view of professionalism which was important for nursing although some of her teachings held the profession back!

She is not directly relevant today but of historical interest. Her ideal of professionalism and the use of evidence to support practice are of interest but do not directly impact on teaching today.     

Annette Huntington
Director of nursing programmes
Massey University

What I remember is a nurse must have a three-fold interest in their work – intellectual interest in the case, an interest in the patient and a technical interest in the patient’s care. 

Florence pioneered and championed nursing as a profession by laying farsighted foundations that still exist today. Her cornerstone values continue to exemplify nursing – compassion, diligence and commitment to patient care.

Kerry-Ann Adlam
Director of Nursing
Taranaki District Health Board

 I still quote her as the first nurse who used statistics to develop her service.

Adele Knowles
Nurse director (Women’s, Children and Public Health)

 

The comment has been made that nurses comprehensively record observations that reflect a deteriorating patient condition but do not recognise the deterioration and therefore are not acting on the information.

Florence Nightingale expressed similar concerns in 1860 in Notes on Nursing. With regard to what observations are for, she said they are “not for the sake of piling up miscellaneous information or curious facts, but for the sake of saving a life and increasing health and comfort”.

Jenny Humphries
Director of Nursing (women’s and children’s health) Southland District Health Board (soon to be Southern DHB)