Louise C. Selanders, RN, EdD: “Florence Nightingale, Perseverance, Power and Possibilities”

In the reading from the Old Testament, Isaiah speaks eloquently of the rewards that can be reaped by leading a righteous and God- directed life. Most significantly, Isaiah identifies God’s enduring presence both in times of need and in times of celebration. He understood that God was capable of perfect justice and mercy.

As with most prophets, Isaiah did not seek to lead people out of the darkness of ignorance into the daylight of knowledge and wisdom. He was an ordinary person in ordinary times completing extraordinary acts because of his experience and vision. Isaiah’s lessons were at once comforting and confronting, containing powerful messages of both judgement and hope. Yet, his wisdom was not well heeded. The people of his time might have been rescued by his prophetic words. Instead, his vision was ignored.

We have gathered here today to celebrate the life of Florence Nightingale and her inclusion by the church in Lesser Feasts and Fasts. This recognizes her dedication to Christian living and her exceptional contribution to humankind in multiple fields of endeavor. The reading of the Old Testament prophet was particularly appropriate because of the parallels that exist between Nightingale’s life and that of Isaiah. Nightingale did not set out to reform public health standards in England and India, thereby saving hundreds of thousands of lives. She did not see herself as initiating the philosophical foundation of nursing which served the dual purposes of improving the standard of health care of a nation as well as improving the status of middle class women through education and employment opportunity. She did not set out to establish statistics as the basis of logical argument. She did not seek to maximize social change through the use of her celebrity. Yet, through work, opportunity, and her profound and unwavering belief in God, this is the legacy which Nightingale left. She, like Isaiah, was an ordinary person in ordinary times that completed extraordinary deeds for the betterment of all people. And she, like Isaiah, has had much of her message ignored during the ensuing years.

Nightingale presents an interesting study in how she accomplished such uncommon deeds. First, I believe that there is the matter of perseverance. Nightingale’s life is a veritable case study of perseverance. In her adolescence and young adulthood, she fought the social norms for women in the Victorian period – the perceived lack of intellect and physical stamina, the inability to possess or manage money or property, the perception that education was non-essential for women. For an individual who felt called to serve mankind, these qualities were incompatible with her mission. Only perseverance caused her to receive an education comparable to that of her male counterparts of the period, to receive and manage an annual allowance from her father which permitted her to live independently in London, and to be productive in her working years in the roles of superintendent, consultant and philosopher.

Nightingale is most remembered for the 22 months that she spent in Scutari during the Crimean War. Only her perseverance allowed her to remain in the setting despite the objections of the medical establishment and a serious illness, which nearly cost her her life.

On her return from the Crimea, it was again perseverance that allowed Nightingale to work through chronic pain in order to reform the medical military establishment, to organize the Nightingale School of Nursing at St. Thomas’ Hospital and to influence government policy relevant to public health issues.

The second quality which allowed Nightingale to succeed was her use of power. Florence Nightingale was a powerful woman – because of her social status and contacts and because of her public persona. However, possession of power does not necessarily indicate the successful use of power. At this, Nightingale was a master. She understood that working within the prevailing social system to achieve permanent change was much more productive than working against the system. She understood that working for the greater public good usually overrode the needs of individuals. Alienation, while occasionally necessary, was never her method of choice. Fulfilling obligations and being truthful and focused were always her preferable modes of operation. This is a lesson as useful in today’s complex organizations just as it was in 1865.

The third characteristic that caused Nightingale to be successful was her understanding of the social possibilities. The ability to perceive what is possible comes from intellect and vision. In fact, I believe that the greatest gift which Nightingale has offered the generations was her intellect – her ability to process enormous quantities of information and understand not only the present, but also the future. She understood that nursing was not to be a means to an end of solving the issues presented in the Crimea, but rather nursing was and is a method of resolving both inadequate healthcare in the prevailing social system as well as a means of providing appropriate employment for all people.

In a number of publications, Nightingale has been accused of being an anti-feminist. Only the most superficial examination of the evidence could lead to this conclusion. What can be said is that Nightingale was not a radical-feminist as defined by 20^th and 21^st century standards. It was Nightingale’s understanding of the potential – the possibilities – of women – not as a gender – but as members of the human race which caused her to have some concern about some feminist group activities. She always supported women as individuals to succeed to their maximum potential. Again, this demonstrates Nightingale’s vision toward society as a whole rather than toward compartmentalized subsections. It was her need to improve the prevailing social standard that compelled her to promote the larger vision of the possibilities of women.

To bring this forward to the 21^st century, it would appear that as a group, nurses, while allowing Nightingale her due for past accomplishments, have not always listened well to the broad philosophical lessons which she offered to the profession. Perseverance, use of power and understanding the possibilities in social change are not qualities that we generally associate with nursing. In the United States, we hare hearing much of the nursing shortage, of poor working conditions, inadequate salary, and the lack of respect, which the profession receives. I certainly would not deny that in some settings these issues exist. Yet, in my role as a professor of nursing, how in good conscience can I send a new group of graduating students into the workforce if I honestly believed this is all that the profession of nursing had in its immediate future. Obviously I believe that there are other answers.

The history of nursing extends not only to the time of Florence Nightingale, but to the beginnings of mankind. Instances of nursing were exhibited any time two people were together and one was injured or sick and the other rendered care. Instances of caring are recorded on wall paintings and ancient Greek pottery. Florence Nightingale’s role was to take nursing to the level of profession, one in which the participants were autonomous, well-educated, excellent problem solvers and with the goal of improving society through improving health. She elevated nursing from the level of occupation or pastime. The issue, of course is, like Isaiah, we have not listened to the wisdom of Nightingale. All is not lost, however. We are able, if at times unwilling, to come together, to collectively and individually persevere and to use power effectively. We must not lose sight of the possibilities. As we celebrate Nightingale, not for miracles, but for her wisdom, I believe that we, in ordinary times and as ordinary people – if nurses can indeed be ordinary people – have the obligation to go forth and do extraordinary things. Amen.