The Age of Hospital Reform

Florence Nightingale 1820-1910

"The Lady with The Lamp"


So this was the first real intervention of the press in the affairs of the war office, this organisation was used to having complete control over its affairs and used to covering up the ghastly errors that were often caused by bad leadership or organisation.

It was after William Russell famously wrote in the Times in September 1854 appealing to women to volunteer to help the wounded. He wrote:

"Are there no devoted women amongst us, able and willing to go forth to minister to the sick and suffering soldiers of the east in the hospitals in Scutari? Are none of the daughters of England, at this extreme hour of need, ready for such work of mercy? Must we fall far below the French in self-sacrifice and devoutness"188


This article was the light that opened the eyes of all those back in Great Britain of the appalling nature of war and also the seemingly lack of concern by the Government about the plight of the wounded in faraway Crimea.
Sir Sidney Herbert, the Secretary of War, was forced to make a decision to try and improve conditions at Scutari Hospital.
He knew Florence as he was a family friend of the Nightingales and more importantly knew of Florence’s Nightingales expertise as a nurse and organiser.
So he contacted her and requested that she go to the Crimea to help the sick, and wounded of the war. She accepted without hesitation. The decision to send her was in November 1854.

Herbert was forced to resign in February, 1855, because of the mess that the Government had got them self into over the Crimea, but remained an active promoter of military reform until his early death. 
Nightingale was given the title

"Superintendent of the female nurses".

She was at first funded to enlist a group of 20 nurses.
She preceded to Scutari hospital, which was just outside Constantinople, now a part of Turkey.

There was opposition to this deployment especially from the Military, as the deployment of women nurses had been tried before. These women however were untrained and were of the lower class they some were not interested in the needs of the injured or sick soldier. Most of them drank too much and caused more problems than they solved.
Her arrival at Scutari was the day before the battle of Inkerman.

The hospital facility at Scutari was overcrowded, and was classed as a 3758 bedded hospital. It was infested with vermin and was filthy, the mortality rate was high. Deaths were due to cholera, wound sepsis, dysentery and “Crimea fever”
How Florence Nightingale and her team dealt with the situation at Scutari is legendary. It was said of her that:

"Her gift was her power to dominate, which lifted her from out the ranks of those who are only 'able' to the highest reached by those who are great".189

Florence Nightingale's nurses were off duty at 8pm and male orderlies took over for the night. Only Florence Nightingale ventured onto the wards after 8pm. The picture of the lady with the lamp is familiar to most people around the world.
Nightingale and her nurses brought down the mortality rate to below four per cent from its original 40 plus per cent.
The lessons learned from the Crimean war went on to influence the military’s medical service, which from then on incorporated a nurse led service on the wards to look after post op and medical patients.

However,although the majority view of Nightingales role was that it was overstated, the results are what matter, Florence Nightingale had set in motion with the rest of the nurses, a system of patient care that obtained excellent results.
The reason why nurses in the three services were commissioned, is a legacy of the original Florence Nightingale nurses, these nurses were all members of the gentry and it seemed appropriate at the time to commission these "Lady" nurses so as they would not have to mix with the other ranks.  

This tradition has in part carried on until now where nurses can apply for a nursing commission.
Florence Nightingale went on to write papers about the sanitary state of not only the British army’s medical facilities and hospitals but also those within what we now call the NHS. 

She died in 1910, but her legacy lives on.


"I think one's feelings waste themselves in words; they ought all to be distilled into actions which bring results."187




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