Florence Nightingale: The Mother of Nursing.

On May 12, it is the birth time of a great woman. We write this editorial for her honor. Florence Nightingale (Figure 1), the founder of modern nursing of professional nursing, was born in Florence, Italy, on 1820, in an English family; she was named of the city of her birth. Florence learned mathematics, language, philosophy and religion (all subjects that later influenced on her work) from her father (1).

Figure 1.

The Portrait of Florence Nightingale

Florence from childhood loved God and holy Book. According to her, on the seventh of February 1837, while she was walking in a garden, she heard the voice of God, which was call her to a specific mission (1, 2).

Florence in 1844 decided to work at the hospital. But, her parents were opposed to this idea. In England in the middle of the nineteen century, nursing was not a decent job (3). In July 1850, she went to Germany and France and worked as a volunteer in hospitals (1). Then in 1853, she returned to London and worked as a manager in the hospital that was called Institute of the sick women (2). A year later, something happened that opened a new way in the Florence life.

Crimean war: In 1854, Britain, France and Turkey started a war with Russia thus Crimean war began. In September in one of the struggles in Alma, the Russia was defeated but England had a lot of casualties (2). There was a lack of medical facilities and high mortality in British military camps. Sydney Herbert, the minister of war, was a friend of Florence; so, she took the advantage (3).

Florence in 1854 with 38 nurses went to a military camp of British soldiers, located on the outskirts of Constantinople (Istanbul) (2). Florence noticed that health status in these camps was devastating. Injured soldiers were left on the floor and the few doctors desperately were trying to manage patients with basic facilities, in dirty environment (4). Florence used her mathematical knowledge, and recorded the mortality rate in the hospital. Statistics showed that in every thousand injured soldiers, the six hundred were dying because of communicable and infectious diseases (2).

The Florence interventions were simple. She tried to provide a clean environment. She provided medical equipment, clean water and fruits (2). With this work the mortality rate decreased from 60% to 42% and then to 2.2% (4).

Florence was like mother for soldiers. She took the lamp every night and used to go to patients’ camp (3). Her great work attracted the attentions in England (5). She also used her fame and succeeded to attract the support of the Queen Victoria, Prince Albert and Prime Minister Lord Palmerston. Florence asked them to have a permission to do an official investigation in the context of the military hospitals. The request was agreed and then the Royal Institute of research on the health of the military established. She was a great humanitarian and scientific figure. Nightingale was also a well-known statistician as she has invented a special pie chart (Figure 2) (2).

Figure 2.

A Polar-Area Diagram, Invented by Florence Nightingale

Florence in 1860 established nightingale nursing school as the first nursing school in the world (4). With the establishment of this school, she changed nursing to a respectful profession.

End of life: Florence Nightingale in the last years of her life was suffering from a disease, which she acquired it during her service in Crimea (2). She wrote many book and reports, mostly in the field of nursing (3). One of these books, “notes on nursing” was published in 1860 that is the first book in nursing education. She insisted on the importance of building trusting relationships with patients (6). Nightingale believed that nurses’ presence with a client is a key stone for making a professional communication. Empathy with patient and making a common experience in moving toward health has been validated by Florence nightingale that reaches us to an aesthetic nursing care (7). Radmehr et al. (8) in a phenomenological study that is published in the present issue of Nursing and Midwifery Studies reported that understanding beyond words, creating a good and nice feeling by making the patient happy, and the sense of unity by perceiving the patient and the nurse as one existence are some aesthetic aspects of nursing (8); and showed that Iranian nurses also follow the spirit of nursing that has been established by Florence Nightingale. Florence services were the first efforts to relieve suffering during war. She died in 13 August 1910 at the age of ninety (1). There are some sentences of Florence included in Table 1 (9).

Table 1.

Some Sentences of Florence

Subject	Sentences
1. Confidentiality	“And remember every nurse should be one who is depended upon, in other words, capable of being a “confidential nurse”. She does not know how soon she may find herself placed in such a situation; she must be no gossip, no vain talker; she should never answer questions about her sick except to those who have a right to ask them”.
2. Building Trust	“If you go without his knowing it, and he finds out, he never will feel secure again that the things which depend upon you will be done when you are away. And in nine cases out of ten he will be right”.
3. Observation	“The most important practical lesson that can be given to nurses is to teach them to observe-how to observe- what symptoms indicate improvement what the reverse- which are of importance-which are of none- which are the evidence of neglect- and what kind of neglect. If you cannot get into the habit of observation one way or another, you had better give up the being (sic) a nurse”. In dwelling upon the vital importance of sound observation, it must never be lost sight of what observation is for. It is not for the sake of piling up miscellaneous information or curious facts, but for the sake of saving life and increasing health and comfort.
4. Communication Skills	“Always sit within the patient’s view, so that when you speak to him he has not painfully to turn his head round in order to look at you. Everybody involuntarily looks at the person when speaking. So, also by continuing to stand you make him continuously raise his eyes to see you . . . Never speak to an invalid from behind, nor from the door, nor from any distance from him, nor when he is doing anything”.
5. Varied Teaching Methodologies	“A little needle work, a little writing, a little cleaning, would be the greatest relief the sick could have”.
6. Fresh Air and Bright Environment	“Where there is sun, there is thought”. “It is the unqualified result of all my experience with the sick, that second only to their need of fresh air is their need of light; that, after a close (sic) room, what hurts most is a dark room. And it is not only light but sunlight they want”.