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Florence Nightingale

Who is She, Her Role in Nursing, and More

Author:Katie Arps, BSN, RN

Editors:Anna Hernández, MD,Alyssa Haag,Emily Miao, PharmD,Kelsey LaFayette, DNP, RN, FNP-C

Illustrator:Jessica Reynolds, MS

Copyeditor:David G. Walker


Who is Florence Nightingale?

Florence Nightingale was a British nurse, social reformer, and statistician who is also credited as the founder of modern nursing. She was born on May 12, 1820, in Florence, Italy where her parents were vacationing. The second daughter to William and Frances Nightingale, Florence was raised in a wealthy English family with many social ties to other British elites of that time. Contrary to the role expected of affluent females of the Victorian Era, Florence wished to become a nurse after feeling a “call” to serve the poor and sick. Her parents initially refused, since nursing was considered a lower class profession, but eventually, her father allowed her to receive nursing training at a hospital in Germany. Following additional training in France, Florence returned to England to become the superintendent of a hospital for “gentlewomen'' in London.

Florence became a national hero upon returning from the Crimean War in 1856 where she and a team of nurses drastically improved the conditions of British army hospitals and the care of injured soldiers. When Florence arrived at the Barrack Hospital at the end of 1854, many more soldiers were dying of infectious diseases, such as typhoid and cholera, than their injuries from battle. With the help of a sanitary commission sent by the British government, Florence and her team lowered the death rate of hospitalized soldiers by providing clean water, promoting frequent hand washing, and establishing appropriate sanitation measures. The nurses also gave individual care to the soldiers, and Florence Nightingale was known to carry a lamp and walk through the wards at night, providing comfort to soldiers. This compassionate action, deeply appreciated by the soldiers, earned Florence Nightingale her famous nickname, “Lady with the Lamp.”

Though her work during the Crimean War is what Florence Nightingale is most well-known for, most of her work that impacted society and modern nursing took place following the war when she returned to England. Often bedridden throughout her life due to chronic effects of an illness she contracted in Crimea, Nightingale continued working tirelessly as a social reformer and healthcare advocate by pushing for improvements in other military hospitals; educating new nurses; promoting public health; and writing many books, letters, and manuscripts. Additionally, Florence contributed to the field of statistics by developing an early form of a pie chart, called a Coxcomb chart, to easily convey mortality rates, and she was the first female to become a member of the Royal Statistical Society.

Florence Nightingale died on August 13, 1910 at the age of 90. Though she was offered a state funeral and burial place in Westminster Abbey, her family followed Florence’s wishes for a small funeral and burial in her family’s plot in Hampshire, England.

Portrait of Florence Nightingale.

What was Florence Nightingale’s impact on the nursing profession?

Through her work during the Crimean War, Florence Nightingale was able to show that access to clean water, sanitation measures, and a healthy diet improved the health of wounded soldiers and reduced the death rate due to preventable infectious diseases. Nightingale continued to advocate for the health of the military by presenting her findings to Queen Victoria in 1856, which led to the creation of a Royal Commission that implemented many improvements across the British military medical system. Today’s basic infection control practices and evidence-based practices aimed at reducing nosocomial infections can trace many of its beginnings to the methods used by Florence.

Through her leadership and example, Florence helped transform nursing into an honorable profession. Using funds raised through donations, Florence opened the Nightingale Training School for Nurses at St Thomas’ Hospital in London in 1860 to train more nurses. Modern nursing science can trace its roots to the legacy of hygienic standards, injury treatment, and health promotion Florence Nightingale developed and taught. 

The current model of nursing care as a holistic, individual-centered approach can also be attributed to Florence Nightingale’s influence. Her strongly-held principle that each person deserves to be cared for and treated with dignity and respect regardless of their social class, occupation, or condition remains important throughout the nursing profession today. Florence's method of assessing each person’s injuries or illness within their individual context and developing a plan to help them heal is seen in today’s nursing process of assessing, creating nursing diagnoses, planning and implementing interventions, and evaluating the results.

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What is Florence Nightingale’s environmental theory?

Florence Nightingale developed a set of guidelines for healing she called the “Health of Houses,” which is an environmental theory describing five important factors that can be improved in order to promote health and healing. The five factors are pure air, pure water, efficient drainage (sanitation), cleanliness, and light. This theory is a holistic approach that takes into account not just the individual but also how their surroundings can affect their course of illness or maintenance of wellness. This theory was novel in Florence’s era, and she described it in two of her books, Notes on Hospitals (1859) and Notes on Nursing (1860) that are still being published today. In these publications, she lays out hygiene standards and the necessity for fresh air, nutritious diet, and adequate sleep and exercise. She intended this information not only for hospitals and nurses but also for use by the general public in their homes to promote public health. 

Today, Florence’s environmental theory remains relevant in the way that hospitals and other facilities are designed with the individuals who will be treated there in mind. These purpose-driven designs take into account safety measures and aesthetics. Additionally, the care management and planning that nurses undertake today to achieve positive outcomes reflect the individual-centered care that was at the heart of Florence Nightingale’s nursing care. 

How can nurses implement Florence Nightingale’s theory in today’s practice?

Florence Nightingale and her work embodied the principles on which modern nursing is built, and today’s nurses can apply these principles through using evidence-based practice, critical thinking, a holistic approach to care, and cultural fluency to ensure the best possible outcomes for individuals. Modern nursing schools still teach about Florence Nightingale and her impact on the nursing profession. History has acknowledged that many aspects of modern nursing, from basic infection control to the establishment of formal nurse training, can be traced back to her. Yet, there is another, less tangible, foundational tenet of nursing which is owed to Florence, and it is one that bears passing along to each new generation of nurses. Though it was not penned by Florence herself, the sentiment can be summed up best in the last line of a nursing code of ethics known as “The Nightingale Pledge” that reads “to be devoted towards the welfare of those committed to my care.” Technology advancements and new research will likely change and improve how care is delivered; however, the dedication of nurses to the individuals they care for will remain relevant and is a timeless element of healthcare.

What are the most important facts to know about Florence Nightingale?

Florence Nightingale, also known as the “Lady with the Lamp,” was a foundational figure in the fields of nursing, statistics, and public health. Raised in an affluent family in Victorian England, she trained to become a nurse after feeling a “call” to do so. Florence then famously led a team of nurses to help improve the quality of care and lower the death rate of British soldiers wounded in the Crimean War. Deemed a hero by her country, Florence used her influence to promote continued reform of the military medical system, raise money to open a nursing school in London, and advocate for healthcare and dignified treatment for people regardless of their social status or disabilities. Her impacts on the nursing profession are many, including demonstrating the effectiveness of infection control measures, establishing nursing as a respected profession, and creating a model of care that was individual-centered. Through her environmental theory, Florence promoted public health and quality bedside nursing care by describing how altering an individual’s environment can help promote health and healing. As the founder of modern nursing, Florence Nightingale’s legacy of devotion to the care of those entrusted to her and the wellbeing of the public in general will live on through nurses for generations to come.

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Related links

Ethics: Nursing
Evidence-based practice (EBP): Nursing
Standard and transmission-based precautions: Clinical skills notes

Resources for research and reference

Alexander, K. L. (2019). Florence Nightingale. In National Women's History Museum. Retrieved July 8, 2022, from https://www.womenshistory.org/education-resources/biographies/florence-nightingale

Florence Nightingale. (2009, November 9). In History.com. Retrieved July 8, 2022, from https://www.history.com/topics/womens-history/florence-nightingale-1

Florence Nightingale. (2021, March 25). In The National Archives. Retrieved July 8, 2022, from https://www.nationalarchives.gov.uk/education/resources/florence-nightingale/

Gilbert, H. A. (2020). Florence Nightingale's environmental theory and its influence on contemporary infection control. Collegian, 27(6): 626–633. DOI: 10.1016/j.colegn.2020.09.006

Riegel, F., Crossetti, M. da G. O., Martini, J. G., & Nes, A. A. G. (2021). Florence Nightingale’s theory and her contributions to holistic critical thinking in nursing. Revista Brasileira De Enfermagem, 74(2). DOI: 10.1590/0034-7167-2020-0139

Salanders, L. Florence Nightingale. In Encyclopedia Britannica. Retrieved July 8, 2022, from https://www.britannica.com/biography/Florence-Nightingale