FOUNDATIONS OF NURSING PRACTICE

Foundations of Nursing Practice

Foundations of Nursing Practice

Introduction

Florence Nightingale founded the modern occupation of nursing. Her efforts led to improved care in hospitals and elevated nursing to a respectable vocation. Nightingale, known as “the Lady With the Lamp,” won British national recognition for her service during the Crimean War, in which she became an expert on childbirth, mortality rates, and hospital administration.

Nightingale was born in the city of Florence, Italy, after which she was named, on May 12,1820. She grew up in a wealthy English family during the Victorian era, surrounded by privilege. Nightingale received a superior classical education and studied French, German, Latin, and Greek. As a young woman of means, she took the grand tour of Europe, visiting hospitals and nursing institutions, as well as more traditional locations. Nightingale was lively and attractive, and it was assumed that she would “marry well”—but she had other ideas. She felt that God had called her to care for the sick, and she prevailed upon her parents to permit her to take training in nursing at a German convent. During this time, respectable nursing existed only in religious orders; most nursing care was delivered by untrained women of the lower class, often of “ill repute.”

In 1854, Britain, France, and Turkey were at war with Russia. By all accounts, hospital conditions in the Crimean battlefields were appalling, with filthy conditions, unsanitary latrines, and wounded soldiers lying naked in their own excrement. Soldiers died of infectious diseases, such as dysentery, cholera, and typhoid, contracted at hospitals as readily as from combat wounds. Nightingale and a party of 38 female nurses were commissioned in the Crimean War to provide nursing services for the British Army. Initially, they were met with resistance from the army staff, but their successful efforts in treating the wounded earned respect and acceptance. Believing that infections arose spontaneously from dirty and poorly ventilated places, Nightingale's sanitation and nursing care efforts improved survival rates.

Nightingale received acclaim in the Crimean, and in 1860, she established the Nightingale Training School for nurses at St Thomas' Hospital. Her treatise Notes on Nursing: What It Is and Is Not, established the basic foundations of nursing practice. Inherent in its design was subordination to medicine. Nurses provided caring, nurturing, and tending to the body needs, similar to a middle-class Victorian mother in deference to the male physician's authority. Nightingale's writings demonstrate that she felt nursing was by its very definition “women's work.” Although she was a member of the National Society for Women's Suffrage, she never considered the vote to be a top priority.

Nightingale spent much of her adult life in seclusion, confined to a sickroom from which she managed to command influence. She wrote numerous articles and pamphlets, including Introductory Notes on Lying in Instructions, a study of mortality in childbirth. Shortly before she died at age 90, Nightingale received the Order of Merit, the first woman to do so.

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