PERSONAL REFLECTIONS… on Florence Nightingale

Writers and readers share connections

by Carol Annett, Ottawa, Canada

Restoration Conversations magazine

SPRING / SUMMER 2024, Issue 5

Florence at the St Thomas Nursing School surrounded by her students, 1860

ph. provided by Florence Nightingale Museum, London

In 1974, I quit nursing training halfway through the program. I never had the honour of saying the Nightingale Pledge, which my mother recited when she graduated from nursing in 1949. So, what sparked my interest in Florence Nightingale almost 50 years after I became a nursing school dropout? It began with a statue my husband noticed on a trip to Italy in 2023.

All along the walls of the nave of the Basilica of Santa Croce in Florence, Italy, there are monuments to great Italians, mainly men, including Dante, Galileo, Leonardo da Vinci, Machiavelli, Marconi, Michelangelo and Rossini. Outside the church, embedded in one wall of the cloisters that enclose a quadrangle of lawn, is a memorial to a woman. An oval medallion frames the two-foot high figure, sculpted in white Carrara marble, of a woman wearing flowing robes and carrying a small oil lamp. She is the legendary Florence Nightingale –the Lady with the Lamp. Why was there a memorial to this nineteenth-century English woman, who was not even Roman Catholic, at Santa Croce? I knew nothing about the woman behind the legend but I vowed to learn more, especially since she was my mother’s personal heroine.

Florence Nightingale (1820–1910) became famous in her own lifetime as a nursing superintendent for the British Army during the Crimean War (1853–1856) and as an advocate for public health reform. In 1913, three years after she died, British expatriates in Florence, Italy commissioned Francis William Sargant to create a memorial at the Basilica of Santa Croce to honour her in the city where she was born. Her first official biography, The Life of Florence Nightingale, by British writer Sir Edward T. Cook, was published to worldwide acclaim that same year. 

Subsequent biographers writing about Florence Nightingale are blessed and cursed with an over-abundance of archival material. The British Library holds 200 bound volumes representing an archive about a single individual second only in size to that of Prime Minister Gladstone. Claydon House in Buckinghamshire holds a huge collection of her family letters. The London Metropolitan Archives maintains a repository connected with the running of the training school founded in her name at St. Thomas’ Hospital in 1860.  Around the world there are over 200 smaller holdings of Nightingale papers. 

Florence Nightingale in the Military Hospital at Scutari, 1855, ph. provided by Florence Nightingale Museum, London

According to one of her more recent biographers, Mark Bostridge, previously unknown letters emerged after her death. Basing his story on this vast collection of reference material, he did well to keep his single volume, Florence Nightingale: The Woman and Her Legend, under 800 pages.

Florence Nightingale was born on 12 May 1820 in Florence, Italy, where her wealthy family was on an extended European holiday. Brought up in rural England with an older sister in Derbyshire and Surrey, Florence was a sensitive, spiritual child who loved animals and showed sympathy for the poor and the sick from an early age.

Florence’s father, who believed in higher learning for women, supervised the education of his daughters at home. Florence was a brilliant student, becoming proficient in French, Italian, Greek, mathematics, history, philosophy and classical literature. Despite her privileged upbringing, Florence sought neither celebrity nor fortune. Rather, she came to focus her intelligence and humanitarian values on promoting public health and disease prevention for all. In 1847, seven years before she left for the Crimea, Florence travelled to Rome with family friends. There she was introduced to Sidney Herbert, who would become a close friend. On this Roman holiday, Florence immersed herself in art and culture. At the Palazzo Barberini, she was profoundly moved by Guido Reni’s portrait of Beatrice Cenci, which is said to have been painted just before Beatrice was beheaded for conspiring to kill her abusive father. At the Sistine Chapel, Florence lay on the floor and gazed up in ecstasy for hours. But the highlight of the trip for her was not a work of art. Florence obtained permission to go on a 10-day retreat at a convent. During her stay, she confided to Madre Santa Colombe that God had spoken to her. 

Florence felt God wanted her to serve others and she decided to answer that call by becoming a nurse. But nurses at that time were viewed as fallen women who were prone to drunkenness and sexual impropriety, as personified in Sarah Gamp, a character in Dickens’ 1843 novel Martin Chuzzlewit. Florence’s parents vehemently opposed her pursuing this vocation and urged her to marry. Still, Florence was determined. She refused all offers of marriage and eventually acquired the training she sought.

On 22 August 1853, Florence Nightingale accepted a position as superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London. Supplemented by an income provided by her father, she was finally able to live independently and pursue her chosen career. Two months after she began working in Harley Street, Britain entered the Crimean War. The following year, her friend Sidney Herbert, as Secretary of State at War, asked Florence Nightingale to superintend Government-sponsored nurses at the military hospital at Scutari, Turkey. In November 1854, she arrived at Scutari with 38 volunteer nurses.

Appalled by conditions in the military hospital, Florence discovered that soldiers died more from infections resulting from poor hygiene, poor nutrition, lack of supplies and improper waste disposal than from their battlefield wounds. Florence worked tirelessly to improve conditions in the hospital. Reports from wounded soldiers telling of her comforting presence propelled Florence to celebrity status back home.

In February 1855, an illustration titled “Miss Nightingale, in the Hospital at Scutari” appeared in The Illustrated London News depicting her nightly rounds. Though the Turkish ‘fanoos’ lantern that she carried was incorrectly pictured as a genie lamp, this was the image of the compassionate nurse that captured public imagination. The legend of the Lady with the Lamp was born.

There was more to Florence Nightingale than this legend. Her work in military hospitals in Crimea was merely a prelude to the more important phase of her career in public health after the war. With her great analytical skills and knowledge of statistics, she set out to reform not only the profession of nursing but also Army and civilian health by advising the governments of Britain and India on improving the design of hospitals and workhouses and modernizing sanitary measures. During her lifetime, she published hundreds of pamphlets, books, reports and articles on subjects ranging from public health and nursing to religion and women’s oppression. Despite becoming an invalid due to chronic illness, she was able to carry out her ground-breaking work, including supervising the Nightingale School of Nursing, which was set up in 1860. The school’s success set the standard for nursing training around the world.

Marjorie Ruppel, as a new graduate of the Royal Columbian School of Nursing in New Westminster, BC, 1949

In 1946, when my mother Marjorie graduated from high school in Canada, she wanted to attend university like her fiancé, Dick MacKinnon. Dick’s tuition at the University of British Columbia (UBC) was paid for by the Canadian government as a benefit for his service in the Royal Canadian Air Force in WW II. There was no money for Marjorie to go to university, so she applied to a school of nursing, which provided room and board. She and my Dad eloped because married women were not eligible to enter nursing school. She enrolled under her maiden name at the Royal Columbian School of Nursing in New Westminster, BC. While her secret husband boarded with her mother and attended UBC, Marjorie lived in the nurses’ residence and trained at the hospital. On 28 April 1949, Mum attended her graduation. After medals and diplomas were handed out, and before she gave the valedictory speech, all the graduates recited the Nightingale Pledge. Her mother and grandmother watched proudly. I was there too, in a way, because Mum was pregnant with me at the time.

Over 20 years later, in 1970, I graduated from a Canadian university with a degree in biology and took a job as a lab technician in a medical research hospital. I hated working with test tubes and before long, decided to go into a field that offered more contact with people – nursing. If I remained in Canada, I would have to do nursing training at a university, which I couldn’t afford then. So, I chose a hospital-based program in England in which classroom lectures were integrated with work experience, and students were paid a stipend.

In 1972, I enrolled at Wolfson School of Nursing at the now closed Westminster Hospital in London. Settling into my tiny room at Wigram Nurses’ Home, I had to learn that the gas fire was not self-igniting—you had to light a match after turning the knob! Spotting a photo of my boyfriend on my chest of drawers, a teaching sister gushed “Ooh, who’s the dishy bloke?” During the next year-and-a-half, interspersed with weeks of classroom learning, I was Nurse MacKinnon, working on medical, surgical and children’s wards. In obstetrics, I assisted midwives delivering babies. In the operating theatre, I observed a leg amputation and open heart surgery and I “scrubbed” for an appendicectomy. 

Carol Annett, the author, as a student nurse at the Wolfson School of Nursing, 1972

I walked to the hospital for day, evening, night and split shifts wearing a black cloak over a blue uniform, with a stiff cardboard collar, black tights, sensible shoes and a white paper cap. Had I completed the program, I would have earned my Westminster Hospital belt buckle and the headpiece, called a “frilly”, that Westminster graduates proudly wore. The rigorous, practical training met the standard set by Florence Nightingale to elevate nursing to a respectable profession beyond the disreputable stereotype portrayed in Dickens’ novel.

I found the hospital environment exciting. But the shift hours, illness, and homesickness wore me down. So, I left the program, flew home and married the dishy bloke. After four more years of university and a one-year internship, I graduated as a registered dietician. I worked for over thirty years in publicly-funded, patient-centred hospitals with advanced sanitation and infection control procedures – measures that Florence Nightingale would have endorsed.

Florence Nightingale is honoured every year around the world. Since 1965, International Nurses Day has been celebrated on her birthday, May 12. Mark Bostridge writes, “If we were to derive one simple lesson from Florence Nightingale’s life and work, it would stem from this single unifying thread: that society has a collective responsibility for the health of all its members.” In a time of global pandemics, Florence Nightingale’s vision is still relevant.

After her children were grown, my mother returned to nursing, the profession she loved. But she had to quit when she developed symptoms of multiple sclerosis. As the disease progressed and she became hospitalized, my Dad became her devoted caregiver. When she was unable to hold a book, he would read to her. One of the books he chose was the inspiring story of Florence Nightingale. Dad knew she was Mum’s personal heroine. Now I’m a great admirer too. As Bostridge observes at the end of his biography, “For us, the lamp still burns.”

Carol Annett is a writer based in Ottawa, Canada. After a career of more than 30 years in the healthcare field, she now spends her time researching and writing about family history, with a particular emphasis on preserving women’s stories.