Posts Tagged ‘Florence Nightingale’

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The Evolution of Nursing: Always a Mirror for Cultural Attitudes, But With Some Constants

May 14, 2012

Of hygiene practices at one public institution, Hobson wrote, “The visitor found a woman with a broken leg twelve days after she had been brought to the hospital in the same miserable garments in which she fell.” In describing an almshouse (poorhouse) hospital, she said, “The condition of the patients was unspeakable; the one [untrained] nurse slept in the bathroom, and the tub was filled with filthy rubbish.”

. . . On the subject of nutrition, Hobson recounted a Friday meal in the same hospital, wherein “the dinner of salt fish was brought in a bag to the ward and emptied on to the table; the convalescents helped themselves, and carried to the others their portions on a tin plate with a spoon.”

Pediatric NP, circa 1965. Courtesy of Barbara Bates Center for the Study of the History of Nursing, Univ. of Penn. School of Nursing

These are quotes from “Key Ideas in Nursing’s First Century,” an article in the May issue of AJN by historian Ellen Davidson Baer. Baer draws on vivid primary sources  from the 19th century, such as the one quoted above, to depict stages in the evolution of nursing into a respected and regulated profession with standards and essential skills and knowledge.

Though nursing has changed a great deal since its early days, Baer sees theory and compassion as intertwined constants throughout the history of nursing, both of them very much present from the start.

She’s also attuned to ways in which the evolution of nursing reveals a great deal about cultural attitudes toward gender (specifically, the roles of women), class, race, scientific knowledge, and professionalism. As you read, it’s easy to see how far nursing has come—but also how much such matters continue to play a role in the ways nurses see themselves and in how the public views nurses.—Jacob Molyneux, senior editor  


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Top 10 (New) AJN Posts of 2011

December 20, 2011

"Consumer Choice,' BdR76, via Flickr

Some of our posts, like this one from 2009 (“New Nurses Face Reality Shock in Hospitals–So What Else Is New?”) keep getting found and read. They remain as relevant today as they were when we posted them. Our top 20 posts for the year (according to reader hits, that is) include several others like this: “What Is Meaningful Use? One Savvy Nurse’s Take”; “Is the Florence Nightingale Pledge in Need of a Makeover?”; “Do Male Nurses Face Reverse Sexism?”; “Are Nursing Strikes Ethical? New Research Raises the Stakes”; and “Workplace Violence Against Nurses: Neither Inevitable or Acceptable.”

But putting aside these contenders (why do so many of them have questions in their titles?), here are the top 10 (again, according to our readers) new posts of 2011, in case you missed them along the way. Which doesn’t mean that these are (necessarily) our best posts, or a representative sample, or that many others didn’t hit home for various subgroups of readers.

While we all get a little tired of lists by this time in the year, we don’t really use them an awful lot here at Off the Charts. So please indulge us this once, and thanks to everyone who wrote, read, and commented on this blog in 2011.—Jacob Molyneux, AJN senior editor/blog editor

1. “Notes of a Student Nurse: A Dose of Reality,” by Jennifer-Clare Williams

2. “Placenta Facebook Photos: Nurse and Mommy Tribes See Expulsion Differently,” by AJN editor-in-chief Shawn Kennedy

3. “Dispatches from the Alabama Tornado Zone,” a series of posts by Susan Hassmiller, senior adviser for nursing at the Robert Wood Johnson Foundation

4. “Confused About the Charge Nurse Role? You’re Not Alone,” by Jacob Molyneux

5. “The Priceless Clarity of Inexperience,” by Marcy Phipps, an ICU nurse and regular contributor to this blog

6. “Don’t Cling to Tradition: A Nursing Student’s Call for Realism, Respect,” by Medora McGinnis

7. “Bullying Wars: Theresa Brown vs. ‘the entire profession,’” by Shawn Kennedy

8. “Remembering 9/11: Nurses Were There,” Shawn Kennedy

9. “Killing Traditional Nursing Duties #2,” Shawn Kennedy

10. This one’s a tie: “Nurses, Hospitals, and Social Media: It Depends What Business You’re In,” by Julianna Paradisi, artist/nurse/blogger, and “One Take on the Top 10 Issues Facing Nursing,” by Shawn Kennedy

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Meeting Nightingale in Alabama; Where Were the Young Nurses? Further Notes from the Disaster Zone

May 13, 2011

Sue Hassmiller has been blogging from the tornado-damaged area in Alabama, where she’s volunteering for the Red Cross. This and all other posts in this series are collected on a separate page for easy reference.—JM, senior editor/blog editor

Finishing up some very difficult hospital visits with victims and family members at the University of Alabama–Birmingham Medical Center today, I saw the sign for the school of nursing. I remembered Dean Dodi Harper telling me last year of a man who had donated to her school what might be the largest grouping of original Florence Nightingale letters. A priceless gift indeed! Her intent was to transcribe the letters and eventually have an exhibit. As I saw the School of Nursing sign, the conversation all came back to me . . . and then I realized it was May 12, Nightingale’s actual birthday, the day we celebrate Nurses Day! Too good to be true: I e-mailed the dean and got an immediate response (I love those type A personalities!). She was away, but the assistant dean for clinical affairs and partnerships, Cindy Selleck, would welcome me—and indeed on this occasion the letters were on display in a temporary exhibit. Having been on a special Nightingale tour last year to England and Istanbul/Scutari, the words of this great mentor had taken on a whole new meaning for me (here’s the blog series I wrote at the time). 

Seeing this very special exhibit and Nightingale’s words on her very own stationery made me realize once again why I had come to Alabama. Between the families that we helped that day and Nightingale’s words of inspiration, this is a Nurses Day I will never forget. Happy Nurses Day all! It was a great one for me!            

Where were you, my young colleagues? Looking around at who served in this disaster gave me a stark reminder of the great need to replenish our ranks. Most nurses were my age and older, a well-experienced corps to be sure, but this just won’t do for the future!! Students ask for advice all the time about how to go about finding a job when there are few jobs currently to be had. And this is what I tell them: 

Red Cross Student Nurse Guidelines

1). Take any job that is available and move on from there.

2). If possible, take this time to continue your education. Getting the vast majority of nurses (80%) to the BSN level by 2020 is a big goal of our Future of Nursing: Campaign for Action.

3). VOLUNTEER. Doing volunteer work can help you get a broad base of experience you could not otherwise get. That’s how I started my career. It was always the Red Cross, but it was also free care medical clinics, children’s medical services, and several years as a camp nurse for diabetic children. I realize that there are rent and student loans to repay, but doing something to expand your resume for even two hours a weeks will benefit you immensely. For more information on the Red Cross go to this page and this page. Your professional associations, like the American Nurses Association, and especially the National Student Nurses Association while you are still in school, are also good places to connect.

The next time I volunteer to serve in a disaster, I want to see you there! Please!

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Into the Alabama Tornado Zone: First Dispatches from a Red Cross Volunteer

May 6, 2011
Last summer, Susan Hassmiller, PhD, RN, FAAN, the Robert Wood Johnson Foundation Senior Adviser for Nursing, wrote a series of posts for this blog as she spent her summer vacation  retracing the steps of Florence Nightingale in England and Turkey. Now she’s gone to Alabama as a Red Cross volunteer in the wake of a series of devastating tornadoes. You can read Susan’s daily on-the-go entries here. The accounts from the first two days—of her family’s history with the Red Cross in other disasters, and of arriving and settling in to less-than-ideal sleeping arrangements—are below. New updates (some of it quite moving and disturbing) will soon follow, and all updates will be collected on a separate page for easy reference.—Jacob Molyneux, senior editor/blog editor
Sue Hassmiller

Monday, May 2: Duty calls
I have been involved with the Red Cross for 36 years now, ever since the organization helped me find my parents when they were victims of an earthquake while vacationing in Mexico City. It was the day my parents made it home safely that I made a silent pledge to myself that I would find a way to repay my gratitude to this wonderful organization. As a young nurse, I signed up with the Red Cross in my college town of Tallahassee. I went on quite a few disasters in my single days, but these days, with all my job and family responsibilities, the real hands-on work comes infrequently. I am torn to be leaving those responsibilities now, and especially on Mother’s Day, when I will be missing being with my own mother and my own (grown) children who will tell me that they are happy and proud to have me as their mother.

And I will cherish those words as always, but I do think of the hundreds of people affected in this disaster who have lost their mothers forever, or the mothers who lost their children, and I think perhaps for a short two weeks of my life I might find some way to help them. That is my desire.

Tuesday, May 3: First night in the disaster shelter
I am at work for the last day before leaving, and feel so grateful that I work for an organization (the Robert Wood Johnson Foundation) that supports their employees in giving back to their community and country in this way. They have always been this way. I have worked there for 14 years and in that time have spent time away during 9/11, Katrina, the Indonesian tsunami, the four hurricanes that hit Florida at the same time, hurricane Floyd in NJ, and now this monster in Alabama that has no name. I don’t serve this way often, but every once in a while there is something so significant that I can’t ignore it. Read the rest of this entry ?

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Nightingale, One More Time

September 2, 2010

By Shawn Kennedy, AJN interim editor-in-chief

Florence Nightingale in the Crimean War (detail)

I know we’ve written a lot about Florence Nightingale on this blog recently (see Susan Hassmiller’s series of posts, In Florence’s Footsteps: Notes from a Journey) and I don’t want to put off those who aren’t necessarily fans, but I came across an editorial written by Gloria Donnelly, editor-in-chief of Holistic Nursing Practice, that resonated with me.  She writes about how the holistic nature of Nightingale’s approach fits with much that’s going on today in health care reform, citing as one example the trend toward teaching people to take charge of their own health. (The entire Fall issue highlights the work of holistic practitioners—I especially liked Garden Walking for Depression: A Research Report.)

Donnelly writes:

We believe that Ms. Nightingale, an advocate of health, self-healing, and healthy environments, would be proud of the strides that nurses have made to promote holistic health and care around the world. . . . Nightingale believed that ’health nursing‘ and cultivating good health were equally important to ’sick nursing,’ the art and principles of which she developed almost single-handedly. Prevention superceded cure in Nightingale’s schema as she advocated for Health Missioners to work, first in the villages of rural India and then in England, teaching women how to prevent disease and maintain healthy environments.

This, in a nutshell, describes nursing at its core. It’s a shame that of all of Nightingale’s philosophies and improvements that were adopted by health care systems around the world, “health nursing” wasn’t a primary one. Was it too simple a concept—was it assumed that people know (or should know) how to care for themselves? Or was it too difficult, since preventing disease often involves a wide spectrum of social changes, such as addressing poverty and improving education and access to care?

Lillian Wald, one of the founders of the Henry Street Settlement in New York City and of public health and school nursing, proved that “health nursing” works. The United Nations Millennium Development Goals are a present-day embodiment of this concept. Yet, while Donnelly’s editorial points to ways that some current trends in health care reflect Nightingale’s approach, most health care systems worldwide have pretty much ignored it in favor of “sick nursing.” How did health care get so far off track? Food for thought.

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On the Nurses Walk

August 23, 2010

By Shawn Kennedy, AJN interim editor-in-chief

Sydney Harbor

As some of you may have seen by my tweets over the last week or so, I was in Australia attending a meeting, the International Academy of Nurse Editors gathering in Coolum (August 11 to 14). We discussed editorial and publishing matters—interesting if you’re “in the biz,” but I imagine most nurses would roll their eyes if I discussed it here.

(Side note, to those interested: there was much discussion about the use and misuse of journal rankings and impact factors and the sustainability of society and clinical practice journals if journal rankings are to be the primary factor in deciding where one should publish one’s work. As long as faculty tenure and promotion are tied to publishing in higher-ranked research and “scholarly” academic journals—and for a thought-provoking discussion on how one defines “scholarly,” see this 2006 editorial (click through to the PDF version) by AJN’s editor-in-chief emeritus, Diana Mason—researchers and scholars will seek to publish in those places, as opposed to in clinical journals that are more widely read by practicing nurses. You’ll hear more from us soon on that discussion.)

Sydney: a proving ground for nurses. So, as long as I was halfway around the world, I took some vacation time and traveled from Coolum to Melbourne and then to Sydney before coming home. Read the rest of this entry ?

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Parting Thoughts: 10 Lessons Learned from Florence Nightingale’s Life

July 22, 2010

The final post in a series by Susan Hassmiller, Robert Wood Johnson Foundation (RWJF) Senior Adviser for Nursing, sent to us as dispatches from her summer vacation spent retracing Florence Nightingale’s influential career. The full series can be found by clicking here.  

My husband has called this trip a “game changer” for me, and indeed it has been.  I see things differently now, including our health care system . . . and the critical contributions that nurses are making, and need to continue making, to improve care for patients. Of course, I always knew this, but somehow this ups the ante for me—and I will use my new education to up the ante for nurses. I have learned so much, but let me share these 10 lessons I gleaned from Ms. Nightingale.

1. Never, ever stop learning. 
A broad education in the arts and sciences helps with critical thinking and making important connections that lead to action. I saw how Florence used her knowledge of math, statistics, sanitation, religion, and architecture to put a holistic plan together to improve the systems that care for patients. 

2. Ground yourself and your work in facts and evidence. Make your case indisputable.  Everyone should do this . . . not just those who call themselves “researchers.”

3. Muster the courage to follow your convictions. Step beyond what you think you can do. 

4. Treat every person holistically. Every person has a spiritual, mental, and physical side that must be nurtured for complete healing to occur. 

5. Know your strengths and know your weaknesses. If you don’t know what they are, ask someone. Choose a job where you can make the most of your strengths. Contribute, contribute, and then contribute some more.

6. Use your network to accomplish what you think you might be unable to accomplish on your own. Don’t be afraid to ask important people to help you finish important jobs and make needed improvements. Likewise, say yes to helping others when you are asked.

7. Speak and write often about the lessons/learnings that you would like to share with others.

8. If you see something that needs to be changed, change it! Nightingale said, “Deed, not creed.” 

9. Don’t blame others for how things are, if you are not willing to change them yourself. Or at least solicit help from others to make needed changes.

10. Keep your standards high. Lack of time, fatigue, and ambivalence all undermine high standards. Our patients deserve more.

Sue Hassmiller at statue of Florence Nightingale, London*

* Note on photo: Of the many statues in London, there are only two that depict women who are not members of the royal family, and both are of nurses! The other nurse statue is of Edith Louisa Cavell, described by Wikipedia as “a British nurse and humanitarian. She is celebrated for helping some 200 Allied soldiers escape from German-occupied Belgium during World War I, for which she was executed.”

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Scutari: A Blog Post Will Never Do Justice To This Visit

July 22, 2010

This is the second to last in a series of posts by Susan Hassmiller, Robert Wood Johnson Foundation Senior Adviser for Nursing, that chronicle her summer vacation spent retracing Florence Nightingale’s influential career.

Scutari was a “tragedy of epic proportions of which bureaucratic muddle and sheer human incompetence played the larger part, thrown in with a measure of bad luck.”

–Mark Bostridge, from his book, Florence Nightingale: The Making of an Icon

The Hospital: What Florence Experienced
It is almost incongruent that a woman who wrote more than 14,000 letters and 200 books said upon arriving at Scutari Hospital, a converted army barracks, that she was without words to describe what she saw. Of course, as time caught up with her, the words flowed quite freely. Death and mutilation surrounded her in this well-known deathtrap.  Her nurses slept (“in catnaps”) in cramped quarters. Men were cramped into rooms and spilled out into the long corridors as they lay on straw beds on cold stone floors. Attendants had to walk over the men who were, by Nightingale’s command, a requisite 18 inches apart. More men died than lived.

Nightingale in Scutari ward/Library of Congress, via Wikimedia Commons

Nightingale hardly slept, took her meals by the spoonful, and spent most of her time caring for the men, overseeing the band of nurses she brought with her (some were hardworking and disciplined, while others were not), administering the overall operation of the system, fundraising, constantly devising ways to make improvements to save more men and, of course, recording everything. She recorded for herself as evidence for her improvements and to teach lessons, but also to publicize the horrors of the situation to decision makers and the public back in London. The London Times and her good friend Sidney Herbert, the Secretary at War, made good use of her reports, which led to myths that she was a spy.

No man was ever allowed to die alone. Either Nightingale or one of her nurses stood over each man with an accordion lantern (not a genie lamp) day and night, to provide comfort until his passing. Nightingale was said to insist that she be present at every operation, as brutal as it was. Chloroform was not used until the second quarter of the war, well after Nightingale arrived.

What I Experienced…
Scutari is the current home of the Turkish First Army and its administrative offices. Security is extremely tight and no pictures were allowed. The Nightingale Museum, which is visited infrequently because special permission and logistics are required to get in, is in one of the four towers of the massive fortress structure. In the long corridors to get to the tower, marble floors now glisten and windows sparkle from daily cleanings—immaculate conditions are the order of the day.

So you have to use your imagination and historical reference to place yourself in her bloody boots. I did. I saw the rooms where they would have been, and imagined how I would have to listen to the screams of grief and step over those who have died. I imagined the nurses making their constant rounds, up and down these very long corridors, doing all they humanly could. I know now that there was no such thing as a “genie’s lamp,” as is the myth in all the pictures. What the nurses carried were cotton accordion lamps, one of which I purchased at the same Grand Bazaar in town where Miss Nightingale bought hers. I did shed a few tears when I walked away with my purchase, knowing what the lamp symbolized. Read the rest of this entry ?

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Florence Nightingale and the Red Cross

July 19, 2010

By Sue Hassmiller, PhD, RN, FAAN, Robert Wood Johnson Foundation Senior Adviser for Nursing (this is the latest in a series of posts by Hassmiller, who’s spending her summer vacation retracing crucial steps in Florence Nightingale’s innovative career)

British Red Cross thrift store, Romsey, England

Anyone who knows me knows I am a devotee of the American Red Cross. After the Red Cross helped me find my parents after a Mexico City earthquake nearly 35 years ago, volunteering for them is how I spend my free time and my money . . . So when I travel, I always check in with the Red Cross, no matter the state, no matter the country, and tell them my story, and tell them: Thank you and keep up the good work.  Read the rest of this entry ?

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From the Crimea to Vietnam: Generations of Veterans Appreciate Florence Nightingale

July 16, 2010

By Sue Hassmiller, PhD, RN, FAAN, Robert Wood Johnson Foundation Senior Adviser for Nursing (this is the latest in a series of posts by Hassmiller, who’s spending her summer vacation retracing crucial steps in Florence Nightingale’s innovative career)

This post is dedicated to Bob Hassmiller.

It is hard to believe that Florence Nightingale is not buried at Westminster Abbey. The offer was made, but turned down by Florence herself. For all the treasures she bestowed upon this earth while here, she was not one for a lot of pomp and circumstance. She simply wanted to do her work nonstop—to ensure that her voice was heard, and her lessons followed—but she did not want much to do with heroes’ welcomes, medals, or an honorary this or that. So in her will, and in the name of furthering medical science, she asked that her body be donated for medical research.  Read the rest of this entry ?

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