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 Prevention superceded cure in Nightingale’s schema as she advocated for Health Missioners to work, first in the villages of rural India and then in England, teaching women how to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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