When you think of Florence Nightingale, you probably imagine a nurse with a lamp, comforting soldiers. Indeed, Florence is considered the mother of modern nursing. But she also made serious contributions in statistical data analysis, and used the diagram named after her, the Nightingale rose diagram, to convince the British Parliament to enact sanitation reforms that saved hundreds of thousands, if not millions, of lives.

During the Crimean war, Florence worked around the clock as head nurse in an overcrowded field hospital. But she also found time to create graphs to illustrate the terrible conditions of that field hospital to members of British Parliament. The sanitation reforms she led greatly improved the life of the soldiers in battle, and widespread adoption of her hygienic practices vastly reduced mortality rates of humanity in general.

Young Florence, unsure of her place in the world. Public domain via Wikipedia

A Call from God

Florence Nightingale was born into a wealthy London family in 1820. Her father believed that women should be educated, and taught her several subjects himself. She was particularly good at math, but didn’t want to pursue a mathematical career. In fact, she didn’t know what she wanted to do, only that she didn’t want to live like a house cat in high society. Florence was miserable at home, and among her many writings she mentions praying for death. Instead of mercy, she got a calling to help the sick and wounded.

When Florence announced her intent to become a nurse, her family was completely devastated. Back then, hospitals were grim, filthy places, and most nurses were either widows, ex-servants, or women of bad character who couldn’t find other work. Nursing was not the sort of thing that rich, educated girls did with their lives.

Florence defied her family and left home to study nursing in Germany. She came back to London and started training nurses in a small hospital, where she was quickly promoted to superintendent. By this time her father had softened on the idea, and was secretly sending Florence a healthy allowance to help support her.

Florence at Scutari. Image via National Army Museum

Triage in Turkey

Soon after the promotion, Britain and France declared war on Russia, and the Crimean war began. Reports of high mortality rates due to filthy field hospitals drove Florence into action.

She happened to be friends with Britain’s war secretary, and got herself and a team of three dozen volunteer nurses deployed to the Turkish base in Scutari where the British army was sending wounded soldiers. They set sail across the Black Sea from base camp in Balaclava, Ukraine, armed with a supply of medicines Florence bought with her own money.

Florence and her nurses found the conditions at this makeshift field hospital unspeakably bad. There were vermin crawling around everywhere, mass infections, and paltry supplies of even the simplest of medicines. More soldiers were dying from typhoid, cholera, and dysentery than from battle wounds. It was time to force the administration into action.

The Statistician of Scutari

At the time, the idea of representing information graphically was fairly new. Florence developed what’s now known as the polar area diagram or Nightingale rose diagram to show Parliament the various ways in which soldiers were dying, and to impress upon them that so many deaths were from preventable diseases. It’s essentially a pie chart, which was itself a fairly new concept, but adds a third dimension of time.

Red shows deaths from battle wounds, black from other causes, and blue-gray from preventable diseases. Image via Wikipedia

Her work, and her argumentation, was convincing. Through a series of letters, Florence explained that epidemics could be controlled with better nutrition, ventilation, and sanitation. The British government commissioned a pre-fab hospital that was built in England and shipped to Turkey. In the meantime, she enlisted the least infirm patients to help scrub the place from top to bottom, and set up a special kitchen to make meals for cholera and dysentery patients. Her efforts paid off greatly, and the mortality rate plummeted.

Working From Home

Florence returned from the war to a hero’s welcome, but she always shied away from attention and never gave any speeches. She turned down invitations left and right until one came in from Queen Victoria. Florence spent an entire afternoon telling the Queen and the prince consort all about the problems with Britain’s military hospitals. They were quite impressed, and when Florence asked for administrative attention on the British army in India, she got it.

Florence contracted brucellosis at Scutari and was mostly bedridden for the rest of her life. She never stopped working, and was frequently consulted about the design and maintenance of field hospitals until her death in 1910.

She fully rejected the life of leisure demonstrated by the women of her age, and rather than raising a family, she used her position to guide humanity into a better future. Florence transformed nursing into a skilled profession for women of good character and changed public opinion along the way.

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