Training | 2010.08.23
Could Florence Nightingale nurse us back to health? | Mark Bostridge
To make that \'paradigm shift\' in public health, Andrew Lansley would do well to look at Nightingale\'s writings
The 100 years since Florence Nightingale \'s death have seen a remarkable transformation in our understanding of her life and work. There was a great deal more to her than the image of the lady with the lamp suggests ("all that ministering angel nonsense," as she caustically referred to the mythology that surrounded her name). Nightingale was one of the 19th century\'s great polymaths. She was the emergent nursing profession\'s most significant theorist, an expert in hospital design, a pioneer in evidence-based medical care and statistical analysis, a radical theologian, a feminist who believed that women should be permitted to lead independent lives (even while she remained ambivalent about the notion of women\'s "rights") – and much else besides.
Regarding Florence Nightingale as an iconic figure has tended to make us forget what a powerful iconoclast she was in her lifetime on behalf of the overlooked and dispossessed. The most effective and lasting of her health reforms stemmed from her outrage at society\'s lack of concern for the welfare of certain of its members. She introduced trained nurses into the workhouses, laying the foundations of the modern NHS and enshrining the principle of humane care for those who were unable to pay for it. She campaigned tirelessly for better health and better equipment for the ordinary soldier. If David Cameron is as serious as he says he is about dealing with the problems faced by veterans of recent British wars as they adapt to civilian life – not least in the rising incidence among them of violent crime and alcohol abuse – he could find no better example than that of Nightingale, who made their plight one of the cornerstones of her reforming life.
Nightingale\'s passionate, pithy, direct prose leaps out at us from the bland civil-service speak of the Department of Health\'s new consultative document, Liberating the NHS , in a quotation from her Notes on Hospitals of 1863: "It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm."
If Nightingale were alive today, she would find it strange hospitals exist at all. She regarded them as belonging to a stage of "imperfect civilisation", and envisaged their end by the year 2000. Although she would have understood the growth of the primary care movement as having its roots in her own work, she would have been alarmed by the conditions of acute care evident in some hospitals today: at the high bed-occupancy rates; the poor hygiene; and the lack of space and of privacy – all of which go against the central tenets of her writings.
Furthermore, she would have been astounded by the complacency that accompanied the most recent outbreaks in the UK of the deadly Clostridium difficile . She would have expressed outrage at the failure to alert external authorities to the likely consequences of falling standards and heavy staff cuts. Nightingale\'s insistence on hand washing, as a simple, preventive measure against infection, has been reintroduced on wards, recognised as an effective defence against the spread of MRSA .
Nightingale\'s vision of a public health system for the future emphasised both the supreme importance of collective action in safeguarding the health of others and the need to educate communities that an individual\'s health was a personal issue and responsibility. Nightingale\'s stress on prevention rather than cure, together with her recognition of the healing properties of nature itself, has a strikingly modern ring to it. "What is health nursing," she wrote in one of her last public statements, "but the cultivation of health. What is health? Health is not only to be well, but to use well every power we have."
Andrew Lansley talks of finding a new approach to public health, "a paradigm shift" . But he might want first to consider Nightingale\'s emphasis on health education among the wider population as an important way forward. In doing so he might even discover something of a meeting of minds.
For more information, please visit
http://www.guardian.co.uk/commentisfree/[...]ingale-nurse-us-back-to-health
Instagram is adding automatic in-app text translation - The Verge views: 1530
Here’s a ‘Brand-New’ Massive Multilingual Dataset for Machine Translation views: 1527