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CHAPTER 6 Florence Nightingale 63

have been a great leader and thinker under any circum- Similar dialogues with political leaders, intellectuals,
stance, or whether her unique, formal education and and social reformers of the day (John Stuart Mill,
social status were necessary for this to occur at the Benjamin Jowett, Edwin Chadwick, and Harriet
time. Would Nightingale become such a leader if born Marineau) advanced Nightingale’s philosophical and
today? What would nursing be today if she had not logical thinking, which is evident in her philosophy and
been born at that time and in that place? theory of nursing (Dossey, 2000; Kalisch & Kalisch,
The Nightingale family’s aristocratic social status 1983a; Woodham-Smith, 1951). These dialogues likely
provided her with easy access to people of power and inspired her to strive to change the things she viewed
influence. Many were family friends, such as Stanley as unacceptable in the society in which she lived.
Herbert, who remained an ally and staunch supporter Finally, Nightingale’s religious affiliation and beliefs
until his death. Nightingale learned to understand were especially strong sources for her nursing theory.
the political processes of Victorian England through Reared as a Unitarian, her belief that action for the
the experiences of her father during his short-lived benefit of others is a primary way of serving God
political career and through his continuing role as served as the foundation for defining her nursing work
an aristocrat involved in the political and social as a religious calling. In addition, the Unitarian com-
activities of his community. She most likely relied on munity strongly supported education as a means of
this foundation and on her own experiences as she developing divine potential and helping people move
waged political battles for her causes. toward perfection in their lives and in their service to
Nightingale also recognized the societal changes God. Nightingale’s faith provided her with personal
of her time and their impact on the health status strength throughout her life and with the belief that
of individuals. The industrial age had descended upon education was a critical factor in establishing the
England, creating new social classes, new diseases, profession of nursing. Also, religious conflicts of the
and new social problems. Dickens’ social commen- time, particularly between the Anglican and Catholic
taries and novels provided English society with Churches in the British Empire, may have led to her
scathing commentaries on health care and the need strongly held belief that nursing could and should be a
for health and social reform in England. In the secular profession (Dossey, 2000; Helmstadter, 1997;
serialized novel (1843 to 1844), Martin Chuzzlewit Nelson, 1997; Woodham-Smith, 1951). Despite her
(Dickens, 1987), Dickens’ portrayal of Sairey Gamp as strong religious beliefs and her acknowledgment of
a drunken, untrained nurse provided society with an her calling, this was not a requirement for her nurses.
image of the horrors of Victorian nursing practice. Indeed, her opposition to the work of the nuns in
Nightingale’s alliance with Dickens undoubtedly in- Crimea (she reported that they were proselytizing)
fluenced her definitions of nursing and health escalated the conflict to the level of involvement of
care and her theory for nursing; that relationship also the Vatican (Dossey, 2000; Woodham-Smith, 1951).
provided her with a forum for expressing her views Nelson’s review of pastoral care in the nineteenth
about social and health care issues (Dossey, 2000; century provides an interesting historical view of the
Kalisch & Kalisch, 1983a; Woodham-Smith, 1951). role of religious service in nursing (Nelson, 1997).

MAJOR CONCEPTS & DEFINITIONS
Nightingale’s theory focused on environment, how- environment. In the context of issues Nightingale
ever Nightingale used the term surroundings in identified and struggled to improve (war-torn envi-
her writing. She defined and described the concepts ronments and workhouses) , this emphasis appears
of ventilation, warmth, light, diet, cleanliness, and to be most appropriate (Gropper, 1990). Her con-
noise—components of surroundings usually re- cern about healthy surroundings involved hospital
ferred to as environment in discussions of her work. settings in Crimea and England, and also extended
When reading Notes on Nursing (Nightingale, 1969) to the public in their private homes and to the
one can easily identify an emphasis on the physical physical living conditions of the poor. She believed

Continued