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Nightingale met a friend Richard Monckton Miles in 1842. Then in 1844, Nightingale asked Dr. Howe if she could do a charitable job in a hospital like the catholic nuns, and refused her marriage to her cousin, Henry Nicholson. By 1845, Nightingale started training herself in the nearby Salisbury Hospital, but her parents were not happy about it, seeing nursing as an inappropriate job for a well to do woman like their daughter. In the next year, Nightingale began teaching herself from the government blue books. In the meantime, Monckton Miles wanted to marry her, but soon she travelled to Rome, Italy with friends to avoid him. (Britain unlimited, 2009). Finally, after she attended the Herbert's Charmouth convalescent home, her knowledge was recognized. In 1849, after refusing finally to Miles proposal, she decided to go to Egypt while accompanying her friends, the Bracebridges. They then travelled through Europe, and ended up at the Kaiserswerth Institution on the Rhine in Germany and Nightingale was asked by Pastor Theodore Fliedner to write a pamphlet about Kaiserswerth. In 1851 Nightingale studied for three months at Kaiserswerth, after her father sent her 500 pound for her studies, later she opened her own nursing establishment Gentlewomen (Dossey, 2005-page 24), (Britain unlimited, 2009),(McEwen, and Wills, 2011, pg.123).
Nightingale became very well versed with public health, hospitals, hospital building and construction, healthcare in general, army medicine, reform, philosophy, and religion in Europe. Being excellent in mathematics, she was able to statistically collect, analyze, and quantify data on many sanitary, hospital or nursing issues and was brilliant, well organized, and the personality type of a perfectionist (Dossey, 2005, pg.24, 76-77).
Work Experience - Nightingale developed her early personal professional experience when she was troubled by the constraints placed on her by her family and society. She wrote in her dairy of 1847-9,
Women are private martyrs. There are private martyrs as well as burnt or drowned ones. Society of course does not know them; and family cannot, because our position to one another is our families is, and must be, like that of Moon to Earth. The Moon revolves around her, moves with her; never leaves her. Yet the earth never sees but one side of her, moves with her, never leaves her. Yet the Earth never sees, but one side of her; the other side remains forever unknown (Selanders, 2005, pg. 65).
After she finished her training at Kaiserswerth, she gained her practical experience, and she was able to formulate her personal professional experience. In 1853, she became the superintendent at the Hospital for the Sick Gentlewomen in Distressed Circumstances, at 1 upper Harley Street, London (Selanders, 2005, pg. 66). As she continued to the build experience during the Crimean war in 1854, the Secretary of War for Great Britain, Mr. Sidney Herbert, asked Nightingale to nurse British soldiers. At Herbert's request, Nightingale took with her thirty-eight skilled nurses to Scutari Army Barracks Hospital in Turkey. Nightingale encountered much opposition from the military physicians. Never the less, that did not stop her from her vision. Nightingale provided care with a statistical proof of reduction of deaths from forty-eight percent to two percent within roughly two years (McEwen, and Wills, 2011, pg.123), (Simkin, 2009). Nightingale found that most of the deaths were likely occurring during the transporting of the patient, and the lack of proper sanitation such as open sewers, cleanliness, lack of air, and good nutrition. Nightingale implemented changes to address these problems. Nightingale became a hero to the troops and the troops wrote songs and poems about her. With the use of her personal knowing, she was called "Lady of the Lamps," as she made rounds, which became a therapeutic relationship with the patients. (Clement, and Averill, 2006, pg. 272). (Wikipedia, 2010). The military physicians opposed her recommendations even though they knew it would benefit the soldiers. Nightingale wrote many notes on the matter affecting health, efficiency of administrator of the British Army using her empirical knowledge she wrote notes that was almost thousands of pages long. She was quoted as saying, "I stand at the altar of the murdered men, and while I live, I shall fight their cause," but she also said "it must never be lost sight of what observation is for"? (Clements, and Averill, 2006, pg. 270). On her third trip to Scutari, she was already the supervisor of all the nurses (McEwen, and Wills, 2011, pg 123), (Dossey, 2005, pg.25). In 1855 a public subscription was raised in Britain to promote her work, unfortunately, Nightingale became very ill with Crimean fever. One year later the war ended, and Nightingale returned to England and she was invited by Queen Victoria and Prince Albert to relate her war experiences. In 1857, the government decided to a royal commission to take care of the disaster of the Crimean war (Britain unlimited, 2009).
Reconstruction of Professional Networks - Nightingale developed her philosophical assumptions, but because she was raised during the Victorian era, women were not considered to work outside their home, because they were too delicate for physical and mental endeavors. For Nightingale, work was considered as a means to an end. First, she took the job at Gentlewomen Hospital, and then accepted the request of the Secretary of State Mr. Herbert. While at her work at Scutari, Nightingale was very concerned with the patient's environment. She believed that a clean environment promotes healing and health. She included information about nursing care, proper building for treating the sick, and administration system (McEwen, and Wills, 2011), (Chin, and Kramer, 2008, pg.56-59). She defined environment as anything that through manipulations assist in putting the individual in the best possible condition for nature to act, this can be found in her Nursing notes (Selanders, 2005, pg. 101). She was concerned about the environment and the portal of transmission of disease in patients and society, which she said could be through dirt, drink, (dirty water), diet, draught, and drains such as stagnant sewages. Mostly she stressed hand washing. She applied all her Emancipatory knowing by defining healthy environment, reflected on her Victorian era of coal burning in the big cities in Great Britain (Selanders, 2005, pg, 110), (McEwen, and Wills, 2011). Ethically, she decided what was right and wrong; especially when hospitals were not allowing nurses to do what she believed was right, physician abuse of nurses, and the belief that nurses were the ones to protect vulnerable patients. She stressed that aesthetics in nursing was made visible through conducts, attitudes, narratives, action, caring with patient's families and colleagues, and person's environments. Through her personal knowing, she noted that nurses must understand and developed one's inner self (Dossey, 2005, pg.50-54).
Nightingale cared about her patients. She would make rounds on her patients at night with a lamp in her hand, (her "Lady of the Lamp" legacy) (McEwen, and Wills, 2011, pg.123), (Muro, 2010), (Wikipedia, 2010). In 1857, the government decided to form a Royal Commission to look into the disaster of the Crimean war. Since women were not allowed to serve on commissions in that era, Nightingale wrote a letter to them instead. (Britain unlimited, 2009). She worked to reform Army Medical Schools and instituted a program of record keeping of government health statistics. When the Sepoy rebellion in India escalated, Nightingale became very concerned about the problem of sanitation. She then assisted with the strategic planning for the public health system in India. At the same time, she was suffering from what would now be called "post-traumatic stress disorder," from her Crimean war experience (Britain unlimited, 2009).
Professional Contributions - She published a book with the title "Notes on Nursing" in1859, and the most notable work of her effort, which was widely remembered, was the St. Thomas School of Nursing, which she founded in1860. Sarah Wardroper was chosen to be the head. Nightingale began living close to the hospital to oversee the hospital's progress. She became the first female to be elected a fellow of the Statistical Society, for using statistics and graphs in nursing (McEwen, and Wills, 2011 page123), (Britain unlimited, 2009). She became a consultant for many nursing infirmaries in England. An example of this was that in December of 1844 a patient by the name of Timothy Daley died from filthiness due to neglect. Nightingale wrote a letter to Mr. Charles Villiers, president of the board of Directors for the Poor. Mr. Farnnall, the metropolitan district inspector was informed, and they came up with a form of inquiry for every workhouse of all the hospital units in London. In 1861 she was asked for nursing advice by the Union forces in the American Civil war, and in 1862 she published her "Observations" about sanitation on India.(Simkin, 2009). In 1867, she worked on rural hygiene especially that of Indian sanitation, then in 1871 she published notes on "Lying in Hospital."? In 1872, the founder of Red Cross, Mr. Henri Dunant, claimed that it was Nightingale's notable work for the public that influenced him to start…[continue]
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