Book Review: Florence Nightingale At First Hand

Book Title: Florence Nightingale At First Hand
Author: Lynn McDonald

Year of publication: 2010

Number of pages: 197pages

Florence Nightingale as we know is the founder of nursing, she was a reformer and a political reformer. She was not the first to reform nursing, but she was the first to make nursing a paid profession. She lived a fulfilled live, a life millions of people emulate. The book titled “Florence Nightingale At First Hand” by Lynn McDonald is a biography of Florence Nightingale.


Nightingale’s interest in nursing emerged in early childhood. While still a girl she began to nurse sick relatives, servants and villagers. In 1845, by then in her mid-twenties, she sought to learn nursing at nearby Salisbury Hospital. Her mother and sister were vehemently opposed. Nursing was then an unskilled occupation, poorly paid and disreputable. The stereotype has nurses drinking too much and using coarse language, although Nightingale herself refuted the latter, though not the former. The years of lost opportunity continued to rankle in old age. As late as 1900 she recorded that she ‘never had a happy moment till I went into hospital life’, and then ‘never had an unhappy moment” Page 6

Nightingale remained unmarried, as means to fulfil her calling and call to service. The book states that there was no form of contraception then, and women were obliged to live for their families. At age 36, Nightingale was already a national heroine.

“In Nightingale’s day there were no educational prerequisites for admission to a training school. Those trained at her school, called ‘probationers’, were given free room and board and a small stipend. In fact, before Nightingale, working-class women did not nurse in Britain. Rather, they were hospital cleaners, although they were called ‘nurses’. Those on night work had some duties as patient ‘watchers’. Nightingale’s reform was to separate cleaning jobs from patient care, reserving the title ‘nurse’ to the latter, and making it a decent, well-paying job, open on the basis of merit, regardless of class origins.” Page 33

Nightingale’s nursing establishment began with the 38 nurses who had travelled with her to Scutari. She believed nurses should not be dumb, and are not doctor’s slave. She was a principled and strong woman.
“On nursing practice Nightingale would make much of the concept of ‘intelligent obedience’ to doctor’s orders – which most decidedly did not mean blind obedience.” Page 52

“The nurse’s role was no less important than the doctor’s: ‘The physician prescribes for supplying the vital force – but the nurse supplies it’.” Page 100


She had nothing against doctors, but she believes medicine or surgery does not cure, as she wrote in one of her books, “diet, not medicine ensures health”

Her challenges

  1. She was not allowed to work as a nurse at first, until the opportunity to serve during the war came up. She was a strong woman, and obviously a feminist. She believed women should be given an opportunity to do things men also do. “Nightingale held that women have the same right to develop their abilities as men… Nightingale totally rejected the double sexual standard so prevalent in her time. That is, she refused to believe that men and women were fundamentally different in their sexual drives, so that men had to have other women if deprived of their wives, the army’s excuse for condoning prostitution. The two sexes had the same moral responsibilities, she held, and a common moral nature.” Page 47
  2. At the beginning of her establishment, some doctors never accepted her, not until they realized she was needed. She cultivated the habit of record keeping, cleaning, cross ventilation during the Crimean war.“Some of the doctors never accepted the presence of Nightingale and her nurses; others soon learned that going to her was the way to get things done. She had supplies that the army either did not have, or did not know that it had because its record keeping was so bad.” Page 72
  3. She fell sick even as a nurse.
    Nurses are life savers, but they also need to protect themselves, which is why there is need for PPE in this generation. Soldiers who died during the Crimean war did not die due to wound, or blood loss, a lot of them died because they were diseased. Later, Nightingale was infected by Crimean fever, likewise some of her nurses.

  4. She was accused and blamed about the mortality rate in the war.
    Nurses are always at the receiving end”, is a common quote we scream when we think we are been cheated as nurses. I don’t want to be sentimental in this, but considering the context of the war, why was she the only one blamed? Her accusers justified their accusation by asking why she never recorded the mortality rate as they increased. This explains the need for documentation as nurses. As explained that it was not a mandatory exercise for Nightingale to record these things. However, she overcame the accusation. After her return from the war, she worked on a 900 page analysis on what went wrong during the war. She found out that the sanitary care was poor, no sanitation for soldiers, they were exposed and fed on little food and unhealthy food. Her analysis was sent to the government, she hoped they would work on it. She believed if soldiers are fed well, and kept in a clean environment, there will be less mortality rate.
  5. Mentoring nurses was a challenge.
    Some hospitals did not want to employ the nurses she trained in her school. Nursing as at then was for untrained women. Most nurses were untrained, unethical and were not of good conduct. For nurses who got employed, several of them faced oppositions at the hospital, and Nightingale encouraged them often.

Nightingale, had a great legacy. She reformed nursing not only in England, but in Vienna, India, USA, Egypt. She was neither a racist, or religious fanatic. She believed in equity, and justice. She lived her life honorably, and nursing is grateful for her reformation.

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