I have often spoken and written of my admiration for the Nursing profession. In clinical medicine and in public health. I have been blessed in my knowing and seeing some of my nurse colleagues in action – in clinical wards and in field as ANMs. And I shall not hesitate to say that much of my practical knowledge in medicine – from how to secure a vein for a fluid drip to how to administer an intradermal injection – techniques essential to providing care, I have learned from my nurse colleagues.
There are two qualities essential to nursing and for any medical health care provider. This was told to me by a health care worker. In her own language Bengali. I have translated this to two words. Efficiency & Empathy.
Therefore, I was very delighted to hold in my hand a book. Old edition and used. In my book shop. Left Bank Books. in Seattle. The book titled. “Nursing: A human needs approach.”
Back at my hotel, by a fireplace I turned pages. And became engrossed. Such a lovely simple language. And the previous reader had underlined key sentences. I softly prayed that she had adopted these lessons. in life. In profession. The ones she underlined. “Optimum care of the sick required education.”
I read the first chapter yesterday. Rich history of Nursing.
In very early days nursing was seen largely as a feminine role – an extension of mothering. The author states that the word may have actually been derived from the same words as “nurture and nourish.” Sounds very logical. Indeed.
The authors divide evolution of nursing in four phases. The folk image phase. The Religious image phase. The Renaissance image phase. The Modern nursing phase.
The stories of first hospitals in India, of homecare nursing by sisters and mothers at home to the sick, the story of Phoebe, the first deaconess (servant) who cared for the sick, widows and orphans. The story of Olympias, a woman of Constantinople who set up the first hospital in Rome. And the story of Rofiada al Islamiah, wife to Prophet Mohammed, considered the mother of Nursing in Mideastern Muslim countries.
And then the story of the “lady with the lamp”, a light in times of darkness, Florence Nightingale.
Florence was born to wealth and a prominent family in Victorian England. Early in life she understood the essence of Christianity in her way. Service. Love. And shunning a life of luxury.
But as I read the chapter on Nightingale today, for the first time I understood the foundation she had made for the profession. Beyond the two E s of Empathy and Efficiency, she had stressed on a third E. Education.
To prepare herself in serving the sick and infirm, Florence studied with Pastor Fleidner at Kaiserworth for three months. In 1853 at 33 years of age, she was appointed to reorganize the care for the sick at a hospital established for “Gentlewomen in Distressed Circumstances”. Through hard work, she soon was noticed.
And Florence was sent to the front of the Crimean war in an Army hospital where wounded came in large numbers from the battlefield. And deaths were very high.
Florence’s genius lay in her observation. She identified three problems: 1) lack of essential medical supplies – drugs, bandages and equipment; 2) absence of sewers and laundry and 3) lack of proper food for the sick. Addressing these and efforts of her staff reduced the death rate drastically. Death came down to under 3 % among the wounded.
Post war Nightingale returned to England in poor health. She remained in poor health for the rest of her life. She lived to be 90.
And it is during this period that she laid the foundation of future nursing. A genius who foresaw the profession like no one else and whose teachings till day hold firm and true.
In 1860, Florence crated a school of nursing. The Nightingale School had three components: 1) a trained matron with undisputed authority over all staff; 2) a planned curriculum and course of theoretical and practical education and a home attached to the hospital where carefully selected students were placed under selected sisters. The word sister has its roots in the religious foundation of the nursing profession. One key component of the nursing education as prescribed by Florence was the value of attending to health care needs as well as human needs of patients.
In due time, Florence set up two streams of nurses. One, the “Ward sisters” for hospital care, supervision and teaching. The second stream was “District nurses”. She said that the district nurses needed special education as they would be working more independently. These district nurses are todays Auxiliary Nurse Midwives (ANMs).
Nightingale lived a long life dedicated to service to mankind in distress. An Angel on earth. But it is her human quality that impresses the most. Her ability to see the service in its best form. In its future. District Nurses. Ward sisters. Empowered with the three Es of Efficiency, Empathy and Education.