What Would Florence Think? - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Tomorrow marks the 200th anniversary of the birth of Florence Nightingale. It is interesting to speculate on how Florence would react to the global response to COVID-19. The museum dedicated to her is in St. Thomas hospital, now on the frontlines of fighting the pandemic in London. There are some remarkable parallels with what she found when she volunteered to nurse soldiers during the Crimean War.

Upon her arrival to a filthy hospital set up in a barracks on the Asian shore of the Bosphorus, Florence saw thousands of soldiers die from infectious diseases rather than their wounds, prompting her to try and improve conditions through better infection control measures and some social distancing of patients. She was highly critical of how both deaths and infections were being tracked. She used data comparisons (the first female member of the Royal Statistical Society) to find the causes of problems and track problems. Florence noted in one of her letters that “the three things that all but destroyed the army in Crimea were ignorance, incapacity, and useless rules.”

Florence was exasperated by politicians who told stories that deviated from the truth. She once told Indian politicians that it was “absurd” not to include cholera in their death counts in an attempt to lower true mortality. She observed that what happened in Crimea could happen again ” unless future regulations are framed more intelligently, and administered by better informed and more capable officers.” She was dogged in her advocacy and did not hesitate to fundraise when supplies were needed. She understood the problems of social inequity in populations and fiercely advocated for better hygiene, better food, sanitation, and exercise.

I would guess that Florence might not be surprised at some of the challenges we are seeing today such as:

political resistance to social distancing measures
a failure to be guided by science
lack of PPE
a disjointed public health system
stressed and overworked healthcare workers
inaccurate data on COVID-19 cases and deaths
lack of accountability for planning at the national level

Florence Nightingale was a keen observer of human nature – the good, the bad, and the ugly. She would be proud of the nurses who are working so hard despite risks to their personal health and the safety of their families. Yet, some of the shocking behavior we see probably would not surprise her at all. Our technology is advanced, our hospitals are spotless but the fractures in coordination and lack of health equity have become all too evident during this pandemic.

What Florence would probably see at this point is an opportunity for true reform in the healthcare delivery system as an outcome of this crisis. She would also view it as being a prime time for nursing to take leadership on a national level. As was true in the Crimean War, the public today is more aware of the role and need for nurses. Her tools would look different-laptop spreadsheets instead of ledgers and twitter instead of letters but the advocacy would be there.

Read Rose Sherman’s book – The Nurse Leader Coach: Become the Boss No One Wants to Leave