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Last Updated: Sunday, 31 October, 2004, 06:07 GMT
The multi-faceted Lady with the Lamp
By Jane Elliott
BBC News health reporter

A new exhibition hopes to explode the myth that Florence Nightingale was simply the 'Lady with the Lamp', mopping the brows of wounded Crimean soldiers.

It is set to show she was more a hard-headed administrator dedicated to improving hygiene and the way services were run.

The exhibition, timed to coincide with the 150th anniversary of Nightingale going to the Crimea, will show she was a great organiser.

She arranged the finances of soldiers, wrote letters to their loved ones, set up a laundry, reorganised the kitchens and attended to the dietary needs of convalescing patients.

Supplies

In 1854, Nightingale was appointed by Sir Sidney Herbert, the Minister at War, to superintend the introduction of female nurses in the Crimea and to lead an expedition of 38 women to take over the management of the barrack hospital at Scutari.

Florence Nightingale's legacy

She and her nurses cleaned and equipped the hospital and ensured vital supplies got through.

Alex Attewell, director of the Florence Nightingale Museum, based at St. Thomas' Hospital, London, said the Victorian chocolate-box myth of Nightingale's contribution to nursing was actually a disservice to her role as an administrator.

"One of the things we are finding is that there is quite a distinction between the myth and her achievements," he said.

"She was not so much a nurse, but an administrator, but that is something the public did not want to know about.

"She was the symbol of hope both for the public and the soldiers."

Logistics

Mr Attewell said Nightingale had only tended to the soldiers for six weeks, dedicating the rest of her time to administration and improvements.

She was not so much a nurse, but an administrator
Alex Attewell,
Florence Nightingale Museum

"The common misconception is that she just mopped brows. Her role was all to do with provisioning and supply and management," he said.

"We bring out her administrative achievements - the provisioning of the hospital and her dealing with the logistical problems.

"We are revealing a sense of the tough side of Florence Nightingale. She had to be tough to cut through the red tape and make the changes she did."

But despite being revered in myth as the saviour of the soldiers, historians now admit that the death toll at Nightingale's hospital in the Crimea was in fact higher than at any other hospital in the East, with patients dying from typhus, typhoid and cholera.

Dead horse

During her first winter at the Scutari Hospital, on the shores of the Bosphorus, at the start of the Crimean War, there was a 42% mortality rate among patients.

By the end of the conflict it had dropped to 3%, but this was mainly because of a sanitary commissions visit organised by Palmerston's government in March 1855, to flush out the sewers and improve ventilation.

In fact, it was not until after the war that Nightingale realised what an important role the clean sewers and good ventilation had had to play in the survival rates of the soldiers.

She was probably the first infection control nurse without actually realising it.
Jean Lawrence,
Infection Control Nurses Association
Mr Attewell said: "When she analysed the statistics, after the war, she realised that the number of deaths dropped when a dead horse was removed from the sewer.

"She discovered that Scutari was a killer when she analysed the figures. She realised that at a sort of micro level the hygiene was important - but it was the bigger issue of the drains that made the difference."

Nightingale's experiences gained in the Crimea shaped her views on hygiene that still inspire nursing today.

"Clean water and light and fresh air became her themes. She thought that if you kept the places clean and well ventilated the hospital would give people the chance of recovering through their own strength," Mr Attewell said.

Jean Lawrence, chairperson of the Infection Control Nurses Association, said: "Florence Nightingale did make a massive contribution. She was probably the first infection control nurse without actually realising it.

"She saw the need for cleanliness and for treating patients in the best possible environment.

"She punched away at the authorities about how buildings should best be designed, and importantly she had the authority ensure changes were made."

The exhibition will run from 4 November until the end of April 2005.




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