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CHAPTER 5 Florence Nightingale’s Legacy of Caring and Its Applications 45

Welch, 1986; Widerquist, 1992; Slater, 1994;
Calabria & Macrae, 1994; Macrae, 1995).
There were four miles of beds in the Barrack
Hospital at Scutari, a suburb of Constantinople. A
letter to the London Timesdated February 24, 1855,
reported the following:

When all the medical officers have retired for the

night and silence and darkness have settled upon

those miles of prostrate sick, she may be observed,

alone with a little lamp in her hand, making her

solitary rounds (Kalisch & Kalisch, 1987).

In April 1855, after having been in Scutari for six
months, Florence wrote to her mother, “[A]m in
sympathy with God, fulfilling the purpose I came
into the world for” (Woodham-Smith, 1983, p. 97).
Henry Wadsworth Longfellow authored “Santa
Filomena” to commemorate Miss Nightingale.

Lo! In That House of Misery

A lady with a lamp I see

Pass through the glimmering gloom

And flit from room to room

And slow as if in a dream of bliss

The speechless sufferer turns to kiss

Her shadow as it falls

Upon the darkening walls

As if a door in heaven should be

Opened and then closed suddenly

The vision came and went

The light shone and was spent.

A lady with a lamp shall stand

In the great history of the land

A noble type of good

Heroic womanhood

(Longfellow, cited in Dolan, 1971, p. 5).

Miss Nightingale slipped home quietly, arriving
at Lea Hurst in Derbyshire on August 7, 1856, after
22 months in the Crimea and after sustained illness
from which she was never to recover; after ceaseless
work; and after witnessing suffering, death, and
despair that would haunt her for the remainder of
her life. Her hair was shorn; she was pale and drawn
(Figure 5–4). She took her family by surprise. The
next morning, a peal of the village church bells
and a prayer of Thanksgiving were, her sister wrote,
“‘all the innocent greeting’ except for those pro-
vided by the spoils of war that had proceeded her—
a one-legged sailor boy, a small Russian orphan,
and a large puppy found in some rocks near
Balaclava. All England was ringing with her name,

but she had left her heart on the battlefields of the

Crimea and in the graveyards of Scutari” (Huxley,

1975, p. 147).

Introducing the Theory

In watching disease, both in private homes and

public hospitals, the thing which strikes the expe-

rienced observer most forcefully is this, that the

symptoms or the sufferings generally considered to be

inevitable and incident to the disease are very often

not symptoms of the disease at all, but of some-

thing quite different—of the want of fresh air, or

light, or of warmth, or of quiet, or of cleanliness, or of

FIGURE 5–4 A rare photograph of Florence taken on her re-

turn from the Crimea. Although greatly weakened by her illness,

she refused to accept her friends’ advice to rest, and pressed on

relentlessly with her plans to reform the army medical services.

From Elspeth Huxley, Florence Nightingale (1975), p. 139, G. P.

Putnam’s Sons, New York.