40 SECTION II Evolution of Nursing Theory: Essential Influences
Introducing the Theorist
Florence Nightingale transformed a “calling from
God” and an intense spirituality into a new social
role for women: that of nurse. Her caring was a
public one. “Work your true work,” she wrote, “and
you will find God within you” (Woodham-Smith,
C. 1983, p. 74). A reflection on this statement
appears in a well-known quote from Notes on
Nursing(1859/1992): “Nature [i.e., the manifesta-
tion of God] alone cures ... what nursing has to
do ... is put the patient in the best condition for
nature to act upon him” (Macrae, 1995, p. 10).
Although Nightingale never defined human care or
caring in Notes on Nursing,there is no doubt that
her life in nursing exemplified and personified an
ethos of caring. Jean Watson (1992, p. 83), in the
1992 commemorative edition ofNotes on Nursing,
observed, “Although Nightingale’s feminine-based
caring-healing model has transcended time and is
prophetic for this century’s health reform, the
model is yet to truly come of age in nursing or the
health care system.” Boykin and Dunphy in a reflec-
tive essay (2002) extend this thinking and relate
Nightingale’s life, rooted in compassion and caring,
as an exemplar of justice-making (p. 14).Justice-
makingis understood as a manifestation of com-
passion and caring, “for it is our actions that brings
about justice” (p. 16).
This chapter reiterates Nightingale’s life from
the years 1820 to 1860, delineating the formative
influences on her thinking and providing historical
context for her ideas about nursing as we recall
them today. Part of what follows is a well-known
tale; yet it remains a tale that is irresistible, casting
an age-old spell on the reader, like the flickering
shadow of Nightingale and her famous lamp in the
dark and dreary halls of the Barrack Hospital,
Scutari, on the outskirts of Constantinople, circa
1854 to 1856. And it is a tale that still carries much
relevance for nursing practice today.
Early Life and Education
A profession, a trade, a necessary occupation, some-
thing to fill and employ all my faculties, I have always
felt essential to me, I have always longed for, con-
sciously or not....The first thought I can remember,
and the last, was nursing work....
—Florence Nightingale, cited in Cook
(1913, p. 106)Nightingale was born in 1820 in Florence,
Italy—the city she was named for. The Nightingales
were on an extended European tour, begun in 1818
shortly after their marriage. This was a common
journey for those of their class and wealth. Their
first daughter, Parthenope, had been born in the
city of that name in the previous year.
A legacy of humanism, liberal thinking, and love
of speculative thought was bequeathed to
Nightingale by her father. His views on the educa-
tion of women were far ahead of his time. W. E. N.,
her father William’s nickname, undertook the edu-
cation of both his daughters. Florence and her sis-
ter studied music; grammar; composition; modern
languages; Ancient Greek and Latin; constitutional
history and Roman, Italian, German, and Turkish
history; and mathematics (Barritt, 1973).
From an early age, Florence exhibited independ-
ence of thought and action. The sketch (Figure
5–1) of W. E. N. and his daughters was done by
Nightingale’s beloved aunt, Julia Smith. It is
Parthenope, the older sister, who clutches her fa-
ther’s hand and Florence who, as described by her
aunt, “independently stumps along by herself ”
(Woodham-Smith, 1983, p. 7).FIGURE 5–1 This sketch of W.E.N. and his daughters was done
by one of his wife Fanny’s sisters, Julia Smith.From Woodham-Smith,
p. 9, permission of Sir Henry Verney, Bart.