to work within that order; she was above all a re-
former, seeking to improve the existing order, not
to change the terrain radically.
In Nightingale’s mind, the specific “scientific”
activity of nursing—hygiene—was the central ele-
ment in health care, without which medicine and
surgery would be ineffective:
The Life and Death, recovery or invaliding of patients
generally depends not on any great and isolated
act, but on the unremitting and thorough perform-
ance of every minute’s practical duty. (Nightingale,
1860/1969)This “practical duty” was the work of women,
and the conception of the proper division of labor
resting upon work demands internal to each re-
spective “science,” nursing and medicine, obscured
the professional inequality. The later successes of
medical science heightened this inequity. The sci-
entific grounding espoused by Nightingale for
nursing was ephemeral at best, as later nineteenth-
century discoveries proved much of her analysis
wrong, although nonetheless powerful. Much of
her strength was in her rhetoric; if not always logi-
cally consistent, it certainly was morally resonant
(Rosenberg, 1979).
Despite exceptional anomalies, such as women
physicians, what Nightingale effectively accom-
plished was a genderization of the division of labor
in health care: male physicians and female nurses.
This appears to be a division that Nightingale sup-
ported. Because this “natural” division of labor was
rooted in the family, women’s work outside the
home ought to resemble domestic tasks and com-
plement the “male principle” with the “female.”
Thus, nursing was left on the shifting sands of a
soon-outmoded “science”; the main focus of its au-
thority grounded in an equally shaky moral sphere,
also subject to change and devaluation in an in-
creasingly secularized, rationalized, and technolog-
ical twentieth century.
Nightingale failed to provide institutionalized
nursing with an autonomous future, on an equal
parity with medicine. She did, however, succeed
in providing women’s work in the public sphere,
establishing for numerous women an identity and
source of employment. Although that public iden-
tity grew out of women’s domestic and nurtur-
ing roles in the family, the conditions of a modern
society required public as well as private forms
of care. It is questionable whether more could
have been achieved at that point in time (King,
1988).
A woman, Queen Victoria, presided over the
age: “Ironically, Queen Victoria, that panoply of
family happiness and stubborn adversary of female
independence, could not help but shed her aura
upon single women.” The queen’s early and lengthy
widowhood, her “relentlessly spreading figure and
commensurately increasing empire, her obstinate
longevity which engorged generations of men and
the collective shocks of history, lent an epic quality
to the lives of solitary women” (Auerbach, 1982, pp.
120–121). Both Nightingale and the queen saw
themselves as working through men, yet their lives
added new, unexpected, and powerful dimensions
to the myth of Victorian womanhood, particu-
larly that of a woman alone and in command
(Auerbach, 1982, pp. 120–121).
Nightingale’s clearly chosen spinsterhood repu-
diated the Victorian family. Her unmarried life pro-
vides a vision of a powerful life lived on her own
terms. This is not the spinsterhood of conven-
tion—one to be pitied, one of broken hearts—but
a radicallynew image. She is freed from the trivia of
family complaints and scorns the feminist collectiv-
ity; yet in this seemingly solitary life, she finds
union not with one man but with all men, person-
ified by the British soldier.
Lytton Strachey’s well-known evocation of
Nightingale, iconoclastic and bold, is perhaps clos-
est to the decidedly masculine imagery she selected
to describe herself, as evidenced in this imaginary
speech to her mother written in 1852:
Well, my dear, you don’t imagine with my “talents,”
and my “European reputation” and my “beautiful let-
ters” and all that, I’m going to stay dangling around
my mother’s drawing room all my life!...[Y]ou must
look upon me as your vagabond son...I shan’t cost
you nearly as much as a son would have done, or had
I married. You must consider me married or a son.
(Woodham-Smith, 1983, p. 66)Ideas about Nursing
Every day sanitary knowledge, or the knowledge of
nursing, or in other words, of how to put the constitu-
tion in such a state as that it will have no disease, or
that it can recover from disease, takes a higher place.—Florence Nightingale,Notes on Nursing
(1860/1969), PrefaceCHAPTER 5 Florence Nightingale’s Legacy of Caring and Its Applications 49