Florence Nightingale, Math Whiz

Profiles in Nursing

Florence Nightingale, Math Whiz

The analytics of nursing

By Elizabeth Hanink, RN, BSN, PHN
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Every nurse learns the basics about Florence Nightingale. She was a wealthy woman who, despite the strictures of her era, turned British healthcare on its head. Far from leading a life of leisure, or later of invalidism, she threw her talents into reforming the world.

However, there are less well-known facts about Ms. Nightingale. Few realize that she was a gifted mathematician; before she became a nurse, she tutored in arithmetic, geometry and algebra. Throughout her life she demonstrated the distinct marks of a serious mathematician: clear reasoning and a healthy skepticism about assumptions. There’s more, too. Although she never went to school, she was fluent in French, Italian, Latin and Greek. 

Applying Statistics to the Military

Ms. Nightingale reveled in applied statistics; she refined the polar-area diagram, a form of the pie chart. Illustrating a statistic as proportional to the area of a wedge in a circular diagram, this type of chart, she said, “affects(s) thro’ the eyes what we fail to convey to the public through their word-proof ears.”

One of her examples shows the number of preventable deaths in the military due to causes other than combat. (Eventually, she convinced Queen Victoria to agree to reforms!)  In 1858, Ms. Nightingale became the first female Fellow of the Royal Statistical Society, and in 1874 the American Statistical Association made her an honorary member.

Standardizing Data from Hospitals

She also formulated a Model Hospital Statistical Form. She helped pioneer the idea that researchers could objectively measure and analyze social forces.

Her studies showed the need for uniform classification so that comparable data was, in fact, comparable; in other words, so that 5 percent at St. Thomas Hospital measured the same phenomena as 5 percent at St. Isadora. Later, facts, not hunches, helped her see that the best-intentioned efforts can have unintended consequences. From then on, she advocated starting small.

Redesigning the Hospital

Hospital design became another passionate concern. Ms. Nightingale saw four major problems with hospitals: crowding even several patients to a bed, limited space and ventilation, and poor lighting. Her pavilion plan (Nightingale wards) featured individual units as part of a larger hospital, but never more than two to three stories high. Each unit was self-sufficient, and each helped prevent the spread of disease with a central nursing station that allowed the monitoring of all patients at all times.

Her design located service areas at each end; ideally, windows surrounded on three sides. Heads came up against the wall with feet facing a wide passageway. All this was to enhance ventilation; after all, depriving patients of proper ventilation is, acoording to her book Notes on Hospitals, “manslaughter under the garb of benevolence!”

No Hospitals in the Year 2000?

Nightingale wards remained in use well into the late 20th century. Strangely, regardless of her interest in them, Ms. Nightingale was firmly against hospitals, stating they belonged to a stage of imperfect civilization, or rather of non-civilization. According to the book Florence Nightingale and the Nursing Legacy, she wrote that she looked forward to a time of no hospitals. “But it is no use to worry about the year 2000!”

Only late in life did Ms. Nightingale acknowledge germs, but just barely. True, many of her admonitions had the practical effect of fighting microbes, but even in old age, miasma (bad air) was the culprit in her mind.

Taking a Stand Against British Rule in India

She authored 200 publications and several books. In keeping with Victorian sensibilities, she made neither public appearances nor statements. Neither did she have the vote. Yet, Florence Nightingale thrived as an activist. Her labor was behind the scenes, with years of work conducted from bed as she struggled with what researchers think were brucellosis and spondylitis. Without setting one foot in India, she intervened in its politics, chastising her government for periodic famines that took the lives of 29 million people during British rule.

The Ideal Nursing Candidate

Although her own broad education enhanced her problem-solving ability, she resisted educational requirements, even registration for nurses. She thought that good candidates would be lost if formal testing determined qualifications. Nurses, she held, should come from all levels of society. Character and experience counted more than exams.

Importantly, she resisted efforts to make nursing subservient in any area, especially male-dominated medicine. When she died at 90, blind and bedridden, Ms. Nightingale left a legacy of work not yet rivaled.   

Elizabeth Hanink RN, BSN, PHN is a freelance writer with extensive hospital and community-based nursing experience

This article is from workingnurse.com.

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