Florence Nightingale in the Crimean War: Scutari and After

Nightingale was a nurse, not a soldier, but the Crimean War filled her wards. Men wounded at the Battle of the Alma and the Battle of Balaclava were shipped across the Black Sea to the British base hospitals at Scutari, and she began work there on 4 November 1854, the day before the Battle of Inkerman sent many more. Through the winter of the siege of Sevastopol, sickness from the trenches, rather than wounds, filled most of the beds.¹

What was Florence Nightingale famous for?

She is remembered for three things. At Scutari she ran the female nursing and much of the supply of the main British base hospital, and a newspaper account of her night rounds made her the Lady with the Lamp. After the war her statistics, above all the polar-area diagrams of 1858, showed that disease had killed far more British soldiers in the East than the enemy had. And in 1860 the Nightingale Fund opened a training school for nurses at St Thomas’s Hospital in London. How many lives she saved at Scutari is still argued over.²

Who was Florence Nightingale before the war?

She was born on 12 May 1820 in Florence, Italy, and named after the city, where her wealthy English family was staying. A woman of her class was expected to marry, but Nightingale wanted work. She trained at the Protestant deaconess institution at Kaiserswerth in Germany, briefly in 1850 and for about three months in 1851, and in 1853 became superintendent of a small institution for sick gentlewomen in Upper Harley Street, London.³

Why did Florence Nightingale go to Scutari?

In October 1854, with Britain and France at war with Russia, The Times printed William Howard Russell’s reports of the neglect of the sick and wounded, which compared them with the French and their nursing sisters, and opened a fund for them; letters to the press called for British women to go out as nurses. Sidney Herbert, the Secretary at War and a friend of hers, wrote to her on 15 October asking her to lead a party of female nurses to Scutari. She had already written offering to go, and the two letters crossed. Until then, as Herbert wrote, only men had served as nurses in British military hospitals.⁴

The party left London on 21 October 1854: Nightingale and 38 nurses, Anglican and Roman Catholic sisters as well as paid hospital nurses. They traveled through France to Marseilles, sailed on to Constantinople and began work at Scutari on 4 November. Her official title was Superintendent of the Female Nurses in the Hospitals in the East; in the wards she was the Lady-in-Chief.⁵

What did Florence Nightingale do in the Crimean War?

The Barrack Hospital was a large Turkish army barracks lent to the British on the Asian shore of the Bosporus. The nurses found it dirty and infested with vermin, short of basic equipment and of proper food; many stores had been left at Varna in Bulgaria when the army sailed for the Crimea. More of the patients were suffering from disease than from battle wounds.⁶

The army doctors were skeptical of the women at first, and it took the flood of casualties after Inkerman for them to accept the nurses’ help. With money from The Times fund and other gifts, Nightingale bought supplies, set up extra-diet kitchens for the sickest men and organized the washing of the patients’ linen. A second party of nurses under Mary Stanley arrived around the turn of 1854 and 1855: 47 women by the count of her biographer Edward Cook, about 50 by that of Sarah Tooley.⁷

Most of her day went on administration, purchasing and letters to London. On 2 May 1855 she crossed to the Crimea to inspect the hospitals at Balaclava and within days fell dangerously ill with “Crimean fever”; on 24 May Lord Raglan telegraphed London that she was out of danger. She went back to Scutari and stayed in the East until after the peace, leaving on 28 July 1856 and reaching home in August.⁸

Was she really the Lady with the Lamp?

The image comes from a letter from Scutari printed in The Times in 1855 and written by Mr. Macdonald, who handed out the paper’s fund for the sick and wounded. When the medical officers had retired for the night, he wrote, “she may be observed alone, with a little lamp in her hand, making her solitary rounds.” Within the year the words were printed under popular portraits of her, and in 1857 the American poet Henry Wadsworth Longfellow wrote of “a Lady with a Lamp” in his poem Santa Filomena, printed in the first issue of The Atlantic Monthly in November 1857.⁹

Did Florence Nightingale lower the death rate at Scutari?

This is where the record is contested. Popular accounts say she cut the death rate from over 40 percent to about 2 percent within a few months. The National Army Museum puts the hospital’s death rate at 42 percent by February 1855. The historian Lynn McDonald, editor of the Collected Works of Florence Nightingale, points out that there are no separate figures for “her” hospital: the official rates combine several hospitals on the Bosporus, and Koulali, where Mary Stanley stayed in charge of the nurses for some months, was not under her superintendence. By McDonald’s reading of Nightingale’s own tables, the worst death rate was at Koulali.¹⁰

McDonald accepts that mortality fell that far but says it took longer than the three or six months popular accounts allow. The turning point came from outside the nursing staff: a Sanitary Commission began work in March 1855, had the sewers repaired and the ventilation improved, and only then did deaths fall steeply.¹¹

Historians disagree about what she understood at the time. In Florence Nightingale: Avenging Angel (1998), Hugh Small argued that during the war she officially opposed the view that bad sanitation was killing her patients. McDonald rejects this, noting that Nightingale’s own report repeatedly called Koulali “the worst of all the hospitals” and blamed the army’s principal medical officer in the Crimea, Sir John Hall. Neither side disputes that the steep fall in deaths followed the sanitary repairs of spring 1855, or that after the war Nightingale became the leading campaigner for that lesson.¹²

What is Florence Nightingale’s rose diagram?

Back in England, Nightingale turned to evidence. A Royal Commission on the health of the army, chaired by Sidney Herbert, took evidence in 1857; its report, with her own testimony, was published in February 1858. Working with the statistician William Farr, she also wrote a long confidential report for the government, Notes on Matters Affecting the Health, Efficiency, and Hospital Administration of the British Army (1858).¹³

Its best-known pages carry the polar-area charts now called rose or coxcomb diagrams. Each of twelve wedges is a month, and its area shows the number of deaths: blue for preventable infectious (zymotic) disease, red for wounds, black for other causes. Set side by side, the two years from April 1854 to March 1856 show that disease killed most British soldiers in the East, and both charts mark the break of March 1855, when the commissions began to improve conditions.¹⁴

In 1858 she became the first woman member of the Statistical Society, now the Royal Statistical Society (the National Army Museum gives the year as 1859).¹⁵

Did Florence Nightingale know Mary Seacole?

Mary Seacole, a Jamaican-born healer, offered to serve as a nurse when Britain went to war, including with Nightingale’s team, and was turned down. In 1855 she paid her own way to the Crimea and with Thomas Day ran the British Hotel near Balaclava, which sold food and supplies to soldiers and gave them a place to rest. Her memoir, Wonderful Adventures of Mrs. Seacole in Many Lands (1857), was a bestseller. The two women worked in different places and in different ways, and their records are best read side by side.¹⁶

What did Florence Nightingale do after the war?

Her Notes on Nursing appeared in 1859. The Nightingale Fund, raised in her honor, had collected more than £40,000 (about £44,000 by the count in the school’s archive catalog), and on 9 July 1860 the first 15 probationers entered the Nightingale Training School at St Thomas’s Hospital in London.¹⁷

From 1857 she lived largely as an invalid at home in London, yet she kept writing and advising on army, hospital and Indian sanitary reform; in 1863 she published her Observations on the reports gathered by the Royal Commission on the Sanitary State of the Army in India.¹⁸

How did Florence Nightingale die?

In 1907 King Edward VII awarded her the Order of Merit, the first time it was given to a woman. She died at her home in London on 13 August 1910, aged 90. Her family declined an offer of burial in Westminster Abbey, which the Abbey attributes to provisions in her will, and she was buried in the churchyard of St Margaret’s Church, East Wellow, in Hampshire, near her parents’ home.¹⁹

How is Florence Nightingale remembered?

Nurses around the world mark International Nurses Day on 12 May, her birthday: the International Council of Nurses has celebrated it since 1965 and announced in 1974 that 12 May would be the date. Her name is often set beside the women who fought in history’s wars, but her tools were different: a ward round, a supply list and a well-drawn chart.²⁰