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An Introvert as Reformer
Introvert Florence Nightingale not only founded the modern profession of nursing, she also pioneered statistical techniques and essential measures of public health.
“Everyone knows the popular conception of Florence Nightingale. The saintly, self-sacrificing woman, the delicate maiden of high degree who threw aside the pleasures of a life of ease to succor the afflicted, the Lady with the Lamp, gliding through the horrors of the hospital at Scutari, and consecrating with the radiance of her goodness the dying soldier’s couch – but the truth was different.” – Lytton Strachey
In his 1918 book Eminent Victorians Strachey nailed the traditional image of Florence Nightingale as an angel of mercy who alleviated the suffering of wounded soldiers during the Crimean War and mobilized other women to do likewise. But let’s look instead at three of Nightingale’s actual achievements.
First, she elevated the role of nurse from near-prostitute disrepute to professional respectability. Second, she advocated for and popularized life-saving public health measures. Third, and most surprisingly, she originated statistical methods of analyzing data that are still used in business and science. And she did all this while deploying interesting ways to have an impact in society while accommodating her introverted personality and the prejudice against women in her day.
Born in 1820 to a wealthy and socially prominent English family, Florence Nightingale was educated at home by her father. At age six, she decided she would have some sort of profession instead of just finding a husband, raising a family and entertaining her peers. When she eventually announced that she’d settled on nursing as her role in society, her mother reacted with horror – “as if I had wanted to be a kitchen-maid,” she later said.
At that time nurses had a reputation of being dirty, drunken, immoral and ignorant. People with means brought doctors into their home to treat illnesses, so hospitals were deplorable places mainly for the poor. Yet Florence surreptitiously read medical commission reports and sanitation manuals, and when the family traveled she spent the inevitable downtime sneaking off to visit as many of Europe’s great hospitals and nursing institutions as she could.
When the Crimean War broke out in 1853, between Russia on the one hand and Britain, France and the Ottoman Empire on the other, Nightingale had been superintendent of a nursing home in London for a year. The atrocious conditions at the British military hospital in Constantinople, Turkey, became known to Nightingale and a family friend named Sidney Herbert, who headed England’s War Office. The two decided Nightingale should lead a delegation of 38 nurses to take charge of the unfolding disaster. At the Scutari hospital she did indeed walk the halls of the wards at night holding a candle, but what she primarily did there was to arrange for better ventilation, decent bedding and healthier food for the soldiers. She also slashed red tape for medical supplies to be delivered.
After dramatically improving conditions at the hospital, over the heads of her nominal superiors and sometimes using her own funds, Nightingale returned home in poor health as the second most famous woman in England (after Queen Victoria). Meeting with the Queen, she delivered proposals for overhauling England’s whole system of military hospitals and spearheaded a report whose innovative statistical diagrams showed how death rates plummeted with better sanitation. This work earned her an invitation to become a fellow of the Royal Statistical Society, the first woman so honored.
Besides sending out all kinds of questionnaires about medical care, conditions and outcomes and then analyzing the data, she founded England’s first professional training school for nurses, criticized workhouses for the poor and formulated the ethic of soldiers’ neutrality that became the basis for the International Committee of the Red Cross. She worked extremely hard at these and other tasks while practically bedridden for the rest of her long life with what is now thought to have been spondylitis, a chronic inflammation of the spine.
And now let’s examine the introvert angle on Florence Nightingale’s life. A bookworm as a child, at a young age she would also record various facts in columns in a small notebook. Unlike her mother and sister, she didn’t enjoy big parties. After she discovered her vocation in nursing, she used the following strategies to have a significant impact while respecting her behind-the-scenes personality:
Kept the focus on her cause, not herself. When she returned from Crimea, admirers wanted to celebrate her achievements with public fanfare. When she refused to participate, they paraded an empty carriage around Southampton instead.
Retreated from other public commitments. According to Barbara Dossey, who studied Nightingale’s archives for telling clues about her personality, “she declared herself an invalid in 1857 to better manage her time and accomplish her enormous reform work that involved generating hundreds of documents.” She did have chronic health problems, but she also used that as a socially acceptable reason for meeting with only one person at a time in her sickroom, refusing star-struck visitors and canceling meetings when she had more urgent tasks to finish.
Accomplished political reforms through others. Nightingale brilliantly managed family connections and friendships with influential men to go over or around bureaucratic obstacles. She planned, collected the data and wrote the reports to back up her proposals, then handed the issue to some cabinet minister whom she knew. If officials still blocked the way, she threatened to appeal to the public, with whom she remained extremely popular – a strategy that moved governmental mountains. In part this approach was necessary because women could not directly participate in politics or government at that time, but it also allowed her to concentrate her finite stores of energy on the aspects of social change where she excelled.
Florence Nightingale well understood her personality and the cost of ignoring her inborn preferences. After her return from Crimea, she wrote: “I who required more time alone than anybody, who could not live without silence and solitude, have never had one moment to myself since I went to Harley Street [where she headed an “Institution for the Care of Sick Gentlewomen in Distressed Circumstances”]. It is by far the greatest sacrifice I have made.”