by Sue Corbett
But, though her physical powers failed her, there was no falling off either in her mental strength or in her intense devotion to the cause of humanity. She was still the “Lady-in-Chief” in the organization of the various phases of nursing which, thanks to the example she had set and the new spirit with which she had imbued the civilized world, now began to establish themselves; she was the general adviser on nursing organization not only of our own but of foreign Governments, and was consulted by British Ministers and generals at the outbreak of each one of our wars, great or small; she expanded important schemes of sanitary and other reforms, though compelled to leave others to carry them out, while at all times her experience and practical advice were at the command of those who needed them.
Almost the entire range of nursing seems to have been embraced by that revolution therein which Florence Nightingale was the chief means of bringing about. Following up the personal services she had already rendered in the East in regard to Army nursing, she prepared, at the request of the War Office, an exhaustive and confidential report on the working of the Army Medical Department in the Crimea as the precursor to complete reorganization at home; she was the means of inspiring more humane and more efficient treatment of the wounded both in the American Civil War and the Franco-German War; and it was the stirring record of her deeds that led to the founding of the Red Cross Society, now established in every civilized land. By the Indian Government also she was almost ceaselessly consulted on questions affecting the health of the Indian Army. On the outbreak of the Indian Mutiny she even offered to go out and organize a nursing staff for the troops in India. The state of her health did not warrant the acceptance of this offer; but no one can doubt that, if campaigns are fought under more humane conditions today as regards the care of wounded soldiers, the result is very largely due to the example and also to the counsels of Florence Nightingale.
But advance no less striking is to be found in other branches of the nursing art as well. In regard to general hospitals, the pronounced success of the nursing school established at St Thomas’s as the outcome of the Nightingale Fund led to the opening of similar schools elsewhere, so that to-day hospital nursing in general occupies a far higher position in the land than it has ever done before, while this, in turn, advanced the whole range of private nursing in the country. Then, again, the system of district nursing, which is now in operation in almost every large centre of population, has had an enormous influence alike in bringing skilled nurses within the reach of sufferers outside the hospitals, and of still further raising the status of nursing as a profession. “Missionary nurses,” Florence Nightingale once wrote, “are the end and aim of all our work. Hospitals are, after all, but an intermediate stage of civilization. While devoting my life to hospital work, to this conclusion have I always come — viz., that hospitals were not the best place for the sick poor except for severe surgical cases.”
District nursing was really set on foot in this country by the late Mr William Rathbone, who, in compliance with the dying request of his first wife, started a single nurse in Liverpool in 1859 as an experiment, The demand for district nurses soon became so great that more were clearly necessary, and Miss Nightingale was consulted as to what should be done. She replied that all the nurses then in training at St Thomas’s were wanted for hospital work, and she recommended that a training school for nurses should be started in Liverpool. The suggestion was adopted, and in November, 1861, on being consulted about the plans, she wrote to the chairman of the training school committee:—
“God bless you and be with you in the effort, for it is one which meets one of our greatest national wants. Nearly every nation is before England in this matter — viz., in providing for nursing the sick at home; and one of the chief uses of a hospital (though almost entirely neglected up to the present time) is this — to train nurses for nursing the sick at home.”
By about 1863 there was a trained nurse at work among the poor in each of the 18 districts into which Liverpool had been divided for the purposes of the scheme. The example of Liverpool was speedily followed by Manchester, where a district nursing association was formed in 1864; the East London Nursing Society was established in 1868, and the Metropolitan and National Association followed in 1874. In the organization of the last-mentioned society Florence Nightingale took the deepest interest, sending to The Times a long letter, in which she expressed her gratification at the idea of the nurses having a central home, set forth in considerable detail the nature and importance of the duties the district nurses were called upon to perform, and appealed strongly — and successfully — for donations towards the cost of a home. After these pioneer societies had been successfully started many others followed; but the greatest development of all was afforded by Queen Victoria’s Jubilee Institute for Nurses, the operations of which have been of the highest importance in spreading the movement throughout the United Kingdom. When, in December, 1896, a meeting was held at Grosvenor House for the purpose of organizing a Commemoration Fund in support of the Institute, a letter from Florence Nightingale was read, in which she expressed the heartiest sympathy with the proposal.
Great and most beneficent changes, again, have followed the substitution in workhouse infirmaries of trained nurses for the pauper women to whose tender mercies the care of the sick in those institutions was formerly left. It was a “Nightingale probationer,” the late Agnes Jones, and 12 of her fellow-nurses from the Nightingale School at St Thomas’s who were the pioneers of this reform at the Brownlow-hill Infirmary, Liverpool; and it was undoubtedly the spirit and the teaching of Florence Nightingale that inspired them in a task which, difficult enough under the conditions then existing, was to create a precedent for Poor Law authorities all the land over.
Midwifery was another branch of the nursing art which Florence Nightingale sought to reform. She published in 1871 “Introductory Notes on Lying-in Hospital”; and, in 1881, writing on this subject to the late Miss Louisa M. Hubbard, who was then projecting the formation of the Matrons’ Aid Society, afterwards the Midwives’ Institute, she said, referring to these “Introductory Notes”:—
“The main object of the ‘Notes’ was (after dealing with the sanitary question) to point out the utter absence of any means of training in any existing institutions in Great Britain. Since the ‘Notes’ were written next to nothing has been done to remedy this defect… The prospectus is most excellent… I wish you success from the bottom of my heart if, as I cannot doubt, your wisdom and energy work out a scheme by which to supply the deadly want of training among women practising midwifery in England. (It is a farce and a mockery to call them midwives or even midwifery nurses, and no certificate now given makes them so.) France, Germany, and even Russia would consider it woman-slaughter to ‘practise’ as we do.”
No less keen was her interest in rural hygiene. The need of observing the laws of health should, she thought, be directly impressed on the minds of the people, and to this end she organized a health crusade in Buckinghamshire in 1892, employing — with the aid of the County Council Technical Instruction Committee — three trained and competent women missioners, who were to give public addresses on health questions, following up these by visiting cottagers in their own homes and giving them practical advice.
Further evidence of Florence Nightingale’s activity and beneficent efforts is afforded by the series of books, pamphlets, and papers that came from her pen. In 1858 appeared her “Notes on Matters affecting the Health, Efficiency, and Hospital Administration of the British Army,” a volume of 560 pages, in which, “so far as the state of my health,” she writes, “has permitted me,” she makes an exhaustive review of the defects that led to the “disaster” at Scutari, and discusses in the most thorough and lucid manner the various points calling for consideration in regard to the management and efficiency of army hospitals. The value of this work, still great, was simply incalculable at the time it was first issued. In October, 1858, Miss Nightingale contributed two papers to the
Liverpool meeting of the National Association for the Promotion of Social Science on “The Health of Hospitals” and “Hospital Construction.” In 1860 she published “Notes on Nursing.” So popular has this work become by reason of its thoroughly practical hints, given in the clearest possible language, that some 100,000 copies of it are said to have been sold. For the Edinburgh meeting of the National Association for the Promotion of Social Science, held in 1863, Miss Nightingale contributed a paper on “How People may Live and not Die in India”; and she followed up the same subject, when the association met at Norwich, in 1873, with a paper on “Life or Death in India,” this paper being subsequently reprinted with an appendix on “Life or Death by Irrigation,” in which considerations arising out of the Bengal famine are discussed more especially from the point of view of the paramount necessity of combining drainage with irrigation.
In these various ways one sees how Florence Nightingale, though a bedridden invalid and well advanced in years, was still ever ready, as she had been throughout life, to devote her energies to promoting the practical well-being of her fellow-creatures. What with writing papers, pamphlets, and letters, receiving reports concerning the many movements in which she was interested, and dealing with communications from Governments, authorities, and others all the world over, she was, even in the closing years of her life, essentially a hard-working woman. How great, indeed, were the demands made upon her time is well shown by a letter addressed by her on October 21, 1895, to the Rev T. G. Clarke, curate of St Philip’s Birmingham, and local secretary of the Balaclava Anniversary Commemoration. In the course of this letter she said:—“I could not resist your appeal, though it is an effort to me, who know not what it is to have a leisure hour, to write a few words”; and she added:—“I generally resist all temptations to write, except on ever-pressing business. I am often speaking to your Balaclava veterans in my heart, but I am much overworked.”
Yet, among all these manifold claims upon her attention, she never forgot that unpretending “Home” in Harley-street, W., over which she was still presiding when she went out to the Crimea. In The Times of November 12, 1901, she appealed for further support for this institution, declaring that it was “Doing good work — work after my own heart, and I trust, God’s work. There is [she continued] no other institution exactly like this. In it our governesses (who are primarily eligible), the wives and daughters of the clergy, of our naval, military, and other professional men, receive every possible care, comfort, and first-rate advice at the most moderate cost… Every one connected with this home and haven for the suffering is doing their utmost for it and it is always full. It is conducted on the same lines as from its beginning, by a committee of ladies, of which Mrs Walter is the president, and she will be glad to receive contributions at 90, Harley-street, W. I ask and pray my friends who still remember me not to let this truly sacred work languish and die for want of a little more money.”
On the occasion of her 84th birthday, in May, 1904, Miss Nightingale (who had already received the Red Cross from Queen Victoria) had conferred upon her by King Edward the dignity of a Lady of Grace of the Order of St John of Jerusalem. October 21, 1904, was the jubilee of the memorable expedition on which she set forth in 1854; to few great reformers had the mercy been vouchsafed of seeing within their own lifetime results so striking and so beneficial as those that had followed the noble efforts of “The Lady with the Lamp”; and the congratulations she received on the occasion of her jubilee were but a sample of that universal veneration she had won.
Further recognition of the value of her life’s labours came to Miss Nightingale with the announcement in the London Gazette of November 29, 1907, that the King had been graciously pleased to confer upon her the Order of Merit, she being the only woman upon whom this exceptionally distinguished mark of Royal favour has been conferred. On March 16, 1908, Miss Nightingale received the honorary freedom of the City of London, an honour which had been conferred upon only one woman before — namely, the late Baroness Burdett-Coutts. Owing to her advanced age, Miss Nightingale was unable to be present at the Guildhall to receive this mark of distinction, and her place was taken by a relative. At her own request the money which would have been spent on a gold casket was devoted to charity, the sum of 100 guineas being given instead to the Hospital for Invalid Gentlewomen; and the casket presented to Miss Nightingale was of oak.
Florence Nightingale, OM, nursing reformer, was born on May 12, 1820. She died on August 13, 1910, aged 90
OCTAVIA HILL
* * *
PIONEER OF AFFORDABLE HOUSING
AUGUST 15, 1912
Widespread regret will be felt at the announcement of the death, on Tuesday, at her house in Marylebone-road, of Miss Octavia Hill, who deserves to be remembered as one of the most practical and most energetic of women philanthropists of her day.
Born about 1838, she was the daughter of Mr James Hill, and a granddaughter of Dr Southwood Smith, an earnest promoter of sanitary science. Quite early in life she showed leanings in the same direction, and when still young she was one of the band of workers who laboured among the London poor under the leadership of Frederick Denison Maurice. The experiences she thus gained convinced her that people are greatly influenced in their habits and ways of thought by their domestic surroundings, and that sanitary science should be followed up in the case of the poor for the purpose of improving not only their dwellings, but the people themselves. In this way, she thought, the work of bringing about their social and spiritual elevation was to be advanced by enabling people to live in conditions of cleanliness, comfort, and decency, and she argued that an important educational reform could be effected by developing in their minds an actual taste in these directions. But she found it hopeless to think of all this as long as tenants were left to the tender mercies of a low-class type of landlord or landlady, whose only idea was to make as much money out of them as possible; and Miss Hill conceived the then novel idea of herself obtaining possession of some squalid house property, of collecting her own weekly rents, and of exercising what influence she could in securing the transformation alike of dwellings and of tenants. She laid her proposals before Mr Ruskin, who not only entered heartily into the scheme, but himself advanced altogether £3,000 for the carrying out of what was avowedly an experiment. It is true that the experiment proved a financial success, the £3,000 being duly returned, but it was none the less creditable to Mr Ruskin that he should have risked so large a sum when, as Miss Hill herself confessed, “not many men would have trusted that the undertaking would succeed.”
Having secured the necessary means, Miss Hill began operations by purchasing, for £750, the unexpired term of the lease of three houses near to her own home in Marylebone. They were well-built houses, but in a deplorable condition of dirt and neglect. As her own rent-collector, Miss Hill entirely did away with a middleman; but in the interests of the people themselves she was extremely strict in enforcing punctual payment of rent. On the other hand, she encouraged the tenants to keep the houses in the cleanly condition to which she had them put, and she set aside a certain amount per year for repairs for each house, the surplus, after breakages and other damage had been made good, being expended in such improvements as the tenants themselves desired. Any suggestion of charity, however, was absolutely discarded. The scheme was organized on a business footing, and it worked so well that, though tenants got two rooms for the amount they had previously paid for one, Miss Hill secured, in a year and a half, 5 per cent interest on the capital, and had repaid out of the rents £48 of the money she had borrowed from Mr Ruskin.
The next purchase was one of six houses, which were also in a most squalid condition, but crowded with inmates. The houses faced a bit of desolate ground occupied by dilapidated cowsheds and manure heaps. The needful repairs and cleaning were carried out, the waste land was turned into a playground, where Mr Ruskin had some trees planted (in addition to creepers against the houses), and Miss Hill, with a strong idea of the mor
al effects of the playground, arranged with lady friends to go there and teach the children games. For the boys she started a drum and fife band, and for the parents she built at the back of her own house a large room where she could meet them from time to time for the purposes of talk or entertainment. Her weekly call for the rent was, however, the great hold which she kept over her tenants, though her treatment of them was the very reverse of that of merely a sympathetic and easy-going philanthropist. “The main tone of action,” she wrote, “must be severe. There is much of rebuke and repression needed, although a deep and silent under-current of sympathy may flow beneath. If the rent is not ready notice to quit must be served. The money is then almost always paid, when the notice is, of course, withdrawn. Besides this inexorable demand for rent (never to be relaxed without entailing cumulative evil on the defaulter, and setting a bad example, too readily to be followed by others) there must be a perpetual crusade carried on against small evils.” Happily, too, this crusade was completely successful. Not only did the tenants acquire the habit of being punctual in their payments, but they learned the blessings of cleanliness and of an abundance of air, light, and water, while the lady-crusader herself, strict as she was in all these things, became the family counsellor for each household and the peacemaker in the settlement of neighbours’ quarrels.
Towards the end of 1869 six ten-roomed houses in a court in Marylebone were bought by the Countess of Ducie, and five more by another lady, and placed under the care of Miss Hill. The inhabitants of the houses were mainly costermongers and small hawkers who were supposed to have sunk to the lowest depths of degradation, and the houses themselves were in an indescribable condition of filthiness and neglect. Even so brave-hearted a woman as Miss Hill might have hesitated to go to these dwellings at night to collect the rents, for the people could only be seen at the end of their day’s toil. But she did not shrink from her task. She had a few improvements done at once — though, for the most part, these were done only gradually, as the people became more capable of valuing them. Then she paid the elder girls to scrub regularly and preserve as models of cleanliness the stairs and passages for which the landlady was responsible, with the result that the girls acquired cleanly habits, and the lesson taught by the stairs soon spread to the rooms. In the same way the tenants, when out of work, were employed to do repairs to the premises, so that “little by little the houses were renovated, the grates reset, the holes in the floor were repaired, the cracking, dirty plaster replaced by a clean smooth surface, the heaps of rubbish removed,” and a general progress made towards order. There was, too, a corresponding moral improvement in the people, and though the new landlady never unduly interfered, never entered a room unless invited, and never offered any gift of money or necessaries of life, she came to be regarded as the best friend of the tenants, and not only “got hold of their hearts,” but was often able to help them at some important crisis or other in their lives.