Year of the Nurse: Florence Nightingale’s alleged racist and anti-feminist legacy in the foundation of nursing
The year of 2020 besides being the year of the pandemic has also been deemed the “Year of the Nurse” by the World Health Organization (WHO). It marks the 200 centenary celebrations of Florence Nightingale's birth, who has single-handedly pioneered the establishment of nursing as a formal profession. Before her, the sick and the dying were usually attended to by their relatives or close friends with no real medical experience. Nightingale was the one who established the principles of modern nursing and hospital sanitation.
Known as the "Lady with the Lamp", Florence Nightingale's legacy is being celebrated by nurses across the world and items relevant to her life are being displayed, almost like holy relics at the Florence Nightingale Museum, like the lamp she carried while checking in on patients to the sash she designed for her team of nurses at the Scutari Hospital in Turkey during the Crimean War. Later, based on her experiences and that of her 38 volunteer nurses, she went on to found the first scientifically based nursing school — the Nightingale School of Nursing at St. Thomas’ Hospital in London — in 1860. She also instituted training for midwives and nurses working in workhouse infirmaries
Across the world, the codes and standards she established were so influential that it shaped and then later bound how the nursing profession took shape in the modern world. But of late, questions are being raised about whether Florence Nightingale had a deeply held prejudice against "native" nurses, trusting only properly trained European women to do the job. This claim first came into prominence after BBC aired an episode on her as part of their award-winning children’s TV show 'Horrible Histories'. In the sketch, Nightingale is shown to racially discriminate against Jamaican-born Mary Seacole, who was also a nurse in her own right and wanted to join Nightingale's team of nurses at Scutari Hospital. Nightingale supposedly refused her four times. The sketch provoked a complaint and BBC was reprimanded for its inaccurate and unjustified accusation leveled against such an iconic figure like Nightingale.
Research shows that Mary Seacole, who was also praised for her work in Crimea, a Jamaican woman of color, had requested to be a part of Nightingale's team, first asking the British War Office and government bodies and then the Crimean Fund who sponsored Nightingale's team. She also met Nightingale. However, she was not allowed to join Nightingale's team, at which point she began suspecting that her offers of help were being rejected because she was a person of color.
Nightingale herself had this to say about Seacole: "I had the greatest difficulty in repelling Mrs. Seacole's advances, and in preventing association between her and my nurses (absolutely out of the question!)... Anyone who employs Mrs. Seacole will introduce much kindness - also much drunkenness and improper conduct". Thus Nightingale's reservations about Seacole might not be prompted by racism per se but to letting soldiers drink alcohol while they recuperated. Nightingale, who was vehemently opposed to drinking, might have been wary of Seacole's willingness to provide alcoholic beverages to soldiers and wondered what effect she might have on the order she had imposed with much difficulty at the Scutari hospital.
However, the charges of Nightingale "colonizing" the nursing profession isn't going away anytime soon. For instance, the New Zealand Nurses Organisation co-chairs, Grant Brookes and Kerri Nuku say that many nurses, in New Zealand and beyond, find Florence Nightingale’s statements on colonization and the fate of Indigenous people a “dangerous legacy” and chose not to celebrate her in the "Year of The Nurse".
According to them, her instructions to nurses told them to always display the “higher or holier” womanly virtues of forbearance and endurance, and “above all” obey male doctors. This has since structured the nursing profession where nurses, mostly women, are treated as inferior to mostly male medical doctors, even though on a day-to-day basis nurses are actually more responsible for patient care than doctors.
The New Zealand Nurses Organisation letter stated that "a little-known fact about Florence Nightingale that she was a close advisor to the Governor of New Zealand, Sir George Grey" and also advised colonial authorities in Australia and elsewhere. Her instructions to colonial governments show that she believed that the population decline of Indigenous people was because of was inherent defects compared to superior Europeans.
According to her, excessive consumption of pork was responsible for the “bad habits, filth, laziness, skin diseases and a tendency to worms and scrofula” which she believed were characteristic of the Māori people (and also of the Irish). She also wrote that: “Incivilisation, with its inherent diseases, when brought into contact with civilisation, without adopting specific precautions for preserving health, will always carry with it a large increase in mortality. The decaying races are chiefly in Australia, New Zealand, Canada and perhaps in certain parts of South Africa. They appear to consist chiefly of tribes which have never been civilised enough or had force of character enough to form fixed settlements or to build towns. These aboriginal populations… appear to be far more susceptible to the operations of causes of disease arising out of imperfect civilisation than are civilised men. As for the Australians, in their present state, very few of the human race are lower in the scale of civilisation than these poor people.”
Similarly, her track record in the African continent has influenced healthcare models adversely, according to a paper that documented the oral histories of African nurses. Nightingale’s influence on nursing education affected nursing practices in African colonies in the early 20th century because of British rule. In 1940, for example, Britain established a Colonial Nursing Service, which sent British nurses to the colonies to care for sick British personnel.
Soon they also began treating indigenous populations. British style hospital-oriented system of training was adopted that made nurses dependent on a centralized system. In actuality, a decentralized system that empowered African nurses to care for the sick and administer medicine in remote areas, where no doctor was around, should have been encouraged.
Midwives became secondary to doctors when in actuality these women were the 'frontline health workers' in villages for expecting mothers and had decades of wisdom handed down to them over generations. Nursing in Africa has been undergoing slow but steady decolonization, but it would be good to investigate Nightingale's legacy in colonies and how they have shaped healthcare and nursing models of today in those countries.