Like many of you, I remember learning about Florence Nightingale at school, “the lady of the lamp”, who revolutionised nursing practices whilst caring for soldiers during the Crimean War. Whilst admired as a school child, she seemed a remote figure from the past even if she was an honoured historical figure pictured on a much prized £10 bank note.

photo courtesy of Wellcome Collection Gallery

I have been thinking of her, born 200 years ago  tomorrow, on May 12th in Florence, Italy, hence her name. In fact, her family lived in a large house in a village just 30 miles south of Highclere. Taught mathematics by her father and encouraged to read and travel, her choice of a career in medicine was extremely unusual in relation to the normal expectation of a suitable husband and marriage.  But she had found a vocation and, in 1850, began worked with Pastor Theodor Fliedner who founded Kaiserswerther Diakonie, a hospital and training centre in Germany which accepted women and from which she graduated in 1851.

Returning to London, Florence Nightingale became superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street. However, just three years later, when she heard about the appalling conditions endured by the wounded in the Crimean War, she set off with 38 volunteer nurses to Scutari, in Istanbul.  When she arrived, despite extensive opposition, she set about assembling a new hospital where she insisted on a precise methodology of decent sanitation with an emphasis on hygiene, good nutrition and space between the beds to try to prevent cross contamination.

I also realised her legacy goes far deeper. Establishing a Nightingale Fund to train nurses, her ideas inspired Linda Richards, who returned to found high quality training and nursing in the USA. She made a comprehensive statistical study of sanitation in India, which led to a lead to a number of recommendations, and wrote hundreds of books and pamphlets which reflect diligence and thoughtful hospital administration. She was the first female member of the Royal Statistical Society and an honorary member of the American one.

Understanding the statistics of disease, of hygiene and handwashing, of administration and care in hospitals sounds so familiar today that we take it for granted and forget how ground breaking it was then.

Sir Robert Jones

My predecessor, Almina, the 5th Countess of Carnarvon, had a smaller but similar experience when she set up her hospital at Highclere during the First World War. Having gained some training before the war in various hospitals, she then plunged into the relentless work that followed the outbreak of war. All her letters and diaries reveal the detailed organisation, the pursuit of good equipment and the best surgeons such as Sir Robert Jones that she utilised, plus her emphasis on fresh air, cleanliness and sanitation, once again regarded as unessential by so many of those in command. An exception was General Sir John Cowans who, in a letter to Alfred de Rothschild held in our archives, compared Almina to Florence Nightingale. This of course was the heart of the book I wrote.

I have sat in the same chairs and rooms as Almina, reading the letters to her from  strangers at some of their lowest points in their life, some of whom went on to become friends. She continued after the war when she founded a London hospital in memory of her father which was renowned for its good nursing, excellent food cooked by French chefs, good wine, whiskey offered by footmen and after dinner liqueurs. If only hospitals were like this today!

She loved to give presents to surgeons, patients and staff, she helped save limbs and life and received never-ending thanks and goodwill. Sadly, she used her entire fortune up and failed to distinguish the difference between capital and revenue.

Each woman lived a long life nursing through war and disease and must have found a way to focus their positive energy which perhaps would be handy to understand today.  Now, with the global effects of the Corona virus, those qualities fought for so hard by those pioneer nurses have once again been raised into national consciousness – clean hands, social distancing and the need for fresh air and exercise.