Part 1

FLORENCE NIGHTINGALE

TO HER NURSES

MACMILLAN AND CO., LIMITED

LONDON · BOMBAY · CALCUTTA MELBOURNE

THE MACMILLAN COMPANY

NEW YORK · BOSTON · CHICAGO DALLAS · SAN FRANCISCO

THE MACMILLAN CO. OF CANADA, LTD.

TORONTO

Florence Nightingale

to her Nurses

A SELECTION FROM MISS NIGHTINGALE’S ADDRESSES TO PROBATIONERS AND NURSES OF THE NIGHTINGALE SCHOOL AT ST. THOMAS’S HOSPITAL

MACMILLAN AND CO., LIMITED

ST. MARTIN’S STREET, LONDON

1914

COPYRIGHT

PREFACE

Between 1872 and 1900 Miss Nightingale used, when she was able, to send an annual letter or address to the probationer-nurses of the Nightingale School at St. Thomas’ Hospital, “and the nurses who have been trained there.”[1] These addresses were usually read aloud by Sir Harry Verney, the chairman of the Nightingale Fund, in the presence of the probationers and nurses, and a printed copy or a lithographed facsimile of the manuscript was given to each of the nurses present, “for private use only.” A few also were written for the Nightingale Nurses serving in Edinburgh.

The letters were not meant for publication, and indeed are hardly suitable to be printed as a whole as there is naturally a good deal of repetition in them. Since Miss Nightingale’s death, however, heads of nursing institutions and others have asked for copies of the addresses to be read or given to nurses, and her family hope that the publication of a selection may do something to carry further the intention with which they were originally written.

Perhaps, too, not only nurses, but others, may care to read some of these letters. There is a natural desire to understand the nature of a great man’s or woman’s influence, and we see in the addresses something at least of what constituted Miss Nightingale’s power. Her earnest care for the nurses, her intense desire that they should be “perfect,” speak in every line. They do not, of course, give full expression to the writer’s mind. They were written after she had reached middle age, as from a teacher of long and wide experience to pupils much younger than herself--pupils some of whom had had very little schooling and did not easily read or write. The want of even elementary education and of habits and traditions of discipline which grow in schools are difficulties less felt now than in 1872, when Miss Nightingale’s first letter to nurses was written. At that time it was necessary in addressing such an audience to write very simply, without learned allusions (though some such appear in disguise) and without too great severity and concentration of style. The familiar words of the Bible and hymns could appeal to the least learned among her hearers, and never lost their power with Miss Nightingale herself.

But through the simple and popular style of the addresses something of a philosophical framework can be seen. When Miss Nightingale hopes that her nurses are a step further on the way to becoming “perfect as our Father in Heaven is perfect,” she has in mind the conception she had formed of a moral government of the world in which science, activity, and religion were one. In her unpublished writings these ideas are dwelt on again and again. They are clearly explained in her note on a prayer of St. Teresa:--

“We cannot really attach any meaning to _perfect_ thought and feeling, unless its perfection has been attained through life and work, unless it is being realised in life and work. It is in fact a contradiction to suppose Perfection to exist except at work, to exist without exercise, without ‘working out.’ We cannot conceive of _perfect_ wisdom, perfect happiness, except as having _attained_, attained perfection through work. The ideas of the Impassible and of Perfection are contradictions.... This seems to be the very meaning of the word ‘perfect’--‘made through’--made perfect through suffering--completed--working out; and even the only idea we can form of the _Perfect Perfect_ ... ‘God in us,’ ‘grieving the Holy Spirit of God,’ ‘My Father worketh and I work’--these seem all indications of this truth.... We cannot explain or conceive of Perfection except as having worked through Imperfection or sin.... The Eternal Perfect almost pre-supposes the Eternal Imperfect.” Hence her deep interest in the “laws which register the connection of physical conditions with moral actions.” She quotes elsewhere a scientific writer who delighted in the consciousness that his books were to the best of his ability expounding the ways of God to man. “I can truly say,” she continues, “that the feeling he describes has been ever present to my mind. Whether in having a drain cleaned out, or in ventilating a hospital ward, or in urging the principles of healthy construction of buildings, or of temperance and useful occupation, or of sewerage and water supply, I always considered myself as obeying a direct command of God, and it was ‘with the earnestness and reverence due to’ God’s laws that I urged them.... For mankind to create the circumstances which create mankind through these His Laws is the ‘way of God.’”

* * * * *

The letters have needed a little editing. Miss Nightingale had great power of succinct and forcible statement on occasion, but here she was not tabulating statistics nor making a businesslike summary for a Minister in a hurry. Certain ideas had to be impressed, in the first place orally, on minds which were not all highly trained; and for this she naturally wrote in a discursive way. She did not correct the proofs. As readers of her _Life_ will know, she was burdened with other work and delicate health, and she found any considerable revision difficult and uncongenial. It has therefore been necessary to make a few emendations, such as occasionally correcting an obvious misprint, adding a missing word, and taking out brackets, stops, and divisions which obscured the sense. A few of the many repetitions and one or two passages only interesting at the time, have also been left out. The object has been to change as little as possible, and I hope nothing has been done that Miss Nightingale would not have done herself if she had corrected the proofs. The first two addresses give perhaps the fullest expression of the main theme to which she returns again and again. Others have been chosen chiefly for the sake of characteristic illustrations of the same theme.

ROSALIND NASH.

I

LONDON, _May, 1872_.

For us who Nurse, our Nursing is a thing, which, unless in it we are making _progress_ every year, every month, every week, take my word for it we are going _back_.

The more experience we gain, the more progress we can make. The progress you make in your year’s training with us is as nothing to what you must make every year _after_ your year’s training is over.

A woman who thinks in herself: “Now I am a ‘full’ Nurse, a ‘skilled’ Nurse, I have learnt all that there is to be learnt”: take my word for it, she does not know _what a Nurse is_, and she never _will_ know; she is _gone_ back already.

Conceit and Nursing cannot exist in the same person, any more than new patches on an old garment.

Every year of her service a good Nurse will say: “I learn something every day.”

I have had more experience in all countries and in different ways of Hospitals than almost any one ever had before (there were no opportunities for learning in _my_ youth such as you have had); but if I could recover strength so much as to walk about, I would begin all over again. I would come for a year’s training to St. Thomas’ Hospital under your admirable Matron (and I venture to add that she would find me the closest in obedience to all our rules), sure that I should learn every day, learn all the more for my past experience.

And then I would try to be learning every day to the last hour of my life. “And when his legs were cuttit off, He fought upon his stumps,” says the ballad; so, when I could no longer learn by nursing others, I would learn by being nursed, by seeing Nurses practise upon _me_. It is all experience.

Agnes Jones, who died as Matron of the Liverpool Workhouse Infirmary (whom you may have heard of as “Una”), wrote from the Workhouse in the last year of her life: “I mean to stay at this post forty years, God willing; but I must come back to St. Thomas’ as soon as I have a holiday; I shall learn so much more” (she had been a year at St. Thomas’) “now that I have more experience.”

When I was a child, I remember reading that Sir Isaac Newton, who was, as you know, perhaps the greatest discoverer among the Stars and the Earth’s wonders who ever lived, said in his last hours: “I seem to myself like a child who has been playing with a few pebbles on the sea-shore, leaving unsearched all the wonders of the great Ocean beyond.”

By the side of this put a Nurse leaving her Training School and reckoning up what she has learnt, ending with--“The only wonder is that one head can contain it all.” (What a small head it must be then!)

I seem to have remembered all through life Sir Isaac Newton’s words.

And to nurse--that is, under Doctor’s orders, to cure or to prevent sickness and maiming, Surgical and Medical,--is a field, a road, of which one may safely say: There is no end-no end in what we may be learning every day.[2]

I have sometimes heard: “But have we not reason to be conceited, when we compare ourselves to ... and ...?” (naming drinking, immoral, careless, dishonest Nurses). I will not think it possible that such things can ever be said among _us_. Taking it even upon the worldly ground, what woman among us, instead of looking to that which is higher, will of her own accord compare herself with that which is lower--with immoral women?

Does not the Apostle say: “I count not myself to have apprehended: but this one thing I do, forgetting those things which are behind, _and reaching forth unto those things which are before, I press toward_ the mark for the prize of the _high calling_ of God in Christ Jesus”; and what higher “calling” can we have than Nursing? But then we must “press forward”; we have indeed _not_ “apprehended” if we have not “apprehended” even so much as this.

There is a little story about “the Pharisee” known over all Christendom. Should Christ come again upon the earth, would He have to apply that parable to us?

And now, let me say a thing which I am sure must have been in all your minds before this: if, unless we improve every day in our Nursing, we are going back: how much more must it be, that, unless we improve every day in our conduct as Christian women, followers of Him by whose name we call ourselves, we shall be going back?

This applies of course to every woman in the world; but it applies more especially to us, because we know no one calling in the world, except it be that of teaching, in which _what we can do_ depends so much upon _what we are_. To be _a good Nurse_ one must be _a good woman_; or one is truly nothing but a tinkling bell. To be a good woman at all, one must be an improving woman; for stagnant waters sooner or later, and stagnant air, as we know ourselves, always grow corrupt and unfit for use.

Is any one of us a _stagnant woman_? Let it not have to be said by any one of us: I left this Home a worse woman than I came into it. I came in with earnest purpose, and now I think of little but my own satisfaction and a good place.

When the head and the hands are very full, as in Nursing, it is so easy, so very easy, if the heart has not an earnest purpose for God and our neighbour, to end in doing one’s work only for oneself, and not at all--even when we seem to be serving our neighbours--not at all for them or for God.

I should hardly like to talk of a subject which, after all, must be very much between each one of us and her God,--which is hardly a matter for _talk_ at all, and certainly not for me, who cannot be among you (though there is nothing in the world I should so dearly wish), but that I thought perhaps you might like to hear of things which persons in the same situation, that is, in different Training Schools on the Continent, have said to me.

I will mention two or three:

1. One said, “The greatest help I ever had in life was that we were taught in our Training School always to raise our hearts to God the first thing on waking in the morning.”

Now it need hardly be said that we cannot make a rule for this; a rule will not teach this, any more than making a rule that the chimney shall not smoke will make the smoke go up the chimney.

If we occupy ourselves the last thing at night with rushing about, gossiping in one another’s rooms; if our last thoughts at night are of some slight against ourselves, or spite against another, or about each other’s tempers, it is needless to say that our first thoughts in the morning will not be of God.

Perhaps there may even have been some quarrel; and if those who pretend to be educated women indulge in these irreligious uneducated disputes, what a scandal before those less educated, to whom an example, not a stone of offence, should be set!

“A thousand irreligious cursed hours” (as some poet says), have not seldom, in the lives of all but a few whom we may truly call Saints upon earth, been spent on some feeling of ill-will. And can we expect to be really able to lift up our hearts the first thing in the morning to the God of “good will towards men” if we do this?

I speak for myself, even more perhaps than for others.

2. Another woman[3] once said to me:--“I was taught in my Training School never to have those long inward discussions with myself, those interminable conversations inside myself, which make up so much more of our own thoughts than we are aware. If it was something about my duties, I went straight to my Superiors, and asked for leave or advice; if it was any of those useless or ill-tempered thoughts about one another, or those that were put over us, we were taught to lay them before God and get the better of them, before they got the better of us.”

A spark can be put out while it is a spark, if it falls on our dress, but not when it has set the whole dress in flames. So it is with an ill-tempered thought against another. And who will tell how much of our thoughts these occupy?

I suppose, of course, that those who think themselves better than others are bent upon setting them a better example.

II

And this brings me to something else. (I can always correct others though I cannot always correct myself.) It is about jealousies and punctilios as to ranks, classes, and offices, when employed in one good work. What an injury this jealous woman is doing, not to others, or not to others so much as to herself; she is doing it to herself! She is not getting out of her work the advantage, the improvement to her own character, the nobleness (for to be useful is the only true nobleness) which God has appointed her that work to attain. She is not getting out of her work what God has given it her for; but just the contrary.

(Nurses are not children, but women; and if they can’t do this for themselves, no one can for them.)

I think it is one of Shakespeare’s heroes who says “I laboured to be wretched.” How true that is! How true it is of some people all their lives; and perhaps there is not one of us who could not say it with truth of herself at one time or other: I laboured to be mean and contemptible and small and ill-tempered, by being revengeful of petty slights.

A woman once said: “What signifies it to me that this one does me an injury or the other speaks ill of me, if I do not deserve it? The injury strikes God before it strikes me, and if He forgives it, why should not I? I hope I love Him better than I do myself.” This may sound fanciful; but is there not truth in it?

What a privilege it is, the work that God has given us Nurses to do, if we will only let Him have His own way with us--a greater privilege to my mind than He has given to any woman (except to those who are teachers), because _we_ can always be useful, always “ministering” to others, real followers of Him who said that He came “not to be ministered unto” but to minister. Cannot we fancy Him saying to _us_, If any one thinks herself greater among you, let her minister unto others.

This is not to say that we are to be doing other people’s work. Quite the reverse. The very essence of all good organisation is that everybody should do her (or his) own work in such a way as to help and not to hinder every one else’s work.

But this being arranged, that any one should say, I am “put upon” by having to associate with so-and-so; or by _not_ having so-and-so to associate with; or, by not having such a post; or, by having such a post; or, by my Superiors “walking upon me,” or, “dancing” upon me (you may laugh, but such things have actually been said), or etc., etc.,--this is simply making the peace of God impossible, the call of God (for in all work He calls us) of none effect; it is grieving the Spirit of God; it is doing our best to make all free-will associations intolerable.

In “Religious Orders” this is provided against by enforcing blind, unconditional obedience through the fears and promises of a Church.

Does it not seem to you that the greater freedom of secular Nursing Institutions, as it requires (or ought to require) greater individual responsibility, greater self-command in each one, greater nobleness in each, greater _self-possession_ in _patience_--so, that very need of self-possession, of greater nobleness in each, requires (or ought to require) greater thought in each, more discretion, and higher, not less, obedience? For the obedience of intelligence, not the obedience of slavery, is what _we_ want.

The slave obeys with stupid obedience, with deceitful evasion of service, or with careless eye service. Now, we cannot suppose God to be satisfied or pleased with stupidity and carelessness. The free woman in Christ obeys, or rather _seconds_ all the rules, all the orders given her, with intelligence, with all her heart, and with all her strength, and with all her _mind_.

“Not slothful in business; fervent in spirit, serving the Lord.”

And you who have to be Head Nurses, or Sisters of Wards, well know what I mean, for you have to be Ward _Mistresses_ as well as Nurses; and how can she (the Ward Mistress) command if she has not learnt how to obey? If she cannot enforce upon herself to obey rules with discretion, how can she enforce upon her Ward to obey rules with discretion?

III

And of those who have to be Ward Mistresses, as well as those who are Ward Mistresses already, or in any charge of trust or authority, I will ask, if Sisters and Head Nurses will allow me to ask of them, as I have so often asked of myself--

What is it that made our Lord speak “as one having authority”? What was the key to _His_ “authority”? Is it anything which we, trying to be “like Him,” could have--like Him?

What are the qualities which give us authority, which enable us to exercise some charge or control over others with “authority”? It is not the charge or position itself, for we often see persons in a position of authority, who have no authority at all; and on the other hand we sometimes see persons in the very humblest position who exercise a great influence or authority on all around them.

The very first element for having control over others is, of course, to have control over oneself. If I cannot take charge of myself, I cannot take charge of others. The next, perhaps, is--not to try to “seem” anything, but to _be_ what we would _seem_.

A person in charge must be felt more than she is heard--not heard more than she is felt. She must fulfil her charge without noisy disputes, by the silent power of a consistent life, in which there is no _seeming_, and no hiding, but plenty of discretion. She must exercise authority without appearing to exercise it.

A person, but more especially a woman, in charge must have a quieter and more impartial mind than those under her, in order to influence them by the best part of them and not by the worst.

We (Sisters) think that we must often make allowances for them, and sometimes put ourselves in their place. And I will appeal to Sisters to say whether we must not observe more than we speak, instead of speaking more than we observe. We must not give an order, much less a reproof, without being fully acquainted with both sides of the case. Else, having scolded wrongfully, we look rather foolish.

The person in charge every one must see to be just and candid, looking at both sides, not moved by entreaties or, by likes and dislikes, but only by justice; and always reasonable, remembering and not forgetting the wants of those of whom she is in charge.

She must have a keen though generous insight into the characters of those she has to control. They must know that she _cares for_ them even while she is checking them; or rather that she checks them _because_ she cares for them. A woman _thus_ reproved is often made your friend for life; a word dropped in this way by a Sister in charge (I am speaking now solely to Sisters and Head Nurses) may sometimes show a probationer the unspeakable importance of this year of her life, when she must sow the seed of her future nursing in this world, and of her future life through eternity. For although future years are of importance to train the plant and make it come up, yet if there is no seed nothing will come up.

Nay, I appeal again to Sisters’ own experience, whether they have not known patients feel the same of words dropped before _them_.

We had in one of the Hospitals which we nurse a little girl patient of seven years old, the child of a bad mother, who used to pray on her knees (when she did not know she was heard) her own little prayer that she might not forget, when she went away to what she already knew to be a bad life, the good words she had been taught. (In this great London, the time that children spend in Hospital is sometimes the only time in their lives that they hear good words.) And sometimes we have had patients, widows of journeymen for instance, who had striven to the last to do for their children and place them all out in service or at work, die in our Hospitals, thanking God that they had had this time to collect their thoughts before death, and to die “so comfortably” as they expressed it.

But, if a Ward is not kept in such a spirit that patients can collect their thoughts, whether it is for life or for death, and that children can hear good words, of course these things will not happen.

Ward management is only made possible by kindness and sympathy. And the mere way in which a thing is said or done to patient, or probationer, makes all the difference. In a Ward, too, where there is no _order_ there can be no “authority”; there must be noise and dispute.

Hospital Sisters are the only women who may be in charge really of men. Is this not enough to show how essential to them are those qualities which alone constitute real authority?

Never to have a quarrel with another; never to say things which rankle in another’s mind; never when we are uncomfortable ourselves to make others uncomfortable--for quarrels come out of such very small matters, a hasty word, a sharp joke, a harsh order: without regard to these things, how can we take charge?

We may say, so-and-so is too weak if she minds that. But, pray, are we not weak in the same way ourselves?