Florence Nightingale: Her Impact on Nursing and Colonialism

Florence Nightingale was born roughly three centuries after the formative years of the British Empire, which began in the early 1500s. Her beliefs and actions were highly influenced by the elite social circles her family belonged to. Her father was a wealthy white landowner and merchant, and her mother was reportedly a social climber who enjoyed engaging with prominent people.

In the past decade, many of Nightingale’s writings were digitized, making it easier to find references of her belief in the supremacy of white culture. She was instrumental in advancing nursing as a profession and healthcare in general. But her history has been promoted through a white cultural lens that can perpetuate the colonization of nursing.

Most young women born in the early 1800s were not educated. Yet, Nightingale’s father made sure she received a classical education, including studies in Italian, French, and German. At an early age, Nightingale showed an interest in helping the poor and ill people in the village. Despite her parents’ objections, she attended Lutheran Hospital of Pastor Fliedner in Kaiserwerth, Germany as a nursing student.

In the following years, her checkered impact on nursing has left an enduring colonial mark on the profession. According to the Stanford Encyclopedia of Philosophy, colonialism is a practice of domination, which involves the subjugation of one people to another.

It is important to recognize both Nightingale’s advances in healthcare and her racist attitude that affected many. This includes the care given to Indigenous children in the Canadian forerunner to residential schools. In her book “Sanitary Statistics of Native Colonial Schools and Hospitals,” she considered the children inferior.

She believed the high death rate of the children was a reflection of the speed at which they were assimilated into British civilization. However, she had no issue with the deaths, writing, “Every society which has been formed has had to sacrifice large proportions of its earlier generation to the new conditions of life arising out of the mere fact of change.”

Later in her book, she comments that the deaths were in large part due to the Indigenous people. The changes created by British rule only triggered a process of “decay,” which the habits of Indigenous people had already set in motion.

Her actions against the Indigenous people of New Zealand caused the New Zealand Nurses Organization (NZNO) to call her statements on colonization a “dangerous legacy.” The NZNO explained how Nightingale’s actions against the Indigenous people of New Zealand led them to cancel celebrations of her 200th birthday.

Her political actions, taken at a time when she was revered as a heroine after the Crimean War, led to the genocide of Indigenous people. It is unfortunate that her contribution to nursing has superseded those of other nurses, including Mary Seacole, Charlotte Edith Monture, and Mary Mahoney, who were trailblazing activists challenging racist and sexist norms of their era.

Nightingale’s actions also led to the colonization of the nursing profession. She continued the patterns of elitism and racism that have influenced nursing education. In many countries, nurses have little independent practice and are considered only an extension of the doctor. It has become known as the “European style of nursing.”

To decolonize nursing, it is essential to acknowledge both legacies that Nightingale has left — her contribution to the nursing profession and the impacts her prejudices against Indigenous people and people of color had. Many of Nightingale’s influences became the foundation upon which our current healthcare system is built.

To this day, bias and accessibility affect the quality of healthcare treatment within Black, Indigneous, and communities of color.

Nightingale was awarded $250,000 from the British government after the Crimean War. In 1860, she used the money to establish the Nightingale Training School for Nurses at St. Thomas Hospital in London. She also influenced the training for midwives and nurses in workhouse infirmaries. These were institutions that employed the indigent for profitable work.

She counseled key political figures and supported British colonialism, despite the deaths and destruction it caused. Yet, many of Nightingale’s contemporaries recognized and spoke against the brutality of colonialism.

A British-Jamaican nurse at the time, Mary Seacole commented on Nightingale rejecting her help during the Crimean War. She writes, “Was it possible that American prejudices against colour had some root here? Did these ladies shrink from accepting my aid because my blood flowed beneath a somewhat duskier skin than theirs?”

Nightingale continued to support the imposition of British culture on Indigenous people. Anything else “would be simply preserving their barbarism for the sake of preserving their lives.”

Despite starting a nursing program, Nightingale was opposed to higher education that promoted women’s autonomy. Instead, she held allegiance to patient care founded on traditional women’s virtues of endurance, obedience, and cleanliness.

She saw the profession as an extension of the female role in society, which hindered women’s education and fostered male dominance.

Nightingale was an advisor to the Governor of New Zealand and advised authorities elsewhere.

In her role, she promoted colonialism and the forced migration of Maori tribes in New Zealand into European settlements.

She writes, “The object should be to draw them gradually into better habits and gradually to civilize them.”

This theory of disease holds that bad smells and filth generate disease. Nightingale held this theory until her death in 1910. Thinking that disease was the responsibility of Indigenous people, she dismissed reports of influenza outbreaks in Indigenous communities after Europeans had visited.

Instead, she advised the governor to focus elsewhere to support health. In her writing, she attributed population decline to what she believed were inherent defects of Indigenous people.

Nightingale was called the “Lady With the Lamp” by the soldiers in the Crimean War.

After spending the day ensuring the hospital was cleaned and taking care of the men, she walked the halls at night carrying a lamp to minister to patients. The soldiers were comforted by the compassion of this seemingly tireless woman who reduced the death rate at the hospital by two-thirds.

During the Victorian era, many believed that cleanliness was next to godliness. Nightingale was no exception. She was one of the first to carry out diligent handwashing. To this day, handwashing is the most basic and effective practice to prevent the spread of disease.

However, she maligned this proverb to lay blame on the indigent, poor, and Indigenous people for their sickness and disease, writing, “When we obey all God’s laws as to cleanliness … health is the result. When we disobey, sickness.”

Following the Crimean War, Nightingale recorded her observations about healthcare in the field in an 830-page report entitled “Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army.” She proposed reforms for military hospitals that sparked a restructuring of the administrative department of the War Office. This included the development of the Royal Commission for the Health of the Army. The group was tasked with investigating the sanitary conditions of the army.

Nightingale’s ideas began in her elite upbringing. Yet, some of Nightingale’s contemporaries, including those with elite backgrounds, rebelled against colonial attitudes and its ideology. They chose to be advocates against racism, colonialism, and sexism.

Nightingale had the choice to do so, as well. However, though a product of her upbringing, she also actively embraced the ideals that led to death, disease, and destruction of Indigenous children and adults and people of color.

Following her service in the Crimean War, she received a heroine’s honor and became a figure of public admiration. Young women wanted to become like her. Even those in the upper class enrolled in her training school, raising nursing to an honorable vocation.