Prof Joyce Hills: Florence Nightingale

August 16, 2021
August 16, 2021 Fiona

Amongst the commemorations listed in the Common Worship calendar for August is Florence Nightingale, who died on 13 August 1910 at the grand age of 90. She is, of course, famous for the work she did in the Crimean War, which from a British perspective lasted from 1854 to 1856, although it actually began in 1853 when the Ottomans declared war on the Russians. Back in England, Nightingale became the founder of modern nursing, and was greatly in demand advising on the development of hospitals, contributing to government enquiries, and being a highly influential figure in the development of public health, which has underpinned the massive improvements in well-being and longevity from which we benefit today.

This past year, living with a pandemic, we have come to expect that there will be timely and comprehensive public health statistics that will help us understand how the covid virus spreads and develops, what effect it has on which groups of people where, what actions might therefore be useful, and whether those actions are being effective. Whatever we think about the government’s decisions at any one time, we take it for granted that statistical analyses, presented in ways that are relatively easy to understand, are fundamental to policy and practice in the area of health.

What may be less well known, and what deserves celebration in commemorating Florence Nightingale, is that we owe much of this to her. She was a great lover of statistics and wielded them with energy, determination and insight, declaring in a letter to William Farr, who was at the time the country’s leading statistician : ‘We want facts. “Facta, facta, facta” is the motto which ought to stand at the head of all statistical work’. There were many influential figures who initially dismissed her arguments about what needed to be done, behaving in just the same way as the diehards in the Crimea when she first attempted to make radical changes to the regime in the Scutari barracks: she was a woman, of genteel birth, what did she know about anything, compared with them, buttressed by long-established ways of doing things which produced a group-think self-righteously resistant to change. Statistics, systematically collected, became Nightingale’s means of attack.

She was also immensely gifted in their presentation, using graphic displays in ways that had not been used before, and giving force to dry figures by bringing them alive through memorable turns of phrase. For example, having scrutinised the rate of death in the peacetime army, she declared that it was equivalent to taking 1100 men on to Salisbury Plain and shooting them. And when, in 1858, she wanted to demonstrate the importance of improved sanitation in saving solders’ lives, she collected figures on the principal causes of death and presented them  in what is now technically known as a ‘polar area diagram’ — effectively, an exploded pie chart, commonly known as Nightingale’s ‘rose diagram’. No one had ever previously attempted to conceptualise and represent statistics in such a way. But this imaginative leap on her part was an immensely powerful piece of visual rhetoric which convinced the sanitary commission of the need to take action.

So we can certainly commemorate Florence Nightingale for the development of nursing, but we should also commemorate the fact that she was a driving force in the development of medical statistics. The measure of this is that she was the first woman to be made a Fellow of the Royal Statistical Society.

 

Joyce Hill

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