46 l Nursing2010 l November www.Nursing2010.com

THIS YEAR WE CELEBRATE the International Year of the Nurse to commemorate the 100-year anniver-sary of Florence Nightingale’s death. On August 15, 1910, her obituary in The New York Times concluded with this observation: “Perhaps the greatest good that has resulted from her noble life has been the setting in motion of a force which has led thousands of women to devote themselves to systematic care of the sick and wounded.”1

Yet today, very few nurses have read Florence Nightingale’s work or derive inspiration from it. When I

invoke Florence Nightingale’s words in clinical teaching, I often get a blank stare from students and ex-perienced nurses alike. Many don’t realize that Nurses Day is celebrat-

ed on May 12th because that is Florence Nightingale’s birthday.

Exactly 150 years ago this year, Florence Nightingale published her cutting-edge book, Notes on Nursing:

What It Is and What It Is Not. In less than 100 pages, she gave

the world a handbook for taking care of the sick

and a blueprint for running a healthcare system. True, much of what she wrote is outdated (though not for her time).

But when you con-sider the following di-

rect quotations from the original edition of her book

and compare them to modern standards, you can see the un-

deniable relevance of her work to today’s healthcare problems.

ON INFECTION CONTROLNotes on Nursing, 18602

“True nursing ignores infection, except to prevent it.” (p. 20)

“Every nurse ought to be careful to wash her hands very frequently dur-ing the day. If her face too, so much the better.” (p. 53)

2010 National Patient Safety Goals (NPSG)3

“Comply with either the current Centers for Disease Control and Pre-vention (CDC) hand hygiene guide-lines or the current World Health Organization (WHO) hand hygiene guidelines.” (NPSG 07.01.01)

World Health Organization Hand Hygiene Guidelines, 20054

“Hand hygiene, a very simple action, remains the primary measure to reduce health-care associated infec-tion and the spread of antimicrobial resistance, enhancing safety of care across all settings.”

ON PATIENT CONFIDENTIALITYNotes on Nursing, 1860“And remember every nurse should be one who is to be depended upon, in other words, capable of being a ‘confi dential’ nurse...she must be no gossip, vain talker; she should never answer questions about her sick except to those who have a right to ask them.” (p. 70)

Why Florence Nightingale still matters

By Fidelindo Lim, MA, RN

Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

www.Nursing2010.com November l Nursing2010 l 47

The Health Insurance Portability and Accountability Act of 1996 (HIPAA)5

“The goal of the privacy rule is to assure that individuals’ health infor-mation is properly protected while allowing the fl ow of health informa-tion needed to provide and promote high quality health care.”

ON PREVENTING NURSING SHORTAGESNotes on Nursing, 1860“To increase the effi ciency of this class [nurses], and to make as many of them as possible the dis-ciples of the true doctrine of health, would be a great national work.” (p. 79)

Nurse Reinvestment Act, 2002President George W. Bush signed into law the Nurse Reinvestment Act (H.R. 3487), designed to en-courage people to enter and remain in nursing careers, thus helping to alleviate the nation’s growing nurs-ing shortage.6

ON PATIENT SAFETYNotes on Nursing, 1860“If you look into reports of trials or accidents, and especially of sui-cides...it is almost incredible how often the whole thing turns upon something which has happened be-cause ‘he,’ or still oftener ‘she,’ was not there.” (p. 22)

Notes on Hospitals, 18597

“It may seem a strange principle to enunciate as the very fi rst require-ment in a Hospital that it should do the sick no harm.”

“Is There a Nurse in the House?” The New York Times, June 18, 20108

“Cost-cutting at hospitals often means fewer nurses, so the number of patients each nurse must care for increases, leading to countless un-necessary deaths. Unless Congress mandates a federal standard for nurse-patient ratios, those deaths will continue.”

2010 National Patient Safety Goals• “The labeling of all medications, medication containers, and other solutions is a risk-reduction activity consistent with safe medication man-agement.” (NPSG 03.04.01)• “Identifi cation of individuals at risk for suicide while under the care of or following discharge from a health care organization is an important step in protecting these at-risk indi-viduals.” (NPSG 15.01.01)• “Reduce the likelihood of patient harm associated with the use of anti-coagulant therapy.” (NPSG 03.05.01)

ON DOCUMENTATIONNotes on Nursing, 1860“Oh, leave these jargons and go your way straight to God’s work, in simplicity and singleness of heart.” (p. 76)

2010 National Patient Safety Goals“Create a standardized list of abbre-viations, acronyms, etc., not to be used.” (NPSG 02.02.01)

ON FALSE ENDEARMENTNotes on Nursing, 1860“I would appeal most seriously to all friends, visitors, and attendants of the sick to leave of this practice of attempting to ‘cheer’ the sick by making light of their danger and by exaggerating their probabilities of recovery.” (p. 54)

National Institute on Aging, A Clinician’s Handbook, 20049

“Avoid using familiar terms, like ‘dear’ and ‘hon,’ which tend to sound pa-tronizing. Talk to your staff about the importance of being respectful to all your patients, especially those who are older and perhaps used to more formal terms of address.”

ON EVIDENCE-BASED PRACTICENotes on Nursing, 1860“The most important practical les-son that can be given to nurses is to teach them what to observe—how to observe—what symptoms indicate improvement—what the reverse—

which are of importance—which are of none—which are the evidence of neglect—and of what kind of neglect.” (p. 59)

“Statistics is the most important science in the world.”10

The Institute of Medicine, 200111

“Evidence-based practice is the integration of best research with clinical expertise and patient values.”

Heed lessons from our historyFlorence Nightingale has been dead for 100 years, but she could have written the 2010 National Patient Safety Goals. I encourage you to grab a copy of her book and try to envi-sion the future of nursing and health-care so deeply rooted in the past. It’s time to bring her back to the nurs-ing syllabus to reinforce evidence-based practice at the bedside. ■

REFERENCES

1. Miss Nightingale dies, aged ninety. The New York Times. 1910; August 15.

2. Nightingale F. Notes on Nursing: What It Is and What It Is Not. London: Harrison and Sons; 1860.

3. The Joint Commission. 2010 National Patient Safety Goals (NPSGs) effective July 1, 2010. http://www.jointcommission.org/patientsafety/nationalpatientsafetygoals/.

4. World Health Organization. WHO launches global patient safety challenge; issues guidelines on hand hygiene in health care; 2005. http://www.who.int/mediacentre/news/releases/2005/pr50/en/.

5. The Health Insurance Portability and Account-ability Act of 1996 (HIPAA) Privacy and Security Rules. http://www.hhs.gov/ocr/privacy.

6. American Nurses Association. Nurse Reinvest-ment Act background. http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/Federal/Issues/NurseReinvestmentAct.aspx.

7. Dossey BM. Florence Nightingale: Mystic, Visionary, Healer. Springhouse, PA: Springhouse Corporation; 1999:237.

8. Brown T. Is there a nurse in the house? The New York Times. 2010; June 18.

9. National Institutes of Aging. Talking With Your Older Patient: A Clinician’s Handbook. Gaithersburg, MD: National Institutes of Health, Department of Health and Human Services; 2008:7.

10. Porter R. Greatest Benefit to Mankind (A Medical History of Humanity). London: Harper Collins; 1997:378.

11. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press; 2001:147.

Fidelindo Lim is a clinical instructor at the New York University College of Nursing, New York, NY.

DOI-10.1097/01.NURSE.0000389025.10889.c3

Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.