what would florence say?
TRANSCRIPT
WHAT WOULD FLORENCE SAY?
Rebecca M. Patton DNP, RN, CNOR, FAAN
Lucy Jo Atkinson Professor in Perioperative Nursing
Case Western Reserve University,
Past President, American Nurses Association
2020 Annual Convention
Florence Who?
• Wealthy connected family• Father saw the value of education
(History, English, Math)• Encouraged his daughters to think• Father fought for the Reformer
Party• Mother connected to politicians
and newspapers’ reporters• Family very social • Florence loved parties
https://www.youtube.com/watch?v=r9LVDwnRk2A
Florence Who?
• Multiple sources describe her and her family
• Florence’s very first patient was a sheepdog, "Cap“
• Promising young man proposed marriage three times
• Had a dream that God wanted her to be nurse
• Family horrified going into public hospital
• Educated in Germany (3 months) as a nurse
• At age 32 (1852) left the family to visit hospitals in Paris
• British government asked (1856) her to supervise nursing care Crimea War – 32 nurses
Crimean War
Mortality rate high, hospital chaotic, horrible treatment
Data Looked Beautiful
• Coxcomb design (pie slices)
• Specific organization of her chart represent complex data
• Twelve Months view
• Death rate shaded
• Cause of death shaded
Lady with the Lamp or with the Bar Chart?
• Lady who conducted pioneering work as a statistician
• Trained first as statistician
• Rare presence in such fields
• Most prominent statistician - used her passion for statistics to save lives of soldiers during the Crimean war
• Groundbreaking work in data visualization that continues to be influential to this day.
After Crimean War
• National heroine for her efforts on the soldiers' behalf (1856)
• Established the first professional nursing school in the world at St Thomas' Hospital (1986)
• London’s Nightingale School of Nursing raised the reputation of nursing as a profession.
• Global impact
• Notable students included Linda Richards, America's first trained nurse.
Regarding Healthcare Acquired Infections - WWFS?
• Happy to know that statistics is required for graduate education
• She would wonder why she is not seeing more visualization of data - to better understand the infections, causes, and solutions.
• Trending of data
Regarding Infections – WWFS?
NCNA 2020 Annual Convention
“True nursing ignores infection, except to prevent it.” (p. 20) “Every nurse ought to be careful to wash her hands very frequently during the day. If her face too, so much the better.” (p. 53)1
2020 National Patient Safety Goals: "Comply with either the current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the current World Health Organization (WHO) hand hygiene guidelines.“
Regarding COVID- WWFS?
• “I told you to wash your hands”
• Follow the science
• Personal hygiene
• Fresh air
• Contact tracing
• Visualization of data
How Many Letters Would Be Written
• Often wrote letters home for dying or dead soldiers
• Lobbied with her writing for legislation to improve sanitation (1870)
• Correspondences exemplify her engagement in policy matters
Pet Therapy – WWFS?
• Sometimes recognized as a founder of modern pet therapy
• Had a pet baby owl called Athena
• Carried around in her pocket
• FN recognized how well animals provided emotional support for patients
Environmental Theory
• Defined Nursing as “the act of utilizing the environment of the patient to assist him in his recovery”
• Influenced the design of hospitals to include full height windows to provide better light and ventilation.
“Consider not only the individual patient but the context of where he or she lives”
– Florence Nightingale
Professional Responsibilities - WWFS
NCNA 2020 Annual Convention
“May we hope that, when we are all dead and gone, leaders will arise who have been personally experienced in the hard, practical work, the difficulties, and the joys of organizing nursing reforms, and who will lead far beyond anything we have done!”
Evidence-Based Practice
NCNA 2020 Annual Convention
“The most important practical lesson 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."
Patient Confidentiality – WWFS?
NCNA 2020 Annual Convention
“And remember every nurse should be one who is to be depended upon, in other words, capable of being a 'confidential' 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."
Educating the Next Generation - WWFS
• “First requirement in a hospital is that it should do sick no harm” - “Is all this death necessary”
• Developing a plan of care –systematic approach
• Working collaboratively / team
• The lamp - Presence
“So never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinateds and roots itself”
How Did She Do It
• Overcame hurdles
• Used her Capital
– Political
– Social
– Financial
– Intellectual
• Networking
• Use writing skills
• Commitment
Call to action - WWFS
“You ask me why I do not write something …. I think one’s feelings waste themselves in words, they ought all to be distilled into actions and into actions that bring results”
- Florence Nightingale
Take Action – WWFS?
NURSE Advocate
Build Financial Capitalto engage at a higher level in the process. Consider becoming a Grass Top.
Build Social Capital to create a network of supporters. Make friends by coming early and often as well as by being a resource.
Build Political Capital to make nursing's voice heard and influence the process. Don't be a "free rider." Respond to nursing's call to action.
Build Intellectual Capital to establish credibility as the expert in both content and process. Investigate the issue from all angles.
Build Financial Capital to engage at a higher level in the process.
Intellectual Capital
Gaining civic knowledgeGaining
Pursuing a formal degreePursuing
Becoming certified in a specialtyBecoming
Disseminating work Disseminating
Writing articlesWriting
Financial Capital
Providing expertise to an organizationProviding
Contributing time, talent and treasure Contributing
Becoming an influentialBecoming
Serving on a board, committee or task force Serving
Social Capital
Participating in professional associations and community groupsParticipating
Mentoring colleagues at work and beyondMentoring
Developing relationships with policy makersDeveloping
Harnessing the power of social mediaHarnessing
For the nursing profession, social capital should be the most basic, intuitive, and strongest form of capital.
Political Capital
Visiting legislators’ officesVisiting
Working on a campaignWorking
Running for elected office Running
Seeking appointed officeSeeking
Becoming a board memberBecoming
Move past excuses
Assessing your capital for policy and Advocacy
INTELLECTUAL SOCIAL POLITICALFINANCIAL
Capital Activity Current P or p
Intellectual
Civic knowledge
Clinical competence
Professional competence
Publication, testimony
Specialty certification
Social
Mentoring
Networking
Professional association
Social media
Capital Activity Current P or p
Political
Activism
Campaign work
Legislative visits
Organizational leadership
Financial
Donations
PAC participation
Volunteering
PolicyEngagement
Partnerships
Assessing your Policy Capital: the PZL Model
Political literacy… starts with Informed voting
https://www.usa.gov/how-to-vote
https://www.idea.int/data-tools/country-view/137/40
https://nursesvote.org/
Building capital assets
• Visit a legislator’s office
• Take part in an advocacy workshop
• Publish your work
• Use social media to disseminate policy
positions
• Join a community or workplace task force
Expanding policy involvement
• Assume leadership role in a professional or
community organization
• Become an expect in content area or on
policy issue
• Serve on legislator’s committee/ policy
group
• Develop a relationship between a policy
stakeholder and/or legislator
• Write a policy brief for a professional
association or community group
Action Steps
REFERENCES
2020 ANNUAL CONVENTION – RALEIGH, NC
American Statistical Association (2020). Florence Nightingale: the lady with the data. Alexandria, VA.
International Council of Nurses (2009). Notes on nursing a guide for today’s caregiver. Bailliere Tindall Elsevier, London.
Nightingale F. (1860)Notes on nursing: what it is and what it is not. Harrison and Sons, London
https://www.youtube.com/watch?v=r9LVDwnRk2A
