The Mystical Legacy of Florence Nightingale
Florence Nightingale: Mystic, Visionary,
Healer was written
to offer a radically different view of her from the starchy, aloof figure
that many of my generation encountered in nursing school. She had come to be
seen as almost irrelevant to modern nursing. In Nightingale I saw someone whose
values and beliefs are deeply appropriate to the challenges facing nursing
today. I was intensely intrigued with her, and immersed myself in this work
with such zeal and passion that it seemed to take over my life.
I
began my historical research on the life of Florence Nightingale (1820-1910)
because nursing and healthcare are both in crisis; this has resulted in many
healthcare providers losing sight of the heart and soul of what it means to be
in service to others. My motivation and goal with this research was to produce
a unified context from which to consider and help resolve the chaos of local,
national, and international health issues that include the nursing shortage and
inadequate patient care. Even as many health care organizations seek to bring
healing and caring into their environments, nurses struggle to convey that
their profession—for which such healing and caring is as fundamental as its
science and technology—is the pivotal
one for healthcare.
Before I began my research, I knew very
little about Nightingale except that she was considered the founder of modern
nursing. As I explored her life and work, I was surprised to find that most
nurses don’t know she was one of the superpower personalities of
nineteenth-century Britain. Nightingale was a comet blazing across the
Victorian sky, changing everything in her path. Her accomplishments rivaled those of the greatest men. Women of
her time simply did not do what she
did.
I marvel at what Nightingale
overcame to bring her life’s work forward. What great challenges she overcame!
She was born into wealth and political influence; was a highly educated
aristocrat, fluent in five languages, master of the mathematics and statistics
of her time, and became the leading expert of her day in hospital design. A born feminist, she scandalized her elite
family by choosing a life dedicated to the alleviation of human suffering. Her life was staged in the bucolic English
countryside, the halls of Parliament, and the bloody battlefields of the
Crimea.
Next to Queen Victoria, Nightingale
was the most famous and influential woman of her era. Had she been a man, she would likely have been Prime Minister. I
encourage nurses and others to visit the Florence Nightingale Museum; it is
recognized as one of the ten best small museums in London. My visits to the
museum are like a pilgrimage; I continue to learn something new about
Nightingale’s relevance and impact for contemporary nursing and healthcare with
every visit.
Alex Attewell, director of the Florence
Nightingale Museum, his colleagues and the wonderful, dedicated volunteers,
have created a treasure for us; they are in the process of expanding the museum
and creating a new foundation that will further enhance our understanding of
Nightingale’s legacy. Alex Attewell is also calling for the establishment of an
International Centre for Study and Research in nursing where Florence
Nightingale’s originality and amazing powers can be brought together in one
place to show her influence in many fields. This Centre would bring together
all her books, manuscripts, personal belongings, and other symbols and articles
that are intimately associated with Nightingale’s life and work.
For
information on the Florence Nightingale Museum and the Florence Nightingale
Foundation, go to http://www.florence-nightingale.co.uk/
Florence Nightingale remains a
profound role model for us today. When we explore her written work, we find
that she has created a blueprint for healing, leading, and global visioning
where we as nurses can come together and shape a vision of a healthcare system
driven by the needs of patients and their families.
Nightingale’s
legacy has endured because her life is an example of patriotism, dedication to
king and country, wealth and power, leadership, warriorship, spirituality,
love, compassion, integrity, wisdom and healing. She inspired changes in medicine, public health, and nursing,
which resonate to this day. She was
forceful and sometimes eccentric, and like all brilliant agents of change, had
her share of critics, who also persist to this day. But which famous figure does not have detractors? This aspect of Nightingale only makes her
human and adds spice to her story.
There
is and will continue to be a major resurgence of interest in Nightingale as we
approach the 100th year of her death in 2010. The magnitude of Nightingale’s story has not
been recognized by nurses and others because her legacy has been trivialized
and sanitized—“the lady with the lamp.” In particular, the depth of Nightingale’s
inner life has been almost totally neglected.
She had a rich inner life
that characterizes a mystic. Like Joan of Arc, Nightingale periodically heard
the voice of God. One simply cannot understand her stunning accomplishments
without taking this into consideration. Her spiritual writings are as sublime
as those of the great medieval female mystics such as Saint Teresa, Hildegard
of Bingen, and Julian of Norwich.
After
combing her 14,000 letters—the largest private collection of letters in the
British Library—I uncovered evidence that her intense spiritual life defined
and empowered her life mission from adolescence onward.
As a nurse, I felt compelled to
write about her. My challenge was to decide what I could add from a historical
perspective about this remarkable woman, when hundreds of people have already
written about her. A major focus of my research was to bring Nightingale
forward as a mystic. Yes, Nightingale was a profound mystic. In my historical
research, I used the framework of a British scholar, Evelyn Underhill, one of
the most recognized writers on western mysticism, to organizational framework
for my research.
Underhill defines mysticism as an
individual’s direct, unmediated experience of God. A mystic is a person who has
such an experience, to a greater or less degree. The life of a mystic is not
focused merely on religious practice or belief, but on what he or she regards
as firsthand personal knowledge of the love of God, or the experience of the
Divine Reality of God.
Nightingale’s spirituality was a
profound sense of connectedness with God. Her God was not a white male who
spoke only English, but a Universal Truth permeating all the great
religions--the God/Life Force/Absolute/Transcendent. Her spirituality was the
unifying force in her life. It infused every thing she thought and did in her
long life of 90 years.
Evelyn Underhill’s framework of
mysticism has five phases: awakening, purgation, illumination, surrender, and
union.
The first phase,
“Awakening” is where a person hears the voice of God. This is so profound and
true that it becomes embedded in that person’s life story, forever changing her
life.
The second phase
is “Purgation.” This is the period in which the person realizes that she/he is
not worthy. How could she possibly be called to do this profound work of
service? She tries to purge herself of worldly connections, often through
fasting and extreme acts such as giving away material possessions.
In the third
phase, “Illumination,” he/she is utterly filled with passion for and a sense of
God.
The fourth
phase, “Surrender,” typically continues for a long time. It is a very profound
period in which the person explores her inner, divine connection. This period
of spiritual development often includes much suffering–because, as the person
strives for perfection, she/he can never feel worthy enough. In mystic
literature, this phase is often referred to as the “dark night of the soul.”
The fifth phase
is “Union,” during which the mystic realizes that he/she has reached a level of
deep inner connectedness with the Divine Reality.
These five stages are not a linear
process. Mystics seldom follow these phases in a rigid, linear sequence. They
can experience Awakening, and then Illumination, only to fall back into
Purgation. Often Purgation and Illumination run parallel, while the Surrender
and Union phases alternate.
In her book, Practical Mysticism (1915), Underhill referred to Nightingale as
representing that of a fully integrated mystic. At an early age, Nightingale
had a serious religious and spiritual nature, always with the desire to nurse
the sick.
Nightingale’s “Awakening” occurred
at age 16, on February 7, 1837. She recorded her first Call from God then, and
on three other occasions later in life when she heard the voice of God again.
Her “Purgation period” lasted around 17 years before she was finally able to
break free and pursue her interest in nursing.
The “Illumination” period began
during Nightingale’s first superintendent position at Harley Hospital in London
for eighteen months, and as Underhill states, it is this illumination period
that assisted Nightingale during her Crimean War mission. Her “Surrender” phase
lasted from around age 36, after she returned from the Crimea, until her late
sixties. She entered the “Union” phase in her seventies when she was not as
driven by her social action.
As a scholar and a seeker of Truth,
she spoke and wrote about God, the Universal God, and the One. For example, she
wrote, “What do we mean by ‘God'? All we can say is that we recognize a power
superior to our own; that we recognize this power as exercised by a wise and
good will.” She believed in the messages contained within Christianity and saw
Jesus Christ as a great man who revealed the fundamental truths of God. She seriously studied and contemplated the
words and parables in her Bible, heavily annotating her own King James Version,
which had a blank page between almost every printed page. She wrote her own
ideas, meanings, and her interpretation in English, French, Latin, Greek, and Italian,
which have been translated and analyzed.
Nightingale honored cultural diversity
and was extraordinarily tolerant and ecumenical in her attitude toward world
religions. She wrote that “to know God we must study Him in the Pagan and
Jewish dispensations as in the Christian.” To her, this broad approach gave
unity to the whole; it was the one continuous thread throughout humanity.
She called for
religious tolerance and she also asked others to be respectful of cultural
diversity. This can be seen in her work for India for over forty years; her
papers on the aboriginal races, and all places where the British Empire had
taken over native peoples and their lands. She read world religions widely. She
was familiar with translations of early writings such the Upanishads of
Hinduism, Plato, Gnosticism, and of Jesus, to name just a few. She wrote her
own liberation theology, Suggestions for
Thought, in three volumes of 829 pages, which she had privately printed.
Much of modern nursing’s heritage comes through its founder, Florence Nightingale. She was a fiery and
visionary interdisciplinary healer and practitioner; her contributions to
nursing and public health practice, research and statistics, social and
political reform, and nursing theory are fundamental to health care. Her
message still speaks to nurses today. It speaks about the complexity and the
crisis within healthcare.
My
new book (Dossey, B.M., Selanders, L.C., Beck. D.M. & Attewell, A. Florence Nightingale Today: Healing,
Leadership, Global Action (NurseBooks.Org, 2005) examines and analyzes this legacy and
demonstrates how it offers a vision for renewing nursing and health care—a
profession and industry in mutual crisis—in the coming decades. This book is grounded
in the necessarily integrated personal, political, scientific, social, and
spiritual domains of Nightingale’s life and work.
As
Nightingale scholars, my co-authors and I have employed historical research and
recent scholarship to assess and analyze in-depth, the Nightingale legacy and
show its relevance to contemporary nursing and health care.
In
the process, Florence Nightingale’s life and work can also help to counter the
often fragmentary, and thus superficial or trivializing accounts, of
Nightingale that continue to appear. Her life stories are contained within the
primary documents that are discussed in this book, along with other supporting
primary and secondary sources. These stories also convey the wholeness and
unity of her life and work. Activist, feminist, healer, mystic,
environmentalist, politician, practitioner, reformer, scientist… all were roles
of this practical health care pioneer.
Nightingale’s three tenets—healing,
leadership, and global vision challenges nurses to engage in healing; she calls
for us to recognize nursing as a spiritual practice. Healing can occur with
curing that uses the best of western medical protocols, treatments, and
procedures when necessary or appropriate. As Louise Selanders reminds us,
Nightingale is the philosophical founder of contemporary nursing. Her legacy is
a guiding light for nurses and all of humankind in how to integrate technology
with healing. This should never be “either/or,” but must be “both/and.” These
ideas are also developed in my co-authored Holistic
Nursing: A Handbook for Practice (4th Ed,) that serves as a
guide on how to implement these concepts into nursing practice, education, and
research.
Today,
there continues to be a focus on curing with empirical knowledge that is
characterized as the mindset of technology, rationality, objectivity, and a
linear cause-and-effect, physical-material world view and set explanations
related to the reality of consciousness.
My coauthor Deva-Marie Beck has done
a superb job of synthesizing Nightingale’s global vision and summarizing the
following seven points that are explored in detail in our forthcoming book.
These are:
1) Make health—and influencing positive
health determinants—a top priority in
human affairs.
2) Value and sustain nurses in their
caring in health care.
3) Collaborate—across disciplines and
across cultures—for promoting health in community settings.
4) Think globally; act to create local
Health Literacy—for both genders, across the lifespan.
5) Make media a catalyst for nursing and
for health.
6) Keep health care holistic and
interdisciplinary.
7) Answer your own “calling. “
When the art and science of the
profession come together, nurses’ intellect, intuition, and healing presence
become more dynamic; the interaction of self with another take on a different
quality. Healing presence is approaching a patient or another in a way that
respects and honors her essence.
Healing encounters are more frequent because there is a coming together
of two people in a present moment where a different level of exchange and
sharing occurs.
Healing is powerful because it is not
predictable. A useful metaphor in listening to another person’s story or in the
telling of a story when a healing moment has been created is that the
boundaries between two people in a caring moment become fluid. A thread of a
story can take a person in a direction that he was not conscious of before the
telling of the story. A nurse can maintain healthy boundaries within this
situation, particularly when the nurse integrates self-care and reflective
practice on a regular basis.
There is a need for
interdisciplinary dialogues in healthcare. Nightingale was a great
interdisciplinarian; she was always thinking in new ways such as analyzing,
communicating, exchanging, surveying, involving, synthesizing, investigating,
interviewing, mentoring, developing, creating, researching, and teaching. She
listened to others; she created new schemes for what was possible for
healthcare providers, patients and their families.
Interdisciplinary dialogues occur
when all team members come together—the professionals, complementary and
alternative practitioners, volunteer caregivers with the patient and his
family—to an integrated relationship-centered care, to explore healing of the
whole person—body, mind, and spirit.
An atmosphere of trust is created so
that each person is listened to and feels that her concerns are being heard. A
person’s story is heard and the uncertainty of being a person with an illness
is honored.
Nurses
can be leaders in creating opportunities for interdisciplinary dialogues and
interdisciplinary approaches to care. An interdisciplinary approach means that
professionals come together to share knowledge; they emphasizes connections
with each other rather than specialization; there is “collaboration with”
rather than “competition among.”
An interdisciplinary approach calls
for being committed to learning new approaches from other disciplines; to have
a new commitment, courage and spirit of exploring and understanding how to use
creativity and inspiration.
Both the healthcare system in the US
and in Britain face grave challenges. Nurses with other healthcare
professionals can reconstruct, reshape, and reinvent the hospital and the
clinic into sacred spaces that empowers the health care system to provide
healing.
The ultimate aim of contemporary
nursing is to integrate Nightingale’s three tenets of healing, leadership and
global vision so that we can reconstruct and reweave new patterns and themes
into our healing tapestry of nursing education, practice, and research. One of
the ways we can practice differently is to create sacred spaces in hospitals,
clinics and schools that will encourage our transpersonal dimension to emerge.
This dimension transcends the limits and boundaries of individual egos and
possibilities that include acknowledgement and appreciation of something
greater. Transpersonal also refers to a healing consciousness of wholeness,
unity, and oneness. This allows nurses, other health care professionals, and
society at large to increase the healing power of their theories,
interventions, behaviors, and relationships.
Nightingale’s core values are being
integrated beautifully by nurses today. She imparted guidelines and core values
for today’s modern nursing practice. These core values are philosophy,
education, ethics, nursing theory, research, self-care, therapeutic
relationships with clients, cultural diversity, healing environments, and the
holistic caring process. And at the core of all her social actions was this
profound connectedness with God. She would also tell us that she could have
done a better job at self-care, for she was notorious for working months and
years without a break.
A major insight occurred as I
focused on Nightingale’s life as a mystic. I realized that there are mystics
who walk with us every single day. I wondered who they are, and what does their
presence mean? As I questioned, I felt
a deepening sense of my connection to all life. I asked myself old questions I
thought I’d laid to rest. I sensed more deeply my need to be of more service to
my friends, my community, the earth itself.
Nightingale influenced me to pay closer attention to how I can put
myself in that reparative state in which healing can take place.
My hope is that people who read my
illustrated biography, Florence
Nightingale: Mystic, Visionary, Healer, and my co-authored book, Florence Nightingale Today: Healing,
Leadership, Global Action will reflect on their own healing journey and
identify their “must,” which is what Nightingale called her work. I hope they
will explore what it means to be called to a work of service, whatever the work
is, for the greater good of their family and community.
Nightingale’s story is an ongoing
one, in which I will continue to connect with other nurses and people who are
also involved in healing work. Discovering the work of other Nightingale
scholars and forming new friendships with them has been one of the greatest
joys of this work.
References
Dossey, B.M. (2000). Florence Nightingale: Mystic, Visionary, Healer. Philadelphia:
Lippincott, Williams & Wilkins.
Dossey, B.M.,
Selanders, L.C., Beck, D.M., & Attewell, A. (2005) Florence Nightingale Today: Healing, Leadership, Global Action.
Washington, D.C.: Nursesbooks.org.
Dossey, B.M.,
Keegan, L. & Guzzetta, C. (2005). Holistic
Nursing: A Handbook for Practice (4th ed.). Sudbury, MA: Jones
& Bartlett.
·
I would also like to recognize the important
work of Dr. Lynn McDonald, Nightingale scholar and Professor of Sociology at
the University of Guelph, Ontario, Canada. She is the Editor of The Collected Works of Florence Nightingale (Wilfried
Laurier University Press, 2001, 2002, 2003;
see web site: www.wlupress.wlu.ca).
The first six of sixteen volumes that includes Nightingale letters and major
documents are now published. (See web site: www.sociology.uoguelph.ca/fnightingale)
Barbara Dossey, PhD, RN, HNC, FAAN,
is internationally recognized as a pioneer in the holistic nursing movement.
She is Director of Holistic Nursing Consultants in Santa Fe, New Mexico. She has authored or co-authored 23 books including Florence Nightingale Today: Healing,
Leadership, Global Action (NurseBooks.Org, 2005), Holistic Nursing: A Handbook
for Practice (4th ed.), Jones & Bartlett, 2005), Florence
Nightingale: Mystic, Visionary, Healer (Lippincott, Williams & Wilkins,
2000), AHNA Standards of Holistic Nursing Practice (Jones & Bartlett,
2000), and AHNA Core Curriculum for Holistic Nursing (editor, Jones &
Bartlett, 1997).
Barbara is a Fellow of the American
Academy of Nursing. She is certified in holistic nursing. She is a seven-time
recipient of the prestigious American Journal of Nursing Book of the Year
Award. She was awarded the 1985 Holistic Nurse of the Year by the American
Holistic Nurses' Association; the 1998 Healer of the Year by the Nurse Healers
Professional Associates International, Inc.; the 1999 Pioneering Spirit Award
by the American Association of Critical Care Nurses; the 1999 Scientific and
Medical Network Book of the Year by the Scientific and Medical Network, United
Kingdom. In 2001 she was recognized as TWU 100 Great Nursing Alumni, Texas
Woman’s University, Denton, Texas. In 2003 she received the Distinguished
Alumna Award from Baylor University, Waco, Texas. With her husband, Larry, she
received the 2003 Archon Award from Sigma Theta Tau, International, the
international honor society of nursing, honoring the contributions that they
have made to promoting global health. In 2004, Barbara and Larry also received
the first awarded Pioneers of Integrative Medicine Award from the Aspen Center
for Integrative Medicine, Aspen, Colorado.
A major focus of her work currently is
holistic nursing, compassionate care for the dying, and virtual education. She is also exploring the impact of Florence
Nightingale’s life and work on modern nursing and humankind. For the 72nd General Episcopal Church Convention
in Philadelphia July 1997, Barbara wrote three of five documents to accompany
the Resolution Proposal to request the reconsideration of Nightingale’s
commemoration and for her name to be placed on the church calendar list of
Lesser Feast and Fasts in the Book of Common Prayer. The official vote to accept Nightingale to the church calendar
occurred in July 2000. The inaugural Florence Nightingale Commemorative Service
was held on August 12, 2001, at the Washington National Cathedral, Washington,
D.C.