Florence Nightingale and 19th century hospitals

• Before Florence Nightingale, nursing had little status and training, hospitals were cramped and diseases spread quickly, and nurses had a bad reputation as being drunk and unprofessional
• In the 19th century, attitudes towards the role of hospitals were beginning to change - they were seen less as places of rest and more as places of cure
• Problems with hospitals before Nightingale


  • Little funding
  • Nurses had little status and training
  • Wealthy preferred to be treated at home
  • Hospitals were cramped
  • Diseases spread quickly
  • Wards were rarely properly cleaned
  • Toilet facilities were bad
• Before the 1860s, nurses were not trained and people did not respect them
• The cartoon "The Nurse Old Style" from 1879 shows how nurses used to be viewed before Nightingale's reforms - as old, lazy, and unprofessional
• Nightingale's impact during the Crimean War


  • She convinced the government to send her and 38 other nurses to improve the hospitals
  • She demanded 300 scrubbing brushes to get rid of dirt
  • Nurses were organized to treat nearly 2,000 wounded soldiers
  • Clean bedding and good meals were provided
  • Mortality rate dropped from 40% to 2%
• Nightingale's experience and popularity in the Crimean War gave her credibility to make changes in hospitals in Britain
• Nightingale's changes to hospital design and nurse training


  • Preferred the Pavilion plan with improved ventilation, large rooms, and separate isolation wards
  • Wrote "Notes on Nursing" in 1859 setting out the key role of a nurse and the importance of thorough training
  • Set up the Nightingale School for nurses at St Thomas's Hospital in 1860, training them mainly on sanitary matters and keeping wards clean
  • Recommended new hospitals be built with materials that could easily be cleaned, like tiles and painted walls
• Nightingale made nursing seem like a more respectable occupation, as nurses were now recruited from the middle classes rather than the working class
• By 1900, hospitals looked very different from the 1700s, with separate wards for infectious patients, operating theatres, and specialist departments for new medical equipment
• Cleanliness was now of the utmost importance in hospitals, though Nightingale was a believer in the miasma theory rather than germ theory
• Doctors were a common sight in hospitals by 1900, with junior doctors getting more hands-on experience
• Hospitals had become places where the sick were treated, rather than just places for them to rest
• By the 20th century, cottage hospitals and voluntary hospitals were set up to provide affordable healthcare, though the poor and disabled still often had to rely on workhouse infirmaries
• Florence Nightingale was a fiercely intelligent and determined woman who revolutionized nursing and hospitals, though she was also seen as an "angelic" figure by her patients