August 5, 2020

Florence Nightingale, the lamp lady who saved thousands of lives with a graphic

The International Day of Nursing It is celebrated every May 12. Why? Because that day, in 1820, Florence Nightingale was born into a wealthy British family. What fate awaited him? Worry about his education to get a good marriage with someone from his social class.

But Florence had other plans. In 1837 he announced to his family his desire to dedicate himself to nursing, a profession that at that time was associated with working class women. Nothing to do with a cultured young woman like Florence! As if that were not enough, in 1840, she begged her parents to "let her study mathematics instead of repetitive work and gang practice."

Despite the initial family opposition, Nightingale managed to train in both disciplines. He learned arithmetic, geometry and algebra with tutors of the stature of the mathematician James Joseph Sylvester. And she became an expert in nursing in a self-taught way, frequenting the health centers she visited on each of her trips.

In August 1853 he assumed the position of superintendent at the Institute for the Care of Sick Ladies (homeless women) in London. There he made some improvements, such as the installation of hot water in the rooms and the location of an elevator.

Between October 1853 and February 1856 took place the Crimean War, a conflict between the Russian Empire and an alliance formed by the United Kingdom, France, the Ottoman Empire and the Kingdom of Piedmont and Sardinia. The British troops mobilized to fight in the Crimea against the policy of aggression by the tsarist government in Turkey.

Although the allies were winning on the battlefield, diseases decimated the British army. In the first weeks of conflict, 80% of the deaths in the field hospitals were victims of poor sanitary treatments. The then Secretary of War in Great Britain and former acquaintance of the Nightingale family, Sidney Herbert, requested help from Florence.

On October 21, 1854, Nightingale and her team of thirty-eight volunteer nurses left for the front. They were transported across the Black Sea to the British base in Scutari. They arrived there in early November 1854.

The outlook they found in the hospital was bleak: the soldiers received inadequate treatment from a medical team that was outclassed by the situation, while the army commanders did not react. Medical supplies were scarce, hygiene was unfortunate, infections abounded, food was inadequate and poorly treated.

Florence Nightingale among the sick and wounded during the Crimean War with her famous lamp.

Florence Nightingale among the sick and wounded during the Crimean War with her famous lamp.

Wikipedia, CC BY

Under these conditions, the soldiers died of diseases such as typhus, typhoid fever, cholera and dysentery. Those deaths far exceeded those due to the injuries caused in the battlefield.

Florence requested health assistance from the British government and, after receiving it, ordered the cleaning of the polluting landfills and improved the ventilation of the hospital. With these measures, the death rate fell rapidly.

The days passed and Florence walked with her lamp, every night, attending and observing the sick, noting their evolution and collecting data.

A pioneer of graphics

After the war, Nightingale devoted himself to ordering his meticulous notes and collecting statistics on mortality in the military hospital. To convince the authorities of his conclusions, he decided to use a graphical system instead of presenting his numbers in a tedious and unintelligible list.

He devised the call diagram of the rose that he managed, in a direct and intuitive way, to convince the British Government of the need to carry out drastic hygienic reforms in the hospital centers.

Diagram made by Nightingale

Diagram made by Nightingale

Wikipedia, CC BY

The diagram of the rose includes an explanation in its lower left corner:

Each of the blue, red and black sections are measured using the center as a common vertex.

The blue sections measured from the center of the circle represent, area by area, deaths from infectious diseases, from predictable to mitigable. Red sections measured from the center represent deaths from injuries. Black sections measured from the center represent deaths from other causes.

The black line that crosses the red triangle in November 1854, marks the limit of deaths due to all other causes during that month. In October of 1854 and April of 1855, the black area coincided with the red one. In January and February of 1855, blue coincided with black.

The complete areas can be compared following the boundary lines of blue, red and black.

As you can see, in this diagram three variables are represented: the time (each sector is a month), the number of deaths (the area of ​​the sector) and the cause of death (color). It was a novel system at a time when the usual statistical graphs were of bars and sectors, and represented only one or two variables.

The diagram of the rose shows that, following the sanitary measures adopted by Florence, the proportion of deaths due to illness (the blue sectors) gradually declined. It provided a visual and quick way to convince the authorities of the changes they should take urgently. Without a doubt, Florence Nightingale saved the lives of many people.

The year 2010 was declared International Year of Nursing to claim, among others, the historical relevance of Florence Nightingale on the centenary of her death.

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This article is a compendium of articles Florence Nigthingale, statistical pioneer Y Florence Nightingale, much more than the lady in the lamp from the blog Women with science, publication of the Chair of Scientific Culture of the UPV / EHU.

This article was originally published in The Conversation. read the original.


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