Tuesday, May 12th, marks the 200th anniversary of Florence Nightingale's birth—a day that has been designated as International Nurse Appreciation Day.

Nightingale was an opinionated intellectual who is primarily known as the founder of modern day nursing. But when you examine her contribution to health care then and now, it is much broader than the nursing profession. Nightingale had an aptitude for mathematics and figures and used this strength to bring about significant social change. (She was one of the first to use a pie chart.) Her nursing theory emphasized influencing the environment to promote healing—a concept commonly used today. The patient and family was always at the center of her actions and her writings. She believed the individual should assume responsibility for their health, recovery, and healing. As a prolific writer, she authored some 70 books, plus articles, pamphlets, and correspondence on nursing, health promotion, and hospital safety. She was forever the advocate for those needing care.

In honor of International Nurse Appreciation Day 2020, it seems appropriate to examine and celebrate her contributions.

A call to nursing

As a teenager in England, Nightingale believed she had a calling to become a nurse—a decision that appalled her parents. Nursing at the time was not a respected vocation let alone considered a profession. But eventually, she won her parents over and was allowed to go to Germany and France for what nurses training was available at the time. When she returned to England her exemplary work was noticed and in 1854, the British government asked her to lead a group of nurses to treat wounded soldiers of the Crimean War. When she arrived, the conditions were deplorable (mice, cockroaches, dirty linens, etc.) and she set about cleaning the environment, providing care, documenting her findings, and training others.

Returning to England in 1856, Nightingale presented her experiences and data to Queen Victoria and Prince Albert. That presentation prompted the formation of a Royal Commission to improve the health of the British Army—and got Nightingale elected as the first woman member of the Royal Statistical Society. Nightingale also was honored by the United States statistical society for her data analysis.

A social change agent who emphasized patient-family centered care

Throughout her career, Nightingale championed nursing as a new profession of patient care. She used terms like: profession, art, and science and developed close alliances with a number of physicians.

Nightingale's philosophy of nursing states a healthy environment is essential for healing. She placed the person and family at the center and encouraged people to take charge of their own health, recovery, and healing. She required there be collaboration between the person/family and the health care provider—and she incorporated that teamwork mentality into her day-to-day life.

She led teams of doctors, engineers, statisticians, and architects—today that would be known as leading an interdisciplinary or inter-professional team. And although perceived as brusque at times, her intellect and experience was highly regarded: She helped reform the Army Medical Service and, in 1859, she helped establish the Army Medical College of Chatham. In 1860, the Nightingale Training School at St. Thomas' Hospital in London was established.

Shortly before his death in 1883, Sir John McNeill, a Scottish surgeon and diplomat wrote Nightingale saying: "You have a strength and a power for good to which I never could pretend. You are leaving your impress on the age in which you live, and the print of your foot will be traced by generations yet unborn."

A legacy that lives on

Few people have emulated the kind of pioneering research Nightingale provided—or her ability to use findings to make policy or social change for the betterment of all. In addition to being a "nurse," she was a social change agent, statistician, and advocate for patient-centered care and patient activation in their own care. Perhaps she was our first rendition of a population health manager with the soldiers of the Crimean War.

As we remember International Nurse Appreciation Day 2020, let us think of the inspiration Nightingale can be for all of us in health care.