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The second theme that emerged from her writings was the focus on the role of the nurse. She clearly distinguished the role of the health nurse in promoting what we today call self-care. In the past, philanthropic visitors in the form of Christian charity would visit the homes of the poor and offer them relief (Monteiro, 1985). Nightingale believed that such activities did little to teach the poor to care for themselves and further “pauperized” them—dependent and vulnerable—keeping them unhealthy, prone to disease, and reliant on others to keep them healthy. The nurse then must help the families at home manage a healthy environment for themselves, and Nightingale saw a trained nurse as being the only person who could pull off such a feat.
By 1901, Nightingale lived in a world without sight or sound, leaving her unable to write. Over the next 5 years, Nightingale lost her ability to communicate and most days existed in a state of unconsciousness. In November 1907, Nightingale was honored with the Order of Merit by King Edward VII, the first time it was ever given to a woman.
After 50 years, in May 1910, the Nightingale Training School of Nursing at St. Thomas celebrated its jubilee. There were now more than a thousand training schools for nurses in the United States alone (Cook, 1913; Tooley, 1910).
Nightingale died in her sleep around noon on August 13, 1910 and was buried quietly and without pomp near the family’s home at Embley, her coffin carried by six sergeants of the British Army. Only a small cross marks her grave at her request: “FN. Born 1820. Died 1910.” (Brown, 1988). The family refused a national funeral and burial at Westminster Abbey out of respect for Nightingale’s last wishes. She had lived for 90 years and 3 months.
Continued Development of Professional Nursing in the United Kingdom Although Florence Nightingale opposed registration, based on the belief that the essential qualities of a nurse could not be taught, examined, or regulated, registration in the United Kingdom began in the 1880s. The Hospitals Association maintained a voluntary registry that was an administrative list. In an effort to protect the public led by Ethel Fenwick, the BNA was formed in 1887 with its charter granted in 1893 to unite British nurses and to provide registration as evidence of systematic training. Finally, in 1919, nurse registration became law. It took 30 years and the tireless efforts of Ethel Fenwick, who was supported by other nursing leaders, such as Isla Stewart, Lucy Osbourne, and Mary Cochrane, to achieve mandated registration (Royal British Nurses’ Association, n.d.).
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