Latest / Culture Positive: An Infection Prevention Podcast / Mother of Infection Prevention
Transcript
- Ally: Welcome to Culture Positive, an infection prevention podcast where healthcare, public health, and real life meet. I'm Allie, and by day I work in infection prevention at an academic hospital, bringing my background in epidemiology and public health into everyday practice. Each week, We'll dive into healthcare stories, public health conversations, workplace realities, and the human side of this work. This is a space for curiosity, honesty, and hopefully some inspiration. I'm glad you're here. There are so many women both present day and throughout history who have made incredible contributions to public health and healthcare. So I want to start a new series here on Culture Positive. Let's hear it for the girls. This series is all about highlighting the women who have worked to make our world a little healthier, safer. And better. And who better to kick things off than a woman I deeply admire from history? Florence Nightingale. Most of us know Florence Nightingale as the founder of modern nursing and the famous lady with the lamp. But there's so much more to her story. Florence was a nurse, a healthcare reformer, a statistician, a writer, and an incredibly effective advocate for using data to improve healthcare. Honestly, as an epidemiologist and infection preventionist, this is the part of her story that really gets me excited. She collected data, she analyzed it, She figured out how to communicate what the data was telling her. And then she used that evidence to advocate for change. So, curious about Florence Nightingale's background, how she became the woman we know today, and the parts of her work that are still woven into healthcare and public health practice? Let's hear it for our girl Flo. And let's get into it. Florence Nightingale was born on May 12, 1820, in Florence, Italy, to William and Frances Nightingale. She was born into a wealthy British family and grew up with many of the privileges that came with that social status. Florence apparently wasn't particularly interested in the traditional lifestyle expected of a wealthy Victorian woman. You know, the balls. Parties, the social engagements. Basically, I don't think Flo would have been spending her evenings at a Bridgerton ball. From a young age, she felt a calling to help people who were sick and suffering. And by her teenage years, Florence had become determined to pursue nursing. Now here's where things get interesting. Victorian England was not exactly the time to be an independent woman. Women of Florence's social class were generally expected to marry, maintain a household, host social gatherings and stay in their lane. Having a career was unconventional, and nursing, was considered particularly unsuitable for a woman from a wealthy family. But society's expectations didn't stop our girl flow. She continued pursuing nursing and eventually received formal training. In the early eighteen fifty, she took a nursing position in London at a hospital for an ailing governess. Within about a year she had become the superintendent. and in eighteen fifty three, something happened that would change the course of her life. The Crimean War began. This war was fought from 1853 to 1856, with Britain, France, the Ottoman Empire, and Sardinia fighting against Russia. And as is unfortunately true with war, soldiers were not only dying from battlefield injuries, but many were reported to be very sick with other illnesses. Thousands of soldiers were admitted to military hospitals, and the conditions of those hospitals were horrific. The hospitals were overcrowded, supplies were limited, sanitation was poor. It was a disaster. Call in the women to clean up the mess. Classic, right? In late eighteen fifty-four. Florence received a request from the Secretary of Ward Sidney Herbert to organize a group of nurses and Traveled to the British military hospital at Scuturi in Constantinople. Florence assembled a team of nurses and headed to the hospital. When she arrived, she found conditions that would not be acceptable in today's hospital settings. The hospital had serious problems with sanitation. Shortages of basic supplies like soap, clean linens, food, and even medical equipment. And on top of that, the nurses found inadequate medical records. There was no system of recording or reporting the hundreds of soldiers that were buried. There was no record made of their deaths. Rats and fleas were everywhere. And you know what we have learned? If there are rats and fleas, you should suspect some infectious diseases are looming nearby. Florence began making changes. She pushed for better sanitation, advocated for waste to be properly disposed of, improved ventilation, allowing for more airflow, clean water, and also established laundry facilities so patients would have clean linens. She improved overall cleanliness. And she also promoted basic hygiene practices like hand hygiene. She made a habit of visiting patients at night. Carrying her lamp as she made her rounds, she became known to the soldiers as the lady with the lamp. This is probably the version of Florence Nightingale most of us learned about in school, the compassionate nurse walking through the hospital at night. Nightingale and her team of nurses were able to reduce death at that hospital from around forty to two percent in just a few months. a pretty remarkable decrease in deaths in such a short amount of time. Flo was not only a phenomenal nurse, but she had something else up her sleeve. A love for data. Nightingale understood something that feels incredibly obvious to us today, but was revolutionary at the time. If you want change in healthcare, you need evidence. She began collecting and analyzing information about the deaths among the soldiers along with disease. What that data showed was shocking. A much larger proportion of soldiers were dying from disease than from battle wounds. Nightingale used statistics to demonstrate the scale of the problem and more importantly to make the information understandable to people who weren't statisticians. The Nightingale Rose Diagram. This was developed as a type of statistical graphic. It's called a polar area diagram. It basically shows the causes of mortality among the soldiers. And Nightingale developed it. The diagram is shaped like a clock with 12 equal segments. Each wedge represents one month of the year. The area of the wedge showed the number of soldiers who had died that month. Blue area showed deaths from preventable disease, picked up in the terrible conditions at the hospital. Red sections showed the deaths from battle wounds, and black areas were deaths from From other causes, sometimes unknown. Basically, she took her numbers and she made it into a colorful picture. And that picture told a story. with her death diagram, Nightingale wanted Army officials and the public to get a quick visual understanding of the scale of the problem. More soldiers died from preventable diseases during the war than from injuries. She did something so important. She made data visual. Flo understood that collecting data wasn't enough. With all of her analytical approaches, she knew she needed to properly communicate the data. You have to make people care about what numbers mean. Some pretty famous people started paying attention to those numbers, one of them being Queen Victoria. Florence met Queen Victoria on several occasions. And the two even wrote letters to each other over about 30 years. In 1907, Nightingale became the first woman to receive the Order of Merit from Edward VII, the UK's highest civilian decoration. Her work and data reported from her time at war led to change. Nightingale wrote notes on matters affecting the health. Efficiency and hospital administration of the British Army. This is an eight hundred and thirty page report analyzing her experience and also proposing new ideas for military hospitals operating under poor conditions. This book would spark a total reconstruction of the War Office's administrative department. Including the establishment of the Royal Commission of Health of the Army in 1857. The importance of overall hygiene, hand hygiene, clean linens, a clean environment are still the cornerstones of infection prevention. And her data drove that change. This is so relevant to public health and healthcare today. Because how many times do we collect data on healthcare associated infections? CODIDS, collapsies, surgical site infections, we are constantly collecting data. We analyze the data and then we try to convince people to actually do something with that. Florence Nightingale was doing this more than a hundred and fifty years ago. She was using data as a tool for advocacy. In eighteen fifty eight she became the first woman elected to the Statistical Society, now known as the Royal Statistical Society. After returning to England, Nightingale didn't just retire. She got to work. She used what she learned during her time at war to push for reforms in military health care and also hospital design. She always advocated for better ventilation, cleanliness, sanitation, and record keeping. She understood that the physical environment of a hospital could influence patient health and recovery. I know infection preventionists think of this constantly The environment matters. The water, the plumbing system, ventilation and exhaust systems, the way we manage our waste matters, clean equipment, hand hygiene, how we design healthcare spaces. Nightingale's work helped move healthcare toward a more systemic approach to To hospital organization and patient care. And then she turned her attention to nursing education. In eighteen sixty, she helped establish the Nightingale Training School for Nurses at St. Thomas Hospital in London. It is known today as the Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care. Her establishment of a nursing school was a major moment in the professionalism of nursing. Nursing was no longer simply viewed as something women did because they were a natural nurturer or compassionate. Nightingale pushed for education, training, and standards. The school became a model for nursing education and helped influence the development of professional nursing around the world. Unfortunately, Florence's health deteriorated after the war, and she spent much of her later life confined at home. But she continued working. She would write, correspond with government officials, advise on healthcare reform, and she continued to advocate for improvements in hospitals and nursing. She even advised on healthcare issues related to the American Civil War. being sick and confined to her home did not stop her. Florence Nightingale became one of the most influential figures in public health and healthcare history. She died in nineteen ten at the age of ninety. So, why are we still talking about Florence Nightingale after all these years? Obviously, her impact on nursing is enormous. But for me, her legacy goes beyond nursing. She demonstrated the power of evidence based advocacy. She showed that healthcare problems can be measured. Data can reveal problems and can influence policy. and I feel strongly that healthcare workers can and should advocate for better systems. As someone who works in infection prevention, I love one of the most famous pieces of advice associated with Nightingale. It's of course about hand hygiene. She wrote: Every nurse ought to be careful to wash her hands very frequently during the day. Music to my infection prevention ears. I will never stop talking about hand hygiene and it being the most effective way to prevent the spread of infections. And while Florence Nightingale did not understand infectious diseases in the exactly same way we do today, she understood something incredibly important. Clean environments and good hygiene can save lives. And that is a lesson we are still reinforcing today. Following her death, her work and legacy have continued to be remembered. In nineteen twelve, the International Committee of the Red Cross instituted the Florence Nightingale Medal to recognize exceptional courage and devotion to victims of armed conflict or natural disasters. Nightingale's birthday, May twelfth, is now known as the International Day of Nursing. Some nurses recite the Nightingale Pledge, an oath of ethics, at pinning ceremonies where newly qualified nurses are welcomed into the profession. In twenty twenty Temporary hospitals set up by NHS England in response to the COVID-19 pandemic were named NHS Nightingale Hospitals. For our huddle corner, a section for some takeaways before signing off. I think it's safe to say, let's hear it for our girl Flo. I admire how Florence didn't fit neatly into one box. She was a nurse, but she was also a statistician, a researcher, a writer, a healthcare administrator, a data communicator, a reformer. And an advocate. I would also argue an infection preventionist. If you enjoyed learning about Florence Nightingale, stick around because there are a whole lot more women in public health and healthcare whose stories deserve to be told. Thank you for listening to Culture Positive. If you have any questions or ideas for an episode, please send me an email at CulturePositivePod at gmail.com. References for the episode can be found in the show notes. Infection prevention is about more than policies and protocols. It's about people. Until next time, stay curious, stay compassionate, and keep building a culture that's truly positive.