Nightingale - The Irish connection

At the centenary of her death, Therese Meehan celebrates Florence Nightingale and her association with Irish nursing

This year, across the island of Ireland and around the world, nurses are holding special events to celebrate the life of Florence Nightingale and her role in bringing to public attention the vital importance to society of having a strong and effective professional nursing workforce. Her death a hundred years ago this year has served as a reminder that this was a hard-learned lesson for Britain and Ireland at the time of the Crimean war.

For about 300 years prior to this time, nursing as an important service in Britain and Ireland had been all but extinct. King Henry VIII had closed the monasteries that had provided medical and nursing services. Although medicine was re-established as a profession, nursing was left in a neglected state; what our history books call ‘the dark period in nursing.’1 Vulnerable, sick or injured people who lived in poor circumstances often suffered and died because there were no professional nurses to provide for their health.

It took the calamity of the Crimean war of 1854-1856 to bring this inhuman and dangerous situation to wide-spread public attention. Suddenly, newspapers were reporting that hundreds of British and Irish soldiers lay wounded, sick and dying in agony and uncared for across the Crimean battlefields and in hospitals at Scutari because there were no nurses to care for them.

This situation was very different from that of their French allies who had Sisters of Charity, known as excellent nurses, who accompanied each regiment and attended to their sick and wounded soldiers immediately. This all came to a head one Saturday morning in October 1854 when a letter from a wounded soldier was published in The Times of London, describing the soldiers’ anguish and expressing the earnest wish of hundreds like himself to have nurses like the French Sisters of Charity. “Why”, he asked, “have we no Sisters of Charity?”

The British government had to find nurses. This was just the sort of opportunity that the 34-year old Florence Nightingale had been waiting for. Like many women of her time who aspired to be nurses, she had struggled for years to find some way of learning to become a professional nurse. She had observed nursing by the French Sisters of Charity in Paris and Alexandria. Twice she had sought to spend some time with the Irish Sisters of Charity at St Vincent’s Hospital on St Stephen’s Green in Dublin, once in 1844 and again in 1852, but for various reasons this could not be arranged. In 1853 she had finally managed to secure an unpaid post as superintendent of a London hospital for invalid gentlewomen, where she worked for a year. In 1854 she was as prepared as she could be to answer the soldiers’ earnest wish for nurses.

At the request of the British government Secretary-at-War, Florence hastily gathered together a small group of 14 lay nurses, 14 nurses from Anglican sisterhoods and 10 Catholic nuns and travelled to the Scutari hospitals. She demonstrated to the world what nurses could do for their country and re-established nursing in Britain and Ireland as an essential professional service.

Nurses across Ireland also have a special reason to celebrate the nursing work of Florence Nightingale. For at the Crimean war, Florence’s long search for experienced nurses to help her learn about nursing was answered when an Irish nurse, Mary Clare Moore, joined her in her work.

Mary Clare Moore was born in the Church of Ireland Parish of St Anne’s in Dublin in 1814 and her family became Catholic when she was nine years old. She was educated in the arts, classics and languages. At the age of 16 she became acquainted with Catherine McAuley and at times joined her at her Institute on Baggot Street visiting the sick poor in their homes and in hospitals. She was a tall, slim, attractive young woman and very energetic with a lively personality. When, in 1830, Catherine succumbed to social pressure to form a religious community in order to preserve her Institute, she founded the Sisters of Mercy and Mary Clare joined her.

Mary Clare received an intensive nursing training over a seven-month period in 1832 when the first great cholera epidemic arrived in Dublin. She worked long and arduous days with Catherine McAuley at the Townsend Street Depot Cholera Hospital, where Catherine, because of her nursing and administrative skill, had been given ‘the fullest control’ of patient care.

During the following years, Mary Clare continued her nursing work in communities and during times of crisis in workhouses, when nuns were permitted temporarily to work in them. In 1839 she became the first superior of the Bermondsey Convent of Mercy in London’s docklands, where the nuns nursed in the poverty-stricken community and the local workhouse, and visited the sick at Guy’s and St Thomas’s hospitals.

When Mary Clare joined Florence Nightingale at the Crimean war in 1854, she was 40 years old. Her lively personality had become balanced by an air of serenity. She was highly skilled in direct patient care. In addition, she was a skilled administrator: as one observer remarked, “Her governing powers were extraordinary... she was fit to rule a kingdom.”2

Mary Clare’s presence and experience were crucially important to Florence during their 18 months working together at the Scutari hospitals. Their close friendship and ability to work well together, and Mary Clare’s ability to remain calm and objective during times of crisis, provided the greatest support to Florence. During the day she assisted Florence with managing the hospital and at night she tended the soldiers on the wards. She advised Florence on a daily basis, mediated disputes, and helped her to stay calm during the immense stress of their work, for which Florence was very grateful. “I am not like my dear Revd Mother who is never ruffled,” Florence wrote.3

The painting by Jerry Barrett shown above, interestingly titled ‘The Mission of Mercy’, shows Florence receiving a wounded soldier at the Barrack Hospital.The original painting, which hangs in the National Portrait Gallery in London, is large – four and half feet by seven feet. Even though Mary Clare stands in the shadow, her face can be seen quite distinctly in the painting, and it is clear that she is looking directly at Florence and that Florence is looking directly at her as she determines what to do with the wounded soldier she is receiving, perhaps an early example of A&E nursing triage!

Towards the end of the war Mary Clare’s strength began to give out and she was taken back to England seriously ill. Florence was at Balaclava when she received this news and wrote to her:

“Your going home is the greatest blow I have had yet... You were far above me in fitness for the General Superintendency, both in worldly talent of administration, and far more in the spiritual qualifications which God values in a superior. My being placed over you in our unenviable reign in the East was my misfortune and not my fault. I will ask you to forgive me for everything or anything which I may unintentionally have done which can ever have given you pain – remembering only that I have always felt what I have just expressed, and that it has given me more pain to reign over you than to you to serve under me... what you have done for the work no one can ever say.”4

Over the course of the war, Florence Nightingale had become a household name in England and elaborate welcomes were planned for her return. But Florence objected strongly to what she called all the ‘fuzz-buzz’ about her. She managed to return to England early one morning without anyone knowing and went directly to the Bermondsey convent to spend the morning with Mary Clare before going on to her family’s home at Lea Hurst.

Florence and Mary Clare remained close friends until Mary Clare’s death in 1874. In a letter to Mary Clare in 1863, reflecting on their work at the Scutari hospitals, Florence wrote:

“How I should have failed without your help... I wondered so much that you could put up with me – I felt it was no use to say to your face, either then or since, how much I admire your ways.”5

After the war Florence Nightingale published her well-known book, Notes of Nursing: What It Is and What It Is Not, laying out what she believed to be the principles of nursing practice. In light of the close professional relationship between Florence and Mary Clare, nurses across Ireland have inherited a special responsibility to enact these principles in their practice today and to build on them.

Florence would expect us to create truly healing environments for patients, with vigilant attention to sanitation (infection control) and to observe meticulously all aspects of patients’ activities and experiences in order to protect them from harm (patient safety). While she recognised that hospital care may be needed, she emphasised that “the patient must not stay a day longer than is absolutely necessary.”6 She would expect discharge planning to begin the minute the patient was admitted. Finally, Florence believed that “the ultimate destination of all nursing is the nursing of the sick in their own homes”.7 She would expect us to practice mainly outside hospitals, helping and teaching people in their homes and communities to prevent illness and to find better ways to improve their health.

Therese Meehan, RGN, PhD, is a nurse historian and adjunct senior lecturer in nursing at University College Dublin

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