Abstract
<p>This paper reviews Florence Nightingale’s contribution to the use of statistics to save lives, beginning with the Crimean War (1854-56). It addresses accusations to the contrary, that her work resulted in lives lost, with primary source data in refutation. It also demolishes exaggerated claims <em>for</em> her, on the extent and speed of death rate reductions achieved, that she collected statistics to this end, and that she did the work virtually single-handedly.</p><p>Comparative French death rates during the war are cited which show how successful the British were with their sanitary reforms. Nightingale’s significant collaboration with the leader of the Sanitary Commission is related. The two went on to numerous successful reforms post-Crimea. The creation of a Statistical Branch was a key part of the strategy.</p><p>Several unsuccessful attempts Nightingale made to improve statistics are noted, beginning with a rejected proposal to add questions on health to the 1861 Census. Next came the Colonial Office’s failure to follow up on her research on excessive deaths in British colonial hospitals and schools, which raised the broader issue of declines in aboriginal numbers. Finally, she had to give up on an attempt to have applied statistics taught at Oxford University, for the benefit of future Cabinet ministers and senior administrators.</p><p>The paper argues that Nightingale’s belief that statistics can be used to save lives still has merit, so long as the endeavour is taken seriously, with adequate attention to detail and complexity.</p>
Highlights
Florence Nightingale (1820-1910) is still known as the leading founder of the modern profession of nursing, the heroine of the Crimean War (1854-56), a hospital reformer, and, to historians of statistics, a major contributor to the discipline, especially for her ability to portray crucial mortality rates so vividly as to persuade authorities to act to reduce them
Comparative French death rates during the war are cited which show how successful the British were with their sanitary reforms
“her hospital,” “ twice as lethal” (88-89). He failed to acknowledge that the 68 regimental hospitals transferred their most serious cases to the general hospitals, and that the regimental death rates varied from a low of 1.2% of admissions to a high of 12.9% (Nightingale, 1858a)
Summary
Florence Nightingale (1820-1910) is still known as the leading founder of the modern profession of nursing, the heroine of the Crimean War (1854-56), a hospital reformer, and, to historians of statistics, a major contributor to the discipline, especially for her ability to portray crucial mortality rates so vividly as to persuade authorities to act to reduce them. Nightingale went on, after the Crimean War, to work with leading experts on public health, notably Dr John Sutherland, the head of the Sanitary Commission, to reform hospitals and health care Their joint work led to improved nursing, safer hospitals and marked declines in death rates, all over the world. He failed to acknowledge that the 68 regimental hospitals transferred their most serious cases to the general hospitals, and that the regimental death rates varied from a low of 1.2% of admissions to a high of 12.9% (Nightingale, 1858a) Her data, reported in her evidence to the Royal Commission, were drawn from the official War Office report (Smith, 1858, discussed in McDonald, 2014). The report of the person who supervised the removal noted 202 cartloads from the two Scutari hospitals in the first week; for Koulali the measure was in tons (U.K., 1854-55)
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