Midwifery will be in the spotlight throughout 2020 as this year has been declared the international year of the nurse and midwife by the World Health Organization (WHO); the Nightingale bicentenary celebrations are also taking place globally.
The year 2020 sees the 200th celebration of Florence Nightingale's birth. Nightingale, leader, icon and pioneer was born in 1820 and died aged 90 in 1910. She is seen as the philosophical founder of modern nursing as well as a female icon, a healthcare pioneer, a competent and respected researcher, statistician, analyst, an innovator and entrepreneur and a leader. Throughout 2020, there will be celebrations of the legacy she left. Nightingale inspired, and continues to inspire, nurses globally. Beyond nursing, her work has also informed mathematicians, architects, public health workers and activists.
Florence Nightingale respected patients regardless of their social class, disabilities, hygiene or occupation, and she insisted that a real nurse would abandon any class differences. The sick and infirm, she noted, require special constructive arrangements; emphasising how they are not paupers but rather are poor in affliction and society owes them every care for recovery (Nelson and Rafferty, 2010). Nightingale's influence on nursing continues. She personified many of the important ideas that are key to nursing today—values, vision and voice, the pre-cursor in many ways to the 6Cs (Department of Health, 2012). Nightingales' legacy of philosophical fundamentals still pervades within the profession today, informing contemporary nursing that has its roots embedded in Nightingale principles.
Nightingale had a special interest in hospital design, especially with a view to prevent cross-infection between patients. In her work, Nightingale discusses the maternal death statistics of lying-in institutions and makes suggestions, with accompanying plans, for changes to hospital layouts which had the potential to reduce the rates of infection and maternal death. Following an outbreak of puerperal sepsis in 1867, Nightingale studied the causes of maternal mortality nationally and internationally. She observed, ‘There appears to have been no uniform system of record of deaths, or of causes of death, in many institutions, and no common agreement as to the period after delivery during which deaths should be counted as due to the puerperal condition.
The first step is to enquire, what is the real normal death rate of lying-in women. Compare the rate with the rates in establishments into which parturition cases are received in numbers. Clarify the causes of death and see if any particular cause predominates in lying-in institutions; and if so, why?’ (Dunne, 1996).
As a passionate statistician, she conducted extensive research and analysis. She published over 200 reports and pamphlets on a wide range of issues, including hygiene, hospital administration and design, and midwifery and healthcare for the poor. She was concerned with the most basic needs of human beings and all aspects of the environment locally and globally. Williams (2008) however, suggests that much of her reputation is based on the myths created by the popular press at the time of the Crimean war.
Nightingale was a nurse, administrator, communicator, statistician, an educator and environmental activist. These attributes can be clearly identified in the Nursing and Midwifery Council's (2018) standards of proficiency for registered nurses. Nightingale was ahead of her time; she began to write in the 1880s that it would take 100–150 years before educated and experienced nurses would arrive to change the healthcare system. Nurses and midwives of today are the generation of 21st-century Nightingales and health representatives. We have to envisage our role beyond nursing and midwifery, and see ourselves as health broadcasters and social media communicators, transforming health and social care with others, and carrying forward Nightingale's vision of social action so as to create a healthy world.
The first-ever international year of the nurse and midwife is being held in 2020, providing a ‘once in a generation opportunity’ to showcase the professions, to raise the status and profile of nurses and midwives globally. The dedication of next year to the cause was approved by leaders at the World Health Assembly (WHA). Both professions are invaluable to the health of people everywhere, without nurses and midwives, it will not be possible to achieve the sustainable development goals or universal health coverage.
The WHO recognises the crucial role of nurses and midwives on a daily basis. While 2020 will be dedicated to highlighting the enormous contributions that nurses and midwives make, it is also important to ensure that the shortage of these two professions across the globe is also addressed. It could be suggested a profession's fascination with a role model who died over 100 years ago will hold back progress, but I could not disagree more with this. Nightingale's words and work still inform contemporary nursing and midwifery. We must however, as we celebrate Nightingale's bicentenary and international year of the nurse and midwife, acknowledge the outstanding contribution made by every contemporary midwife locally, nationally and internationally.