The Nurse Who Ruffled Feathers

Environmental & Science Education, STEM, Health, Medicine, Society, History of Science, Nature of Science

Ed Hessler 

More than 200 years ago was born Florence Nightingale (May 12, 1820 - August 13, 1910) who became a "boots-on-the-ground clinician." A war in which she was a nurse "in the mid-1850s, led her to three insights that came to define her professional life, " writes primary care physician, Danielle Ofri, in STAT.

Ofri notes two things about those insights. They were revolutionary and unpopular:

--Medical care has the potential to do harm.

--Nurses require stringent and scientific training.

--Medical care does not exist in a vacuum from the world around it.

Ofri describes what led Nightingale to these insights, noting that the third one "has received less historical attention. You've heard of the term "miasma," no doubt. "While the public muttered disdainfully about India's ''miasmas,' Nightingale focused instead on data," including sanitation, water quality, housing, food, use of alcohol, and physical activity. (my emphasis)

Ofri turns her attention to the prescience of Nightingale's observations and to the re-envirioning of the health care system, post COVID-19, noting that her list is short. "But even at our creative best, " she writes, "the medical disparities will remain entrenched unless society is re-envisioned as well. Medical care does not exist in a vacuum from the world around it."

The heroism -- we love heroes, at least in the short term -- is far from enough and why should we expect others to do the heavy lifting for us. This is a partial prescription offered by Dr. Ofri; "Remaking health care will mean focusing on the lanes that relate to educational quality, job security, housing stability, and paid sick leave (to name a few) in addition to the more traditional  medical lanes like expanding primary care, enhancing mental health and addiction treatment, improving care coordination, controlling drug prices, detoxifying electronic medical records, improving patient safety, and achieving universal, equitable access to health care."

Please read her essay.