Nursing historiography is centered on whiteness. Even worse, nursing history revolves largely around a single white nurse: Florence Nightingale. This, unfortunately, doesn’t mean nurses understand who Nightingale was. There are nurse historians doing incredible and diverse work, but in general, nursing, both as a profession and as an academic discipline, promotes a view of Nightingale based in a culture of white supremacy rather than historical facts. Here, I make explicit Nightingale’s role in British colonial violence by analyzing some of her writings on the British colonies. This history allows us to better discuss the consequences of her legacy in nursing.
Nightingale and colonialism
What is rarely discussed in nursing history is Nightingale’s racism and her political role in the genocide of Indigenous people under British rule. She counseled many key political figures and her writings on the subject show that she was a staunch supporter of British colonialism, even with the knowledge of the death and destruction left in its wake. She believed Indigenous lives were a small price to pay for the expansion of the British Empire. Although some of her contemporaries recognized the brutality of the colonial system, Nightingale believed imposing British culture to be necessary. Anything else, she believed, “would be simply preserving their barbarism for the sake of preserving their lives.”1
This racist statement by Florence Nightingale is one of many. Thanks to digitization efforts, her writings are now accessible, and it’s easy to find sources that reveal Nightingale’s racism. She was steadfast in her belief of the supremacy of white Christian culture. By her own accounts, Nightingale considered Indigenous peoples to be inferior, and the British state to be a “civilizing” force. The quote above is from Nightingale’s Sanitary Statistics of Native Colonial Schools and Hospitals, published in 1863, a report commissioned by the Colonial Office of the British government. In it, she concluded that the high death rates of Indigenous people in colonial schools and hospitals reflected the haste of British authorities to assimilate them. She felt assimilation should be more gradual in order to minimize the death toll, but she had no issue with the death toll itself: “Every society which has been formed has had to sacrifice large proportions of its earlier generation to the new conditions of life arising out of the mere fact of change.”2
In the report, Nightingale defended the deaths of Indigenous children in the Canadian precursors to residential schools: “There is nothing in the school education as described in the returns, sufficient to account for the special prevalence of tubercular diseases in these schools. The causes must probably be looked for in the close foul atmosphere of the native dwelling.”3 Her comments on the Canadian situation were indicative of her larger position: that the deaths of Indigenous people was due to habits of Indigenous people themselves, and that British rule catalyzed a process of “decay” already in motion.
Victorian “Cleanliness” and Miasma Theory as Ideological Weapons
It is important to understand the meaning of cleanliness within the Victorian era and for Nightingale. Cleanliness was a synonym for purity, and the Victorian rituals attached to it came with a sense of godly supremacy.4 It is beyond the scope of this article to discuss the ideological roots of the term, but it went hand in hand with the miasma theory of disease, which Nightingale believed until the end of her life. Miasma theory held that bad smells and filth generated disease. Filth was not just physical, it was also moral. For example, under miasma theory, Nightingale believed sex workers embodied evil that spontaneously generated disease. As Nightingale explained: “When we obey all God’s laws as to cleanliness,…, health is the result. When we disobey, sickness.”5
Indigenous traditions offended the “cleanliness” ideal of Victorian Britain. Miasma theory conveniently supported British supremacy and was a pillar of public health until the end of the 19th century. More importantly, it was a political weapon to destroy Indigenous health and wellness traditions, as it labelled anything non-British or non-Christian as “filthy.” It is inaccurate to assume that when Nightingale speaks of “cleanliness” it is somehow detached from its ideological roots. When she speaks of cleanliness, filth, or foulness, there is always an implicit Christian bias. She could never have supported any form Indigenous health practices because they were not based in Christian values.
The New Zealand Nursing Organization’s Reframing of the Nightingale Legacy
From 1861 to 1868, Nightingale was advisor to George Grey, Governor of New Zealand. Her role in advising the governor during a brutal era of repression against Maori anti-colonial uprisings is part of the reason the New Zealand Nurses’ Organization (NZNO) has decided not to celebrate Nightingale’s birthday in 2020.6
Why 2020? The World Health Organization declared the year of Nightingale’s 200th birthday to be the International Year of the Nurse and the Midwife. For the nurses of the NZNO, however, “Raising her as the beacon for nursing globally causes trauma and re-ignites the history and pain of colonization.”7 They explain that the Eurocentric campaign for the year of the nurse is harmful and disrespectful to Indigenous nurses and call her legacy “dangerous.”
The NZNO’s statement is the only article I’ve found that explicitly discusses Nightingale’s racist heritage. Critical writings are buried by the hagiographies, despite the abundance and accessibility of Nightingale’s own writings.
“She’s a product of her time” is a racist excuse I’ve often heard from colleagues when discussing less appealing aspects of Nightingale’s canon. Her “time” was the Victorian epoch, named after Queen Victoria, who ascended to the British throne in 1837. It was a time of brutal capitalist expansion, an era that saw the rise of the suffragettes, countless working-class uprisings, and anti-colonial revolts. Nightingale was not just a product of her time; she was a product of her social class and its conservative values, which she actively embraced. Her racist discourse was part of the upper classes’ reaction to some of the anti-colonial movements rocking the British empire. The Great Indian Revolt of 1857 sent shockwaves throughout the empire, as did the New Zealand wars. Nightingale was an active participant in British colonialism. Excusing racism or any type of discrimination by claiming it as normal in a particular era is never ok, and as is the case with Nightingale, it also reveals ignorance about the era itself.
History or Cult?
Despite the clarity of Nightingale’s writings, nursing academia continues to produce hagiographies venerating her. While some nurse scholars have offered critical perspectives on Nightingale, her body of work is largely unchallenged within the nursing profession.8 Countless nursing schools, awards, hospital wings and more are named after her. The International Committee of the Red Cross grants a Nightingale medal. Many of the professional nursing colleges and associations in Canada where I live have Nightingale awards, as do most North American nursing schools and faculties. Nursing students around the world recite the Nightingale pledge in solemn ceremonies. In 1971, the International Council of Nurses (ICN) declared International Nursing Day as May 12, in honor of her birthday.
The weight of Nightingale seems to smother our capacity as a profession to celebrate other historical nursing leaders, especially Black and Indigenous women. One in particular stands out; Mary Seacole, a Black nurse from the same era, who also served in areas where Nightingale worked, such as Crimea, and for much longer. She achieved fame in her own right because of the selflessness and grit with which she treated wounded soldiers.
Edith Monture was the first Indigenous nurse in Canada and a pioneer in maternal and Indigenous health. Emma Goldman, a Jewish nurse in addition to an anarchist activist, was an advocate for women’s health and fought against the devastating impacts of capitalist industrialization on the health of working people. None of these trailblazing women fit within the Nightingale “ideal” of the nurse; they were willful and rebellious, and by their very existence, challenged racist and sexist norms.
Nursing academia often uses Nightingale’s writings on public health and education to champion her as a defender of human rights; she’s credited with coming up with the social determinants of health, described as an expert in peacekeeping, and an advocate for the good of humankind.9 I would argue that there is little in her writings to support these claims.
As the NZNO points out, “The historical figures we choose to venerate say a lot about who we are.” The continued veneration of Nightingale tells a story of racism and exclusion within nursing. We cannot claim to teach nursing advocacy and leadership when our model for these concepts was a Victorian bigot. The goal of this article is not to erase Nightingale from our history books; on the contrary, I’m proposing that we get to actually know her and what her legacy means for nursing.
We lose nothing by relegating Nightingale to her rightful place in history. We gain critical insight, growth, and a richer understanding of what nursing is.
- Florence Nightingale, Sanitary Statistics of Native Colonial Schools and Hospitals (1863), 16. Return to text.
- Nightingale, Sanitary Statistics, 18. Return to text.
- Nightingale, Sanitary Statistics. Return to text.
- Anne McClintock, Imperial Leather: Race, Gender and Sexuality in the Colonial Contest (Routledge, 1995), 216. Alison Bashford, Purity and Pollution: Gender, Embodiment, and Victorian Medicine (Palgrave Macmillan, 1998), 36-37 Return to text.
- Florence Nightingale, Florence Nightingale to Her Nurses (MacMillan and Co., 1914), 120. Return to text.
- Grant Brooks and kaiwhakahaere Kerri Nuku, “Why We Aren’t Celebrating Florence’s Birthday,” Kai Tiaki Nursing New Zealand 26, no. 3 (2020): 34–35. Return to text.
- Grant and Nuku, “Why We Aren’t Celebrating Florence’s Birthday,” 34. Return to text.
- Roberta Waite and Deena Nardi, “Nursing Colonialism in America: Implications for Nursing Leadership,” Journal of Professional Nursing 35, no. 1 (2019): 18–25; Jessica Dillard-Wright, Jane Hopkins Walsh, and Brandon Blaine Brown, “We Have Never Been Nurses: Nursing in the Anthropocene, Undoing the Capitalocene,” Advances in Nursing Science 43, no. 2 (2020): 132–46. Return to text.
- D.-M. Beck, “A Brief History of the United Nations and Nursing: A Healthy World Is Our Common Future,” in A New Era in Global Health, ed. W. Rosa (Springer, 2017). Barbara M. Dossey, William E. Rosa, and Deva-Marie Beck, “Nursing and the Sustainable Development Goals: From Nightingale to Now,” AJN The American Journal of Nursing 119, no. 5 (2019): 44-49. Return to text.