Florence Nightingale and Mary Seacole on nursing and health care

Journal of Advanced Nursing 2014 Jun;70(6):1436-44. doi: 10.1111/jan.12291. Epub 2013 Nov 13.


Aims. The purpose of this article is to correct inaccurate information about both Mary Seacole and Florence Nightingale, material that promotes Seacole as a pioneer nurse and heroine, while either ignoring Nightingale or trivializing her contribution.

Background. Nursing journals have been prominent in promoting inaccurate accounts of the contribution of Seacole to nursing. Some have intermittently published positive material about Nightingale, but none has published redress. Design. Discussion paper.

Data. Primary sources from 1855-2012 were found, which contradict some key claims made about Seacole. Further sources – not included here – are identified, with a website reference.

Implications for Nursing. It is argued that Nightingale remains relevant as a model for nurses, with the many crises in patient care and continuing challenges of hospital safety.

Conclusion. Greater accuracy and honesty are required in reporting about nursing heroes. Without these, great ideas and examples can be lost to nursing and health care.

Keywords: Crimean War, Florence Nightingale, Mary Seacole, nursing, pioneers of health care


The promotion of Jamaican businesswoman and ‘doctress’ Mary Seacole (1805-1881) as the pioneer nurse, to replace Florence Nightingale (1820-1910) in that role, was given considerable credence early in 2013, with her being named ‘pioneer of health care’ by the UK Department of Health in its new Leadership Awards programme. She had already been dubbed ‘pioneer nurse,’ words to be engraved on a bronze statue of her planned for St Thomas’ Hospital, home, for more than a century, of the Nightingale School of Nursing, and base of Nightingale’s more than 40 years of work estab­lishing professional nursing and mentoring nursing leaders from around the world. Both ‘pioneering’ and ‘heroine’ appear on the plaque for Seacole at Brunel University’s Mary Seacole Building, opened by the Queen in 2006.

In 2006, Seacole was also named one of ten ‘great Britons,’ along with Winston Churchill, William Shakespeare and Charles Darwin, on a series of postage stamps in honour of the founding of the National Portrait Gallery. Three other women were on that list: suffragist Emmeline Pankhurst, author Virginia Woolf and founder of the hospice movement, Cicely Saunders, but Nightingale is conspicuously absent. The announcement called Seacole, ‘the famous Jamaican nurse,’ and ‘a notable humanitarian, whose ‘hands-on’ approach to nursing has become an inspiration to nurses today’ (National Portrait Gallery Press Release 2006).


Support for the Seacole campaign has built strongly in the nursing profession, aided by major media outlets. The 2013 Leadership Awards programme is supported by two nursing unions, the Royal College of Nursing and Unison, both of which promote the placing of her statue at St Thomas’ hos­pital, London, where Nightingale established her first school of nursing. Unison has further called for the removal of Nightingale as founder of nursing (BBC Online News 1999). The programme brings Seacole into an elite group of four ‘pioneers,’ with Dr Edward Jenner, of smallpox vac­cine fame, Elizabeth Garrett Anderson, the first woman medical dean and Aneurin Bevan, the Cabinet minister who brought in the National Health Service in 1948. However, Jenner did produce a vaccine, Garrett Anderson was a medical dean and Bevan did establish the NHS, while evi­dence for Seacole’s role in pioneering health care, or any work in public health, is scarce. The announcement was not specific about what she had pioneered or done. A Nurs­ing Standard editorial further raised the ‘pioneer’ honour to that of ‘hero’ of health care, again without specifying what that heroic contribution was (Scott 2013).

In the above presentation of Seacole, Nightingale is absent, although she qualifies eminently as a pioneer, not only for founding the first secular training school for nurses in the world in 1860 but also for many hospital reforms (when hos­pitals were notoriously unsafe), and effective measures for health promotion (when sanitation and nutrition standards were dismal). She was a pioneer research methodologist, adept at presenting data vividly to persuade UK government officials to make fundamental changes. Perhaps her most important contribution to public health care was the reform of the workhouse infirmaries, her goal from the time she first visited them in the 1840s, when her family did not permit her to nurse. Visiting, however, she explained, only served to ‘break the visitor’s heart,’ so she put it aside, to wait until she had the opportunity to bring in real reforms (McDonald 2004 p. 237, p. 248, McDonald 2010 p. 141).

Nightingale succeeded in having trained nursing intro­duced into the Liverpool Workhouse Infirmary in 1865, and also in many London workhouses in the following few years. She pressed for legislative change, with limited success. She took the first steps towards mentoring the first trained nurses appointed matrons of London workhouse infirmaries (McDonald 2009). Given that there were five patients in the workhouse infirmaries for everyone in a regular, civil hospi­tal, those reforms were crucial to upgrading the whole hospi­tal system. This happened gradually over the late nineteenth century, with Nightingale being involved at all points. The National Health Service of 1948 is unthinkable without those reforms – when she set out there were no nurses, and bed sharing was common, for example. Nevertheless, Nightingale is dismissed as representing the past and many nurses pro­mote Seacole as the new pioneer of nursing.

However, Seacole never did anything akin to regular hos­pital nursing, nor ever claimed to have. She was a business­woman, initially a lodging house proprietress and, later, during the Crimean War, running a restaurant/bar/store/ takeaway and catering service for officers. She was also a herbalist, a ‘doctress’ in her own terms and generous in giving away remedies to those who could not pay. She gave such assistance as she could in epidemics, when no remedies could help. She was kind to many people, officers and ordinary soldiers. She gave first aid on the battlefield (post-battle) on several occasions. She provided hot tea and lemonade to cold soldiers on the wharf awaiting transport to hospital. She deserves much credit, but not as a pioneer nurse or a hero of health care.

Data sources

The primary sources were Seacole’s own memoir, Nightingale’s vast publications and correspondence, newspaper reports from the time and officers’ correspondence and memoirs.


The Seacole promotion campaign

An editorial by James P Smith, founding Editor of JAN, in 1984 identified Seacole as a ‘Black British Nurse’ (Smith 1984), words not previously used for her, and ones she herself would have vehemently rejected; she called herself ‘yellow’ (Seacole 1857 p. 27, p. 78, p. 79) and ‘brunette’ (p. 4); ‘blacks’ (p. 12, p. 19, p. 21, p.37, p. 38, p. 39, p. 45, p. 58, p. 66, p. 72, p. 138, p. 141), ‘negroes’ (p. 42, p. 43, p. 44, p. 52, p. 69, p. 72) and ‘niggers’ (p. 20, p. 45, p. 48) were other people, often her employees. These refer­ences, and many others shortly, from her Wonderful Adventures of Mrs Seacole in Many Lands, refute most of the claims made for her on nursing and medical skills, hero­ism, pioneering and race. The JAN editorial contains such inaccuracies as the statement that Seacole was ‘proud of her black blood,’ when, in fact, she disparaged those roots, differentiating herself from ‘lazy’ Creoles (Seacole 2), while announcing her pride in her Scots blood (p. 1).

The JAN editorial also states that she was rejected ‘for the colour of her skin,’ for which there is no firm evidence, and her own memoir shows that she never properly applied for a position (Seacole 76). That she was ‘decorated for her ser­vices in the Crimea,’ is clearly false, although this would become a common myth (medals went only to members of the military). The editorial also accorded her, without giving any evidence, the ambition ‘to nurse soldiers’ in the Indian Mutiny of 1857, with the rumour that the queen would not let her – for which the only source is a comment of her sister’s to visitor Anthony Trollope (Trollope 1868 p. 21), presum­ably based on what Seacole herself had told her.

Seacole was not only not ‘black,’ she was not British. When she left London for the Crimean War in 1855, she was on her third UK visit. On the first, she was a child; on the second, old enough to work, when she supported herself by selling Jamaican preserves and pickles (Seacole p. 4). On the last, she had come from Panama to try to realize some profits from her gold mining investments (p. 71). After some years back in Jamaica, post-Crimea, Seacole returned to London in 1865, where she retired. She adapted well to British society, to become an early successful Jamaican immigrant. She died in London in 1881. In 2004, she was named top of a list of Great Black Britons. However, none of this makes her a ‘black British nurse.’

The JAN editorial’s ‘Black British Nurse’ designation, however, has become standard language, making for a sharp contrast with Nightingale as the ‘White British nurse,’ and the obvious conclusion that the two were not treated equally; one being given due or too much credit, the other denied it, probably for reasons of race. Sometimes Nightin­gale is blamed for Seacole’s exclusion, although the only account of their meeting is Seacole’s, and she reported it as friendly (Seacole 90-91). Nightingale had left for the war before Seacole had formed the plan of going — she had gone to London for her gold stocks, not nursing soldiers.

Seacole’s own memoir, Wonderful Adventures of Mrs Seacole in Many Lands, is a fine book, although readers must brace themselves for slurs on blacks, ‘niggers,’ Greeks and Turks. Seacole grew up and continued to live in a prejudiced, White, world: she was herself three-fourths White, had a White husband, White business partner and wholly White cli­entele. She suffered prejudice on account of her one-fourth Black roots. Philosophically, she believed in racial equality, and spoke well of Blacks who had managed to escape slavery in America to make new lives for themselves in Panama.

Smith (2007) continued to promote Seacole, next in a letter to the editor of the Nursing Standard on the statue campaign. He called those opposed to the statue at St Thomas’ ‘some­what ridiculous’, insisting that Seacole ‘was undoubtedly a hands-on practitioner.’ He now described her as ‘a mixed-race British nurse,’ but again without saying where she nursed.

The Nursing Standard has become the main nursing pub­lication to promote Seacole. Examples of claims at variance with primary source data in it, the Nursing Times, and other sources, are given on a website, with primary sources that show otherwise. The website invites notification of any errors on its part, and undertakes to correct them, but, to date, not a complaint has been received (http://www.maryseacole.info/; accessed 22 August 2013).

JAN itself contributed further inaccuracies in by covering the 1994 launch of the first two sets of Seacole nursing awards, announced by the then Secretary of State for Health, Brian Mawhiney (the NHS awards of 2013 are a third set). The minister accorded her ‘considerable nursing skills’ – unspecified – and stated that she had made ‘a major contribution to nursing the wounded in the Crimean War,’ although she missed the first three, major, battles. He added a new credit, ‘as a nurse in and around London’ (Anony­mous 1994). No detail was given for any of those claims, and none is known.

Seacole as ‘doctress,’ not ‘nurse’

The JAN editorial’s claim that Seacole was ‘well versed with the prognosis and treatment of tropical diseases’ (Smith 1984) is simply unverifiable – we have only her word for ‘suc­cesses’ – and her claims were modest for cholera and she made none for yellow fever (Seacole pp. 59-63). She frankly admitted ‘lamentable blunders’ and allowed that medicines she had used later made her ‘shudder’ (p. 31). She used ‘sugar of lead,’ or acetate of lead, and mercury chloride in cholera remedies (p. 31). In recourse to toxic substances, she was no worse than doctors of the time, as can be seen in numerous Lancet articles and medical textbooks. Crimean War doctors also used such substances, although without claiming success as a result (Smith 1858 vol. 2 pp. 70-71). Unhappily, they and she used substances that intensified dehydration, when the effective treatment is the opposite: rehydration.

Seacole did no hospital nursing before, after or during the Crimean War. She never called herself simply a ‘nurse,’ but she did use the combined expressions ‘doctress and nurse’ (p. 125), ‘nurse and doctress’ (p. 7) pre-Crimea and at the Crimea (p. 127), and ‘doctress, nurse, and “mother”‘ (p. 124). However, these instances do not pertain to hospi­tal nursing. When she said simply ‘nurse,’ during the Cri­mean War, she was referring to Nightingale or one of her nurses (p. 76, p. 87, p. 90). She used the verb to ‘nurse’ in referring to home care she gave in Jamaica in the last days of her patroness and her husband (p. 5), once in Panama for a relative of her husband, later her business partner (p. 69); and once in the Crimean War for an Artillery officer (p. 153). None of them was in hospital and for none did she give details about the care they received.

Seacole did donate ‘100 bottles of anti-cholera medicine and 100 boxes of pills’ in a cholera epidemic (Mansion House Cholera Relief Fund 1866, p. 6A) in the UK. How­ever, as the ingredients of those medicines were not speci-fied-and she was known to use harmful substances – it is not clear if her donation helped.

During the Crimean War, she was not nursing, but pro­viding food and drink, for profit, to officers. For the ordin­ary soldiers, there was a ‘canteen,’ but her services were unspecified (Seacole p. 114). She announced, on printed cards, the intention of starting a ‘mess table and comfort­able quarters for sick and convalescent officers’ (p. 81), but she did not do this. She proceeded instead, on the advice of chef Alexis Soyer, to furnish food and drink (Soyer 1857, p. 233). However, the Seacole campaign literature claims that she started variously a hospital, sick bay, or hostel, to care for, at her own expense, ordinary soldiers (McDonald 2012). These are at variance with the primary sources.

A timeline (Figure 1) gives Seacole’s occupations and activities, along with those of Nightingale, all dated, and all based on primary sources. Nightingale’s are only a selection of what she did on nursing, given space limitations.

Nightingale as pioneer

Nightingale’s continuing legacy as a pioneer is set out in a recent JAN editorial ‘Florence Nightingale -never more rel­evant than today’ (Lee et al. 2013). To the many points on health promotion, disease prevention and patient care made in it, one might add Nightingale’s pioneering work in evi­dence-based health care (McDonald 2001).

A great deal of inaccurate information continues to be pro­moted and the laudable desire to be racially inclusive and provide a ‘black’ role model in health care is doubtless part of the answer. However, many UK institutions promote this inaccurate story, notably the National Portrait Gallery, Royal Mail, National Army Museum, Royal College of Nurs­ing, BBC and the Departments of Health and Education.

The school system is another source of incorrect informa­tion, on both Seacole and Nightingale, augmented by edu­cational material provided by the BBC. The BBC’s Horrible Histories is an extreme example, not the original book, but the BBC YouTube for schoolchildren which uses the same name. A segment with actors has Nightingale as a White nurse in uniform, literally shoving aside a youngish, Black Seacole also in uniform, although, in reality, she was older, stout and dressed as a restaurant proprietress. The Nightin­gale actress says that nursing is ‘for British girls’ http://www.bbc.co.uk/cbbc/shows/horrible-histories accessed 22 August 2013), words the real Nightingale never said and did not believe.

Channel 4’s hour-long film, The Real Angel of the Cri­mean War, makes its own case for Seacole while, again, discrediting Nightingale. There was no apparent defence of Nightingale by nurses.

Implications for nursing

Nursing leaders seem to be unembarrassed at being unable to provide any evidence for the claims they make about Seacole. Letters by the Nightingale Society (2012) to both the RCN and Unison on the incorrect information on their websites simply went unanswered (Nightingale Society). Given Nightingale’s strong support for quality care in a public system, it is strange to see Unison’s failure to see her as an ally. Indeed, in 1999, in urging that Nightingale no longer be celebrated as the founder of nursing, it argued for replacing her with Elizabeth Fry, who founded an agency to provide private care to those who could afford it.


Great accuracy and honesty are required in reporting on nursing heroes. Without these, nurses and other healthcare decision-makers risk losing an ongoing relevant source. High death rates from hospital-acquired infections and prescription errors show how badly needed still are the careful data collection and its application that Nightingale pioneered. Access to high-quality health care remains an issue, even in most developed countries, where, again, Nightingale’s bold vision sets the standard.

Figure 1. Florence Nightingale and Mary Seacole Timeline

Nursing, Health Care and Other Occupations

For Nightingale the items are highlights only; throughout she advised young women considering becoming nurses; responded to requests from doctors and local leaders for nurses and midwives, held meetings with hospital matrons and heads of nursing schools, met with pupils after their first year of training and continued to mentor many for years.

1805 Mary Grant (later Seacole) born in Kingston, Jamaica
1820 Florence Nightingale born in Florence, Italy
1830s MS makes two visits to England; on 2nd sold Jamaican pickles and preserves
1836 Marries Edwin Seacole; together ran store in Black River. MS ‘nursed’ him and patroness in dying days, no specifics given 1837 FN call to service, wanted to nurse, family did not allow
1843 MS‘s mother’s boarding house destroyed by fire, rebuilt 1840s FN visits workhouse infirmaries which ‘broke the visitor’s heart’
1850 MS travels to Panama, supervises food/clothing production for sale at brother’s hotel/store; opens own store/restaurant; cholera epidemic but no doctor–she treats patients, claims some cures, uses lead acetate 1850 FN first visit to Kaiserswerth Deaconess Institution;

1851 FN nurses 3 months in Kaiserswerth wards and works in apothecary

1853 MS in Jamaica; sees yellow fever epidemic, no cures 1853 FN nurses 3 months in Paris hospitals;

1853-54 FN nurses at and directs Establishment for Gentlewomen during Illness, Harley St.

1854 MS returns to Panama, invests in gold mine, prospects; in September leaves for London to attend to gold stocks, unsuccessful

late October 1854 starts applying in person to be ‘army assistant,’ does not submit application to be a nurse; reports rejection; forms plan with business partner to open ‘mess table and comfortable quarters’ for convalescent officers

21 Oct 1854 FN leaves for Crimean War with 38 nurses

5 Nov 1854 FN arrives at Barrack Hospital; does hands-on work. supervises nursing at several hospitals; promotes soldiers’ welfare/ nutrition; reports bad conditions to government

February 1855 MS departs for Crimea, arrives 8 March at Scutari, meets FN, brief conversation, gets bed for night

March 1855 MS arrives in Crimea; for 3-4 weeks provides tea and lemonade at wharf for soldiers awaiting transport; opens ‘Mrs Seacole’s hut’ at Kadikoi, for food, drink and catering for officers, with a ‘canteen for soldiery’

18 June 1855 MS sells 2 mule-loads of food and drink to spectators at Cathcart’s Hill watching 1st Redan assault, assists with first aid post-battle

16 August 1855 MS sells food and drink at Battle of Tchernaya, assists with first aid post-battle

8 September 1855 MS sells food and drink at 2nd Redan assault; assists with first aid post-battle; takes souvenir loot from Russian bodies

9 September 1855 MS borrows mules for catering deserted Sebastopol, visits city; takes souvenir loot from Russian churches/soldiers

September 1855-April 1856 MS caters for excursions, expands business during peace negotiations

May 1855 FN‘s first trip to Crimean hospitals; falls ill of ‘Crimean fever,’ recovers; convalesces, returns to Scutari

Nov 1855 FN makes 2nd visit to establish nursing in Crimean hospitals; continues nursing and supervision; writes letters to families on behalf of soldiers; provides information on last care to families; continues to report on need for reforms

Nov 1855 FN returns to Scutari on outbreak of cholera there, nurses worst cases and much night nursing

April 1856 troops/officers depart for England on signing of peace treaty 30 March; MS and Day‘s business fails

July 1856 MS returns to England, feted: dinners, races, etc., briefly runs store at Aldershot

November 1856 first bankruptcy court hearing; MS wears medals; fund raising begins

March-May 1856 FN makes 3rd visit to Crimea; establishes nursing at Land Transport hospital; in April made superintendent of all Crimean hospital nursing by general order

28 July 1856 FN leaves Scutari on departure of last soldiers; arrives back in London 7 August

Sept-Oct visits queen at Balmoral; meets Lord Panmure, secretary for war; agrees to write ‘confidential’ account of war

Oct 1856 starts statistical work

1857 bankruptcy certificate granted MS and Day on 17 January; Wonderful Adventures of Mrs Seacole in many Lands published (London: James Blackwood); Surrey Gardens festival for MS in July, but proceeds meagre 1857 FN works on own reports and royal commission on the war; advises on nursing in navy; begins work to establish training school
1858 FN publishes Notes on the Health of the British ArmySubsidiary Notes [on] the Introduction of Female Nursing into Military Hospitals; writes ‘Notes on Hospitals’; gives evidence to Royal Commission on war
1859 Weekes does sculpture of MS wearing medals (now at Getty Centre, Los Angeles)

October 1859 MS departs for Jamaica

1859 FN publishes A Contribution to the Sanitary History of the British Army; publishes expanded Notes on Hospitals
January 1860 FN publishes Notes on Nursing: What It Is, and What It Is Not

June 1860 Nightingale School of Nursing opens at St Thomas’ Hospital

1861 Nightingale Ward and midwifery training open at King’s College, London; FN starts work on trained army nursing at Royal Victoria Hospital, Netley; publishes Notes on Nursing for the Labouring Classes; advises on hospitals for U.S. Civil War; census entry reads: ‘formerly hospital matron’
1862 FN liaises on nursing in Baden; works on India royal commission; army hospitals
1863 MS visits Panama 1863 FN gives evidence to Royal Commission on India; publishes ‘How People May Live and Not Die in India’
1864 FN starts work on workhouse infirmary reforms; advises on Geneva Convention
October 1865 MS returns to England from Jamaica 1865 first trained nursing at a workhouse begins at Liverpool; FN publishes Introduction to Wm. Rathbone, Organization of District Nursing; ‘Suggestions for a System of Nursing for Hospitals in India’
August 1866 MS donates 100 bottles of anti-cholera medicine and 100 boxes of pills to Lord Mayor’s Fund (ingredients unknown) 1866 FN starts work on nurses for Australia; on extending workhouse nursing to London; on trained nursing in India
January 1867 fundraising begins, which supported MS for rest of her life 1867 FN writes brief ‘Suggestions on the Subject of Providing Training and Organizing Nurses for the Sick Poor in Workhouse Infirmaries’ for Parliamentary committee on workhouses
1868 Nightingale nurses begin work in Sydney, Australia; FN publishes ‘Una and the Lion’ on death of Agnes Jones of Liverpool Workhouse Infirmary; first work on trained nurses for St Pancras Workhouse Infirmary
1869 Challen paints portrait of MS wearing 3 medals (now at National Portrait Gallery) 1869 works on nurses’ housing at Netley; works on Liverpool Workhouse nursing; analyzes maternal mortality at King’s College
1870 sends public letters to workhouse nurses; works on relief assistance for Franco-Prussian War; publishes letter in Lancet on cholera
April 1871 Census entry, MS living in Paddington, London, occupation ‘annuitant’

July 1871 Gleichen terracotta bust of MS wearing 3 medals (now at Institute of Jamaica)

1871 FN Census entry: ‘director of Nightingale nurses’; move of Nightingale School to new St Thomas’ Hospital; training school at St Pancras begins; publishes Introductory Notes on Lying-in Institutions
1872 first ‘address’ by FN to nurses and probationers; improves lectures for nurses at St Thomas’; trained nurses begin at Edinburgh Royal Infirmary
1873 carte de visite printed, with photograph of MS wearing medals, Maull & Co. 1873 FN works on St Thomas’ curriculum and library for nurses; publishes ‘Life or Death in India’
1874 FN begins work to send nurses to Montreal; works on establishing district nursing agency
1875 FN works on army nursing, meets with nurses for Montreal; works on district nursing in Liverpool
1876 FN begins mentoring matron of St Mary’s Hospital, Paddington; Nightingale Fund begins supporting district nurse training
1877 FN mentors matron at Addenbrooke’s, Cambridge; works on extending district nursing; publishes ‘The Indian Famine’
1878 FN works on nurses for Lincoln and St Bart’s, London; for Belfast, Kent, and Herbert (army) Hospital; publishes ‘The People of India’
1879 FN gets inquiry started on abuses in nursing at Buxton Hospital; advises on nursing in Austria; works on sending nurses to Anglo-Zulu War; publishes ‘Woman Slavery in Natal,’ in Aborigines’ Friend
1880 FN mentors Manchester matron; advises on bad army nursing in Southern Africa; workhouse infirmary nursing and district nursing
April 1881 Census entry, MS living in St Marylebone, occupation ‘independent’

14 May 1881 death of Mary Seacole

1881 Census entry: ‘director of Nightingale Fund for training hospital nurses’; advises on Metropolitan and National Nursing Association
1882 FN works on nursing in India; at Westminster Hospital, London; organizes nurses for Egyptian Campaign
1883 FN works on cholera in Egypt; nursing at Netley; plans for Nurses’ Home, St Marylebone Workhouse
1884 FN works on nursing for Berlin; assists matron under investigation at St Mary’s; opening of Nurses’ Home, St Marylebone Workhouse
1885 FN works on nursing for new Egyptian Campaign; and for Belfast Children’s Hospital and Union Infirmary
1886 FN works on nursing for Northern Hospital, Liverpool; for India and Herbert Hospital; Jubilee Fund for District Nursing; publishes 2 articles in Quain, Dictionary of Medicine
1887 FN works on selection and mentoring of new matron at St Thomas’, and at Edinburgh Royal Infirmary; promotes nursing and health in home in India
1888 FN works on clinical lectures for probationers; district nursing for Scotland, midwifery nurse training; army nursing in India; nurses for Gordon Boys’ Home; opposes proposal for state registration of nurses
1889 FN begins mentoring matrons of London Hospital and Birmingham Workhouse Infirmary; advises on nursing for London fever hospitals; assists matron and nurses going to Argentina
1890 FN appointment of new matron at St Thomas’; publishes Introduction to Wm. Rathbone, Sketch of the History and Progress of District Nursing; advises on nursing in Baden and New Zealand
1891 FN meets with Indian delegates to hygiene congress; publishes ‘Sanitation in India’

FN Census entry: ‘director of Nightingale Fund Training School for Nurses’

1892 FN works on district nursing in England and Scotland; mentors matron for Consumption Hospital; works on midwifery nursing; publishes ‘The Reform of Sick Nursing and the Late Mrs Wardroper’ in British Medical Journal; publishes on hospitals in Chambers’s Encyclopaedia
1893 FN meets with American nursing leaders Isabel Hampton and Louise Darche; assists matron Flora Masson under investigation
1894 FN begins work on nurse training for Italy; publishes revised articles in Quain, Dictionary of Medicine
1895 FN does fundraising letter for St Thomas’ Hospital; works with new medical instructor at Training School; begins work on trained nursing in Boston; works on nursing for Bolton Workhouse Infirmary
1896 FN works on nurse training for Finland; circulates information on Finnish aseptic procedures; advises on telephones and bells at St Thomas’; works on trained nursing for Irish workhouses and Calcutta; mentors matron of City of Dublin Hospital; publishes letter on district nursing
1897 FN works on nursing at London Hospital; assists matron at Edinburgh on investigation; advises departing nurses for Hong Kong and India
1898 FN works to establish district nursing in Canada; does last work on health visitors; holds last meetings with St Thomas’ nurses; makes last notes on antiseptic procedures
1899 FN mentors matron of a New York hospital; meets with nursing leaders from Canada, U.S. and New Zealand
1900 FN holds last meetings with matrons of St Marylebone Workhouse and London Hospital; advises on nursing for Boer War; sends last ‘address’ (of 14) to Nightingale nurses
1901 FN assists Amy Hughes with publication on nursing; sends public letter on district nursing; FN Census entry: ‘living on own means’
1902 FN holds last meeting with matron of St Thomas’
1903 FN sends letter on district nursing to Australia
1905 FN sends last letter to nurses at Edinburgh Royal Infirmary
1906 FN meets with midwife from Canada
1908 FN sends last greetings to nurses
13 August 1910 Florence Nightingale dies at home in London


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