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As it happens: RBC Symposium Day 1 June 19, 2017

Posted by mariemanthey in Creative Health Care Management, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice, Values.
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Today is the pre-conference afternoon of the 2017 International Relationship-Based Care Symposium, here in Minneapolis at the Hilton Minneapolis!

Here are links to the handout materials available at this time:

Gratitude_Human_Connection

DeepenFacilitationCapacity

It’s been great already to have a brunch at my home – to which I invited international guests, several local nursing leaders and CHCM consultants. Conversations ranged over various topics including comparisons between people’s situations in different countries.

The conference itself is a very enthusiastic experience! I have been constantly in motion and it’s wonderful. Everyone is very happy to be here and many are saying ‘this is exactly what we need at our hospital!’

This afternoon I was able to be a surprise guest at the Daisy Foundation session. I spoke about the the impact of Florence Marie Fisher coloring in my coloring book, and also what a wonderful thing it was for me to be able to nominate her for the DAISY award. In closing I brought in Florence Nightingale as well.

I enjoy talking about the power of nursing: as I experienced in my lifetime the impact of my nurse when I was five years old.  I like to make it clear that the work that I’ve been involved in leading is directly the result of Florence Marie Fisher coloring in my coloring book.

I don’t think that that concept can possibly be emphasized too strongly: the power of good nursing care!

Much more to come, looking forward to sharing it with all of you!

 

 

Personally… Being Mortal by Atul Gawande June 11, 2017

Posted by mariemanthey in Inspiration, Manthey Life Mosaic, Professional Practice.
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I lost a close friend recently, after a long struggle with some chronic medical conditions.

It’s a sad period, but one comfort is that his last days went as well as they possibly could. I’m reminded of this book: Being Mortal, written by practicing surgeon Atul Gawande.

In the book Atul explores what it means to ensure that the positive meanings of one’s life extend through the final phases of that life, clinically and in all other ways. Atul has completely defeated the normative medical profession’s reluctance to address that period after medicine stops being applicable. He explores what continues to be important for the person themself and their family.

I found it extremely moving and useful – not just for that period but for everyday. Highly recommend!

Additional Resources:

NY Times Book Review

Frontline: PBS Special

Pennsylvania Library Book Discussion Notes

The Guardian Book Review

Blast from the Past: Feisty Former Chicagoan (1978) May 13, 2017

Posted by mariemanthey in History, Inspiration, Leadership, Manthey Life Mosaic, Professional Practice, Values.
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Primary Nursing: Hospitals bring back Florence Nightingale

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This article was one of the first in mainstream media about Primary Nursing, Marie Manthey .. and Florence Nightingale!

The picture on page 1 is so wonderful, isn’t it?

Here are some excerpts from the article, which you can see directly via the links at the top of this post.

“We’re not just dealing with inert lumps of flesh that hurt” Davis says. “We’re dealing with people’s emotional well-being, too. And that’s what makes nursing exciting again.”

Chicago Tribune: Sunday, February 2, 1978

by Joan Zyda

Sometime after World War II, the American registered nurse was forced into being less like Florence Nightingale and more like a factory foreman.

The shortage of nurses resulted in assembly-line nursing, which brought with it an assortment of nameless, often uncaring persons who trained for brief periods before being turned loose on patients. They were practical nurses, vocational nurses, technicians, orderlies, nurse’s aides, and nursing assistants.

If you’ve been in a hospital in the lst three decades, you have seen this production line in action. Somebody took your temperature, somebody else gave you a bath, somebody else took your blod pressure, somebody else brought in your food tray, somebody else …

Conducting this “orchestra” was, and still is, the chief duty of the registered nurse in most hospitals. Despite years of learning to care for sick people, she ends up in a supervisory job that takes her out of the mainstream of patient care. If she sees patients at all, it’s only briefly when she gives them a shot or a pill, or if there’s a “problem.”

“The patients are completely perplexed and often get irritable or depressed by this fragmented and impersonal care; it frights and frustrates the doctors; the morale of nurses sinks to an incredible low, resulting in a high turnover rate and absenteeism; and it has caused a decline in patient care at many hospitals,” says Dr. William Shaffrrath, diretor of the National Joint Practice Commission in Chicago.

The commission was set up in 1972 by the American Medical Association and the American Nurses Association to solve the growing dissatisfaction with hospital nursing care.

Teh solution, with which the commission has been shaking the pillars of medicine, is to put the registered nurse back at the patient’s bedside, where she can use her training. Some hospitals have already done this, including Rush-Presbyterian-St. Luke’s Medical Center, University of Chicago Hospitals, Good Samaritan Hospital in Downers Grove, and Evanston Hospital.

“Most nurses we talked to are frustrated. They don’t want to be supervisors,” Schaffrath says. “They prefer hands-on nursing in the Florence Nightingale tradition. They want to walk cot to cot, tending to and cheering on the patients.”

Schaffrath credits Marie Manthey, 42, a fiesty former Chicagoan and now vice president of patient services at Yale-New Haven Hospital in Connecticut, for blowing the whistle on nursing. She has advocated for the “return to the bedside” alternative in articles in several prominent medical journals.

As a registered nurse for 22 years, Manthey has had an inside look at the failings of her profession.

“Registered nurses have become faceless people, and it’s the system’s fault,” she says. “Nursing has become extremely production-oriented with very little concern for human needs. Most nurses are embarrassed about that. They say, almost apologetically, ‘Well, I’m just a staff nurse,’ which equates to, ‘I’m just a housewife.’

“But if nurses got their identity back,” Manthey says, “they’d be a proud people again. Then they’d be saying, ‘Hey, wait a minute. I am a staff nurse. I am an important person.”

“Nurses are supposed to be in the thick of things,” Manthey says firmly.

Manthey has coined her remedy, “Primary Nursing” a system whose main goal is just that — to get the nurse to provide total nursing care to a patient during their hospitalization. That means the same nurse does all the work for a patient from admission to discharge.

“The Nurse and the Patient get to know each other,” Manthey says.

With Primary Nursing, the nurse takes over many tasks she used to assign her aides.. because they’re all relevant to patient care.”

/ end content on front page of article, clip 1of2

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For further content from this article, see clipping number 2, and/or let us know if you’d like us to post further excerpts here.

Isn’t it amazing to look back and remember the days when Nursing was at that factory-process level??

What Would Nightingale Do? May 12, 2017

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Happy birthday, Florence Nightingale!

Florence’s life and career continue to be an inspiration for Nursing as well as leaders in general. She was an extraordinary strategist who had powerful insights into organizational dynamics. Facing a challenge, she would assess the pockets of power, align herself with strong allies, and convince people that a solution to the problem would be found.

She was able to make tough choices, including letting some things go until they had to be fixed.

I’m reminded of the story of her arrival in Crimea. The British Military Surgeons refused to let her enter the hospital. They did not want to deal with a “do-gooder” … and a lady at that.

The fact that she arrived with a ship fully loaded with medical supplies, dressings, bedding, food, clothing, etc. gave her the leverage she needed.

She responded to their refusal to let her enter the hospital by refusing to allow the ship to be unloaded. For some days it sat in the harbor with desperately needed medicine, equipment and supplies — until finally surgeons changed their minds and invited her and her nurses to come work in the hospital. It seems clear to me that during those days the ship was in the harbor, there were patients who suffered because they didn’t have the food and medicine on the ship.

The lesson I take from this is that the strategy of letting a failing system fail might be better than the situation-by-situation “fixes” nurses engage in, which take them away from the patient.   Complex systems call for systems-based solutions.  Strategy is important.

We need the courage of Nightingale to focus our energy where it will be best used for patient care now, as she did back then.

Richard Olding Beard: An Extraordinary Feminist. May 7, 2017

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This note is about a work-in-progress, a scratch pad entry from the Desk of Marie Manthey.. it includes a resource list at the end and an invitation to comment and join in the process!

Nursing and the Women’s Movement have had an interesting, challenging and contradictory relationship since modern nursing was born around the 1870’s.

Never a feminist herself, Florence Nightingale created a profession for nurses – for women – where none had existed before. This profession is based on values that have been associated with women.

Fast forward 40 years to the life of Richard Olding Beard, a professor of physiology in the University of Minnesota Medical School. His strong vision of the contribution nursing could make to the benefit of society gave the school of nursing a trajectory that continues to compel the future.

He founded the School of Nursing at the University of Minnesota, which was the first nursing education program within an academic institution. He clearly supported higher education for women and recognized the foundation of science in nursing. He presciently imbued the School of Nursing with multiple societal values that continue to be expressed in the work of its graduates today. Richard Olding Beard saw Nursing’s potential capacity for increasing social justice in the world; for example because of how nursing values the act of caring for the sick – all of them – without regard for position, wealth or status.

There is much more to come, in the full article. To end this preview, here is one of my favorite quotes of his:

“The history of a university or school – and particularly of a professional school – may be guided or misguided by its governing body, may be inspired or uninspired by its faculty, but it is actually written in the work and in the play, in the life and character, in the future achievements and influence of its students.” R. O. Beard, Graduation of the School of Nursing, September 1923.

Beard’s writings (articles mainly) have been a treasure trove for me, and I encourage you to check them out. There is a collection of his writings at the Anderson Archives at the University of Minnesota Library.

Additional information: Honoring the Past, Creating the Future – School of Nursing Celebrates a Century of Leadership. Minnesota Nursing, Spring/Summer 2009. P 2-3.

Please comment below with any questions, thoughts, anecdotes etc..!

Looking forward to Nurses Week! May 5, 2017

Posted by mariemanthey in Inspiration, Professional Practice, Thought for today.
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May is Nurses Month!

Let us take this opportunity in the cycle of time to reflect and celebrate the gift that we have.

Forever, in the history of civilization, there has been an inclination among people to reach out and help another in need in their community. Forever, in the history of civilization, it has been understood that this form of human interaction is of greater benefit to society then interactions that are harmful, destructive, damaging, or painful. Yet, for reasons that are somewhat imperfectly understood (by us and others), those of us who regularly engage in the helpful and compassionate interactions are undervalued, or devalued in this particular period of the history of mankind.

The fact that materialism, success in business, scientific knowledge, wealth, and gaining a competitive edge using aggressive techniques are the common sources of prestige and status must not interfere with the clarity of our vision that the work we do has enormous significance in the ultimate advancement of civilization.

Nurses are among the most trusted professionals in the eyes of the public, but that trust not always taken into account in the rewards side of the ledger. Nurses need to stop taking personally the way society can undervalue our work, and focus on making visible the impact our type of interaction can have on the level of civilization experienced by those who live in the world today.

Let us celebrate the power we can have via the choices we make in our nursing interactions with humanity… let us find ways to help the rest of the world understand what it is missing.. let us cherish the feeling we get from our work when we are conscious of the sanctity of one human being helping another.

For that is what Nursing is.

Let us Celebrate!!

Updated from original text published in ‘Primarily Nursing’, From the Desk Of column, 1988.

Happy New Year….R & R December 27, 2015

Posted by mariemanthey in History, Nursing Peer Support Network, Professional Practice.
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R  &  R refers to Reflection and Resolution.    My goal in writing this is to honor the end 2015 with reflection and with the same post honor the beginning of 2016 with a committed  resolve to keep up the post.    My track record for keeping the post relevant is not good, and I intend to develop a ‘posting habit’.   Goodness knows I have enough life experience creating both good and bad habits, that I should be able to be successful in doing this.

 

My reflection about the past year is based on the three major areas I now choose to spend my time and energy.   They are 1) Clinical Practice issues, 2) the History of Nursing, especially the University of Minnesota (U of MN) School of Nursing (SON) and 3) my newest passion, creating a Peer Support service for nurses in addiction/recovery/reemployment.    (upon immediate reflection….this will either be a couple of posts….or one very long one!)

First of all, Clinical Practice issues.    The work of the company I founded, Creative Health Care Management, continues to function as Health Care thought leaders through speaking at national conference, publishing thought-provoking professional books, articles and a quarterly journal, and helping care systems  provide a healthy culture for people receiving care and those caring for them. (A very tall order!)  I have the sheer pleasure of working with colleagues who are value driven, highly experienced change agents.   When we get together and talk about our work (twice a year) it is like the best think tank you can imagine.   I will try to do a better job of telling you the exciting ideas and realities of this work.

My love of history started with Primary Nursing.   I hated history as a student and therefore knew little about it.    Something about Primary Nursing spoke to me about the past so I started reading old American Journal of Nursing (AJN) issues.   Amazing!    Shortly I was hooked on history, fell in love with Nightingale’s story and continued paying attention to history for a couple of decades.   In retirement (!) I joined the Heritage committee of the U of MN SON and became chair of the committee several years ago.   This committee is made of six people who are passionate about understanding history and who delight in making the connection between the past and the future.   We are one of the most hard-working committees of the Alumni Society and our engagement is such that we spend many hours on our subject in addition to the six hours/month in our committee meetings.   Faculty and students, with great leadership from School of Nursing Dean Connie White Delaney, have come alive with interest in history and it is being incorporated into curriculum with increasing frequency.

In my next post, I will continue this year end reflection by sharing a newly developed passion for helping nurses who are dealing with addiction, recovery and re-entry into the profession; and our creation of a Nursing Peer Support Network.

Thanks to all who read this.   Please dialog with me and with each other.   Back soon.

 

The Choice of Every Nurse Every Day…an excerpt of my introduction to this new book….. June 24, 2013

Posted by mariemanthey in Creative Health Care Management, History, Inspiration, Professional Practice, Values.
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Advancing-Professional-Nursing-Practice-Book

A painting is not created by a free floating hand making marks with oils on canvas. The hand belongs to an artist connecting with his or her mind, body, and spirit, not only to the process of creating a painting, but to those who will one day see the painting. The hands of the artist are not where the skill lies. Without the whole person showing up in the creation of the painting, there is no art; there is just painting.

The art of nursing can be thought of in much the same way. The nurse can show up as little more than a pair of hands doing tasks, but this is not nursing; this is just doing tasks.

The art of nursing (as is perhaps true of any art) is about connection. In the art of nursing, the nurse connects to the patient, and the nurse also connects to the profession of nursing. Advancing Professional Nursing Practice is about the art of both of those connections. It is a book in which the ANA standards are named and explained, connecting nurses to the practice and performance standards of their profession. It is also a book about Relationship-Based Care, which is a care delivery model that connects nurses to patients and families by removing barriers to the nurse-patient/family relationship and improving relationships throughout the organization.

I’m always happy for nurses who get to work in cultures that support healthy relationships throughout the organization, and I share the distress of those who work in environments that seem to be fueled by chaos and competition. It is the choice of the nurse, however, whether to show up in either environment as a whole person, fully invested in the care of patients and families; or simply as a technically competent task doer.

In 1966, the way I viewed nursing was changed forever by an article I read in the American Journal of Nursing. It was written by Sister Madeleine Clemence, and it was called “Existentialism: A Philosophy of Commitment.” The way I saw it, this learned nun, a woman far ahead of her time, was challenging me, a young nurse leader, to show up as a whole person in my work. Her article challenged me to change my own practice and to mentor others to do the same:

“Commitment can mean many things: a promise to keep, a sense of dedication that transcends all other considerations, an unswerving allegiance to a given point of view. In existentialism, commitment means even more: a willingness to live fully one’s own life, to make that life meaningful through acceptance of, rather than detachment from, all that it may hold of both joy and sorrow.”[1]

It was no accident that Sister Madeleine was talking about “acceptance of, rather than detachment from, all that life may hold” in the context of the nurse’s work. As a nurse herself, she could see that the work of the nurse is secular for all, but sacred for only those who commit themselves to making it so. As we go about the work of nursing, are we solving problems or are we entering into the mystery of what it means to be with a person who is suffering, vulnerable, and afraid? She quotes philosopher Gabriel Marcel, writing, “A mystery is a reality in which I find myself involved…whereas a problem is [merely] in front of me.”

It raises a provocative question for nurses: Am I involved with my patients, or are they merely in front of me?

Over a century-and-a-half ago, Florence Nightingale helped to make nursing an art through bringing compassion into her own practice and then writing about it so that others might see that when the basic relational needs of the patient are tended to, there is a healing that takes place whether cure is possible or not. She famously encouraged the soldiers of the Crimean War to write to their loved ones. She understood the simple human truth that connection is healing—connection with loved ones (be they near or far), connection with one’s own thoughts and feelings, connection with the realities of one’s current situation.

The compassionate focus on connection that Florence Nightingale brought to nursing is still there, but it has gotten lost in the shuffle over and over; throughout history every time there was a major change in the world of health care. Here is some historical background:

Prior to the Great Depression, private duty nursing was the main avenue of employment for the nation’s RNs. As the Depression eliminated this avenue for many, RNs returned to their home hospitals as temporary workers, often on a volunteer basis, sometimes working for their room and board. As such, they found themselves working in a highly regimented, task-based, time-focused system of care that was designed to control practice and teach student nurses. This eventually became the main avenue for employment of RNs and remained so until fairly recently.  This move from more autonomy for RNs to less autonomy is a pattern that has repeated itself throughout modern history.

After WWII, the proliferation of new hospital beds coupled with the baby boom (which greatly reduced the nursing workforce), resulted in team nursing, a delivery system designed to maximally utilize technical expertise and assistive support staff under the direction and supervision of an RN. Again, the focus was on assigning and supervising the performance of tasks, since the only person educated to provide a therapeutic relationship was nearly always consumed with supervision and the performance of tasks requiring a higher skill level than that of her staff.

The system upheaval that characterized the last 30 years of the twentieth century, which was driven by finance, technology, and regulation, resulted in most health care organizations dealing with higher patient acuity coupled with severe cost cutting, which again resulted in a focus on managing the tasks of care rather than managing therapeutic relationships. The resulting dehumanization within the care system drove a spiral of regulations and system constraints that further complicated (and continue to complicate) an already intensely complex adaptive system.

The age we live in is no different. As we deal with the myriad changes of health care reform, we’re seeing, once again, a return to task-based practice. This time, however, it feels different to me in various ways. I’m heartened by the numbers of organizations that are embracing Relationship-Based Care. The publication of See Me as a Person is another example – it addresses the need for nurses and other caregivers to be “in it” with their patients rather than merely ministering to their bodies. As the next major societal shift in health care advances, whatever it is, the profession of nursing must continue to define itself. Society trusts us to do so, and our covenant requires it.

Nurses must ask themselves some important questions: What exactly is it that must always be present in order for nursing to really be nursing? What is the actual core of nursing? What strengthens that core? And what must be present in order for that core to even exist? In short, what is the nursing imperative?

I would ask you to mount your own inquiry, and come up with your own answers. Here are mine:

The nursing imperative is a two sided coin. On one side there is the imperative to be clinically competent in both technical skills and clinical judgment. The other side is the willingness to step into being with the human being for whom the nurse is caring. In health care, people experience vulnerability at every level of their being: mental, emotional, physical, and spiritual. The privilege of nursing is having the knowledge and skill, the position and relationship, to interact with a vulnerable human being in a way that alleviates pain and increases mental, emotional, physical, and spiritual comfort. This is the privilege of nursing—the being with a vulnerable human being. If this privilege is ignored or overlooked, nursing isn’t happening. No matter what is happening in a care environment, authentic human connection with the vulnerable human beings in our care can and must happen. That, to my mind, is the nursing imperative.

It’s clear that half of the nursing imperative is that we have a mastery of the technical aspects of nursing, but the other half of the nursing imperative—and it truly is no less than half—is staying present to the vulnerability of others. This book seeks to address the dual nature of the nurse’s work, both the instrumental and relational. If you are a nurse (or about to become one), I’d ask you to keep this dual nature in mind as you read this book.

Marie Manthey, MNA, FRCN, FAAN, PhD (hon.)

March 8, 2013


[1] Clemence, M. (1966). Existentialism: A philosophy of commitment. American Journal of Nursing, 66(3), 500-5.

Follow the Money November 13, 2011

Posted by mariemanthey in Leadership, Professional Practice, Thought for today.
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Follow the money.   As health care reform initiates evolve, the control exerted by reimbursement decisions becomes abundantly clear.    Equally clear is the reality that if an idea is not reimbursed, no matter how beneficial it is for health, it will not be sustained.   While it has taken nursing a long time to accept this reality, we ‘get it’ now.

I think the long delay in our ‘getting it’ is the direct result of the concentration of nurses working in hospitals where, within the umbrella of our revenue being inextricably tied to room rates and days of care, we have had freedom to maneuver many reforms/improvements in care delivery without following the money.

No longer.   Recent legislation has stimulated many initiatives to change the system .   Nurse leaders are now clear about the importance of influencing legislation and clarifying the metrics supporting nurse-led health and health care improvements.   We all need to commit to being informed and taking action to support legislation that will improve health and the health care system.

For example, reimbursement influenced by patient satisfaction scores is but one of the upcoming changes that will profoundly impact the way nursing departments are managed and led.   Withholding reimbursement for conditions caused by errors, is another.  What is and is not being paid for will drive both the system and the nation’s health as never before.

At the very least, every nurse needs to know the following:

  1. content, implications and local response to the IOM report on nursing
  2. local developments of ACO’s and Health (or medicine) Care Homes

We need to stop being the victim profession and start being the leaders society needs us to be.  Nightingale would be out in front with both metrics and the ability to powerfully influence the decision makers.   How can we be less?

I’d love to have a lively discussion about these issues.

A Wise Woman Once said….A Celebration of Florence Nightingale’s Legacy May 12, 2010

Posted by mariemanthey in Academia, History, Leadership, Professional Practice, Values.
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A wise woman once said: “It is fundamental that the hospital shall do nothing to harm the sick.” This woman then went on to create what has become in modern times, the profession of nursing. She instinctively recognized the eternal truth of the phrase “To whom it is given”, to care for the sick and to found the profession of nursing – based on the equal strengths of knowledge and compassion.

I often think about Florence Nightingale’s legacy using the metaphor of a seed. Within every seed are all the qualities and characteristics of the entity that is to grow from the seed. Not all qualities and characteristics are nourished and grow equally. Some grow quickly, others much more slowly. And so it is with Nightingale and nursing. In celebrating her life, and its meaning for nursing and for the world, the qualities and characteristics she embedded in the profession deserve to be recognized, both those that flourished and are strong today, as well as those that have yet to be developed. http://en.wikipedia.org/wiki/Florence_Nightingale

Some of Nightingale’s strongest qualities are that she was an intellectual, environmentalist, statistician, politician, administrator, spiritualist and hands-on caregiver.

Nigthtingale’s intense spirituality is made evident in a book of her letters written to her family while on a three month tour of Egypt and Greece. She was not so much religious as she was spiritual. I was amazed to learn that she studied every religion, including paganism, since she believed any one of them could bring her closer to God. Her passion to serve the sick is a direct result of her spiritual life.

As is well-known, Florence was a lady of highest standing is society. Her parents were wealthy. In fact, after their wedding, they embarked on a six year honeymoon tour of the world. They named their first child, Florence, after the city she was born in and their second, Parthenon, for the major tour feature of the city where she was born.

Florence knew early in her life that the role society assigned to her was not acceptable to her. She was highly intellectual; a quality that resulted in her being taught by her father. She learned subjects not generally understood by women like geography, mathematics, politics and world history. She rebelled against her family’s and society’s beliefs about the role of women in the upper classes and eventually, with enormous struggle and cost, prepared herself as a nurse. She believed in the depth of her soul that this was God’s will for her.

Her skill as an administrator became evident when she was commissioned to nurse English soldiers in Scutari. She understood the value of resources and how to use them to accomplish a goal. When the Army Surgeons refused to allow the nurses access to the hospitalized soldiers, Florence withheld access to the ship full of supplies. She managed to withhold access to them until the surgeons relented and invited the nurses to come and work in the hospital. So not only was she an administrator, but also a politician. She analyzed and used the “pockets of power” in any situation. Today, nurses have well-developed administrative skills, but we still need to sharpen our political acumen.

Another interesting strength of Nightingale is in her use of statistics. In contrast to modern nurses, Nightingale loved the field of statistics and was quite creative in her use of numbers. She actually reformed the British military health care system by demonstrating statistically a dramatic drop in mortality rates when soldiers were in the care of nurses. During the war that statistic went from a 43% death rate to a 2% death rate due to the incredible reforms in hospital care she pioneered. Speaking of pioneering, the field of statistics considers Florence one of their pioneers as she created the first pie chart that clearly shows metric relationships among various segments of a whole. Several years ago the magazine, Science News, ran a feature on Florence as their pioneer, showing her on the cover with a replica of one of her pie charts. http://www.sciencenews.org/index/generic/activity/view/id/38937/title/Florence_Nightingale_The_passionate_statistician

Nightingale’s life reflects a wholesome integration of intellect and spirit. She was brilliant; considered a mystic – one who has received a revelation directly from God. As I read Barbara Dossey’s book about Florence’s life, I was amazed to learn she wrote and spoke in five languages. She even made notes in her bible in five languages, which meant she could actually think in different languages. http://www.dosseydossey.com/barbara/book.html

She walked among the pallets in the rat and vermin infested hospitals for the lowly foot soldiers, whispering words of encouragement and hope to the suffering soldiers. She embodied the twin values of knowledge and compassion. The lowly soldiers nicknamed her “The Lady with the Lamp.” They told their parents and families about this remarkable woman. Word quickly spread throughout England that “a high-class lady” was saving lives in Crimea. Grateful parents began donating small sums of money to what eventually became the Nightingale Fund. Florence used this money to start the first modern school of nursing at St. Thomas Hospital. Therefore the profession of nursing as we know it today was funded, not by the health care system, but from outside sources.

One of the criteria used to differentiate a profession from an occupation is that a profession is based on a system of values so fundamental to the nature of mankind that those who hold them can be said to profess to them, as in witnessing. Thanks to the seeds planted by Nightingale, nursing has just such a system of values.

Deeply embedded in the profession of nursing is the belief that of all the forms of human interaction, that of one human being helping another is of high value. Such a simple concept, and yet so rare in modern society. We live in a world today that values competitiveness over cooperation; winners are “better” than losers, which rewards aggressive behaviors in the conduct of daily business affairs and that condones violence as an appropriate way to address wrongs.

We work in institutions that are run as businesses, where profitability trumps all other values. Where putting a price tag on the value of nursing has been an elusive goal. I’m sure Nightingale is proud of Linda Aiken’s research showing that when there is a higher ratio of RN’s to other staff, fewer patients die and there are less complications.

Yet, nursing holds on to the value of one human being helping another. We know the incredible privilege we have when people give us access to all levels of their being: their bodies, minds, spirits and emotions and we cherish that privilege. The public’s trust is reflected in the Gallup polls where nursing is consistently the most trusted profession.

We cherish the privilege of walking into the room of a sick person and being able to interact in a way that alleviates their pain, or increases their comfort. This is an act of nobility and dignity.

Nightingale said nursing is a noble profession; it is up to you nurses to make it noble. There is nothing wrong with our values, even though they are not shared by the system or society. If the world accepted our values, it would be a more civilized world.

Marie Manthey on the birthday of Florence Nightingale.