Florence Nightingale's ther Skills

To have the kind of long-term influence on public health policy that she did, Florence Nightingale must have had skills beyond being a nurse. And yet, I never thought of those other capabilities until I read Tim Harford’s article.

 

Eloquence was one such attribute. When she landed in the Crimean warfront in 1854, here’s how she described the situation:

“This is the Kingdom of Hell.”

Equally important, she was a statistician. The first female fellow of what became the Royal Statistical Society, in fact. As Harford puts it:

“For Nightingale… the data were not just a passion but a weapon (to influence policy).”

She understood that presentation mattered. That a picture conveys a lot more than dry numbers. It is therefore unsurprising that she once wrote to a friend:

“Whenever I am infuriated, I revenge myself with a new diagram.”

 

Returning home after the war, she led a long campaign to improve public standards of health and sanitation. On the plus side, she had a “saintly reputation and powerful friends”. On the minus side, she was “a woman in a man’s world”. The chief medical officer, John Simon, considered contagious diseases of the time like cholera to be “practically speaking, unavoidable”. Nightingale disagreed: in her view, “many deaths from infectious disease in the army, in hospitals and in the community were completely preventable”.

 

This is where her knowledge of statistics and presentation helped. Tables of data were too dry:

“Nightingale understood that if she was to win an argument, she needed something more eye-catching.”

On a snarky note, after sending one such report with better graphics to Queen Victoria, Nightingale commented:

“She may look at it because it has pictures.”

She came up with the famous rose diagram, that visually depicts “a powerful two-act story of catastrophic disease in the Crimean war hospitals, followed by recovery after sanitary conditions improved”. The visually brilliant diagram won the day: new health acts were passed, and life expectancy increased.

 

But equally, she understood the dangers of getting carried away by visual presentations:

“She realised that the more spectacular the statistical rhetoric was, the more unimpeachable the underlying numbers needed to be.”

All of which is why Harford writes:

“Nightingale is an icon for our (COVID-19) times.”