Until recently, if you said, “nightingale” I would think of a bird. If someone had asked me if I had ever heard of Florence Nightingale, I would have said, “Sure.” If they then asked me who she was, I would have said, “A nurse, I think.”
But what I did not know was she wasn’t only a nurse, she was a game changing statistician whose statistical work saved thousands of lives and the course of medical sanitation forever.
Florence Nightingale. Nightingale was born in May 1820 into a wealthy British family in Florence, Italy, the city she was named for. While her penchant for statistics emerged at age 9 when she charted and graphed her garden plants, she is widely known today for how she nursed and cared for British and allied soldiers during the Crimean War In the 1850s.
Numerous biographies have noted how hard Nightingale worked at educating herself in nursing at a time when she faced social opposition from her family and others because nursing wasn’t acceptable for affluent young English women.
But she later became so revered in Great Britain that she was the only non-royal woman to appear on a banknote. Still revered today the Brits even named their new 4,000 bed COVID emergency hospital after her in 2020.
Nightingale the Statistician. I have always enjoyed converting data, especially financial data, into visual graphs and charts. So I have been captivated by Tim Harford’s book The Data Detective – Ten Easy Rules to Make Sense of Statistics. As Harford always does so effectively in his articles and books, he uses stories here to explain his ten rules.
Harford’s rule number nine is Remember That Misinformation Can be Beautiful, Too. In this chapter Harford explains how important, powerful, and potentially misleading charts and graphs can be.
But he uses Florence Nightingale’s story as a positive example of how when raw data is effectively presented visually it can make a huge impact.
While Nightingale is popularly known for her nursing, her impact was really made in the way she gathered data and developed medical-recordkeeping during the Crimean War in an Istanbul hospital and later back in Great Britain.
When Nightingale arrived at the Istanbul hospital she found conditions there quite dirty and unpleasant and there were virtually no medical records. She started record-keeping and lobbied her powerful political allies back in London for a “sanitary commission” to come there and clean-up the hospital.
The Commission came and “whitewashed the walls, carted away filth and dead animals, and flushed out the sewers.” While Nightingale’s hope was to make the hospital less unpleasant, what also happened was the death rate for patients dropped from 50% to 20%. This was before most doctors, including Nightingale, understood microscopic germs and the power of using antiseptics. (Because there was no internet or effective communication methods then, most doctors had not even heard about Hungarian doctor Ignaz Semmelweis’s 1850 hand-washing discovery.)
Nightingale had begun to gather medical and hospital data then and would be a pioneer in this field for the rest of her life. Her biggest challenge when she returned to London was how to present data in a visual and meaningful way so as to make hospitals safer and move government to fund improvements.
In 1858 Nightingale created what became known as her Rose Diagram to visually display death rates in Crimea before and after enhanced sanitary conditions. It was likely the first infographic and what is called today a polar area diagram. She used this Rose Diagram and other visual graphics to convince even Queen Victoria of the importance of sanitation.
Author Tim Harford writes about how thorough Nightingale was in both accurately calculating data and displaying it simply enough for decision-makers to be moved into action. While the Rose Diagram is not easy for us in 2021 to grasp quickly on this page, I can see that if it was used in a live setting by Nightingale in person, it could be quickly impactful.
Nightingale’s impact on medical record-keeping, statistics, and thousands, if not millions, of lives is a remarkable story of a real game changer.
