Professor Marion Lynch marks International Nurses' Day and the 200th birthday of Florence Nightingale with a vision of nursing in 2020...

The 12^th May is International Nurses' Day and 2020 is the 200^th anniversary of the birth of Florence Nightingale. While plans to celebrate this event have been curtailed, the work of nurses has not. Student nurses, retired nurses, and current nurses repurposed into new roles have stepped up and stepped in to care for those we love, to ensure that people get the quality of care they need, and no one is left alone.

As we reflect on nurses and the role of nursing, it is interesting to draw attention to what we see and what we hear.

A previous Paintings in Hospitals blog explored the image of nurses and highlighted that nurses in art are portrayed either in a war or on the wards. Images of nurses in 2020 have us in a new armour of Personal Protective Equipment (PPE), wearing weary faces worn down by care. Our masks mask the exhaustion but not the compassion. Our smiles are seen in our eyes - a welcome view of hope and kindness to hold onto in despair. We see nurses now and such images are new - the challenges are not.

Marion in and out of Personal Protective Equipment (PPE)

What do we hear? I heard Florence Nightingale’s voice today. Not in a dream. Not as a metaphor. Not through a painting, a statue, or even a swiftly built COVID-19 hospital. Surfing the web for Florence news, I found the Florence Nightingale Museum online exhibition.

Her words are powerful, as powerful as the realisation that I have never, in 37 years as a nurse, heard her voice.

“When I am no longer even a memory, just a name, I hope my voice may perpetuate the great work of my life.”

She doesn’t say “Hello, my name is Florence,” the way we nurses introduce ourselves today. She says more. She is not just a name, just a memory, or ’just a nurse’. The great work of her life has been harnessed and expanded upon through science, through education and through the arts.

Portrait of Florence Nightingale, c. 1870

Molly Case puts it best in her poem Hold Your Pen Torches High written to commemorate 2020 International Nurses' Day. In a true person-centred way, Molly places the patient at the centre of the scene and care, putting into words the effect a nurse has on the isolated and unwell.

“A voice she had missed, and from her living room she is no longer adrift, no longer alone, moored to the nurse who picked up the phone.”

This image of a new lamp in a new socially distancing world is shining a light on nurses working differently: skills with a lack of resources, low wages and, apart from a weekly clap, little regard for the skills and service nurses provide. It is also shining a light on some old solutions: wash your hands, use the evidence, be kind.

Such 2020 vision reflecting on the current COVID-19 may trigger us to think about why we are a nurse, and whether we still want to be one once this pandemic has passed. Artist Ian McKillop highlights the words of Florence Nightingale and the part art plays in patient care:

We are in a time, once again, when our need for the ‘calming’ effect of the Arts is growing ever more apparent. I think Florence Nightingale put it concisely when she said, -Variety of Form and Brilliancy of colour in the object presented to patients are an actual means of recovery.- For years Man has had an overarching need to “make their mark”, but it is through Art and Music alone that the soul of humanity is truly marked.

The role of the arts in health goes back 2,000 years to the Ancient Greek plays and paintings. This historical link between the aesthetic or beauty, truth and goodness, informs our 21^st century too. Our thinking about health and the arts are now forming part of the picture of health service development but not yet enough. Still, it is appearing in the most unlikely of places, including at a European Union update to unite all working to limit the damage of the COVID-19 pandemic.

Portrait of Emily Dickinson, American poet, circa 1846

Hope is the Thing with Feathers is Emily Dickson’s poem about resilience.

“Hope” is the thing with feathers -
That perches in the soul -
And sings the tune without the words -
And never stops - at all -

And sweetest - in the Gale - is heard -
And sore must be the storm -
That could abash the little Bird
That kept so many warm -

I’ve heard it in the chillest land -
And on the strangest Sea -
Yet - never - in Extremity,
It asked a crumb - of me.

These words resonate across the multitude of care homes, the community nursing teams, and the newly formed Intensive Care Units.

Resilience is another R to address. While one R rate is a number being pushed down to zero, resilience is not a number, it cannot be counted and yet must increase. It may run out. Art sustains the soul and the words of Florence, Emily and Molly sustain us to continue.

I hope that the art of caring, combined with the science, will sustain their souls and persuade us to stay, to speak out, and to sustain what matters most - the art of nursing. This will thrive in the post-COVID-19 world if as a society really see it, hear it and value it. 

Anne Marie Rafferty puts it perfectly. “This virus is teaching us the value of nursing, but we need to see that recognised and built into our health system and policy moving forward.”

Art and poetry make what cannot be seen or said visible and heard. For nurses, our presence is needed both at the bedside and at the board table. Let us not be missing in art, in action, nor in positions of influence again.

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Professor Marion Lynch is a Nurse and Consultant in International Health Systems, Quality Improvement and Innovation. She was formerly Deputy Medical Director at NHS England, South East. From a family of nurses, Marion’s first role was on a Haematology Unit at the John Radcliffe Hospital in Oxford, caring for teenagers with Leukaemia. A portfolio career with academic opportunities, including receiving her Doctorate, has led to roles including Programmes Lead for Patient Leadership at the NHS Leadership Academy in the Thames Valley. Marion is also a Visiting Professor in Dementia Care with the University of West London, where she teaches and supervises students. Last year she set up her own charity, the Fiona Foundation for Kids, in order to provide special care for children living in the Mathare slums in Nairobi, Kenya.