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Although it may be uncomfortable to read about the humiliating behavioral oversight or horrendous working hours that Nightingale's probationary nurses went through, her ultimate vision was their empowerment, nursing scholar Deva-Marie Beck, Ph.D., RN, said.

"It's important when we look at Nightingale and her works that we look at them through that Victorian lens," said Beck, a speaker at U.S. and international ceremonies commemorating Nightingale and co-author of a forthcoming book on the application of Nightingale's legacy to the 21st century.

Victorian women could not vote or own property, Beck said, and first realized the possibilities of working outside the home only when Nightingale formed her nursing school at London's St. Thomas' Hospital in 1860. Scholars say nursing itself at that time was saddled with a reputation as the work for slovenly, drunken housemaids who fell into the field for want of marriage or a higher social standing.

"As a result, her training program caught on just at the perfect time in history," Beck said.

The role of women in Victorian society is an undercurrent of Nightingale's career, many researchers say, because of the professional and cultural barriers she faced despite a wealthy, well-educated background. Overcoming family objections to a nursing career in her mid-20s was only the beginning.

Early years

Florence Nightingale grew up the youngest daughter of a Cambridge-educated father who endowed her with a comfortable childhood and a home-taught education steeped in literature, history, languages and mathematics. In her teens and early 20s, she became enamored with social causes of the day, including the welfare of Britain's easily forgotten poor.

Although her family forbade her to work as a nurse at an infirmary near their Embley home, Nightingale began studying British hospitals and making trips abroad to train and read up on health practices in France, Egypt, Rome and Germany.

Much of what she read, learned and trained for in those formative years was applied in her first job as a nursing superintendent for a women's hospital on Upper Harley Street in London (a job she took without a salary, as "ladies did not accept pay," Monteiro said).

Nightingale immediately made several substantial changes to nursing practice at the hospital. She arranged for the installation of a bell system for patients to call for nurses' help. She had hot water piped to upper floors and established centralized nurses' stations. She also learned to budget and organize her unit, and brought better resources for food and medicine to the hospital. She turned her eye on administrative practices of the hospital, demanding it open to Catholic and Jewish patients.

Nightingale changed the role of nurses by shifting their menial housecleaning chores to other workers, and moved nurse's stations from remote sites to on-floor units. She also visited other London hospitals to research methods for improving working and training conditions for hospital nurses.

"It gave her administrative experience on how to budget and organize and so on," said Lynn McDonald, Ph.D., a Canadian university professor of sociology and a prominent Nightingale researcher. "Of course, what she wanted to do was to nurse the sick poor. And the [Harley Street institution] was not truly where her heart was."

Medical reforms

Best known for Florence Nightingale and "The Charge of the Light Brigade," the 1853-56 Crimean War is most notable in history for its impact on the century to come. A British-French alliance pushed Russia off the imperialist stage and led to the rise of Germany and Italy into nation-states with the end of the old post-Napoleonic coalitions.

What also resonated from the war was a collective cry for medical reforms from a British public repulsed by the conditions their soldiers encountered in Crimea.

The British army carelessly squandered lives by mismanaging its supplies and equipment. At an army barracks hospital hurriedly set up in Turkey across the Black Sea from the Ukraine, thousands of ill and wounded soldiers were packed into overcrowded, unventilated areas without proper food, clothing, bedding and basic medical supplies such as bandages and medicine, according to historians. The conditions at the Scutari army barracks hospital were worsened by the presence of rats, cholera and flowing sewage that ran down the center of large, unventilated hospital corridors.