Chapter VII: LONDON, May 16, 1888

MY DEAR FRIENDS,--Here, one year more, is my very best love and heart-felt “good speed” to the work.

To each and to all I wish the very highest success, in the widest meaning of the word, in the life’s work you have chosen.

And I am more sorry than for anything else that my illness, more than usually serious, has let me know personally so little of you, except through our dear Matron and dear Home Sister.

You are going steadily and devotedly on in preparing yourselves for future work. Accept my heartiest sympathy and thanks.

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We hear much of “Associations” now. It is impossible indeed to live in isolation: we are dependent upon others for the supply of all our wants, and others upon us.

Every Hospital is an “Association” in itself. _We_ of this School are an Association in the deepest sense, regulated--at least we strive towards it--on high and generous principles; through organisation working at once for our own and our fellow Nurses’ success. For, to make progress possible, we must make this interdependence a source of good: not a means of standing still.

There is no magic in the word “Association,” but there is a secret, a mighty call in it, _if_ we will but listen to the “still small voice” in it, calling upon each of us to do our best.

It calls upon our dear heads, and they answer. It calls upon each of us.

We must never forget that the “Individual” makes the Association. What the Association _is_ depends upon each of its members. A Nurses’ Association can never be a substitute for the individual Nurse. It is she who must, each in her measure, give life to the Association, while the Association helps _her_.

We _have_ our dear heads. Thank God for them! Let us each one of us be a living member, according to her several ability. It is the individual that signifies--rather than the law or the rule.

Has not every one who has experience of the world been struck by this: you may have the most admirable circumstances and organisations and examinations and certificates, yet, if the individual allows herself to sink to a lower level, it is all but a “tinkling cymbal” for her. It is how the circumstances are worked that signifies. Circumstances are opportunities.

Rules may become a dead letter. It is the spirit of them that “giveth life.” It is the individual, inside, that counts, the level she is upon which tells. The rest is only the outward shell or envelope. She must become a “rule of thought” to herself through the Ruler.

And on the other hand, it strikes you often, as a great man has said, if the individual finds herself afterwards in less admirable circumstances, but keeps her high level, and rises to a higher and a higher level still--if she makes of her difficulties, her opportunities--steps to ascend--she commands her circumstances; she is capable of the best Nursing work and spirit, capable of the best influence over her Patients.

It is again, what the individual Nurse _is_ and can do during her _living_ training and _living_ work that signifies, not what she is certified for, like a steam-boiler, which is certified to stand so much pressure of work.

She may have gone through a first-rate course, plenty of examinations, and we may find nothing inside. It may be the difference between a Nurse nursing, and a Nurse reading a book on Nursing. Unless it bear fruit, it is all gilding and veneering: the reality is not there, growing, growing every year. Every Nurse must grow. No Nurse can stand still. She must go forward or she will go backward every year.

And how can a Certificate or public Register show this? Rather, she ought to have a moral “Clinical” Thermometer in herself. Our stature does not grow every year after we are “grown up.” Neither does it grow down. It is otherwise with our moral stature and our Nursing stature. We grow down, if we don’t grow up, every year.

At the present time, when there are so many Associations, when periodicals and publicity are so much the fashion, when there is such a dragging of everything before the public, there is some danger of our forgetting that any true Nursing work must be quiet work--an individual work. Anything else is contrary to the whole realness of the work. _Where_ am _I_, the individual, in my inmost soul? _What_ am _I_, the inner woman called “I”? That is the question.

This “I” must be quiet yet quick; quick without hurry; gentle without slowness, discreet without self-importance. “In quietness and in confidence must be her strength.”

I must be trustworthy, to carry out directions intelligently and perfectly, _unseen_ as well as seen; “unto the Lord” _as well as_ unto men; no mere eye service. (How can this be if she is a mere Association Nurse, and not an individual Nurse?)

I must have moral influence over my Patients. And I _can_ only have this by _being_ what I appear, especially now that everybody is educated, so that Patients become my keen critics and judges. My Patients are watching me. They know what my profession, my calling is: to devote myself to the good of the sick. They are asking themselves: does that Nurse act up to her profession? This is no supposition. It is a fact. It is a call to us, to each individual Nurse, to act up to her profession.

We hear a good deal nowadays about Nursing being made a “profession.” Rather, is it not the question for _me_: _am I_ living up to my “profession”?

But I must not crave for the Patient to be always recognising my services. On the contrary: the best service I can give is that the Patient shall scarcely be aware of any--shall recognise my presence most by recognising that he has _no_ wants.

(Shakespeare tells me that to be “nurse like” is to be to the Patient--

So kind, so duteous, diligent,
So tender over his occasions, true,
So feat.)

I must be thorough--a work, not a word--a Nurse, not a book, not an answer, not a certificate, not a mechanism, a mere piece of a mechanism or Association.

At the same time, in as far as Associations really give help and pledges for progress, are not mere crutches, stereotypes for standing still, let us bid them “God speed” with our whole hearts.

We all know what “parasites” are, plants or animals which live upon others and don’t work for their own food, and so degenerate. For the work to get food is quite as necessary as the food itself for healthy active life and development.

Now, there is a danger in the air of becoming Parasites in Nursing (and also Midwifery)--of our becoming Nurses (and Midwives) by deputy, a danger now when there is so great an inclination to make school and college education, all sorts of Sciences and Arts, even Nursing and Midwifery, a book and examination business, a profession in the low, not in the high sense of the word. And the danger is that we shall be content to let the book and the theory and the words do for us. One of the most religious of men says that we let the going to Church and the clergyman do for us _instead of_ the learning and the practice, if we have the Parasite tendency, and that even the better the service and the better the sermon and the theory and the teaching, the more danger there is that we may let it do. He says that we may become satisfied to be prayed for instead of praying--to have our work for Christ done by a paid deputy--to be fed by a deputy who gives us our supply for a week--to substitute for thought what is meant as a stimulus to thought and practice. This is the parasite of the pew he says (as the literary parasite thinks he knows everything because he has a “good library”). He enjoys his weekly, perhaps his daily worship, while character and life, will and practice are not only not making progress, but are actually deteriorating.

Do you remember Tennyson’s farmer, who says of the clergyman:

I ’eärd ’um a bummin’ awaäy ... ower my ’eäd, ...
An’ I thowt a said whot a owt to ’a said an’ I coom’d awaäy.

We laugh at that. But is the Parasite much better than that?

Now the Ambulance Classes, the Registration, the Certificates of Nursing and of Nurses (and of midwifery), especially any which may demand the minimum of _practice_, which may _substitute_ for _personal_ progress in active proficiency, mere literary or word progress, instead of making it the material for growth in correct knowledge and practice, all such like things may tend this way.

It is not the certificate which makes the Nurse or the Midwife. It may _un-make_ her. The danger is lest she let the certificate be _instead of_ herself, _instead of_ her own never ceasing going up higher as a woman and a Nurse.

This is the “day” of Examinations in the turn that Education--Elementary, the Higher Education, Professional Education--seems taking. And it is a great step which has substituted this for what used to be called “interest.” Only let us never allow it to encroach upon what cannot be tested by examinations. Only let the “day” of _Practice_, the development of each individual’s thought and practice, character and dutifulness, keep up, through the materials given us for growth and for correct knowledge, with the “day of examinations” in the Nurse’s life, which is above all a moral and practical life, a life not of show, but of faithful action.

But above all, dear comrades, let each one of us, each individual of us, not only bid “God speed” in her heart to this, our own School (or Association--call it so if you will), but _strive_ to _speed_ it with all the best that is in her, even as your “Association” and its dear heads strive to speed each one of you.

Let each one of us take the abundant and excellent food for the mind which is offered us, in our training, our classes, our lectures, our examinations and reading--not as “Parasites,” no, none of you will ever do that--but as bright and vigorous fellow-workers, working out the better way every day to the end of life.

Once more, my heartiest sympathy, my dearest love to each and to all of you,

from your ever faithful old comrade,

FLORENCE NIGHTINGALE.

_Printed by_ R. & R. CLARK, LIMITED, _Edinburgh_.

FOOTNOTES:

[1] The beginning of the first address will suggest a reason for this turn of phrase. A nurse who had been through training might not always be “worthy of the name of ‘Trained Nurse’” (Address of 1876).

[2] There is a well-known Society abroad (for charitable works) of which the Members go through a two years’ probation on their first entering, but after ten years they return and go through a second probation of one year. This is one of the most striking recognitions I know of the fact that progress is always to be made: that grown-up people, even of middle-age, ought always to have their education going on. But only those _can_ learn _after_ middle age who have gone on learning up to middle age.

[3] The Madre Santa Colomba, of the Convent of the Trinità dei Monti in Rome.--EDITOR’S NOTE.

[4] There is a most suggestive story told of one, some 300 years ago, an able and learned man, who presented himself for admission into a Society for Preaching and Charitable Works. He was kept for many months on this query: _Are you a Christian?_ by his “Master of Probationers.” He took kindly and heartily to it; went with his whole soul and mind into this little momentous question, and solved it victoriously in his own course, and in his after course of usefulness for others. Am I a Christian? is most certainly the first and most important question for each one of us Nurses. Let us ask it, each of herself, every day.

[5] Nightingale Nurse and Lady Superintendent of Liverpool Workhouse Infirmary. Pioneer of Workhouse Nursing. After her early death in 1868 Miss Nightingale wrote in _Good Words_ an article, “Una and the Lion,” on her life and work.--EDITOR’S NOTE.

[6] Madame Caroline Werckner, an Englishwoman.--EDITOR’S NOTE.

[7] Do you remember the word of one of the greatest poets of the Middle Ages?

The soul Which o’er the body keeps a holy ward, Placed there by God, yielding alone to Him _The trust He gave_.

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Typographical errors corrected by the etext transcriber:

to set it face heavenward=> to set its face heavenward {pg 84}

And lo I am with you alway, even unto the end of the world=> And lo I am with you always, even unto the end of the world {pg 98}