In the 1850’s Florence Nightingale said “It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm. It is quite necessary, nevertheless, to lay down such a principle.”
by JONATHAN M. METSCH, DR.P.H., LLC
Jul 02, 2014 | 195 views | 0 0 comments | 0 0 recommendations | email to a friend | print
Recently a New York Times http://www.nytimes.com article * stated: “What would she have thought of the Affordable Care Act? She would have liked its emphasis on public health, on data and on adequate care for everyone. There’s just one thing she would have missed — her belief that caring for the sick is not a business but a calling.

She didn’t mean “calling” in a religious sense. She meant having a kind of feeling for one’s work — an inner sense of what is right, which she termed “enthusiasm,” from the Greek entheos, having a god within. The opposite of a “calling” was “telling” — that is, rewards, punishments and threats — and she observed that without a calling, no amount of telling would satisfy. Which is what would have worried her about the Affordable Care Act. It relies on telling, on thousands of new regulations, rules and laws. There’s no calling in it.

Now, Nightingale understood the different goals of doctor, nurse, lawyer and economist. From her study of hospitals she’d concluded that patients get the best care when no single power is ascendant, rather when there is the “perpetual rub” between doctor, nurse and administrator.

What would have worried her about the health care act is that its balance is off: It gives too much power to the telling of economists and lawyers and too little to the calling of doctors and nurses.

Nightingale, however, was an optimist. God wants us to make mistakes, she believed; mistakes are the basis of evolution. She was also a fighter, so I imagine she would have seen the health care law as a work in progress, and what we have still to learn from her, even so long after her death, is her willingness to fight and her determination to get it right. She didn’t accept being told in her own life, and she wouldn’t have wanted us to accept it in ours.”

* to read the full NYTs article “Far More Than a Lady With a Lamp”, by Victoria Sweet, highlight and click on open hyperlink http://www.nytimes.com/2014/03/04/health/florence-nightingales-wisdom.html?_r=0

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