Florence Nightingale: Visionary for the Role of Clinical Nurse Specialist

Jennifer H. Matthews, PhD, RN, A-CNS, FAAN; Phyllis B. Whitehead, PhD, APRN/CNS, ACHPN, RN-BC, FNAP; Cindy Ward, DNP, RN-BC, CMSRN, ACNS-BC; Marion Kyner, MSN, RN, CNS; Terri Crowder, DNP, RN, CNS, ACNS-BC, CCRN


Online J Issues Nurs. 2020;25(2) 

In This Article

Abstract and Introduction


Florence Nightingale is well known as the mother of nursing, aptly recognized as "Lady in Chief", immortalized as "the Lady with the Lamp", and revered as a visionary and a catalyst for healthcare reform. Nightingale's life and impact on patient care, nursing and nursing practice, and healthcare systems and organizations parallel the clinical nurse specialist (CNS) roles and three spheres of impact. In this article we highlight key events of Nightingale's work that illustrate her calling and devotion as a nurse and review her observations of organizations and nursing practice and her famous twenty-month experience (1854–1856) in the Crimean War at the British Army Hospitals at Scutari. Nightingale's critical thinking and problem analyses; implementation of interventions and positive outcomes; advancement of nursing practice based on evidence; detailed documentation and statistical analysis; and tenacious political advocacy to reform healthcare systems resembles the role of the CNS as an expert clinician, nurse educator, researcher, consultant, and leader in healthcare systems and policy creation. This article explores Nightingale's contribution to nursing practice and education as a visionary for the role of the clinical nurse specialist.


Well-known as a visionary and a catalyst for change, Florence Nightingale broke barriers underpinned by her determination, her sense of moral duty and responsibility, and her political influence during a tumultuous era of war, diseases, and suffrage. This tenacity has resulted in outcomes that have transformed medicine to a higher level of diligence; advanced a framework for nursing practice and education; and influenced healthcare around the world in the fundamental areas of public health sanitation, infection control, nutrition, and health promotion. Additionally, Nightingale is celebrated as an administrator, patient advocate, hospital reformer, and pioneer in the use of statistics which she used to support her political activism. Her observations and passion for improving nursing practice and healthcare systems did not end until near her death in 1910.

In this article, through a review of the history of Florence Nightingale's seminal years in Turkey at Scutari during the Crimean War and her notes on nursing, the authors utilize her vision, ideology, and outcomes in nursing as a framework to characterize the clinical nurse specialist (CNS) role, a role that she exemplified during her career. The following section is an abbreviated review of Nightingale's work at Scutari includes topics noted that reflect today's CNS spheres of impact.