The Lamp Still Burns: Nurses on the Forefront of COVID-19, Health Disparities, and Gender Inequities

Stephanie L. Ferguson, PhD, RN, FAAN; Michelle A. Williams, ScD


Nurs Econ. 2020;38(5):252-253. 

In This Article

Abstract and Introduction


Much has changed since the days of Florence Nightingale, but many struggles and obstacles to health remain. Strategies to support nursing are critical to keep the lamp burning.


Florence Nightingale and her team of nurses were instrumental in creating strategic nursing interventions at a British military hospital when caring for soldiers in the Crimean War (National Army Museum, n.d.). These interventions included an unprecedented level of comprehensive care – from implementing rigorous practices for handwashing and clean linens, to writing letters to families on behalf of soldiers, to treating and comforting patients overnight – even as the male doctors slept (Haynes, 2020). She earned the nickname "The Lady With the Lamp," and set the standard for modern nursing (The National Archives, n.d.).

Alarmed at the rates of cholera and typhoid killing the young men in her care, Nightingale pioneered the use of statistics and data graphics to illustrate that it was germs, not guns, causing the vast majority of soldiers' deaths (Science Museum, n.d.). She professed that effective sanitary and hygienic practices could, in fact, save lives. By the time the war was over, she was well on her way to making medical history.

In honor of the 200th anniversary of Nightingale's birth, the World Health Organization (WHO, 2020a) has declared 2020 the International Year of the Nurse and the Midwife. Her contributions to professionalizing nursing, developing data science, and creating public health protocols should provide the foundation of our response to the coronavirus pandemic. But 160 years after Nightingale set up the first training school for nurses, we face a global nursing shortage that not only puts millions of lives at immediate risk, but pushes her goal of a healthier, more just world she imagined further out of reach.

According to a new report by the WHO (2020b), the International Council of Nurses, and Nursing Now, almost 6 million more nurses are needed to meet global demand; almost 90% of that shortage affects low and middle-income countries. Many nurses are recruited away from their countries of birth or training to higher-income countries, which worsens the inequitable distribution of skilled nursing. And, as the report explains, some regions – particularly in the west – having an aging nursing workforce; globally, one of every six nurses will retire in the next 10 years.