UAB dean’s paper highlights Nightingale’s leadership for global health and nursing

Recurring themes emerge throughout Florence Nightingale letters, including health and sanitation reform, collaborative partnerships, advocacy for public health.

The University of Alabama at Birmingham School of Nursing is home to a one-of-its-kind, interactive exhibit of 50 famous Florence Nightingale letters. School of Nursing Dean Doreen C. Harper, Ph.D., analyzed the components of these letters, which highlight Nightingale’s visionary leadership for global health and nursing within the historical context of Great Britain’s colonization of India.

The result of this analysis was the paper “Leadership Lessons in Global Nursing and Health from the Nightingale Letter Collection at the University of Alabama at Birmingham,” recently published in the Journal of Holistic Medicine. The descriptive study used a narrative analysis to examine selected letters that Nightingale wrote to or about Dr. Thomas Gillham Hewlett, a physician and health officer in Bombay, India.

“Florence Nightingale is indisputably the founder of modern nursing,” Harper said. “Nightingale also was a prominent force in the creation of global health care and global nursing. To this day, these letters offer countless leadership lessons relevant to the future of nursing and health care. It was a joy to study these letters and try to increase understanding of her visionary leadership for global nursing and health.”

Harper, along with co-authors Kimberly Davey and Pamela Fordham, analyzed the letters as temporally contextualized data and focused on how the narratives are composed and what is conveyed.

Several recurring themes central to Nightingale’s leadership on global nursing and health emerge throughout the letters, including health and sanitation reform, collaborative partnerships, data-driven policy development, and advocacy for public health. These themes are illustrated through her letters to and testimony about Hewlett in her vivid descriptions of health education and promotion, data-driven policy documents, public health and sanitation advice, and collaboration with citizens, medicine, policymakers and governments to improve the health and welfare of the people of India.

“The focus on leadership in nursing as a global construct highlights the lessons learned from our Nightingale Letter Collection that have relevance for the future of nursing and health care,” Harper said. “This is particularly true in Nightingale’s collaboration with policy leaders, her analysis of data to set policy agendas, and public health reform centered on improving the health and well-being of underserved populations.”

UAB’s Nightingale letters were handwritten during the period of 1853-93, when she was between the ages of 33 and 73, and cover topics such as hospitals, health care, nursing matters, sanitary conditions and charitable contributions. They include correspondence with Hewlett and Madame Julie Salis-Schwabe, with whom she discusses war-relief efforts and charitable contributions for the Franco-Prussian and Austro-Hungarian wars.

UAB’s Nightingale letters, permanently housed in UAB’s Reynolds Historical Library, were purchased in 1951 from a New York bookstore by noted Alabama-born radiologist Lawrence Reynolds, M.D. Reynolds donated most of the Nightingale letters to UAB in 1958; additional Nightingale letters were donated by the Reynolds family following his death in 1961. The exhibit features reproductions and digital images of the letters housed on iPads for ease of reading. The Delia and John Robert Charitable Trust provided the funding for digitizing the letters, and several letters that are included in the exhibit have been sponsored by donors.

The exhibit, housed on the first floor of the UAB School of Nursing, was made possible by a generous gift from Barrett and Rick MacKay and the Harry B. and Jane H. Brock Foundation. The space is named the Barrett Brock MacKay Florence Nightingale Exhibit to honor MacKay for her exceptional commitment to the growth and development of the school and to the advancement of nursing education and practice.

The Florence Nightingale Collection letters also may be accessed via a simple catalog search on the UAB Lister Hill Library website at