Nursing historiography is centered on whiteness. Even worse, nursing history revolves largely around a single white nurse: Florence Nightingale. This, unfortunately, doesn’t mean nurses understand who Nightingale was. There are nurse historians doing incredible and diverse work, but in general, nursing, both as a profession and as an academic discipline, promotes a view of Nightingale based in a culture of white supremacy rather than historical facts. Here, I make explicit Nightingale’s role in British colonial violence by analyzing some of her writings on the British colonies. This history allows us to better discuss the consequences of her legacy in nursing.

Nightingale and colonialism

What is rarely discussed in nursing history is Nightingale’s racism and her political role in the genocide of Indigenous people under British rule. She counseled many key political figures and her writings on the subject show that she was a staunch supporter of British colonialism, even with the knowledge of the death and destruction left in its wake. She believed Indigenous lives were a small price to pay for the expansion of the British Empire. Although some of her contemporaries recognized the brutality of the colonial system, Nightingale believed imposing British culture to be necessary. Anything else, she believed, “would be simply preserving their barbarism for the sake of preserving their lives.”¹

This racist statement by Florence Nightingale is one of many. Thanks to digitization efforts, her writings are now accessible, and it’s easy to find sources that reveal Nightingale’s racism. She was steadfast in her belief of the supremacy of white Christian culture. By her own accounts, Nightingale considered Indigenous peoples to be inferior, and the British state to be a “civilizing” force. The quote above is from Nightingale’s Sanitary Statistics of Native Colonial Schools and Hospitals, published in 1863, a report commissioned by the Colonial Office of the British government. In it, she concluded that the high death rates of Indigenous people in colonial schools and hospitals reflected the haste of British authorities to assimilate them. She felt assimilation should be more gradual in order to minimize the death toll, but she had no issue with the death toll itself: “Every society which has been formed has had to sacrifice large proportions of its earlier generation to the new conditions of life arising out of the mere fact of change.”²

In the report, Nightingale defended the deaths of Indigenous children in the Canadian precursors to residential schools: “There is nothing in the school education as described in the returns, sufficient to account for the special prevalence of tubercular diseases in these schools. The causes must probably be looked for in the close foul atmosphere of the native dwelling.”³ Her comments on the Canadian situation were indicative of her larger position: that the deaths of Indigenous people was due to habits of Indigenous people themselves, and that British rule catalyzed a process of “decay” already in motion.

Victorian “Cleanliness” and Miasma Theory as Ideological Weapons

It is important to understand the meaning of cleanliness within the Victorian era and for Nightingale. Cleanliness was a synonym for purity, and the Victorian rituals attached to it came with a sense of godly supremacy.⁴ It is beyond the scope of this article to discuss the ideological roots of the term, but it went hand in hand with the miasma theory of disease, which Nightingale believed until the end of her life. Miasma theory held that bad smells and filth generated disease. Filth was not just physical, it was also moral. For example, under miasma theory, Nightingale believed sex workers embodied evil that spontaneously generated disease. As Nightingale explained: “When we obey all God’s laws as to cleanliness,…, health is the result. When we disobey, sickness.”⁵

Indigenous traditions offended the “cleanliness” ideal of Victorian Britain. Miasma theory conveniently supported British supremacy and was a pillar of public health until the end of the 19th century. More importantly, it was a political weapon to destroy Indigenous health and wellness traditions, as it labelled anything non-British or non-Christian as “filthy.” It is inaccurate to assume that when Nightingale speaks of “cleanliness” it is somehow detached from its ideological roots. When she speaks of cleanliness, filth, or foulness, there is always an implicit Christian bias. She could never have supported any form Indigenous health practices because they were not based in Christian values.