At our meeting on Wednesday Dr. Sylvia Fields, a Landings resident, told us of her lifelong association with the medical profession and the highlights of her many contributions to its philosophies and practice. Sylvia is a former member of the Rotary Club of Skidaway Island and a Paul Harris fellow. A native of New York, Sylvia told us briefly of a tough childhood in Brooklyn and of her subsequent training as a nurse at Adelphi College and Columbia University in New York; she received an Ed.D from Columbia.
During her long career Sylvia was a faculty member at SUNY Stony Brook, Emory University, Atlanta, and Jefferson Medical College in Philadelphia, and her interests became increasingly focused on Inter-professional attitudes and Empathy in health care providers. Sylvia was the Executive Director of the Savannah Health Mission at Memorial's Georgia Ear in Savannah, serving those who lacked medical insurance and access to medical care, and she taught for some years at Armstrong State University. Currently Sylvia is a member of the Memorial Hospital, Mercer University Institutional Review Board (IRB), and is leading the development of a new scholarship program to mentor nurses and resident physicians in research related to “Patient Outcomes Studies.” This involves federally mandated HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems). This is a new requirement to find consumer reactions to the care received in a hospital; the data determines, in part, the amount of reimbursement hospitals receive from the government for the care rendered.

“Nightingale Scholars” is the name to be given to medical personnel for funded "overtime internships" in order to create and participate in teaching and research activities aimed at improving patient satisfaction and wellness and therefore leading to higher HCAHPS Scores. The impetus and the name comes from the career of Florence Nightingale, whom, Sylvia said, everyone knows, even if they do not know much about her life.

Florence Nightingale (1820-1910) was born to an upper class British family while they were in Florence, Italy, hence her name. She was tutored by her father and governesses until young adulthood, when she began her rebellion against the life expected of young women of the time, namely, wifehood and motherhood. She began a life of nursing, training in Germany, France, and England before heading, at the request of the British Government (her family knew influential statesmen) to a hospital serving those who fought in the war between Turkey and Russia, also involving France and Britain. Britain’s involvement concerned its interest in preserving its key maritime routes to its empire, particularly to India via the Mediterranean Sea. British casualties were horrendous (as were all the others), and the situation was made worst by the necessity of transporting injured British soldiers to the Turkish port of Scutari, a city >150 miles away across the Black Sea at the entrance to the Strait of the Dardanelles. The conditions at the hospital in Scutari were terrible; built as a barracks, it was rat infested and filthy, with scurvy, dysentery, infection, and gangrene rife with no meds, no bandages, nothing to alleviate the pain and suffering of those who actually reached it alive. As a result of Florence Nightingale's work, the mortality rate of the injured soldiers dropped from 40% to 2%. She was honored by Queen Victoria when she returned to England.

The changes made by Florence Nightingale in this hospital, together with her writings and work for years following the time spent in the Scutari hospital, are still to be seen today. In the face of opposition and resentment by the medical profession in the Crimea (and elsewhere,) Florence began to influence medical practice towards many of the key elements of care seen today. The changes seen today stemming from her early beliefs, writings, and actions include, Public Health and Community Health policies, Visiting Nurse Services, midwife training, anesthesia, and nurse accreditation. They led to the development of healthcare facilities, education for nurses leading to diplomas, BSN and MSN degrees, and participation by the nursing profession in research into drug efficacy and health procedures in, and out of, the hospital setting. Among other “firsts”, Florence is the first person to have instituted the process of record keeping and statistical analysis in the practice of medicine.