Yavtushenko Anastasia

Florence Nightingale was born in 1820 to wealthy English parents traveling in Florence, Italy. Both Florence and her sister were named after the Italian cities in which they were born – her sister Parthenope was born in Naples and given the Greek name for its ancient city. At home in England, the Nightingales divided their time between two houses, Lea Hurst in Derbyshire for the summer and Embley in Hampshire for the winter. The two girls were educated by their father, and Florence, in particular, excelled academically. With regard to the marriage and social life of their daughters, the Nightingales held high expectations. However, Florence had other ideas, because as a teenager in 1837 she received a "divine calling” to do God’s work, which sparked her advocacy of social and health care causes and eventually led her to establish nursing as a distinct profession.

The period between the later half of the 17th century and the middle of the 19th has been described by medical historian Fielding Garrison as the “dark age” of nursing. Nurses in those days were typically poor, unskilled and often associated with immoral behavior (1). The hospitals they served held equally low reputations as unclean, disorderly, and infection breeding. They were often regarded merely as places to die. So it is not difficult to see why Florence Nightingale’s family, wealthy and respectable as they were, discouraged her from selecting this “unsuitable” profession. But Florence went against her parent’s wishes, refused a prospective marriage and in 1851 trained as a nurse in Kaiserswerth, Germany at Pastor Theodore Fliedner’s hospital and school for Lutheran deaconesses. Fliedner’s school was one of the earliest institutions for the proper training of nurses outside of the Catholic religious orders (2). In 1853 Nightingale went for additional training in Paris with the Sisters of Mercy (3). After her return to England, Florence took a position as superintendent for London’s Establishment of Gentlewomen during Illness in 1853.

(Click here to view a letter written by Florence Nightingale to a Mrs. James on September 20, 1853, about patient admittance, payment, demographics and lengths of stay at London’s Establishment of Gentlewomen during Illness).

Florence Nightingale is probably most famous for her work during the Crimean War (1854-1856). Responding to unpopular newspaper reports of the horrendous situation in the English war camp hospitals, Secretary of War Sidney Herbert, a personal friend of Nightingale, consented to let her organize and manage a group of female nurses to go to Turkey. On November 4, 1854, Nightingale and 38 nurses arrived in Scutari, the location of the British camp outside Constantinople. The doctors originally did not welcome the incoming female nurses, but as the number of patients escalated, their help was needed in the overcrowded, undersupplied, and unsanitary hospital (4). Under Florence’s leadership, the nurses brought cleanliness, sanitation, nutritious food and comfort to the patients. Nightingale was known for providing the kind of personal care, like writing letters home for soldiers, that comforted them and improved their psychological health. Her group of nurses transformed the hospital into a healthy environment within six months, and as a result, the death rate of patients fell from 40 to 2 percent (5). In 1857, Florence returned home a heroine. It was the soldiers in Crimea that initially named her the "Lady with the Lamp" because of the reassuring sight of her carrying around a lamp to check on the sick and wounded during the night, and the title remained with her.

(Thirty-four years to the date (November 4, 1888) after she landed in Scutari for the Battle of Inkermann of the Crimean War, Florence Nightingale wrote a letter to her friend Thomas Gillham Hewlett remembering the heroic nature of soldiers. Click here to view this letter.)

Upon her return from the Crimean War, she devoted the next few years to the Royal Commission investigating health in the British Army. It was her discussions with Queen Victoria on the conditions of the camp hospitals that sparked the commission’s formation. Also, Nightingale's statistical data and analysis strongly influenced the commission's findings, which resulted in great public health advances in the British army.

In 1859, Florence Nightingale’s book Notes on Nursing: What it is, and What it is Not was published. Based on knowledge acquired at school in Kaiserswerth and while nursing the sick during the Crimean War, Notes on Nursing provides a simple but practical discussion of good patient care, along with helpful hints. According to Florence Nightingale, hygiene, sanitation, fresh air, proper lighting, a good diet, warmth, quietness and attentiveness were necessary conditions for hospitals and were to be ensured by trained nurses. Taken for granted today, her commonsense advice helped transform hospitals from death houses to sanctuaries of care. This work quickly became a classic introduction to nursing, and has remained in publication to the present day.

During the war a public subscription fund was set up for Florence Nightingale to continue her education of nurses in England, and the Nightingale Training School at St. Thomas’ Hospital opened in 1860. The education of recruits involved a year of practical instruction in the wards, supplemented with courses of lecturing, and followed by two years of work experience in the hospital (9). After graduation, many of the students staffed British hospitals, and others spread the Nightingale education system to other countries.

Through her work and her school, Florence Nightingale is responsible for elevating the profession of nursing to an honorable status. She also wrote about 200 books, pamphlets and reports on hospital, sanitation, and other health-related issues, as well as contributing to the field of statistics (10). Throughout her life she provided advice on a variety of health care issues to associates all over the globe. Though ill and bedridden for much of her later life, Nightingale managed to continue her great work through correspondence.

• is the basis for rational and effective treatment of the patient;
• allows in most cases to anticipate possible options for the further course of the disease and its consequences;
• allows for timely and adequate anti-epidemic and preventive measures.

1. Should be carried out taking into account the clinic and epidemiology.

2. Must be anti-epidemic and preventive - early diagnosis is needed not only for timely treatment, but also for timely anti-epidemic and preventive measures aimed at preventing the spread of the disease, prevention of nosocomial infections.

Clinical:

• amnestic method (patient complaints, medical history, life history and epidemiological history);
• objective examination of organs and systems of the patient.

Paraclinical:

• specific methods (laboratory) and structural and functional (instrumental) diagnostics.

Complaints of the patient should be collected carefully, because in many cases it makes it possible to suspect a particular infectious disease. In the presence of dyspeptic manifestations (nausea, vomiting, diarrhea) it is necessary to find out what is related to their occurrence, the frequency of vomiting or defecation, their nature, volume, the presence of pathological impurities. They ask about the place and intensity of pain (head, abdomen, muscles, joints), sleep disorders, etc.

The anamnesis is an elucidation of features of development of a disease, definition of the leading symptom, definition of complications. Sometimes a well-collected history allows for diagnosis. The anamnesis of the disease should be collected in detail and actively. It is impossible to limit oneself only to the patient's story, it is necessary to ask him in addition: about the peculiarities of the beginning of the disease, how the disease developed in the future, in what sequence and when the main signs of the disease appeared; what treatment the patient received at home, because it could significantly change the clinical picture.

• Provides clarification on the transferred diseases
• The presence of chronic diseases
• Tuberculosis
• Diabetes
• Allergy history is important
• The presence of bad habits

• possible source of the pathogen;
• the route of infection and the likely susceptibility of the person who became ill;
• possible contacts with patients with similar clinical signs;
• communication with persons who came from an epidemically unfavorable area;
• possible contact with animals;
• information on food consumption (when and where they were purchased, how long and in what conditions they were stored, what dishes were prepared from them, time and place of consumption, who still used questionable foods and how they feel);
• water supply conditions, drinking water quality and sanitary condition of the area where the patient lives;
• whether the patient follows the rules of personal hygiene;
• profession of the patient, his age, state of health before the disease;
• season, geographical and climatic conditions;
• what infectious diseases have you had in the past;
• information on preventive vaccinations.

• general condition of the patient;
• skin color and elasticity;
• soft tissue turgor;
• body temperature

• consciousness (impaired in patients with meningitis, encephalitis, hepatic encephalopathy);
• behavior (agitation in typhus, aggression in rabies);
• Assessment of the patient's speech and voice.

• appearance and facial expression (can be very characteristic of tetanus - sardonic smile);

• body position (opisthotonus when editing, meningeal posture - head tilted back);

• Paleness - with vasospasm, bleeding, blood deposits in the vessels of the abdominal cavity (shock).
• Hyperemia, mainly of the face - with hemorrhagic fevers pseudotuberculosis, typhus.
• Jaundice - deposition of bilirubin pigment in the skin - with viral hepatitis, hemolytic anemia.
• Moisture of the skin - excessive sweating, occurs during a critical decrease in body temperature in brucellosis, malaria, sepsis.
• Dry skin is caused by large fluid losses in cholera.
• Elasticity (turgor of the skin) is determined by taking the skin in the fold of the abdominal wall and the extensor surface of the arm. Normally, the fold disappears quickly, in the case of reduced turgor (dehydration) does not straighten for a long time.

Laboratory methods of examination include general clinical tests, which include general blood tests, general urine tests and fecal tests. Laboratory methods of examination also include biochemical methods of examination, which determine the level of glucose, creatinine, urea, bilirubin, liver enzymes, blood lipids; coagulogram, which analyzes the indicators of blood clotting; blood hormone tests; determination of tumor markers; tests of blood and other biological materials for infectious diseases; allergological, toxicological, cytological and parasitological examinations.

Instrumental methods of examination include X-ray, endoscopic, ultrasound, methods of recording the electrical activity of organs and a number of other methods of examination.

I was offended to see how indifferently the sad news was received even by those whom it most of all should have touched. How selfish we are! <...> He was a strong man, fought all his life and achieved everything he wanted: he won a name, wealth, literary celebrity and a place in high society, even at court. He appreciated all this and enjoyed everything, but I am sure that his poems were dearest to him in the world and that he knew that their charm is incomparable, the very heights of poetry. The further, the more others will understand it. From a letter from Nikolai Strakhov to Sofya Tolstoy, 1892

Already after the death of the writer, in 1893, the last volume of memoirs "The Early Years of My Life" was published. Fet also did not have time to release the volume that completes the cycle of poems “Evening Lights”. The works for this poetic book were included in the two-volume "Lyric Poems", which was published in 1894 by Nikolai Strakhov and Grand Duke Konstantin Romanov.

In 1877, Fet sold Stepanovka in order to buy a house in Moscow, and in the Kursk province the old estate Vorobyovka. Despite the fact that many new concerns fell on the landowner Shenshin, he did not abandon literature. After a 20-year break, in 1883 a new book of poetry, Evening Lights, was published. By this time, Fet had come to terms with the fact that his works were "for the few". “People don’t need my literature, and I don’t need fools ,” he said. In turn, the readers responded to the poet in the same way.

“When I began to re-read these three little pieces [“ Departed ”,“ Death ”,“ Alter ego ”] - I was terribly struck by their connection, and that terrible despondency that is hidden under this energetic, bright speech. Poor Fet! .. Alone everywhere, and in his magnificent Vorobyovka! From a letter from Nikolai Strakhov to Leo Tolstoy , 1879

In the last years of his life, Fet received public recognition. In 1884, for the translation of Horace's works, he became the first recipient of the full Pushkin Prize of the Imperial Academy of Sciences. Two years later, the poet was elected its corresponding member. In 1888, Athanasius Fet was personally introduced to Emperor Alexander III and awarded the court title of chamberlain.

While still in Stepanovka, Fet began to write the book “My Memoirs”, where he talked about his life as a landowner. The memoirs cover the period from 1848 to 1889. The book was published in two volumes in 1890.

On December 3, 1892, Fet asked his wife to call a doctor, and in the meantime he dictated to his secretary: “I don’t understand the conscious increase in inevitable suffering. I voluntarily go to the inevitable" and signed "Fet (Shenshin)". The writer died of a heart attack, but it is known that at first he tried to commit suicide by rushing after a steel stiletto. Afanasy Fet was buried in the village of Kleymenovo, the Shenshin family estate.

In 1857, Afanasy Fet married the younger sister of Vasily Botkin, Maria, the heiress of a wealthy merchant family. The following year, with the rank of guards staff captain, he retired, without having achieved the nobility. The couple settled first in Moscow , and in 1860 in the Stepanovka estate, which they bought in the Mtsensk district of the Oryol province - in the writer's homeland.

As Ivan Turgenev said, “he [Fet] has now become an agronomist-owner to the point of desperation, let his beard down to his loins, doesn’t want to hear about literature, and drove the Muse away from behind ...”. Fet devoted himself to rural care and household chores: he grew crops, designed a stud farm, kept cows, sheep, poultry, bred bees, and fish. From Stepanovka, Fet made an exemplary estate: the yields from his fields raised the statistics of the province, and Fet's apple marshmallow was delivered directly to the imperial court.

However, in 1863 the poet published another book - a two-volume set of his poems. Some critics greeted the book with joy, noting the "wonderful lyrical talent" of the writer, while others attacked him with harsh articles and parodies. Fet was accused of being a "serf landowner" and hiding under the guise of a lyric poet.

Afanasy Fet regularly published in the journals Russky Vestnik, Literary Library and Zarya. His essays on the post-reform state of agriculture were published there. They were published under the editorial titles Notes on Freelance Labor, From the Village, and On the Question of Hiring Workers. In 1867, Afanasy Fet was elected a justice of the peace. This largely influenced the fact that 10 years later, by imperial decree, the surname Shenshin was finally approved for him and the title of nobility was returned. But the writer continued to sign his works with the surname Fet.

In 1838, Fet entered the law faculty of Moscow University , but soon switched to the historical and philological department. From the first year he wrote poems that interested classmates. The young man decided to show them to Professor Pogodin, and he to the writer Nikolai Gogol . Soon Pogodin conveyed a review of the famous classic: "Gogol said that this is an undoubted talent . " The works of Fet and his friends were approved - the translator Irinarkh Vvedensky and the poet Apollon Grigoriev, to whom Fet moved from Pogodin's house. He recalled that "the house of the Grigorievs was the true cradle of my mental self." The two poets supported each other in their work and life.

In 1840, Fet's first collection of poems, Lyrical Pantheon, was published. It was published under the initials "A. F." It included ballads and elegies, idylls and epitaphs. The collection was liked by critics: Vissarion Belinsky , Pyotr Kudryavtsev and the poet Yevgeny Baratynsky . A year later, Fet's poems were regularly published by Pogodin's magazine Moskvityanin, and later by the magazine Domestic Notes. In the last year, 85 Fetov's poems were published.

The idea to return the title of nobility did not leave Afanasy Fet, and he decided to enter the military service: the officer rank gave the right to hereditary nobility. In 1845, he was accepted as a non-commissioned officer in the Order's cuirassier regiment in the Chersonese province. A year later, Fet was promoted to cornet.

In 1850, bypassing all the censorship committees, Fet released a second collection of poems, which was praised on the pages of major Russian magazines. By this time, he was transferred to the rank of lieutenant and quartered closer to the capital. In the Baltic port, Afanasy Fet participated in the Crimean campaign, whose troops guarded the Estonian coast.

In 1854, in St. Petersburg, the poet entered the literary circle of Sovremennik , where he met writers Nikolai Nekrasov , Ivan Goncharov and Ivan Turgenev , critics Alexander Druzhinin and Vasily Botkin. Soon Fet's poems began to be printed by Sovremennik.

... We consider Mr. Fet not only a true poetic talent, but a rare phenomenon in our time, because true poetic talent, to whatever extent it manifests itself, is always a rare phenomenon: for this you need many special, happy, natural conditions. Vasily Botkin

Under the supervision of Turgenev, the second collection of Fetov's poems was carefully revised, and in 1856 they published “Poems by A.A. Feta. The poet, although he accepted the corrections of the famous writer, later admitted that "the edition from Turgenev's editorial board came out as cleared as it was mutilated."

Encouraged by success, Fet began to write whole poems, stories in verse, fiction, as well as travel essays and critical articles. In addition, he translated the works of Heinrich Heine, Johann Goethe, Andre Chenier, Adam Mickiewicz and other poets.

“We can safely say that a person who understands poetry and willingly opens his soul to its sensations will not draw as much poetic pleasure from any Russian author, after Pushkin, as Mr. Fet gives him.” Nikolai Nekrasov

Afanasy Fet was born in 1820 in the village of Novoselki near the city of Mtsensk, Oryol province. Until the age of 14, he bore the surname of his father, the wealthy landowner Athanasius Shenshin. As it turned out later, Shenshin's marriage to Charlotte Fet was illegal in Russia, since they got married only after the birth of their son, which the Orthodox Church categorically did not accept. Because of this, the young man was deprived of the privileges of a hereditary nobleman. He began to bear the name of his mother's first husband, Johann Fet.

Athanasius was educated at home. Basically, he was taught literacy and the alphabet not by professional teachers, but by valets, cooks, courtyards, and seminarians. But Fet absorbed most of his knowledge from the surrounding nature, the peasant way of life and rural life. He liked to communicate for a long time with the maids, who shared news, told tales and legends.

At the age of 14, the boy was sent to the German boarding school Krummer in the Estonian city of Vyru. It was there that he fell in love with the poetry of Alexander Pushkin . In 1837, young Fet arrived in Moscow, where he continued his studies at the boarding school of Professor of World History Mikhail Pogodin.

In quiet moments of complete carelessness, I seemed to feel the underwater rotation of flower spirals, trying to bring the flower to the surface; but in the end it turned out that only spirals of stems were striving outward, on which there were no flowers. I drew some verses on my slate board and erased them again, finding them meaningless. From the memoirs of Afanasy Fet

1. In his youth, Ivan Bunin was a Tolstoyan. He dreamed of "a clean, healthy," kind "life among nature, by his own labors, in simple clothes . " The writer visited the settlements of the followers of the Russian classic near Poltava. In 1894 he met Leo Tolstoy himself . This meeting made a "stunning impression" on Bunin . Tolstoy advised the young writer not to “take it easy,” but to always act according to his conscience: “Do you want to live a simple, working life? This is good, just don’t force yourself, don’t make a uniform out of it, in any life you can be a good person .

2. Bunin loved to travel. He traveled all over the South of Russia, was in many eastern countries, knew Europe well, wandered around Ceylon and Africa. On trips, he was "occupied with psychological, religious, historical issues", he "sought to survey the faces of the world and leave in it the stamp of his soul" . Bunin created some of his works under the influence of travel impressions. For example, while traveling on a steamer from Italy, he had the idea for the story "The Gentleman from San Francisco", and after a trip to Ceylon, he composed the story "Brothers".

3. Bunin was outraged by city writers who spoke about the countryside in their works. Many of them had never been to the countryside and did not understand what they were writing about.

One well-known poet ... said in his poems that he was walking, “dismantling the ears of millet”, while such a plant does not exist in nature: as you know, there is millet, the grain of which is millet, and the ears (more precisely, panicles) grow so low that it is impossible to disassemble them by hand on the go; another ( Balmont ) compared the harrier, an evening bird of the breed of owls, with gray-haired plumage, mysteriously quiet, slow and completely silent during flights, with passion (“and the passion left like a flying harrier”), admired the flowering of the plantain (“the plantain is all in bloom!”), although the plantain, which grows on the field roads with small green leaves, never blooms. Ivan Bunin

4. In 1918, a decree “On the introduction of a new spelling” was issued, which changed the spelling rules and excluded several letters from the Russian alphabet. Bunin did not accept this reform and continued to write in accordance with the old spelling. He insisted that "Dark Alleys" be published according to pre-revolutionary rules, but the publisher released the book according to new ones and confronted the author with a fait accompli. The writer even refused the American publishing house named after Chekhov to publish his books in the new spelling.

5. Ivan Bunin was very sensitive to his appearance. Writer Nina Berberova in her autobiography recalled how Bunin argued that he was more beautiful than Alexander Blok . And Vladimir Nabokov noted that Bunin was very worried about age-related changes: “When I met him, he was painfully occupied with his own aging. From the very first words we said to each other, he noted with pleasure that he was standing straighter than me, although thirty years older .

6. Ivan Bunin had an unloved letter - "f". He tried to use it as little as possible, so in his books there were almost no heroes in whose name this letter would be present. Literary chronicler Alexander Bahrakh recalled how Bunin told him: “You know, they almost called me Philip. <...> What could still happen - "Philip Bunin". How vile that sounds! I probably wouldn't publish it . "

7. In the USSR, the first after the revolution, the five-volume Collected Works of Bunin, shortened and cleaned out by censorship, was published only in 1956. It did not include "Cursed Days", letters and diaries of the writer - this journalism was the main reason for hushing up the author's work in his homeland. It was only during perestroika that the author's forbidden works were published in full.

The Second World War found the Bunins in the French city of Grasse. By that time, the money from the Nobel Prize had ended, and the family had to live from hand to mouth.

Cracked fingers from the cold, no bathing, no washing of feet, nauseating soups made from white turnips <…> I was “rich” - now, by the will of fate, I suddenly became a beggar, like Job. Was "famous all over the world" - now no one in the world needs it - the world is not up to me! Ivan Bunin

Meanwhile, Bunin continued to work. The 74-year-old writer noted in his diary: “Lord, prolong my strength for my lonely, poor life in this beauty and work!” In 1944, he completed the collection Dark Alleys, which included 38 stories. Among them - "Clean Monday", "Ballad", "Muse", "Business cards". Later, nine years later, he supplemented the collection with two more stories, "In the Spring, in Judea" and "Overnight". The author himself considered the story “Dark Alleys” to be his best work.

The war reconciled the writer with the hated Bolshevik regime. Everything went by the wayside, the motherland came to the fore. Bunin bought a map of the world and noted on it the course of hostilities, which he read about in the newspapers. He celebrated the defeat of the Nazi army at Stalingrad as a personal victory, and during the days of the Tehran meeting, surprised at himself, he wrote in his diary: which didn't happen on the road . At the end of the war, the writer often thought about returning to his homeland.

In May 1945, the Bunins arrived in Paris, where they celebrated the day of victory over Nazi Germany. Here, in 1946, they learned about their restoration of citizenship of the USSR and even wanted to return. In a letter to the prose writer Mark Aldanov, Bunin wrote: “But here, too, a beggarly, painful, anxious existence awaits us. So, after all, there is only one thing left: home. This, as you can hear, they really want and promise mountains of gold in every sense. But how do you decide? I'll wait, I'll think ... " But after the Decree" On the magazines "Zvezda" and "Leningrad" of 1946, in which the Central Committee of the USSR criticized the work of Mikhail Zoshchenko and Anna Akhmatova , the writer changed his mind about returning.

Ivan Bunin died in Paris on November 8, 1953. The writer was buried in the Sainte-Genevieve-des-Bois cemetery .