No Excuses, Only Work

April 24, 2026
— No Excuses, Only Work —

I never gave or took any excuse.
— Florence Nightingale

ABOUT THE AUTHOR
Florence Nightingale (1820–1910) is remembered as the founder of modern nursing, but that title flattens her. She was also a pioneering statistician, a hospital reformer, a public health theorist, and one of the most effective bureaucratic fighters of the nineteenth century — a woman who took on the British War Office and won.
She was born in Florence, Italy, into a wealthy English family who expected her to marry well and live decoratively. She refused. From girlhood she felt what she described as a direct calling from God — she wrote it in her journal at age sixteen — to serve the sick and suffering. Her family resisted for years. She studied nursing in secret, read hospital reports in her spare time, and persisted until, at thirty-four, she was offered a chance that would define an era.
In 1854, during the Crimean War, the British press began reporting on the catastrophic conditions in military hospitals — soldiers dying of infection and neglect at rates that dwarfed battlefield deaths. Nightingale arrived at the Scutari barracks hospital in Turkey with thirty-eight nurses and a will that nothing in the institution was prepared for. She found men lying in sewage, without clean water, without adequate food, without basic medical supplies. She worked through the nights, carrying her lamp through the wards — earning the name the soldiers would never stop using for her — and simultaneously waged a paper war against every administrator who stood between the sick and what they needed.
Within months, the death rate at Scutari dropped from over forty percent to just over two percent.
She returned to England in 1856 a national legend, so famous she had to refuse public honors to protect her privacy. She spent the remaining fifty-four years of her life largely confined to her home by illness — and in those fifty-four years wrote over two hundred books, reports, and pamphlets, overhauled the British Army’s medical statistics, laid the conceptual groundwork for modern hospital design, and helped establish the first secular school of nursing in the world. She corresponded with prime ministers and heads of state. She never stopped working.
She died in 1910 at age ninety, in her sleep.

HISTORICAL CONTEXT
The line “I never gave or took any excuse” appears in her personal notes and correspondence, and it reads less like a boast than like a vow she made to herself early and renewed every day. It captures something essential about how she moved through the world: the same standard she held herself to, she held the institution to, and she would not accept the hospital’s excuses any more than she would manufacture her own.
This was radical in both directions. The Victorian world was awash in polite excuses — for why the ward could not be cleaned, for why the supplies had not arrived, for why things were the way they were. Nightingale refused to live inside that world. She asked what was needed, determined what could be done, and did it — and she expected the same of everyone around her.
It is worth noting that she understood this ethic as inseparable from her faith. She believed God had called her to this work. To give an excuse was, in some sense, to answer God with a reason why she hadn’t come.

A STORY TO SIT WITH
In the winter of 1854–55, Nightingale was battling not only infection and death but the indifference of the Purveyor’s Office, which controlled hospital supplies and insisted that nothing could be issued without proper paperwork — even when men were dying for want of it.
She solved this with her own money. She had arrived with personal funds and supplies purchased before she left England, and when the bureaucracy said no, she bought what was needed herself and walked it to the wards. She did not wait for permission. She did not file a complaint and wait for a response. She identified the gap, filled it, and kept moving.
The men in the wards knew who she was. They wrote home about her. One soldier — barely literate, dictating a letter — told his family: “She would speak to one and another, and nod and smile to as many more; but she could not do it to all, you know. We lay there by hundreds; but we could kiss her shadow as it fell, and lie down content.”
She kissed no one. She gave no excuses and accepted none. And the men lying in those wards — men who had been dying of neglect — kissed her shadow because someone had finally come who meant to do the work.

SCRIPTURE CROSS-LINKS
James 2:17 — “Even so faith, if it hath not works, is dead, being alone.”
Doctrine and Covenants 58:27 — “Verily I say, men should be anxiously engaged in a good cause, and do many things of their own free will, and bring to pass much righteousness.”
Proverbs 31:25 — “Strength and honour are her clothing; and she shall rejoice in time to come.”
Alma 26:12 — “Yea, I know that I am nothing; as to my strength I am weak; therefore I will not boast of myself, but I will boast of my God, for in his strength I can do all things.”
2 Nephi 25:23 — “For we labor diligently to write, to persuade our children… it is by grace that we are saved, after all we can do.”

THEMATIC REFLECTION
An excuse is a transfer of responsibility. It moves the weight of an unmet obligation from your shoulders onto something else — the situation, the timing, the difficulty, the other person, the system. And the transfer feels so natural, so reasonable, so entirely justified in the moment, that most of us make it without noticing.
Nightingale noticed. She noticed it in herself and refused it, and she noticed it in institutions and refused it there too. What she understood — and what every person who has ever changed anything understands — is that the world is never short of reasons why a thing cannot be done. The question is whether you are going to live inside those reasons or whether you are going to find a way around them.
This does not mean ignoring real limits. Nightingale was not naive; she worked within systems and through systems, not just against them. But she never accepted I can’t when the honest answer was I haven’t yet found a way. The distinction is everything.
Our faith asks us to be “anxiously engaged in a good cause.” Not occasionally engaged. Not engaged when conditions are favorable. Anxiously — which is to say urgently, actively, without waiting to be told. That is the spirit Nightingale lived.

RICHARD’S PERSONAL REFLECTION
Medicine could train you to be a machine for excuses, if you let it. The system is overburdened, the time is short, the paperwork is relentless, the patient load is impossible. Every one of those things can be true and also be an excuse for not doing the one thing the person in front of you actually needs.
I learned early — from good mentors and from some painful mistakes — that the question is never what does the system allow me to do? The question is what does this patient need, and how close can I get to it? Those two questions often have very different answers. The first leads to adequate care. The second leads to medicine worth practicing.
I also learned that an excuse taken by a physician — I didn’t have time, I didn’t think to ask, I assumed someone else would handle it — lands very differently on the patient than it feels to the physician. To the patient, it can be the reason a diagnosis was missed, a conversation never happened, a hand that was never held. I kept that asymmetry in mind for thirty years. It never made the work easy. It made the work honest.

GRANDFATHER’S COUNSEL
My dear ones, this is a short line with a long reach. I never gave or took any excuse.
You will be tempted — we all are — to explain why the thing didn’t get done, why the call wasn’t made, why the apology was late, why the effort fell short. Sometimes the explanations are real. Sometimes they’re just excuses dressed in real clothing. Nightingale developed an eye for the difference, and I hope you will too.
The test is simple: if the thing mattered, was there truly nothing more you could do? Usually there was. Usually there was one more try, one more door, one more hour, one more way to ask. The person who finds that thing — who doesn’t accept the first no as final when the stakes are real — that is the person who changes things.
You come from people who did not quit. You come from women and men who found ways when there were no ways offered. Carry that inheritance forward. Don’t give excuses, and don’t take them. Do the work, and let the work speak.