The least useful numbers we take the most seriously

People want numbers. Knowing what those numbers mean usually comes second to watching them move in the right direction. More users, more logins, more clicks. It’s remarkable how quickly a rising metric starts to feel like sound judgment.

But a metric that feels good isn’t the same as a metric that helps you decide anything.

And that gap (the space between numbers that impress and numbers that matter) isn’t new.

I’m Nate Sowder, and this is unquoted, installment 13. It’s on Florence Nightingale and why organizations still measure everything except the choices that lead to decisions.

Before the war (and the lamp)

Florence Nightingale was born in 1820 to a wealthy English family that valued education as long as it didn’t lead anywhere inconvenient. She grew up surrounded by tutors, books and expectations that her intellect would remain a private accomplishment. When she took to history, philosophy and mathematics with a seriousness that made her parents uneasy, well, that wasn’t the goal they were going for. Knowledge, in their view, was for refinement (or so they’d hoped).

By her late teens, she had begun pushing against the edges of what society considered acceptable for someone of her background. Nursing, at the time, was not an esteemed profession. It was closer to domestic labor, associated with poverty, poor training and conditions that respectable families wanted nothing to do with. The thought of Florence entering that world was, to her parents, pretty unthinkable.

Beyond her house, Europe was shifting.

The British Army was expanding its presence abroad. Hospitals weren’t prepared for the scale or severity of the injuries they received. Medical infrastructure was inconsistent, oversight was minimal, and record-keeping existed but didn’t translate into updated policy or changes in care.

When the Crimean War began in 1853, Britain assumed its existing systems would be enough. They weren’t. Reports of catastrophic conditions reached London. Overcrowded wards, contaminated water, shortages of supplies, and mortality rates that dwarfed expectations. Public pressure mounted, and the government needed a response that looked decisive.

Nightingale was asked to lead a team of nurses to the military hospital in Scutari.

She accepted, arriving to find a system overwhelmed not only by the war, but by a number of hard to overcome assumptions.

This is where most accounts of Florence Nightingale begin to lean on the familiar imagery. The lamp, the night rounds, the comforting presence in a place defined by suffering.

While that version is true enough to persist, it leaves out the part that gives her work its lasting impression, and why it’s the subject of this week’s unquoted.

The moment she stepped into Scutari, she realized the crisis was much more than medical.

She had entered an information crisis.

The hospital produced records, but the records concealed more than they revealed. Deaths were counted, but not categorized. Conditions were noted, but not analyzed. The data existed, but it carried no structure that could lead anyone toward responsibility.

And this is where the story takes a turn.

The Florence Nightingale we’re here for is the woman who recognized that the health of an institution depends on the clarity of the information that shapes its decisions.

No decision strategy = hope

When Nightingale began working through records at Scutari, her goal was to understand how a hospital this large could operate with so many people and have so little sense of direction. Ledgers were full (supplies, patient counts, daily notes) but nothing in them hinted at anything actionable. The information described activities being completed, but not anything about that activity’s implication.

Over time, this problem persisted. Reports were produced because that was the routine. No one had agreed on what those reports were meant to surface, which scenarios mattered, which changes signaled risk, or which patterns required action. Without that understanding, documentation became a ritual — evidence that work had occurred, not evidence that anything had been understood.

This pushed Nightingale to stop reading the reports as documentation and start reading them as evidence of how little the institution understood itself. The hospital was active… busy, even… but that activity had no correlation.

Here’s what’s interesting. Decisions weren’t necessarily being avoided. People in power didn’t know what decisions they’d make if the right information presented itself. Their entire operation was basing itself on activity, optimism and ‘God’s will’ (which is a form of fate that requires no responsibility because it assumes none is possible).

Nightingale knew the only way forward was to be clear about the goal and then to look for the signals that would tell her whether that goal was getting closer or slipping further away. If the aim was fewer deaths, then she needed to understand what conditions made death more likely, and which of those conditions could be influenced by decisions inside the hospital. That meant defining the kind of evidence that would force a change in course, and then arranging the information so those inflection points (signals) could be seen.

She worked through the records with that question in mind. Not “what happened?” but “what would have made us act sooner?” Once she separated preventable deaths from battle wounds, organized the accounts in intervals that revealed trends, and drew distinctions that had never been documented with any seriousness, the crisis took on a shape the institution couldn’t look past. The patterns had been buried under routine, but they were unmistakable.

Her work made the responsibility clear. She identified the decisions that mattered and then arranged the information around those decisions so the institution could no longer look away from its own role in the outcomes. Once the data showed the hospital was contributing to the deaths, the excuses fell apart. Their work had to change.

Where organizations lose the plot

The pattern Nightingale uncovered isn’t confined to a nineteenth-century hospital. We produce so much information, yet struggle with the same absence of direction. Metrics pile up. Dashboards expand. Data becomes a security blanket for activity. Ask a team what decisions any one of their numbers is meant to influence, and the answer may disappoint you. But hey, the dashboard looks compelling, right?

The problem starts early. Most organizations begin with the data they have, or the data they want, and work backward into meaning. Nightingale did the opposite. She started with the decision. She asked what needed to be understood, what changes mattered, and what signals would make a different course unavoidable.

There’s a simple discipline in that sequence.

Start with decisions
Instead of asking what additional data might be useful, ask which decisions need to be made more quickly, more confidently or with greater precision. A metric only matters if it changes a decision.

Translate decisions into signals
Once decisions are clear, the next step is to name the behaviors or conditions that would trigger movement. These signals tie to action, connecting behavior to strategy.

Then map signals to the data
Only after the signals are understood does the question of data come into play. Which information reflects those signals? Which is reliable? Which is unnecessary? This prevents teams from collecting numbers for their own sake and turns data into something closer to what Nightingale built (which was a structure that makes responsibility visible).

The work most people avoid

With every failing system, the explanation stops making sense. There’s a gap between what’s happening and what’s being said. The choice is to either declare the situation unfair and leave the responsibility where you found it… or you can step closer, notice what isn’t being noticed, and take on the work the institution isn’t prepared to do.

When Nightingale chose the second path and saw that conditions at Scutari were overwhelming, every excuse was available to her… war, fate, limited resources, the failures of others. Instead of accepting them, she studied what didn’t add up, verifying what the reports wouldn’t show. None of it was convenient. None of it was glamorous, and nearly all of it was thankless.

But as with every unquoted, that’s the work the greats take on.

Nightingale was trying to see the situation clearly enough that responsibility had somewhere to ‘land’. Her nighttime rounds weren’t mythology or symbolism. This was the work of a woman who understood that improvement begins where convenience ends.

It takes someone great to take on that kind of work.
She did, and it was about a lot more than a lamp.

Florence Nightingale on vanity metrics was originally published in UX Collective on Medium, where people are continuing the conversation by highlighting and responding to this story.