PERSPECTIVES

Although nursing can be traced back to 1 AD as an entity, it seems impossible that when I entered practice that the profession was only about 100 years old. Most of us remember Dr. Ingalls telling us that “the first nurse was the first mother!” We started our careers in the fifties and have experienced half of the time since FLORENCE NIGHTINGALE

advanced what was done by many as a nursing profession, a calling, a work to be honored. Those of us who were born in the thirties have also experienced one third of the history of this country.  Our experiences need to be recorded and I have chosen to use my anecdotes as opposed to cold hard facts, although I try to be as factual as possible.

A very significant event in my professional life was the unique opportunity to consult for several months each of several years for the health care system in the United Kingdom and to be part of their standards development. The sense of history, continuity and its importance that is present there is so important for each of us. I made some wonderful friends with some NIGHTINGALE NURSES.

Nightingale Nurses Pin

Compare this JOHNS HOPKINS pin
to the original Nightingale one. Very similar
but I do not know the connection.

As a result, I had the opportunity to go to the NIGHTINGALE MUSEUM in London

Nightingale Museum London

for a behind the scenes visit, and to the areas in ST THOMAS HOSPITAL/GUYS

St Thomas when Florence was there.

where FLORENCE NIGHTINGALE lived and worked.  In the 1990’s the nursing unit had been left pretty much like it was many years ago and was still an active patient care area when I was there. 

Looked the same to me,
take away the people.

The quarters that nurses lived now held offices but the board room that FLORENCE used was still in use and was where we ate our working lunches.  The classroom that was part of the nursing school was used for me to deliver lectures.  The nurses who were trained/educated here are a very proud bunch.  To be a NIGHTINGALE NURSE carries clout far beyond the credential itself. 

This work took me also to deliver a speech at the WESTMINSTER CHURCH HOUSE in London.  I was helping to build legislation regarding accreditation and survey process. Just before I was to go inot the round room, I was told that it was the room that once held Roosevelt, Stalin and Churchill at the end of WWII.  I was so nervous that I was taken with a bout of coughing that I could not control.  I also had a picture taken by the official photographer of Churchill and it is still one of my most prized possessions.

I was very humbled by this experience.

Many nurses up until the middle of the century remained committed to the profession due to situation, economics or in many cases religious commitment.  This supported a practice of providing a “nurse’s home.”  Most hospitals had a dormitory like accommodation or perhaps apartments on the hospital grounds that were given to nurses for very inexpensive or no rent at all.  As I look back today it seems that this kind of life was pretty sterile, cold and pretty horrible by today’s standards.  It was, in retrospect, a way to control nurses and to get workers available at a moment’s notice.  When I went to work at WESLEY LONG HOSPITAL in the late 40’s there was just such a residence across the parking lot from the hospital.  Nurses who lived there generally took all their meals at the hospital cafeteria.  The buildings varied from house-like small residences to large buildings attached to the hospital.  Later when I worked in Saudi Arabia we were provided by the company accomodations that were similar.  The other time I witnessed such an accommodation was when I taught classes in Barrow Alaska. The housing would be impossible if this was not provided in these two places.  Usually there were adequate lounging areas with things like ping pong tables, tv, and group kitchens.  Residents had much greater privacy than did the student nurse dormitories.  But in many cases there was still restrictions on time to be in at night (well into the fifties.)

Work days were generally five or six eight-hour shifts a week.  However there was much overtime that was expected, required or extracted from the permanent nursing staff who lived there. The nurses who had families and were married were give a different set of expectations.  If the hospital had a SCHOOL OF NURSING, one might live in the residence as part of their “training” and simply stay after graduation until they were married or in many cases the rest of their career.  Of course this practice gradually went away in the years after the fifties.  DUKE did not have this as a practice and I am not sure when or if they ever did.  Perhaps there is a historian out there that knows. The NIGHTENGALE NURSES actually lived on the units where they worked in the same way as nursing residences were in this country.  Many of us knew a maiden aunt or other relative that was a nurse and lived this way.  They were always thought of kindly, and invited to all family functions.

Until the mid-sixties, as a nurse you would be required to put off marriage for the years that you were in school, but that is not to say that there were lots of secrets. If you did get married you were immediately out of school. DUKE was somewhat advanced in that marriage was not smiled upon but you could get married in your senior year, but you could not be pregnant.  A number of my classmates left because of marriage, and two married in their senior year.  These two women, SUE GREENWOOD (HEAD) AND KATY KELLER (MAULTSBY) went on to have very excellent careers in Nursing as beloved teachers. Sue was required to leave and gave birth to the oldest of her four daughters, Julie, the summer of our senior year. I know I was on my elective rotation on OBSTETRICS and was the first to see her enter this world. Sue returned to school many years later and became a very important member of the faculty at the UNIVERSITY OF NORTH CAROLINA in Charlotte and a very prominent participant in nursing practice for our state. 

So, I am going to be a nurse! There were other interesting decisions that were further complicated by choices in how you wanted to get the nursing credentials.  It was easy for me as DR JOE STEVENS, my mentor, was very helpful and directive in making my decision as I have discussed earlier. Women, there were no men in nursing save those in the military, could attend a three year hospital based program and receive a DIPLOMA in nursing, you could go to only a handful of university based program and get a BACHELORS OF SCIENCE IN NURSING, you could go to school for a year and get a certificate in LICENSED PRACTICAL NURSING, or you could get on-the-job training as a NURSING ASSISTANT.  The two-year ASSOCIATE DEGREE program was not yet an option. All of these avenues would take you to specialization and upward mobility in a greater of lesser degree.

As a sophomore DUKE student, I was still waiting to do things that I had been doing for several years as a nursing assistant. At the time it seemed that my friends from high school and our classmates at Duke who were in the 3 year diploma programs, were so far ahead of me. They were already “in charge” on nights and evenings.  They were running the show on their units under the direction of a house supervisor.  We were still cooling our heels in the “chem” lab, anatomy lab, taking sociology and doing procedures on each other in the nursing arts lab. They seemed so far ahead and so much more skilled.  We were told that we not only would know what to do but the WHY and we would know in depth what we were doing.  They were right, of course, but in my teen-age mind I had one foot on the gas and didn't know the car had a brake. 

The work that we were doing was so basic, so routine to me.  It got me into a lot of trouble.  We were taught in the lab how to make a bed and after the hundreds I had made using the HILDA TAYLOR method (remember her from an earlier post?), I was able to do it rapidly and well.  The instructors would strive to find something amiss, especially LOIS KNOWLES.  They seemed happy when I faltered but now I know it was because of my arrogant attitude.  The precision required I found to be far less that than required by HILDA TAYLOR.  There was another issue, I had been taught short cuts and I unwittingly used them to finish fast. That was certainly not acceptable.  It was some years later that I appreciated the wisdom of my instructors.