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Linda Richards

American Nurse

1841-1930

A selection from
REMINESCENCES OF AMERICA'S FIRST TRAINED NURSE

Narrated by Beth Richmond

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THE FIRST AMERICAN TRAINING SCHOOL FOR NURSES

Among the prominent young women physicians of America was Dr. Susan Dimock, a woman of Southern birth who, after taking a course of medicine in the North, went to Germany to complete her medical education. She was there four years, and during her stay became interested in the work of the deaconesses at Kaiserswerth. This suggested to her reform in the nursing methods of America, which she inaugurated at the New England Hospital for Women and Children, of which she took charge on her return from abroad.

Although only twenty-five years of age, she showed wonderful administrative ability in addition to her unusual gifts as a physician. Previous to this date, September 1, I872, nurses had received instruction in the care of obstetrical cases only. Now the work was regularly organized for the definite training of young women in general nursing.

The hospital was originally in two small houses, one fronting on Pleasant Street, the other on Warrenton Street, Boston; and it was there that I was the first student to enroll my name in the first class of five nurses in the first American training school. On September 15, only two weeks after the opening of the school, we moved out to the new hospital where it now stands, on Dimock Street, formerly called Codman Avenue.

We nurses did very different work from that done by pupil nurses nowadays. Our days were not eight hours; they were nearer twice eight. We rose at 5:30 A.M. and left the wards at 9 P.M. to go to our beds, which were in little rooms between the wards. Each nurse took care of her ward of six patients both day and night. Many a time I have got up nine times in the night; often I did not get to sleep before the next call came; but, being blessed with a sound body and a firm resolution to go through the training school, cost what it might, I maintained a cheerful spirit, We wore no uniforms, the only stipulation being that our dresses should be washable.

After the first six months a night nurse was employed, and the day nurses were allowed to go to bed and to sleep. We soon had a second class of nurses also, and when I came away at the end of the year we had seventeen nurses in the school, instead of the five when the school opened.

Every second week we were off duty one afternoon from two to five o'clock. We had no evenings out, no hours for study or recreation, and no regular leave on Sunday. Only twice during the year was I given the opportunity to go to church. No monthly allowance was given for three months.

The course was for only one year, and embraced training in medical, surgical, and obstetrical nursing, but the kind and amount of instruction was very limited. Twelve lectures were given by the visiting staff of physicians, and the only bedside or practical instruction we received was from the young women interns, who taught us to read and register temperature, to count the pulse and respiration, and the methods of performing the various duties as they were assigned. We were supposed to understand and act. If complaint was made that we did not do well, we were called to account, and an intern was directed to give further instruction. This instruction usually amounted to a consultation between intern and the nurse as to the best way to do the service in question, the intern often being no wiser in the art of nursing than the pupil nurse. Great care was taken that we should not know the names of the medicines given. All bottles were numbered, not labeled. We had no text-books, nor did we have entrance or final examinations. Each nurse was quietly given her diploma as she completed her year of training. Any distinction which has come to me as the first trained nurse in America arises solely from the fact that Iwas the first student to enter the newly organized school, and so the first to graduate from it.

Dr. Dimock sent me to nurse one outside patient during my year of training. It was a case of pneumonia, and I was to do the day nursing, leaving the sisters to care for the patient at night. The doctor made daily visits. My orders were all verbal. I applied poultices to the chest once in three hours, bathed the patient, gave the medicine and the prescribed food. After one week, till the patient recovered, I went twice daily to see that all things were done properly, and daily made a report to Dr. Dimock.

Nurses were sometimes sent to bring in a maternity case, and were always sent home with such. I was of ten sent from the hospital upon errands for Dr. Dimock. One rainy Sunday she requested me to take a message to a physician in Roxbury. The once was new and the young man had not the appearance of having more patients than he could attend to. Mistaking me for a medical intern of the New England Hospital, he received me most graciously, read the note I handed him, and was about to give me a verbal message for Dr. Dimock. I asked him if he would be kind enough to write his reply. I cannot help smiling even now when I think of the instant change in his manner when he learned that I was a nurse and not a doctor. He wrote his reply and, with the air of having received an insult, handed it to me, and turned in silence to take up work at his desk. Student nurses were a novelty then, and had frequent proofs that they were not highly thought of.

Dr. Zakrzweska, one of the visiting staff, occasionally invited me to her office when I was off duty, and gave me much valuable instruction as well as excellent advice. The influence of her personal interest was invaluable to me.

When I look back over the year I spent at the New England Hospital ln 1872 and 1873, and compare the training I received with the advantages of today, 1 wonder we turned out to be of any value. It does not seem quite loyal to my school to tell how very little training we received, for every one in authority gave us of her best nursing knowledge. We pioneer nurses entered the school with a strong desire to learn; we were well and strong; we were on the watch for stray bits of knowledge, and were quick to grasp any which came within our reach. What we learned we learned thoroughly, and it has proved a good foundation for the building of subsequent years.

At the time of my graduation I was asked to remain in the New England Hospital as head nurse. The Massachusetts General Hospital had just organized a training school and invited me to take charge of it. From the Hartford Hospital in Connecticut there came also an offer of a position as head nurse in the surgical ward. But after long consideration and on the advice of friends, I accepted the proffered position of night superintendent in the Bellevue Hospital Training School in New York.

Bellevue

The training school of Bellevue had been organized in May, 1873, under the direction of an English Sister of the All Saints Order, who had had hospital experience in London. Sister Helen was a wonderful woman, though I do not think she would todaypass as swell-trained nurse. She had the gift of organization; she knew how to distribute work to those best qualified to do the part well; she was a thorough and strict disciplinarian; she greatly prized good work, though she was not given to many words of commendation ; and she required much of those who belonged to the school. This little woman robed in black, with a close-fitting white cap, went noiselessly about the wards, taking in at a glance what might escape the notice of one not well trained in the art of observing.

The course of Bellevue Training School was at that time two years. There was no class work, and lectures were given only irregularly. After my arrival at Bellevue, I spent a day and a half in the wards, to become familiar with the methods of work before taking charge of night duty. Fortunately, in those days so long ago, I was blessed with a retentive memory and a faculty for quickly learning the location of wards. But in the short time given me, my powers were taxed to the uttermost to become familiar with one hundred patients, to learn the names of the doctors and the division of which each had charge, to know where each senior doctor roomed (for only the night superintendent was allowed to call a doctor at night) , to know where to find the supplies in each ward, and to learn many other things too numerous to mention.

It must be known that the patients in Bellevue Hospital at that time were from the slums of New York, a class of people with which I had never come in contact before; and very different from those in the New England Hospital, where most of them were private patients, reined and educated. At first I had a feeling of fear of these poor sick, most of whom came into the hospital more or less under the influence of stimulants. But this feeling soon passed away, giving glace to one of profound pity, and later An many cases to one of true affection. There, in the midst of all the sin and poverty, were found real pearls; and no true woman can come in daily touch with a ward filled with patients without soon learning to look for and find the Jewels, and thereby make of herself a stronger woman.

I shall never forget my first experience on night duty at Bellevue. No sooner had the day nurses left the wards than the gas was turned so 1ow that the faces of the patients could not be distinguished. One could see only the dim outlines of figures wrapped in gray blankets lying upon the beds. If any work was to be done, a candle must be lighted, and only two candles a week were allowed each ward. lf more were used, the nurse had to provide them.. At midnight all the steam was turned off; at 3 A.M. it was turned on again, and the crackling of the pipes would waken every one in the wards. How cold and dismal were the hours between midnight and three o'clock in the morning!

The captain of the night watch made several rounds of the wards through the night, and at 5 A.M. he turned off all the gas, leaving us in total darkness. Patients took advantage of this condition to leave their beds and give trouble in gangways. At the end of my first month I told Sister Helen I could, not be responsible for the patients unless I could have light in the wards. She said, "Go to the warden and tell him." Under the solemn promise (always faithfully kept) to use no more gas than would enable us to fulfill tour duties, and to turn of all gas as soon as it was light, we were allowed night light. So one step in advance was taken.

Written night orders and reports were at that time unknown. Night nurses went on duty at 8 P.M. I was on duty at 7:30 P.M. I saw each head day nurse as she left her ward, received her orders, and transmitted them to the night nurses. In the morning I gave reports to the head nurses as they began their day duty. All this was verbal. When I had been on duty nearly a year, I kept notes of one case to be written up by a nurse for Sister Helen. Each nurse was required to write up a case. The doctor of the division saw the report and thought it was for him. He was glad of it, as it helped him in his notes on the case, and after that he asked me to write reports of all serious cases. This was the beginning in Bellevue of a custom now considered an elemental necessity in all hospitals, and in all serious cases of illness under the care of trained nurses. Class instruction at Bellevue began in the autumn of 1874, on the return of Sister Helen after a summer spent in Eng- land. Bellevue Training School sent nurses out for private duty during the first years of its existence. Even graduate nurses of the New England Hospital who went there to take charge of wards had this experience, but I was given no outside duty while there.

During one month of my time in Bellevue, my services were transferred to the lying-in wards. The medical staff would not allow the training school to have these wards unless a woman who had had training in that branch of nursing could be put in charge. The New England Hospital gave this training to their students, So I was placed in charge of the lying-in wards, and another New England Hospital graduate, Mrs. Walhaupter, who went to Bellevue as head nurse of a ward) was given charge of the night duty in these wards. We had the wards just twenty-seven days, when all the lying-in and waiting women were moved to pavilions on Bluckwell's Island, and I was changed back to my original work as superintendent of night duty. During those twenty-seven days we had twenty-seven births. I was obliged to be present at all births, night and day, and I was the only nurse allowed to be present. The reason for this was the prevalence of an epidemic of puerperal fever, which of course caused a very high death rate. At first, under this arrangement, there was marked improvement; but it did not last, and the removal above spoken of was decided upon. There the pavilion accommodations were rough, but the dread fever was stamped out. No one who saw the old ward for waiting women would have wondered at the amount of fever or the large death rate. Another fretsome feature was that the waiting women had to sit there and make shrouds. I used to wonder if they speculated as to whether they were making their own.

Two of my classmates from the New England Hospital were at Bellevue with me. Though graduated, we chose to take the final examinations at the end of the first year, and we found no difficulty in passing.

I have always been glad that I went to Bellevue, because of the very valuable experience I gained there, though the training did not compare favorably with what we had had in the New England Hospital, where far greater nicety in caring for patients was required. I have often since told my nurses, during my long life in hospital work, that experience comes only in hard work, and I certainly had my full share of that while at Bellevue. My perfect health stood me in good stead. Many was the time I went into the wards at 7.30 in the evening and did not sit down until 8.30 the next morning, when I changed my shoes to go home. When I came away, two people were given my work to do and my responsibilities to carry.

After the completion of my year's work at Bellevue, it was with sincere regret that I refused the kind offer to remain as Sister Helen's assistant; but a desire to take up the special work of training school organization induced me to go to a new field.

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