Sentimental Women Need Not Apply: A History Of The American Nurse

This program was made possible by a grant from the National Endowment for the Humanities a federal agency which supports research education programs for the general public. Additional funding was provided by the Massachusetts foundation for humanities and public policy. The Connecticut humidity's Council and the Eastment fund. That. Hello. Hi. Hi. Hi. And never too tired. To say no to cold. Don't talk. How. Do you understand. Oh but I can't look at it anymore. Ma'am you're not going to look at a man without arms or leg without pain. And you might.

Say. So it's taking care of woman became critically ill very suddenly and she had what we call a Code Blue next situation where someone stops breathing or their heart stops beating and an alarm is called to the hospital and doctors and a respiratory therapist and several nurses will come to resuscitate that person. I was at the head of her bed and during the code I talked to her as we were doing our procedures. I told her that she wasn't alone that we were right here with her. We were taking care of her that we would do everything that we could for her. She came out of it. I got to take her to intensive care and be her nurse for the rest of the night. She was had a tube down her throat so she couldn't talk. This was to help her breathe and we gave her I gave her medicine during the night to keep her comfortable. But all during that night I

talked to her. I told her who I was. She was what had happened that she was in alone that I was with her and that I would take care of her. She didn't much better the next day the tube came out and she was able to talk. And throughout that whole experience she said she could remember my voice. She didn't know what happened or why all of this happened. All of a sudden. But she could remember my voice and she said that I saved her life and she kept saying that over and over again. So it was a wonderful day. Now one thing. You. Read. You write to the noble profession. Of. Roger. Nightingale. Today. I tried to write about. I. Say. The word that underlies this was once thought of quite

simply as women's work work that anyone could do that has changed. One hundred fifty years ago the nursing profession did not exist today. We could not function without it. Nursing has become complex and specialized. It is beyond our ability to care for our own. We have come to rely on the care of strangers. Nursing has made some way nursing changed my life as a nurse's aide and as a nurse being with sick people changed my life. Being around dying people completely changed the way I looked at my own life and my own death. I feel it's giving me a real measure of serenity that I wouldn't have had otherwise. That it's taken away a lot of my fear about my body and my aging and what will happen to me and given me a matter of fact way of looking at the world and acceptance of things in the world.

It's an oddity of this culture in the society that most people never see a baby get born and never see a person die never see a body after it's dead. All of these things pain and illness and dying aren't Streamwood private and extraordinarily intense experiences. I suppose in a way a nurse carries the taint of illness with wherever she goes. And even though people respond very positively and will tend to confide in a nurse and ask for advice from a nurse. There's also the awareness that that nurse has seen and participated in things that other people are uncomfortable it we live in a culture that wants people to care but doesn't value care and it doesn't want to pay for carry and doesn't understand in some ways what caring is because it can't be packaged it can't be quantified it can't be measured. And so what happens is that we don't think about caring as something that's terribly important

even though deeply all of us want it. And when you talk to someone for example who's had a patient in a hospital and they've been sick what they'll remember when anything else is what kind of care was given to them by the nurse. If you are in need of care in the 19th century the last place you want to be was a hospital. Most people were cared for at home by family and friends. Only the truly desperate willingly entered the few charity institutions that served as both House and hospital in the nation's cities. There was no such thing as professional nursing. The work was carried out by untrained attendants or more commonly by recovering patients at Bellevue and New York City. Many of the nurses were vagrants and prostitutes sentenced to jail but transferred to Bellevue as nurses. At night. There were no nurses at all. Three watchman roam the halls freely drugging allowed or inmates with Mauritian to keep them quiet.

This was the state of most American hospitals until in 1861 The Civil War. ERA. As yet we have done little fighting but I've lost a large number of men they are dying daily in the camps and hospitals from pneumonia dysentery and camp diseases caused by severe exposure lack proper food. When. Our hospitals are so bad the fight against being sent to them they will not go unless they are compelled. And many brave it out Time can. The appalling death rate in the camp hospitals was a threat to the war. In October of 1861 the union secretary of war Simon Cameron. Wrote an upper class British woman requesting how. The woman was Florence Nightingale a miracle worker who had brought order and sanity to the rat infested British barracks hospital in the Crimean.

Nightingale. Reduce the mortality rate in involved with things that really have nothing to do with what the doc Scroggs what she did was keep the people clean at rush hour to give them up. Dodging the atmosphere in which those patients realized that there were people who had to sing said the bottle to go around every night and tell a Remine good night but no no way to measure the effect they have had on those. So to feel that they were in the mind of loving caring when the secretary appointed reformer Dorothy Dix a superintendent of women nurses. Using Nightingale's principles. Dick's help the union hospitals and

supervised the nurse recruitment campaign. She examined her volunteers closely and accepted only women over 30. Women whose virtues included modesty and plain looks. I am in possession of your circular and will comply with all your requirements. I am plain looking it up to suit you and. I have known your relatives in the war. No I never had a husband. I am not looking for one. Will you marry God. Most military doctors protested vehemently against the presence of women at the hospital. The gory realities of war they found were unsuitable for delicate female lines. But soldiers were dying by the thousands for the simple lack of care and the doctors were soon forced to accept whatever help they could get. As the war dragged on even Dorothea Dix relented. By 1864 her only question would be nursery's was. When can you start.

The volunteers were inexperienced and untrained but they Pinback their skirts and went to where. They washed and fed the homeless. They wrote letters to the families of men who could not write and they listened to the last words of the dying. They worked until they were exhausted. And slept where ever they could find a corner to themselves. Their methods were simple. As the hospitals and. Even the military surgeons acknowledge the contributions of the female volunteer. If good hospitals were possible in times of war reformer's reason why not in times of peace. Dr. William W. King in 1870. A comparison between the danger of death and battle and the danger of death in civilian life shows that it would be seven times safer to fight through all three days of Gettysburg and a fractured arm and require treatment in a city hospital.

Groups of women reformers in the Northeast lead that the cure for bad hospitals was good nursing like Nightingale. They believe that nurses were not born but made and that education was what would make in 1873 the reform group's announced plans to open hospital nursing schools in Boston New Haven and New York City. They hoped to recruit students from the thousands of working middle class when. Looking into the cities in search of. Respectable young who would not have dreamed of working in the dirty dangerous hospital. These new schools need nursing. Except that the programs were strongly opposed by hospital boards and doctors. Doctors actually were quite upset about the idea of training nurses in the beginning. You have to remember this is a period in which a lot of physicians train without ever walking into a hospital themselves. They were still being trained in apprenticeship themselves. It was a period of think where medicine was someone more uncertain about

what it could and couldn't do and which a lot of what a physician was able to do depending on the relationship he set up with patients. So here was the possibility that a trained woman who could reach other women in particular as patients would be a real threat to the physician. So that in order to make yourself acceptable to physicians some way had to be shown that these women would be assistants essentially to the doctor but who would not threaten his authority. The reformers went to great lengths to placate the opposition. Screening applicants carefully to weed out any that might have been as a result the earliest student nurses were American born women most of them Protestant. All of them white when the schools first opened in the 1870s. Nursing leadership was looking for a very particular kind of woman. They wanted someone who was probably in her early 20s to late 20s that is they didn't want the young girl straight from

school they wanted a woman with some maturity and some life experience of some sort. They also looked a lot men with country experience that is form women because they thought they had both the strength and the stamina to do the work. But also the training at home didn't know how to take care of people. Gail talks about she didn't want nurses to be sort of sentimental women who came into nursing the way a young man might have gone to the Foreign Legion after some family disaster. That is they didn't want women who were coming because they had some men had abandoned them. A marriage proposal had failed. They didn't want women who came in who were had sexual interests. They were very refined in power. Twenty nine students were admitted to the Bellevue class which started on May 24th 1873. The patients complained that these young women were too refined to be of any help in such a place and trained nurses from the wards and their jobs

threatened cursed at the students. And on one occasion threw rocks. Sari welcome. It was only the beginning. In exchange for room board and a small stipend the women worked 10 hours a day seven days a week with one afternoon off in the kitchen. They ended the age old practice of using the same pots were coffee tea even raw and long in the linen rooms they prepared and made by huge supplies of bandages and dressing in the war. Today the bed the walls the furniture and the patients for the first time in memory and the stench that had characterized the house disappeared. Even more remarkable. The patients started to get better nursing care was accomplished with the medical treatment of the time. When nurses came to train in the hospital they also became what doctors use to cure people. There wasn't a large armamentarium of drugs that could be

used and so they would have been for cold compresses as mustard plasters mainly what doctors had available to them was more of a watch and see. And that watching and seeing was mainly done by nurses Isabelle Stuart 19:8. During my first weeks in training I was not sure I wanted to stay. But after the smallpox quarantine there was no question in my mind. I saw nurses at their best and I saw what was in nursing very much more clearly than I had when I went in. One of our students died and several were terribly scarred. But the heroic side of nursing was traumatized. And I had a feeling of belonging to something quite stirring. Nurse's training was here to stay at least for white. Black women were largely unwelcome in the new nursing programs. In the north hospitals established from.

The south. Blacks were excluded altogether. The first flaggers to be trains was the Holy One went to the New England hospital for women and children in 1879. I think it was something like 16 month of course. The charter of the New England hospital for women and children had provided for the mission of one black and one Jew to each class. So Mary Mahoney was the blood black hospitals established their own training programs and maintained them through the long decades of segregation. But for both black and white students graduation soon proved an unexpected trap. Most of the care given in hospitals was given by nursing students which meant any time a hospital wanted to expand its workforce what it could do was expand its nursing school or indeed open a nursing school and have five students in it and declared that this was training. It's a classic example in some ways of incredible exploitation because what

happened was that nurses were used by the hospitals the workforce never really got a decent education or even a decent experience in lots of different kinds of nursing were hardly paid at all. And then when they finished weren't hired by the hospital hospitals trained nurses they did not employ them as soon as a student's training was complete their place was given to another student and the graduate was cast out search for private duty work in patients homes the private nurse was seen as a domestic servant required to be on call 24 hours a day frequently to sleep on a cot in the patients room. The work was lonely and ill paid and yet the competition for jobs was fierce. Many women call themselves nurses. Some were graduates of hospital programs some had taken short correspondence courses. Some had no training at all. Isabelle Hampton 1893 in the absence of educational and professional standards I am sadly forced to admit that the term trained nurse means

anything everything and next to nothing. A small number of nurses came together in 1895 to clear up the confusion. They formed an organization eventually known as the American Nurses Association and called for laws to raise nursing standards. I am the first professional women's group in the country attracted the enthusiastic support of most training school superintendents but did not appeal to the majority of graduate nurses who were more concerned with making a living. Few graduates involve themselves in the internal politics of nursing and even fewer became involved in the politics of society. Nursing and feminism have often been distant. In spite of or maybe because of nursing being namely a female occupation. Leaders were striving to give nursing an image of professionalism. They didn't want to be seen as political and then later I think nurses were slow to join the women's movement because there was a certain

resentment that know nursing was sometimes dismissed as the typical female occupation in an occupational world where female jobs are universally devalued and paid less and so on. If you're an occupation aspiring to professional status it's not something that you want to emphasize. We don't have very much power at all. And I think that perhaps if there were more men in nursing that would have changed over the years. You don't think men would have stood having so much responsibility without the power and authority that goes with it. A lot of people won't like hearing this but I think that I'm dealt with with much more respect than the women the doctors not so much today but maybe five years ago or so. You know I would rather talk to me than a nurse. You know they say you know go get Stanway I need to talk to them about something. Whereas if they were talking to one of the girls you know they can rant and rave and go on and you know they would rather deal on a

man to man basis. I wouldn't say it's women's work. But since most of the people who do it women I think that we have to be careful that we don't give away those parts of it that we should be holding on to to men because when men come into nursing they tend to go into administration and teaching and things like that happen they go to basically wrap it up and I don't want to discriminate or anything like that. But I do think that women as the most the only profession where women predominate they should really get her work and work whether men do it or not whether men or women do it. It's women's work in the sense that it's personal it's private it's dirty it's direct. There's no B.S. about it. Women have always done that level of cleanup. It's

women's work because it's service to strangers. It's women's work because it's disparaged and poorly rewarded. And I say what is work in a real proud way. I don't think there's anything to be ashamed of with that. And I don't necessarily want status to change. Lillian walde 1893 I had spent two strenuous years in a new york training school for nurses but had little more than an inspiration to be of use in some way other than private duty. When a friend convinced me to give a course in home nursing in an old building on Henry Street in the school room a little girl told me of her sick mother. Gathering from her incoherent account that a baby had been born. I followed the child across the courtyard and up into a rear tenement by slimy steps whose accumulated dirt was augmented that day by the mud of the streets and finally into the sick room. The woman lay on a wretched unclean bed under the hemorrhage. Two days.

After I bathed she kissed my hand but I wept for days afterward that morning's experience was a baptism of fire. Nonee Walsh was a trained nurse doing volunteer work the day she discovered the sick woman in the tenement. Within a month she and a colleague from nursing school established themselves as visiting nurses making calls in the slums of New York's Lower East Side. They were joined by other nurses eager to be of help. In an area where one in 10 babies died from bad food. And one in three families was stricken with tuberculosis. Within a few years the Henry Street visiting nurses were seeing thousands of patients and the idea took hold throughout the northeast by 1910 visiting nurses had become the backbone of a national public health movement. A visiting nurse would call on as many as 15 families a day. Starting off

with the most critical cases she would change dressings. Assist with homebrews care for newborn babies. Teach nutrition. Then she returned to her critical patients help them with something and put them to bed for the public health nursing was a movement that was sponsored by practically everybody Health Department sponsored Boards of Education sent nurses into schools women's clubs. Practically every group in the community that had any voluntary concerns about the poor would send these nurses out to take care of this originally the sick poor. And then gradually they would introduce all sorts of programs to teach people how to stay healthy or to teach people how to just not spread their tuberculosis or other communicable diseases within the community to help organizations began to send nurses into the rural areas of the country bringing health

care to many communities that had never happened. Graduated. From years of training to be a horseback ride horseback or walk. I rode pretty well throughout the county from 12 mile wide. It's just fun for me to do it now. Very very happy with my animals. You be a very good friend. I remember one night it was raining and the call came at midnight we'd all on the bed. And pretty soon you heard somebody out there saying hello hello hello. They woke up and I said I wife think the Doctor will you come. And I

said I'm not a doctor. The trouble is that she didn't have a baby. And I that's what the you're going to have. He said Well ain't no doctor that's why I want you to come. So we thought about well maybe three miles back at night I had a labyrinth of the power. And you've got cabin two room cabin and along August about four o'clock my baby came. Everything was normal everything we are right now I was getting on a horse going home. The man was helping me and he said I'm glad you came that night. I know you know. But you know I want you to come. I you know it was you know my first baby. Increasingly the number of nurses involved in the field began to shift from the voluntary to the publicly funded organizations and by the mid-1920s most tobaco nurses were working for the publicly funded programs.

Get to see the is walking with their baby. Very much so true. So everything now is said to be like those people I worked in a hospital for two years and then I said no I got to get out. And let me tell you that why. And I do. I went into the rural area and I saw how people were living. I saw people who had to use paper for war. I saw what I call indentured slavery. I really learned what was nursing. You know so many times we think of the nurse in the white uniform who is you know helping the birds in the hospital but up there in the rural areas you do many things.

And to me it is nursing in the white community. The nurse became a model highest that a black woman who was represented and this nurse with her white uniform in her satchel. She was really looked upon with pride and respect because there were so few black doctors and many of the small rural communities the black nurse was the only health care professional available. Working without the direct supervision of doctors public health nurses created a women's world that stood apart from the mainstream of American health care but their independence posed a threat to the medical establishment. In 1929 the American Medical Association lobbied to end congressional funding of public health projects saying that the programs were

unproductive and tended to promote communism. The nurses fought back but the funds were not renewed and many nurses were out of a job. While nursing offer was worth partly by its own excesses that the other side of it that their crusade to get Americans to have health examination every year to get prenatal care to have their children vaccinated were by and large successful. By the end of the 20s and so there was a certain loss of impetus for the move people felt well a lot of the main goals have been achieved and we don't have to put the same kind of effort into it. For a few decades. Public health promised a new role for American nurses but the promise was short lived. Public health nursing did not disappear but most nurses found themselves once again at the mercy of the private employer or the hospital. By 1930 there were 7000 hospitals in the United States more than

eight times as many as when the first nurses entered training school hospitals offered more and better services and emergency care surgery and childbirth shifted from the home to the ward. Much of this expansion was based on the steady supply of student nurses who continued to be the cheap and dependable workforce for the hospital. Staff. The footsteps of a girl Golomb young sympathetic. Footsteps today under the perils of a truly noble profession where those who are proud the way before her well come guide her footsteps. She starts a new life. A student in the school of nursing once a student entered a nursing program. She became completely controlled and

dominated by the school. It was almost as if you entered a monastery. Most of the students said goodbye to their friends and their families. And three years later they returned as a nurse. The discipline was that was what was bad. They had so many rules and regulations. For example we had a small school so therefore we had smaller classes. I think it was only 15 in my class and of course you get a smaller nurses quarters but you had all of the nurses quarters and you couldn't bring even your mother up to your room. Study study study lecture lecture lecture day in and day out week upon week month after month long holiday intensive years. There's nurse created all furniture is to remain strictly placed.

This is to say if a chair is placed by the ruling powers in a remote corner of the room there it must stay there. The nurse must sit unless she prefers to stand floppy Pens may be filled in the office on Tuesdays and Fridays after 7:00 p.m. This is taken to be a precaution against the nurses writing plays and novels when they should be sitting in the chair in the remote corner of the room thinking about bandages don't lie on. Your back with your hand on your head. It would not cost less money than anyone. Yes we can agree here that we don't take it then that one nursing historian has argued that training took women and turn them into girls. That is partly because women were expected to follow orders to behave properly to follow the female hierarchy to assent to what the doctor wanted that whatever autonomy they might have deemed as adult women was sort of beaten out of them in nursing school and what was beaten into the nurse with the proper way to do things the right way then the life or death of the patient depends on whether or not you

got the creases out of the bed and made your hospital corners in appropriate ways. And so what that meant is the kind of individuality and inventiveness that nurses might have developed as adult women was in fact pushed out of them a lot during training. By the end of the thirties all states required that every nursing school graduate pass a licensing exam to become a registered nurse. But registration did not improve the job market with the graduate fewer and fewer patients could afford private duty. The depression merely changed the workplace than it was during the Depression. That private duty is the major form of nursing work as the major field for nurses really ends and it is during the late thirties and forties that nurses become the workforce for the hospital in part because of an expansion of hospitals and in part because their wages dropped so much that it became in fact cheaper for the hospital to hire graduate trainers than to use student

labor. The hospitals offered minimal wages and in some cases only room and board in the Depression. Many nurses consider themselves fortunate to be working at all. What do you attribute your smart thinking. I have very good memory of good. I've got in the hospital it took three years to become a nurse but in Hollywood all it took was a white cat. If you ever go to school well what school did you go to. Now you're not allowed to travel 20 hours a week. You can stop them. The registrations are the highest they get mad dumpsite. That's not what you're here. The popular image of the nurse ranges from the silly to the obscene a grab bag of

stereotypes that reflects the mixed feelings about women in general and nurses in particular. But with the onset of the public perception of the nurse changes overnight. The popular image takes on strong and noble qualities. In fact angelic qualities. But war as General Sherman pointed out is no place or an angel. Or a soldier. Ways of young men who were really ready for some World War. They got word two through nothing but just they were in change shape of war. But you're not. Oh. War is a terrible thing.

Women have served as nurses in every American war but did not have an official role until 19 91 when the government established the Army Nurse Corps. Since that time the military has maintained a permanent body of nurses that is augmented with new recruits as the need arises. When we first started work I got to the hospital and a couple of hours later I was working. You know somebody threw my stuff in the room and took me over to the ward and introduced me and we were busy. And that was it. I remember looking around in these beds were pretty much full all the operating rooms and there were just bodies leaving bodies everywhere. And they these medics came running in with the letter

and plopped it down on the saw horses and my first thought was something something's wrong here right this person so little. And I realized it was a baby and the baby's head had just been blown open and the corpsman had come over and said Sit down. I'll take care of it. And I couldn't register I couldn't. I knew I was supposed to do something and I knew I couldn't just let everybody else take care of it. But at that moment I was immobilized and all I could I remember thinking why. That I couldn't conceive why this baby was there with it's with his head blown up and it just didn't make any sense to me. No one had ever mentioned babies. I thought I was just I don't I don't know what I thought it was going to be doing but I thought I knew what had to do with men and I knew what had to do with soldiers and I knew it had to do

with war. But the truth is that I was 20 years old from Brooklyn New York and I didn't know from nothing about war role the nurse has never been more important in wartime and on the battlefield. But the more successful she does her work the more she makes those soldiers whole again. The more quickly they go back out to get themselves killed and kill others while we're out. How can she do this job in good conscience. Very hard to say. The nurse belongs where she is needed. If nurses are trained to care for people who are injured and they certainly are. There's no better place to find injured people in the middle of a battlefield. You know that the boys were say in the morning. Oh don't don't go down to the bed he would wish it was night. So they use the word voice they used to say. They didn't use the word dying. They tried to avoid talking about it. They

used to say well I wish the good of talking about things you know if it was worthwhile so up your troubles in your old kid bag. Mine was. There are just. 20000 nurses served in World War 1. These were women who worked without officers rank or pay who saw firsthand the day to day realities of 20th century warfare. They faced more carnage and death than a single tour of duty and most nurses see in a lifetime. Gashes from Bandit eyes torn by shrapnel faces half shot away. He was a boy with a great set face. He's hanging on to far gone to make a sound. His stomach is blown wide open and held together by a few bands of sopping gauze

which I must pull away. I do so as gently as I can. The water is sickening. The gauze is greenish yellow. Gangrene. He was wounded days ago and has been waiting on the grounds. He will die. Surely my lord. 1918. There they are. They had to stay in the trenches over time because they did not get to repairs. Now you probably will hear some other thing about that. Guy actually saw their Chos come out when I took their shot. They chose chose though and the thing they said don't bother sister. They said does better without food. They cannot send us back without food. Teresa Cate's 1941 Manila this afternoon 36

bombers flew over our heads in perfect formation. And our entire hospital staff rushed out to see them. I watched the bombs fall and felt pain at the pit of my stomach. Soon our wards receiving rooms operating rooms as well as a large hospital yard were filled with the wounded in a dime. Crimson Tide This is why are we scattered everywhere. In. Reward to the fighting took place on an unprecedented scale and nurses were badly needed. In 1942 American casualties amounted to as many as 1000 a day and the need for nurses grew critical. The army stepped up recruitment but still only offered nurses relative rank which amounted to an officer's uniform without his pay status or benefits. All the same nurses responded. 10000 new recruits enlisted in prepared for duty at the front line.

States Army nurses receive baptism by army. They go into battle machine gun firing live ammunition and bullets into. The training of renourishment. Along the coast of Italy. A new contingent of nations with mental hospital. Funding 3000 miles to do that. In 1945 the need was so drastic President Roosevelt called for a draft of nursing's. I applied to the Navy and I don't doubt a lot of nurses here you know. Other than that now they are coming. They want excuse was a house that. Black

white nurses say whites. So because they did not have housing and like Atlantic up black nurses and it was at that juncture the black nurses said this doesn't make any sense. You're going to consider drafting nurses when you want low bar against black nurses there. Eight thousand. The Army Nurse Corps had established a quota of 56 negro nurses and had sent them all to work in segregated hospitals and military installations. The Navy would not accept any black nurses as long as the Army and the Navy discriminated against them and they accepted that discrimination. Then there would be little chance they felt of winning integration into the mainstream of nursing in the civilian society.

So black nurses had to take the military establishment head on. Black nurses let loose an avalanche of protest. They mobilized community support by filling the pages of the black press with articles and editorials. They want the White House and the War Department with telegrams and letters. Within weeks the government capitulated. By late January 1945 the army and the Navy declared an end to quotas and exclusion. Three weeks later the first black nurse was inducted into the net. Ready. This is a very happy day for me. My long association with me. I have seen many and I told you of the first world war two represented the coming of age of the block.

It represented a double victory not only to America defeat the fascists and Nazi threat but the country was forced to lower some of the discriminatory barriers against black people in general and black nurses in particular. World War II was a coming of age for all nurses. At last they achieved officer status full employment and a better public image. These gains were achieved at great personal cost but the essential role of the nurse in war would never be questioned again. Less than one hundred years after civil war doctors refused to work with women volunteers. American nurses demonstrated to the utmost value of their care. A few weeks ago from my job I had to call a man about about veterans stuff and in our conversation he told me that

he had been wounded during the Tet Offensive and that he had been a patient at my hospital and that he always remembered the nurse who got him ready for surgery and I felt this coldness descend on me and I we were on the phone. He lives in another state and I thought should I tell him. Surely not. What am I going to do with the information once I have it. And finally I just said you know I was a pre-op nurse at a hospital in tact and he started to cry and he said I've always wanted to thank you. And I thought House wanted to be tagged that there was a there was for me that that might mean that I answered that question that's been hanging for so long that I could never answer for myself that in

fact at least for this one person it made a difference. In my day. They wanted you to know nursing but they didn't want you to be subservient to what you were. You were there as somebody always used to say. I never liked the expression The Handmaid's or the doctors. Now the nurses are learning they are an equal with the doctors in a hospital they're not considered second class citizens like we worked on a second class citizens compared to today. Actually in some ways it's gone full circle from the perspective of Florence Nightingale is a very very independent woman who is very scientifically oriented and a leader in her field. The profession then moved to being more of a club collaborative profession with physicians. I would say more around the 20s and 30s and 40s and now what we're seeing is the evolution to really identify what does nursing do that is purely nursing.

And that's not an easy question to answer. Yes. Within nursing there has been an ongoing debate what is a nurse what does she need to know to do her job. Many leaders feel that a nurses work is so difficult that nothing short of a college degree will prepare her. Others feel that college programs are too long too expensive and will keep young people from coming into the profession as health care has become more complex. Nursing has diversified to accommodate it simple care has increasingly been given over to licensed practical nurses and nurses aides registered nurses have taken on intensive care management and administrative position with nurses in these new roles continually ask themselves the question that has haunted the profession from the beginning. How far can a nurse get from the patient side and still call herself a nurse. The problem for nursing really is that it's not one perversion it's about 19 different

professions. You start out with a profession that the nurses are trained for caring for patients usually bedridden patients but not always. They nurses get very good at that. And then if they wish to advance they must. But they find themselves further and further from the patient. Years ago I worked as a supervisor. I worked as a staff nurse. I loved it. And then when you're there for a while they say well become a supervisor. So I became a head nurse and I became a supervisor and supervisor just what it said you just going around looking supervising make sure things get done properly. But there's no reward in that. I mean anybody can do that if you want to be a manager you go to school. Get your MBA. But the rewards in nursing is patient care. You know one day you can go into work and you feel real good about it and you really enjoy nursing and you enjoy taking care of the patients.

And you know you just like what you're doing. And then there's other times they say why am I doing this for the crap that you get. You know I'm just not getting paid enough for people. I don't generally go into nursing because of the compensation that they will be receiving. I think there's always been some kind of an intrinsic satisfaction and that's why people went into nursing because they felt that they could help and that was partly why people were motivated into nursing I don't think they've actually ever been paid great wages. And that was kind of a given. You can't pay the rent with that. The satisfaction that you get out of taking care of people that is the reality of it is that if there is a need for nurses which there is that the salary issue has to be looked into much more so than I think it ever had in the past. Just getting through eight hours as a nurse. Right. There are not enough nurses. You're understaffed all the time. People are getting sicker all the time.

There's just too much to do and a good nurse is constantly in pain because she can't do it. You don't you almost don't have the time to get is involved with the patient. I should like to as you have been able to in the past. And when time is short. Yeah. There are basic things that have to be done that are of utmost importance and you do those. But in the process you lose the time to do big knife little thing the back rubs and the and the the the bad is where you get to take time with people and really get to know them get to know families and things and that's the part that you always got enjoyment out of. And there's just never a time when more in all ways a machine is getting in between us the patient and the nurse you go into a room and you read the telemetry you read the patient's heartbeat you read the I.V. monitor before you even look at the patient's face sometimes because that's where the medical orders are oriented. That's where the goal of care and cure

are oriented and that's where malpractice and liability is oriented. And to some extent that's what patients expect you to do. They look at you to be the competent person who knows how to take care of the machines. The challenge for nurses is to have that intimate moment of compassion with a person in spite of everything that surrounds them. We need some of those machines but we need to always be able to get beyond them and not let them be in control. We need to find constantly find those moments. Heart to Heart moments with our patients. You see this little baby and I select it has all these lines and all these these this equipment hooked up to them and all you want to do is pick him up and hold them you want to say it's going to be OK. It seems kind of cruel to leave the child just there with with lions hooked up and connected to him. And it's sometimes the most important thing. The thing that I'll spend an

hour or two hours trying to do is to rearrange things so that we can get a mother in right next to the crib and if she feels comfortable enough to pick up that child and hold him because I know it was my own child laying there I'd want to pick him up and hold him and just give him a squeeze. I can remember that we had the young man he was a 21 year old man who was in a car accident his. He had a lot of injuries in his upper body. It was it was hard for. He didn't look like himself anymore. When we called his mother on the phone to tell her that there had been an accident and she needed to come to the hospital and to drive safely and be careful on the way for herself and when she got there she was crying. She knows she could tell I think from the voice of the person on the phone the doctor calls in that instance she could tell from the doctor's voice that something was was had gone wrong and that things weren't good. When the mother got to the

hospital and we brought her into the quiet room that we have and we explained that there had been a bad accident and that her child had been killed that we all did everything we could for him and that he didn't probably suffer a lot. And then we brought we brought her into the room and I held her while she held her baby her grown up baby and cried. It probably didn't take a whole long for that to happen but it felt like forever. When I went home that night I held my babies and cried. I like it is nothing new. Nothing short of amazing that any society doesn't see the care giver. It was the mother's role the maternal role the protective role as one of the most essential. Other professions although occupations could get along without

nurses. I don't think they can get along with nurses anymore. They get along with mothers. I think nurses are caught in a terrible bind between wanting to care and being placed in structures in which it becomes very difficult to care in a culture which says caring is nice but we're not going to pay for it. Well we're not going to make it possible because the hospitals have about a whole lot of other things. And caring is not often one of them and it means that nurses are constantly trying to care in an environment in which it is very difficult for them to do that. I think most people who go into nursing go into nursing because they care. And sometimes you have to think back of you think of yourself and say well I care about what am I getting all this. And so losing is a level playing field and we're probably losing many good people because of this. But I think caring. I think it's

still there but I think we have to guard it as we got freedom so that we don't. This.

Yes. And.

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