Our Medical Work from 1866-1896—No. 13

The opening of the First Seventh-day Adventist School of Nursing.

By the Ministry staff

In order to understand the events which led to the opening of the first school of nurs­ing among Adventists, it is necessary to understand something of the situation regard­ing the care of the sick as it existed at that time in this country at large. We think of the years from 1873 to 1893 as the pioneer years in nursing education in the United States.

Florence Nightingale's service in connection with the Crimean War in 1854 to 1856 had stirred people to some action and had effected transformations in many hospitals. As late as I88o the papers were still filled with the influ­ence of the reforms which she was initiating in England. Not only was she moving the Parliament of Great Britain to improve the sanitary conditions in India, but through her work and influence the whole program of sani­tation and care of the army was revolution­ized. Using the funds that were bestowed upon her for her service in Crimea, she opened up a school of nursing in London to which only gentlewomen might be admitted, an act quite contrary to public opinion in that day.

It was in 1873 that graduates from the Nightingale school in London, England, came to the Bellevue Hospital in New York City to see what could be done to improve an al­most intolerable condition which existed in the care of the sick. Hospitals in that day, unlike the well-equipped, scientific institutions of the present, were uninviting places to which the sick came to spend their last days. Few people who could afford care elsewhere braved the environment of an institution in which the comforts of home were sadly lacking, and crudeness and ignorance in nursing care were the rule.

At Bellevue, conditions were no better. The drunken woman in the street was given the choice of going to the jail or to the hospital to care for the sick. Into such an environ­ment came one of the first graduates of the Nightingale school, and it was not long until, ward by ward, changes were made; and out of the ghastly dirt and filth and ignorance, came cleanliness, sobriety, sympathy, and in­telligent care.

There was one girl in a country home in Wisconsin, by the name of Catherine Lindsay (later known as Kate Lindsay), who was much moved by what she read of such conditions, and who determined that she, too, would someday be a nurse. During this period she read the Health Reformer and also Doctor Trail's Water Cure Journal. It was no doubt through the reading of such literature that she conceived the idea of spending two years in one of the water-cure institutes then in existence in the State of New Jersey. We liarcily know just what comprised her work and study during those two years, but we do know that in connection with the nursing care given the sick, Miss Lindsay acquired thor­ough, practical skill in administering many of the treatments which we today call physical therapy.

Thirsting for more knowledge herself, as did many of the fine women who entered nurs­ing in that day, and believing that in order to care for the sick intelligently and with interest, the trained nurse should have better opportu­nities for learning, she entered the University of Michigan school of medicine at Ann Arbor, in 1870. She was a member of the first class admitting women to its ranks in that university, and was graduated from the institution as physician in 1875. She went directly to our first health institute in Battle Creek, to connect with our work there.

At that time an attempt was being made to conduct something like a school of hygiene in connection with the educational work in Battle Creek. The attendance in this school of hygiene numbered from 30 to 6o students each year. Doctor Lindsay was interested, however, in establishing a regular course for the preparation of nurses, and she talked this with the staff at every opportunity. But it was not until the year 1833 that an attempt was made to carry out such a program. In that year a three-month course in nursing was offered. This proved very unsatisfactory, and the next year it was increased to two years. In 1888 a five-year course was outlined for all students who wished to volunteer, and who would pledge to devote themselves to missionary work for that length of time under the direction of the sanitarium board, at the same time receiving instruction in advance of the regular training classes.

The usual difficulty obtained in the admit­tance of students. Evidently there was no strong school-of-nursing committee to con­trol the admittance of students, and hold the number in proportion to the clinical facilities offered by the institution. We find that in one of the early classes (1890), this first school took in seventy-five students in one class. True to the history of such an unwise policy of acceptance, in two years only twenty-five of the class remained. Many factors brought about such a reduction in the group. Facilities for teaching such a large group were inadequate, as was also the clinical ma­terial.

Perhaps it was to supplement the depleted student group that the postgraduate course, an additional three years, was planned, which made five years altogether. Study of the catalogue of that day reveals much of interest in this five-year course, and also the cause for the troubles that were met in putting it into operation. Writing in the year 1903. Mrs. H. M. S. Foy speaks of those early years thus:

For a long time the medical missionary board and the managers of the sanitarium school for mis­sionary nurses have recognized the necessity for a more complete training than it has been possible to give nurses in the time which has heretofore been al­lowed for didactic and practical instruction. When nurses have been assigned to important posts, such as the superintendency of practical work in mission fields or city branches, it has almost invariably been necessary to give a supplementary course of training to secure the necessary fitness for the work. In some instances nurses have been sent without being prop­erly qualified, on account of the urgency of the call, and the results have not always been the most desir­able. To overcome this difficulty, the so-called post­graduate course was organized about two years ago."

The first two years consisted of the general courses offered at that time in the nursing schools that were springing up throughout the country, and in addition, hydrotherapy. calisthenics, Swedish gymnastics, massage, and electricity were included. As we read the curriculum of the remaining three years we do not wonder that there were some difficul­ties in carrying out the program outlined. Such subjects as electrophysics, anthropometry, and symptomatology, as well as sanitary sci­ence, chemistry, bacteriology, and pharmacy, were included in the instruction given. We note also that office work and case taking was taught this early group. These early pioneers should also be commended for their earnest endeavor to prepare students to engage in dis­trict nursing.

As we look at the curriculum planned for that early school we can see in it evidence of an endeavor to meet a certain need, but a failure to approach the problem with sound. constructive educational vision, in which all factors affecting the success of such a pro­gram would be considered. We also realize that in the endeavor to establish a school it may have been difficult to convince dominant leaders of the necessary changes which were obviously needed. It should have been recog­nized that only a very small proportion of the students admitted had a sufficient background of education to make them competent to carry such types of study. Mrs. Foy, in telling how this difficulty was met, writes:

"After due consideration it was decided to raise the standard of entrance. Students are required to have not only a knowledge of the common branches, but at least an elementary knowledge of the sci­ences and a thorough knowledge of hygiene, both practical and theoretical. In order to accommodate those who are not prepared to enter the nurses' training school proper, there has been organized a preparatory course which covers a period of six months. The work done includes anatomy, physiol­ogy, hygiene, elementary chemistry, botany, natural whilosophy, astronomy, and cooking."'

Thus we see the nucleus of our present prenursing program, and how an effort was made to meet the educational deficiencies of the applicants admitted. Many of the courses listed as prerequisite courses were given in connection with Battle Creek College. Kate Lindsay, writing of a later plan to increase the basic two-year course to a three-year term, which would seem a much sounder solution to all needs, stated:

"No one can read the outline of study intimated in the advertisement on another page, which indeed only partially presents the real work of the school, and say that three years is too long to obtain a proficiency in those branches.

"To be sure, a shorter course of training will prepare one to care for the sick better than one having no training at all. One who is advanced, in years and wishes to spend a portion of his time in ministering to sufferers can select some of the practical parts of the training course and thus prepare for a measure of usefulness ; but the professional Christian nurse should aim at nothing below a high grade of efficiency. . . Those who pretend to give such a training in three, four, or six months cannot realize what they are talking about."

Even as early as 1903, the early pioneers of our nursing work began to talk about the regulations of the profession. Speaking of this, Doctor Lindsay says:

"The nurse's calling is being very rapidly raised to the dignity of a profession, and as such is being more carefully guarded. Our different State author­ities are taking an interest, and are providing for the examination and registration of nurses. They establish the standard, and one feature of that standard is to be a three-year course."'

She then states a policy which shows the far-reaching vision of those early pioneers of Christian nursing education: "It is better to anticipate this move and be prepared for the test when it comes, than to wait and a little later be compelled to adopt it or go out of business." At the time this was written there were in the United States 545 training schools for nurses.

It should be remembered that in those pio­neer days there were few textbooks. The first textbook of which we have any record was written by Miss Clara S. Weeks in 1894. About the same year Dr. Kate Lindsay pub­lished a volume which included some brief lec­tures on anatomy and physiology, hygiene, medical and surgical nursing, the care of children, gynecology, and obstetrics. In the appendix of this same volume, there appeared a paper read before the section of hospitals, dispensaries, and nursing schools of the In­ternational Congress of Charities, Clinics, and Philanthropy, held in connection with the World's Fair in Chicago in 1893. This paper was read by Mrs. S. M. Baker, one of the first to be graduated from the Battle Creek school. It was at this World's Fair that the pioneer nurses of America met, and here were born the organizations which are known as the American Nurses' Association and the Na­tional League of Nursing Education.

Early literature indicates that Doctor Lind­say made every effort to place proper ideals for the profession in the hearts of the Sev­enth-day Adventist youth of that day. Thus we find in copies of the Medical Missionary of September, 1905, a nurses' pledge written by her. The pledge reads as follows:

"Realizing the serious nature of the duties and the grave character of the responsibilities of the professional nurse, and especially appreciating the solemn obligations of the missionary nurse, I hereby solemnly pledge myself, by the help of God, faith­fully to perform the duties of my calling, sacredly to regard its obligations and responsibilities, con­scientiously to teach and practice the principles taught me by my instructors, to keep inviolate the professional confidences which may be reposed in me by those under my care, and to labor earnestly and truly for the relief of human suffering and the amelioration of human woe, and especially for the moral and physical uplifting of those of my fellow mortals who may be in need of my assistance, wher­ever duty may call me to labor."'

Speaking again of the thoroughness of the nurse's work, she wrote in 1904:

"As a missionary nurse it is essential that the very highest ideals be attained. That there be no occasion for the truth's being trailed in the dust by one's own imperfections and mistakes. In the first place the nurse should have a training that is thorough in the fullest sense. She should spare no pains to obtain the best possible fitting for her work, and to get the most out of it. Physicians can very quickly determine whether the nurse has had thor­ough training or not. An unqualified workman in any vocation cannot command the respect of his associates."

Thus we see the high ideals and standards which permeated that first school of nursing among Seventh-day Adventists. In less than two decades this first school established in 1884 had sent graduate missionary nurses to Denmark, Norway, Sweden, Finland, Germany, Switzerland, England, France, Australia, Ire­land, India, Japan, East Indies, West Indies, Honolulu, Samoa, New Zealand, South Amer­ica, Palestine, Philippine Islands, Egypt, South Africa, and many other lands, "as well as occupying places of responsibility in our various institutions in several State confer­ences, and in our denominational schools."

We here reproduce pages two and three of a four-page announcement of the first training school for nurses at Battle Creek, Michigan, issued November it888, which shows the curriculum for the complete five-year course, and other items of interest.

Kathryn Jensen Nelson.

Notes

1 The Medical Missionary, Vol. XII. Feb., 1903, P. 38.

2 Ibid.

3 Id., Vol. XIV, Aug., 1904, p. 242.

4 Ibid.

5 Id., Sept., 1905, pp. 280, 281.

FURTHER REFERENCES

Lindsay, Kate, M.D., "The Sanitarium Medical Missionary School" (lectures), Battle Creek Press.

Weeks, Clara S., "A Textbook of Nursing," D. Appleton and Company, New York City, 1894.

The Medical Missionary, Vol. I, 1891 ; Vol. II, 1892; Vol. VI, 1896; Vol. XIII, 1904: Vol. XIV, 1905.


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By the Ministry staff

January 1941

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