Summary: A chapter from the Medical History of Michigan that illustrates the way that nurses were involved in both home and institutional care.
Library of Congress: Pioneering the Upper Midwest: Books from Michigan, Minnesota, and Wisconsin, ca. 1820-1910
A chapter from the Medical History of Michigan. The book in its entirety is online at:
Medical History of Michigan, Volume I. (Michigan State Medical Society, 1930).
Medical History of Michigan, Volume II. (Michigan State Medical Society, 1930)
To Miss Marie Belle McCabe, of Grand Rapids, should go the credit for the portion of this chapter on nursing.
She bestowed many months of hard, painstaking work upon the gathering of the material, and has selected, arranged and drafted it. My part has been merely to give a certain direction to the project, to add a bit here and there, and to edit the manuscript. Some of the items, particularly her descriptions of nurses' uniforms, reflect clearly a feminine viewpoint and could not have been readily conceived by the masculine mind. We believe that they will be appreciated by our women readers.
We think that the facts contained in the chapter are essentially correct, although necessarily Miss McCabe was obliged often to rely on the personal recollections of those who have been devoting their lives to this field of endeavor. For lack of space and because our sources of information were to a considerable extent limited, much that would have been of interest has been omitted or passed over with brief mention. We regret that questionnaires remained sometimes unanswered and that we thus have not had access to data upon which an adequate account might have been given of certain nursing institutions and the work of individual contributors to this field.
We believe that our readers will find in this chapter not only a brief history of nursing in Michigan, but also a short, reliable account of the present state of many of its institutions. (R. R. S.)
The basis for all nursing was the care that the mother bestowed upon the members of her household in time of illness. Her anxiety for her loved ones, along with her desire to give aid and relief to the suffering, made her gentle and painstaking in the methods she used. At first, the mother was concerned with her own family, but as settlements grew larger, she would offer her services to a neighbor in time of trouble. Apparently there was no need for greater skill than that acquired by experience within the family and the neighborhood. Certain women, however, were handier in caring for the sick than their neighbors; naturally they would be called into service very often. Gradually, women, because of their natural inclination and repeated experience, were set aside by the neighborhood to minister to the sick. These women were called nurses.
As communities grew, the limits of friendship were less observed and women skilled in giving aid to the suffering were called into homes of strangers and would receive remuneration for their services. This was the beginning of the practical nurse for hire, and for decades she was sufficient for the needs of the people.
A curious transformation occurred. The gentlewoman retired from nursing, leaving this service for the menial to perform. Then we find the Grace Pools and the Sairey Gamps of literature, with their slovenliness, drunkenness, and immorality. When hospitals were first established, the nursing was done by these untaught hirelings. Since these nurses were also the scrub women, the scullions and the cooks, and all this for a very small wage, they were usually of inferior mental capacity and desirability. They were often morally vile and incompetent. As a reaction to these distressing conditions, arose the ideals that brought into being the nursing profession as it is known today.
Florence Nightingale, back in the first half of the nineteenth century, had the vision of what type of person should be entrusted with the care of the sick. She knew that intelligence, cleanliness and morality were fundamental characteristics. When she established her training school for nurses in England, the pupils nurses were selected with these qualities in mind. With the rise of scientific medicine and surgery, physicians recognized that the care the patient required was too complicated and exacting to be entrusted to the untrained, old type nurse, and they were ready to help usher in a new order of nurses. Nurses of high ideals of service had a difficult task, however, in obtaining recognition. Doctors and the public were accustomed to the unskilled and ignorant nurse, and were slow to accept the intelligent, educated woman whose training made it possible for her to follow orders accurately in the scientific care of the sick and whose presence in the sick room added so much to the mental comfort of the patient.
Michigan felt the need of the nurse many years before she arrived. In a history of Detroit published in 1834, the lack of a sufficient number of nurses to care for the sick and for orphans was mentioned with regret. And later in that year, when the whole vicinity was suffering with cholera, Father Kundig organized a Catholic Female Association, whose members would devote their time to nursing as long as the community needed them. Even at the time of the Civil War, there were no trained nurses. There were a few hospitals in the state, but the care of the patients was intrusted to convalescents and hired men and women. The first University Hospital at Ann Arbor was built in 1869. The early records show that the male patients were cared for by the handy man about the hospital. Two practical nurses were employed to attend the women patients. Another hospital, at an early date, recorded that it was difficult to have all patients cared for properly. The hospital paid wages varying from $3.00 to $10.00 a week for practical nurses, but there was never any assurance that the new day would find a complete corps. The women employed were very unreliable and would resign their positions without notice. It is also recorded that the hired nurses were likely to neglect the disagreeable patients when caring for the kindly disposed was more congenial to them.
The Michigan hospitals were not unique; these conditions prevailed all over the country. The way out of the difficulty was met by Bellevue Hospital in New York, by establishing a training school for nurses in 1873. Sister Helen, a Roman Catholic nun, who had been associated with Florence Nightingale, was secured to open the school. Within six years from the date of the establishment of this first nursing school, nine other schools were started; most of them in the East.
When the Sisters of Charity and the Sisters of Mercy began to come into Michigan, they established asylums for the sick and the friendless. They could not pay for the nursing of their charges, therefore they started training women who could help them in this needed work. At first, the training was offered to sisters and novices of the particulars order, but after a time, the need for trained nurses who could go out into the community was so great that the privilege was extended to the laity.
Many physicians associated with the early Michigan hospitals realized that the way to have trustworthy nursing for their patients was to provide some sort of training. Dr. John Harvey Kellogg, a young physician coming into Michigan from New York City to take charge of the Battle Creek Sanitarium in 1874, found that if he was to have skillful nurses for his surgical and medical patients, he would have to train them himself. He was a student in Bellevue Hospital Medical College when the training school for nurses was established. Since he knew what might be accomplished, he began giving short courses for nurses and attendants. The course increased to six months and included technic in hydrotherapy and massage. Gradually the course was extended and a formal training school for nurses was opened in 1883. At the time Dr. Kellogg was teaching men and women how to give skilled care to his critical cases, the doctors of Harper Hospital in Detroit were feeling keenly the need for trained nurses. The result was the opening of the Farrand Training School for Nurses in 1883. The school was named in honor of Dr. David Osborne Farrand. The idea upon which this school was founded was, "That it should be a school open to women of culture and stability, who would become pupils with a view of making nursing a life work, and it should be so well established that eventually it would furnish trained nurses not only for Harper Hospital, but for the community at large." In the establishment of each training school in Michigan, the purpose was evidenced by some such expression as "in response to the community's growing need for graduate nurses."
Up to 1890, Michigan had four training schools for nurses; one in Battle Creek, one in Detroit, one in Grand Rapids, and one in Saginaw. The next decade saw twelve more schools established, and, strange to say, all twelve were in the immediate neighborhoods of the early ones. However, from 1900 through 1910, twenty other training schools were founded. These were distributed over the state, three being in the upper peninsula. There were a number of schools which, for one reason or another, ceased to thrive and went out of existence. At the present time, there are forty-nine accredited schools of nursing in Michigan, all endeavoring to give careful training to their students.
During the infancy of the early schools, there was little uniformity in class instruction or in subject matter. The degree of proficiency of the training was in direct proportion to the vision of the superintendent of nurses and her advisory board. There also was wide variation in the age requirement for entrance. Some of the training schools would enter any adult, while some limited the age, as did Blodgett Memorial Hospital, to women between the ages of 25 and 35. Little attention was paid to preliminary education. Marked attention however was paid to high moral character, good disposition, and good health. The candidates were obliged to qualify in these three attributes. One early school deemed proficiency in house work before entrance a very desirable accomplishment.
Since the organization of the Michigan State Board of Registration of Nurses in 1910, there has been a greater uniformity in the courses offered in the choice of subject matter in the training schools throughout the state. The entrance age limit is now defined to be eighteen by law, but there are still training schools that refuse entrance to those so young. The Farrand Training School of Harper Hospital requires that the applicant be at least nineteen. Michigan law also demands that the applicant shall have completed the tenth grade before entering a training school. In this respect, again, Michigan training schools show some variation. Although no accredited school enters a student with less than two years of high school, several schools expect three and four years. The training schools in connection with the following hospitals demand the completion of high school before a pupil is accepted: University Hospital, Ann Arbor; St. Joseph's Hospital, Ann Arbor; Harper Hospital, Detroit; Children's Free Hospital Detroit; Henry Ford Hospital, Detroit; Battle Creek Sanitarium and Hospital, Battle Creek; Mercy Hospital, Grayling; St. Luke's Hospital, Marquette; Hackley Hospital, Muskegon; Edward W. Sparrow Hospital, Lansing; Blodgett Memorial Hospital, Grand Rapids; and St. Mary's Hospital, Grand Rapids. At the present time, regardless of the legal requirements, student nurses themselves realize the value of good preparation, and most of them enter the training school only after the completion of a high school course. The State Board of Registration of Nurses, in going over its files for 1929, found that 79.8 per cent of the nurses applying for registration had a high school diploma. Only 15.6 per cent of the nurses seeking registration were adhering to the minimum requirements. The State Board, also, finds that each year shows an increasing number of graduate nurses who have had a partial or complete college course.
The length of time spent in training has increased. At first some of the courses were but six months long, others as long as eighteen months. But by 1900 all of the better schools of nursing gave a training of at least two years. The law limits the course to a minimum of two years; at present, all but five of the schools offer three year courses. Three of these schools affiliated with the State University or colleges combine in five year courses, and graduates obtain a Bachelor of Science degree. The five training schools with courses less than three years exceed the minimum two years by six months.
Class work in the early training schools did not occupy the important place it does today. Staff doctors did much in the instruction of student nurses. Naturally it was done in a rather haphazard way, for it was difficult for the physician to fit the work of instruction into his daily routine and classes were held with too little regularity. The superintendent of nurses was, of course, held responsible for the instruction of the pupil nurses and she helped them in nursing procedures. She, also, with many other duties to fulfill, was likely to find her day too full for formal class periods. One school records that for the first three years of its existence it averaged eight lectures a month to student nurses. A report of the superintendent of another pioneer hospital states that no lectures had been given to the nurses that year. She hastens to say that the fault did not lie entirely with the doctors. The work was too heavy for the number of workers, and the nurses had no time to attend classes. But the elaborate course of study outlined by the National League of Nursing Education in 1927 shows how far nursing education has advanced since its inception in 1880.
Not only has the course of study become more inclusive and technical, but also the instruction has become more regular and assured. Getting away from the early days in which physicians and superintendents of nurses assumed the entire responsibility of educating the young nurses, every training school today employs a registered nurse for this purpose. Some of the larger schools employ several such instructors. Many of the training schools are augmenting this teaching with that of experienced teachers outside the medical and nursing professions. In 1912, the Children's Free Hospital of Detroit enrolled their students for a course in chemistry given by the Cass Technical High School. Soon other training schools began sending their probationers to Cass for instruction in the basis sciences: Chemistry, anatomy and physiology, bacteriology, dietetics, psychology, materia medica, and dietotherapy. The plan gave the students the opportunity of receiving instruction from specialists in each of the sciences. Moreover, the instructors of nurses are given more time for following up the practical procedures in nursing technic. Making use of the public schools was next tried in Grand Rapids. Two of the hospitals, Butterworth and St. Mary's, sent their beginning students to the junior college for the basic sciences in September, 1918. The following fall, Blodgett Memorial joined them in the movement. With the rise of junior colleges throughout the state, other schools for nursing have followed this example and are sending their student nurses to the college for class work, or by having the college teachers meet the classes in the hospital. Many hospitals give their dietitians to teach dietetics and dietotherapy to the nurses. Some hospitals employ registered pharmacists to hold the classes in materia medica. Two of the hospitals founded by the Sisters of Mercy have engaged priests to teach the nurses psychology and ethics. It is interesting to note that in both cases the priests hold Ph.D. degrees in psychology. It is not to be questioned that nursing procedure and clinical instruction must be given by nurses and doctors, since they are expert in these fields. More and more our hospitals are arranging with doctors, as well as with instructor nurses, to carry on this work. The present directors of training schools are putting forth a painstaking effort to secure an expert teaching force.
Three of the Michigan schools for nursing are affiliated with institutions of higher learning. They permit their students to take academic work leading to a Bachelor of Science degree and to have the hospital training at the same time. These schools offer a three-year course as well. The University of Michigan grants a B.S. degree to students in the University Hospital School for Nurses who complete the five-year course. The Edward W. Sparrow Hospital for Nurses is affiliated with the Michigan State College at East Lansing for the five-year course. Battle Creek College receives the nurses from the Battle Creek Sanitarium and Hospital School for Nurses when then enroll for the five-year course. Nurses receiving degrees from these three institutions must have met all entrance requirements of their college. Those graduating after the five-year course must be examined by the State Board before they are permitted to use the title of R. N.
Michigan schools for nurses not only offer a very excellent opportunity for training in their own hospitals, but they sponsor scholarships and loan funds that enable their graduates to study further. The Farrand Training School of Harper Hospital, Detroit, offers an annual scholarship from the Lystra Gretter fund that may be used for advanced study. The Foster Foundation of Grand Rapids grants $1,000.00 each year to a nurse graduating from any one of the three local hospitals. It is awarded to the nurse who passes with the highest mark a competitive examination which is given to representatives from the three training schools. The Michigan State Nurses Association now maintains a fund from which two loan scholarships may be granted each year. One scholarship may go to the graduate nurse who wishes to enter a Class A college. The other scholarship may go to a graduate nurse desiring to study public health nursing, provided the nurse selects a school with a well organized public health department. The Michigan State Nurses Association scholarships are granted to nurses who are between 23 and 45 years of age. All of these scholarships are granted to those who have had at least one year's experience. More and more the graduate nurse is encouraged, either by her own training school, or by other agencies, to do advanced study which will help her grow in her profession. It is recognized that the further development of the nursing profession depends upon graduates of unusual ability. With all other conditions equal, the nurse with the best training can make the most valuable contribution.
Nurses far removed from the conditions that controlled their lack of fitness in the early nineteenth century, and ever inspired by such leaders as Florence Nightingale to carry on against all odds, have developed into a glorious band of intelligent, expert workers, with ideals that are commensurate with the dignity of their service. The Michigan nurse has not been slow to fill her rightful place in the nursing activities of the world, and in many instances she has taken a leading part.
"I solemnly pledge myself before God and in the presence of this assembly, to pas my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischevious, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping, and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.--(Mrs.) Lystra E. Gretter, Farrand Training School for Nurses, Detroit."
The number of young persons who at present select nursing for their life work has increased since the latter part of the nineteenth century. Up to the year 1890, there were less than fifty students enrolled in the training schools for nurses in Michigan. In 1921, 1,575 men and women were studying nursing. In making this comparison, it is only fair to state that by 1921 the number of training schools had so increased that any locality of the state was within a reasonable distance of at least one of them. The proximity of such schools possibly had something to do with the increased interest in nursing. Of course, the population of the state had increased. While these factors all contributed, there is no question but that the ideal of service and the glory of the profession made a very strong appeal to the young person of character. The nurse played such an unselfish and heroic part during the World War, that she won respect from all observers. Her growing interest in the social conditions of her own locality and of the world was making her an outstanding citizen. Young girls were attracted by the nurses and nursing activities, and so it is not surprising that many of them elected the profession. It is pre-eminently a woman's work.
Again, a nurse's training may be gained with comparatively little expense to the student. Usually no fee from the student is asked, and hospitals occasionally pay the student nurse a small sum to cover the expense of uniforms and books. This money is not considered a remuneration for what work she may do in the hospital. The cost of the training for each student is much greater than the actual money value of the service each girl can perform for the hospital. Training for no other profession can be gained at so little expense. Hospital boards feel that the service the trained nurse can give to the community more than pays for the training.
Years ago, when hospitals were less certain as to what should comprise a suitable training for the nurse, and the question was being debated as to what a nurse might owe the hospital for this training, the student performed heavy labors and worked long hours. It was a Michigan hospital, Harper Hospital of Detroit, that first established the eight-hour day for nurses. This standard day for women was not only accepted by other hospitals throughout our country, but also laws were passed to protect women in industry from a day too long to maintain good health. While Harper observed the eight-hour day for its students as early as 1891, some of the hospitals have only recently limited the nurse's working time to a fifty-six-hour week.
The purpose of many training schools today is not only to train the young nurse in the care of the sick, but to supply a carefully controlled social background as well. The "house mother," "social directors," and superintendents of nurses are awake to the needs for recreation and social contacts. The homes of the student nurses are more than housing quarters. They are homelike, have artistic living rooms, libraries supplied with books other than texts, and music rooms furnished with pianos, phonographs and radios. The well equipped kitchenette offers facilities for teas and suppers. Nurses are frequently given the opportunity for choral singing, public speaking, and dramatics. If the school has no gymnasium, it often rents one, and students may thus take part in basketball, folk dancing, and other indoor sports. Life in the nurses' home offers the same social advantages as that in the college dormitory. Thus the student nurse learns to balance her day with work and play.
Since 1880, when some kind of training was first offered in Michigan to persons who wished to care for the sick, many training schools have sprung into existence, some to weather the difficulties that beset them and others to fall by the wayside. Every hospital that offered a nurse's training contributed to the rise of the nursing profession in Michigan. When a hospital discontinued its training school, either because of the force of circumstances or for other reasons that seemed desirable, it did not withdraw from active its graduates who were already raising the standards in the field of nursing. Nor was the influence which the school initiated during its existence completely lost when it no longer accepted students. Such a training school as the one connected with the Homeopathic Hospital of the State University was a pioneer in advancing nursing education. The Lockwood Hospital and Deaconess Home in Petoskey offered one of the first training schools in that section of Michigan. The nursing school at the Ann Arbor Private Hospital was disbanded when progress in the educational program and the facilities of the University Hospital School for Nurses made it possible for it to care for all the student nurses in the vicinity of Ann Arbor. Dr. Reuben Peterson and Miss Fantine Pemberton, the two persons who organized the Ann Arbor Private Hospital Training School for Nurses, were very active in developing a program for nursing education for the University training school. The training schools connected with the Paulina Stearns Hospital in Ludington, St. Joseph's Hospital in Menominee, and the Samaritan Hospital in Detroit were discontinued in 1923, after years of successful teaching. Unstable economic conditions caused the Calumet and Hecla Hospital of Calumet to dispense with its training school. The Newberry State Hospital stopped giving nurses' training after 1921. Today, along with six other hospitals, it offers a course for the training of attendants. This brief mention of those schools which have gone out of existence as such, and not live only in the lives of the nurses who were influenced by them, does not begin to evaluate their service. No more will be said of them, however. In the following pages only schools recognized by the State Board of Registration of Nurses and Trained Attendants in 1929 will be included. The schools will be considered in chronological order. Whenever possible, the oldest schools will receive special mention because they "blazed the trail" for the training schools that followed.
In 1881, the Michigan Medical News reports, "It gives us pleasure to announce the establishment in this city [Detroit] of a training school for nurses. The work has been undertaken by the Michigan College of Medicine, and the coöperation of a number of prominent citizens and ladies has already insured its success. The Michigan College of Medicine is entitled to credit for the innovation. For $25.00 and two years study and practice of their profession, they [the nurses] will receive $216.00 and be prepared to earn at least $10.00 a week in this remunerative and useful field of work for women." This notice is the only record of the training school which has been found. How long the school existed and how many nurses it trained are undetermined. Nevertheless, this school has the honor of being the first formal training school for nurses to be mentioned in print in Michigan.
Two schools for nurses were organized in the year 1883. These schools are outstanding today because of the breadth of their work and because of their influence in the development of nursing. Certainly a pioneer in nursing education in the middle West, as well as in Michigan, was the Farrand Training School honoring Dr. David Osborne Farrand. It was established in connection with Harper Hospital, Detroit. The only trained nurses this section of the country had known up to that time were from one of the very few training schools in the East or Chicago. There was also a dearth of physicians. Dr. Farrand, as well as other doctors, felt that medical service could be extended over a greater field if the physician could leave at the bedside of a critical case a reliable, skilled nurse. The Farrand Training School was opened with the ideal of training women of culture and stability who were willing to make nursing a life work and who would care for the sick not only in Harper Hospital, but in the community as well.
The first principal was Miss Emma Hodkinson, a graduate of the Bellevue Hospital Training School for Nurses in New York City. The early entrance requirements were credentials of good health and character and a good education. Entrance was limited to women between 24 and 35 years of age. The length of training was eighteen months. While the curriculum was made up of but few subject, the records show that from the beginning the program was systematically and carefully observed. The classes were taught by the principal. The subject matter for each course was very carefully selected to fit the needs of the nurse.
If not from the first, at least at a very early date, the Harper nurse's uniform was made from a distinctive checked gingham manufactured in England exclusively for the Farrand School. The good is now woven in this country, but the design has never been changed. Needless to say, the style of the uniform has been changed from time to time, as fashion dictates.
Mrs. Lystra Gretter, of the Buffalo General Hospital, became the principal within the first five years of its beginning. She guided its destiny for a period of twenty years. The purpose of the school has always been to keep pace with the demands of the community. Mrs. Gretter rearranged, lengthened, and added to the curriculum that these needs might be met. The eighteen months of training was extended to two years. This satisfied only for a time and in 1891 a three-years course was developed. The year 1891 was an important one for the nurses of Harper, as well as other hospitals, and for women in industry everywhere. Harper adopted the eight-hour day for its nurses. It was the first hospital in American to take such reform measures, and for several years it stood alone in this idea. The result of that radical step has been harvested by women in employment around the world.
The course of study has often been revised to meet the increasing demands upon the nurse. When Harper joined other Detroit hospitals in sending their beginning nurses to Cass High School for instruction in the basis sciences, the total corps of the school's instructors was maintained. This made a teaching force to give adequate supervision to the nurses on duty. Now the training school has its own class room unit, including a well equipped laboratory.
The Farrand Training School opened with a registration of seventeen pupils. Now the enrollment is two hundred. The entrance requirements have changed somewhat. Graduation from a high school is considered the minimum educational background and an applicant may be accepted if she is as young as nineteen.
During the forty-six years that Farrand has been training nurses, it has always stood for excellency and proficiency in nursing technic. The able women who have served as principals have left their stamp not on students alone, but on the nursing profession in the state. Many illustrious names in the field of nursing social welfare are to be found among the 1200 graduates from this school.
Mrs. Gretter was interested in every progressive movement in nursing. She contributed in a large way to many branches of the service. Her ideals for the nurse are expressed in the Florence Nightingale Pledge, which was written by her and her Committee on Nursing Education for the class of 1893. Because it expresses superior ideals for women entering the nursing profession, the pledge has been adopted by other training schools. Hundreds of young nurses have agreed to the covenants of the pledge on commencement days.
Miss Matilda Krueger, of the class of 1907, followed Mrs. Gretter as principal of the training school. Miss Krueger was called from this post to take a very important place in the nursing service of the American Red Cross in Serbia. She died while serving her country.
Miss Emily McLaughlin, 1896, then took charge of the training school for the next nine years. Miss McLaughlin had served during the Spanish American War. When her country needed her again, she organized the nursing force for Unite 17 which did such faithful work during the World War.
Miss Margaret McDermid was left in charge of the school when Miss McLaughlin went overseas. She was followed by Miss Lula B. Durkee, 1894. Miss Durkee had also seen service in the Spanish-American War.
Other alumnæ that have become prominent in nursing circles are Miss Alice Bowen, 1889, who established the Visiting Nurse Association of Detroit; Miss Agnes Deans, 1895, who organized the Central Directory for Nurses and who became an executive in public health work under Miss Delano; Mrs. Elsbeth Vaughn, 1904, who assisted Miss Delano during the war and is now with the American Red Cross in St. Louis, Missouri; Miss Elizabeth Parker, 1888, who held important positions in nursing work in the state, especially in the tuberculosis crusade, the State Nurses Association, and on the State Board of Registration of Nurses.
These are but a few of them. There is, unfortunately, no space in which to mention all of the graduates who served in times of disaster and in wars, nor those who are serving in hospitals and private homes, and in community work.
When Dr. John Harvey Kellogg, a recent graduate from Bellevue Hospital Medical School in New York, took charge of the Health Reform Institute in Battle Creek in 1874, he found that he needed men and women with some scientific understanding of the care of sick to assist him in his work. From time to time, he organized the "family of helpers" into classes, in order to give demonstrations of technic in nursing procedure. He augmented these demonstrations with lectures on physiology and hygiene. Dr. Kellogg was so interested in spreading the gospel of healthful living that, when time permitted, he taught classes in the community the value of sufficient rest, proper foods, and wholesome exercise for the maintenance of health. Out of these classes grew three schools; the school of nursing, the school of dietetics, and the school of physical education.
Dr. Kellogg was still a student in Bellevue when the first American training school for nurses was opened. It was in 1883, however, when he and his associate, Dr. Kate Lindsay, organized the three months' course for the instruction of nurses in connection with the sanitarium. Within the year they increased the curriculum so that a two years' training was established. The first class, with a membership of seven, was graduated in 1886.
Both Dr. Kellogg and Dr. Lindsay were vitally interested in scholarship and learning. They taught the first class themselves. Dr. Kellogg would give the theory and Dr. Lindsay followed up with the practice. After Dr. Lindsay's time, the records show that when a class did not exhibit proficiency in a certain procedure that Dr. Kellogg deemed necessary, he would take over the instruction of that class. No doubt, the success of this school through the years is due, in part, to the constant seeking after knowledge by its founders and the incorporation of the findings into the course of study given to student nurses; and also, in part, to the careful way of teaching.
A report of this school of nursing published in 1896 stated that for several years the course of study had included anatomy and physiology, hygiene, surgical nursing, practical nursing, hydrotherapy, and cookery for the first year students. The second year students studied massage, manual Swedish movements, cookery, and disease. The young women were given procedures in obstetrics and gynecology. A knowledge of general housework was considered important.
The student girls shared in the ironing, while the men cleaned the carpets. Both men and women students acquired skill in caring for the patients' room and in setting trays. Young men and women would sometimes attempt to take the training without a sufficient educational background. Under the circumstances, the sanitarium maintained them while they learned the rudiments of an "English" education. Consequently, the date of graduation for these nurses was delayed.
Nurses in training constantly had the ideal of service for others held before them. Among the first students, Christian Health Bands were organized. These bands of nurses would use their leisure time visiting the lonesome and the sick. They gave bedside care whenever it was needed. They always tried to leave some message of cheer and helpfulness, either in words or by gifts. From this practice has grown the out-patient department that today offers community nursing to Battle Creek and vicinity. The benefit is not felt by the community alone, because the nurses are getting excellent training in public health service.
The Christian Health Bands aroused such a desire to help others by caring for the sick and by teaching healthful living that many of the members volunteered for mission work. This spirit so permeated the school that the name was changed to the Battle Creek Sanitarium Missionary Training School for Nurses. The students volunteers felt the need for a more extensive and intensive training before they entered into such responsible work, and a five-year course was given to them. This course included religious training as well as a ramified nurses' training. From this course, several of the young men entered medical school and are practicing physicians today. The five-year course was discontinued after several years.
The year 1888 was noted not only for the beginning of this five-year course, but it also marked the introduction of scientific cooking into the training course. Mrs. C. E. Kellogg, a scientifically trained women, converted her kitchen into a nutrition laboratory, and after thorough experimentation, she brought her findings to the cookery classes for the nurses.
The student nurses were not receiving as complete a training as Dr. Kellogg and his staff wished, and so a general hospital was added to the sanitarium in 1887. This made it possible for the nurses to have experience in all nursing services except in contagion and mental cases. The name of the school was again changed to Battle Creek Sanitarium and Hospital School for Nurses.
An important change took place in 1923, when the management of the Battle Creek Sanitarium and Hospital bought the buildings of the old Battle Creek College and housed the three schools, School of Nursing, School of Physical Education, School of Home Economics under one roof. These three schools became the nucleus for the present Battle Creek College. Two years later, the College of Liberal Arts and Sciences was added. Battle Creek College wan then granted full recognition as a four-year college worthy to grant the baccalaureate degrees by the North Central Association of College and Secondary Schools.
Mrs. Mary Staines Foy, who has been the director of nurses since 1899, and who was ever watching for opportunities for expanding the curriculum of the training school that it might become of still greater service to the students, saw her chance. She and Mrs. Louise Gleim-Fischer assumed the task of reorganizing the nursing school so that two courses might be offered. One course was for three years. It prepared the student to take the examination for registration. The other course was for five years and led to a scientific degree, as well as giving an adequate training in nursing. The subjects required of all the student nurses were put in three consecutive years, during which time hospital training was given. Five-year students spend the other two years in the literary college, preferably before entering the school for nursing. The three-year course was planned for a curriculum which totals 1,025 hours of class work. This is 200 hours more than that suggested by the standard curriculum; 196 of these hours are devoted to hydrotherapy, electrotherapy, and massage. Mrs. Gleim-Fischer was made dean of the school of nursing and remained in that position for three years.
The educational requirements for entrance were raised to meet the college requirements. This school of nursing, along with other schools in the state, is finding that applicants for admission are presenting ever higher educational attainments. The later classes have had a sprinkling of students with some college training. The classes of 1927 and 1928 each had seven college graduates among their number.
The school attracts students from all over the world. No doubt this is true because of the wide distribution of the graduates. Several races have sent representatives here for training. In former years men were accepted. This practice, however, has been discontinued since the World War.
The uniform of the Battle Creek Sanitarium and Hospital School for Nursing has undergone an interesting revolution. The long, tight woolen sleeves gave way to elbow length when the nurse found that it was difficult to manage the sleeves and give a bath at the same time. The dark woolen dress was replaced by brown striped gingham. A lovely blue and white followed the brown tripes. The large full apron acquired a bib. The cap, after caps were introduced, was roomy and frilled and of remote kin to the trim head dress crowns today's uniform. Of course, waist lines have been competing with skirt lengths to see which would change most often. The recent skirts, however, have not swept the floor as the nineteenth century ones did.
Nineteen hundred and twenty-eight young men and young women have graduated from his school of nursing and have gone "into all the world," where they are holding positions of trust and responsibility. Mrs. Mary Staines Foy, a member of the first class, then again of the class of 1890, has been intimately and constructive associated wit the Battle Creek Sanitarium for fifty-one years. For the past thirty she has been the director of nurses. Miss Charlotte Hoffman, also an early graduate, went to Honolulu to be chief nurse in the sanitarium there. She worked in several missions in California and in 1913 she returned to Battle Creek to take charge of t he nursing service for the obstetric and out-patient departments of the sanitarium. Miss Lenna Cooper, 1900, was selected by the United States government to be the chief dietitian during the World War. At present she is food director of the University of Michigan and professor of institutional administration of Battle Creek College. Miss Leone Sweet, 1903, Miss Jessie Midgley, 1903, Miss Fern Sheick, 1924, as well as other alumnæ, are teaching or supervising in their own school.
Graduates of Battle Creek Sanitarium and Hospital School of Nursing are found in hospitals all over the country as administrators, supervisors, or instructors. Many more are in foreign hospitals.
One of the first industrial nurses in the country came from this school. In In 1904, Miss Jennie Williams was employed by the National Cash Register Company in Dayton, Ohio, to do first aid among the employees.
Thirty-nine graduates served their country during the World War; eighteen of the number were men. Nine nurses went to France with Base Hospital 114 and one is buried there. Numbers of nurses were sent to Camp Custer. During the influenza epidemic, student nurses were sent to relieve the Red Cross nurses at Camp Custer
When the Union Benevolent Association of Grand Rapids began to admit the sick as well as the aged into their home, a need for nurses was felt. It is true that women could be hired to care for patients, but this was more or less unsatisfactory. They were untrained, and their unfitness for the responsible work of a nurse was soon recognized. The advisability of opening a training school for nurses was discussed for over a year, with the result that two members of the Womans's Board were sent to England to study the conditions under which the nurses' schools organized by Florence Nightingale were conducted. Finally, in 1886, at a meeting attended by the Union Benevolent Association Hospital Committee and a number of interested physicians, the plans were formulated for the establishment of a "nursing academy." The proposed course of study was to be so thorough and so complete that any one taking it might receive a certificate on graduation that would entitle her to do nursing in the hospital and in private families.
The school was opened in 1886. It was named the Marian Louise Withey School of Nursing. Entrance was granted to young women who could furnish references as to excellent health and good character, who were between 25 and 35, and who had had a common school education. Preference was shown to applicants with experience in general house work. Five candidates could meet all of these, qualifications, and were accepted for the first class. During the first year, however, the number was raised to nine. From the very beginning of the Marian L. Withey School, more applications for entrance have been made each year than could be accepted, and the school has always been able to choose its students.
The first course was for eighteen months, with the training divided among the medical, surgical, obstetrical, and children's wards. Occasionally student nurses were permitted to go into homes as an accommodation to citizens, as well as for further experience for the nurse. The remuneration the nurse received for such service was paid to the hospital. Some of the Grand Rapids doctors were much interested in the experiment of training nurses, and they willing coöperated by teaching them. The doctors gave the lectures in anatomy, physiology, hygiene, disinfectants, as well as the clinical instruction. The arrangement of classes and the supervision of the nurses were in the hands of Miss Stephenson, a graduate nurse from Harper Hospital. She planned a course of eight lectures a month for the first year. This number of lectures was found not to be sufficient to acquaint the student with all she needed to know, and the number was raised to ten a month for the second year.
The early classes were asked to supply themselves with suitable dresses and aprons. This permitted an interesting assortment. One young lady appeared for duty in a lovely Paisley-patterned calico gown with a modish train. By 1893, a uniform was adopted that controlled the personal tastes somewhat, leaving the individuality to assert itself only in the matter of the size of the bow on the apron. It developed that the larger the bow, the more confidence the nurse felt in her own appearance. The detailed regularity of the trim uniform of today leaves no chance for the display of rivalry among the wearers.
The community has been interested in its own first school for nursing from its very inception. This interest has asserted itself in many ways. The graduating exercises for the first class was a social event attended by a large audience. The stage was beautifully decorated with flowers. The class was dressed in striped seersucker with white caps and aprons. Each graduate received exquisite floral tributes from friends. Mrs. Withey, a member of the Hospital Committee, when she handed their diplomas to them, admonished the class to be discreet and above gossip; to be brave, to be patient, gentle and faithful. In fact, she summarized the community's ideal for the nurse when she said, "Keep a high standard constantly in view." She also offered them the protection and comfort of the Home if ever sickness or misfortune should overtake them. It was not alone such glorious occasions as commencement exercises that friends of the school showed interest. Dr. Frances Hillyer, Dr. Frances Rutherford, and Dr. Elizabeth Earle were actively concerned for the school and for each individual student. When it was difficult to secure a suitable superintendent for the hospital, Dr. Earle gave half of her time to the hospital and actually held the school together. Dr. Earle was courageous enough to make the public see just what it owed to the young women who were taking the training. She plead for reasonable housing quarters. Her efforts were rewarded in 1889, when a modern lodge, tastefully furnished, was opened for the student nurses. Dr. Earle has told of some of the idiosyncrasies of the patrons of the school. The school charged $10.00 per week for a nurse's service in a private home. One woman refused to pay. She felt that $7.50 a week was enough to ask for the services of an undergraduate, especially since the student nurse was required to do so little. The patron pointed out that the nurse allowed two hours a day for rest and she was seldom called after midnight. In a remarkably short time, the school was excellently organized, and it has been serving a grateful public for forty-four years.
It was made evident that the type of training the Hospital Committee had in mind when the school was opened could not be given in eighteen months. In 1890, the course was extended to two years. Again in 1902, the curriculum was reorganized and the period of training lengthened to three years. The school has ever faithfully studied the nursing situation, and has sympathetically accepted any change that will better the service of its nurses. In 1919, soon after the Union Benevolent Association Hospital moved to a new site and was re-named Blodgett Memorial, the first year students joined the nurses from the other hospitals, St. Mary's and Butterworth, for class work in the academic subjects in the junior college. Three years ago, instruction in elementary nursing procedures was added to that part of the nursing curriculum given at the college. Consequently, the hospital instructor of nurses has had more time to devote to advanced students, and for supervision of beginning students in their duties on the floors.
For the last three years, the senior nurses of the three hospitals of Grand Rapids have entered competitive examinations for the $1,000 award from the Foster Foundation, which goes to the student making the best record. The money is to be used for further study. Two of these three awards have gone to Blodgett seniors, Miss Lucille Broersman and Miss Nellie Westvcer.
Five hundred and seventy women have graduated from this school. Among these alumnae may be found many individuals who have made outstanding contributions to the nursing profession. Miss Ida M. Barrett, an early graduate, became the superintendent of the hospital and school of nursing in 1893. She remained in this position for twenty-five years and served both hospital and school with intense devotion and remarkable success. Miss Mary Welsh, also an early graduate, became assistant superintendent and dietitian under Miss Barrett. After serving the hospital in this capacity for eighteen years, she became the superintendent of nurses and assistant superintendent of the hospital. Beyond question, when two fine women of such remarkable character are each willing to devote twenty-five years to the growth and development of a school, that school is destined to become a splendid influence in the development of nursing in that community. Miss Welsh, after a number of years of service elsewhere, returned to Blodgett to resume her work as superintendent of nurses and now occupies that position there. Her remarkable character and intelligent direction of the school commands universal respect and the love and devotion of every nurse who has ever been so fortunate as to serve under her.
Among the graduates of the Marian Louise Withey Training School for Nurses should be mentioned Miss Kate Merrill, who was the first visiting nurse in Grand Rapids. To her must be given the credit for establishing public health nursing. Miss Alice Hall, in the tuberculosis clinic, has contributed in no small way to the welfare of the citizens of Grand Rapids and Kent County. Miss Adah L. Hershey established public health nursing in Des Moines, Iowa. Miss Helen A. Farnsworth is head of the Central School of Nursing in Kansas City, Missouri. Miss Christine Hendrie also has been prominent in educational work. Many of its graduates have taken up private duty nursing. Miss Margaret Stekel, Miss Elizabeth Brice and Miss Edith Wilson are among the nurses who have served especially well in this capacity.
Dr. Abbott, in charge of the woman's department of the State Hospital in Anna, Illinois, is a Blodgett alumna. Miss Vera Ingerson has been in charge of hospital in Korea for years.
Miss Mary Fletcher, Miss Mary Welsh and Miss Christine Bauer enlisted in the Spanish-American War and each saw service in Southern army camps. Eighty-eight stars are on the Blodgett Alumnæ service flag for the recent war. One of these stars is gold. Miss Grace Meyers not only represented her school during the World War, but she served as assistant superintendent of nurses at Blodgett Hospital for four years, and after the war became superintendent for two years.
Among the many women of the Hospital Board who have served the institution for many years and with marked devotion, two at least, deserve special mention, Mrs. Marian Louise Withey, a woman of strong character, great intelligence and energy, was a hard working and most loyal supporter of school and hospital during all of their earlier years of struggle. With equal loyalty and with remarkable ability for the many duties which she has assumed, Mrs. Dudley E. Waters has, for very many years, helped in the upbuilding of the school and contributed to the comfort and attractiveness of the hospital.
The Newberry Training School for Nurses--now the Grace Hospital School for Nurses--was established in 1889, in connection with Grace Hospital, Dr. W. L. Babcock and Dr. Stephen H. Knight were active in these early days in stimulating interest in the project. A committee composed of Mrs. Helen Handy Newberry, Mrs. Helen Joy, Mr. Truman H. Newberry, Mr. John S. Newberry and Mr. Eldridge M. Fowler made it possible for the school to be instituted.
Miss Eugenia Hibbard was the first principal of the school. During the nine years of her supervision, the school passed from its infancy to a well organized training school. A course of two years was first offered; later one of thirty months. Now post-graduate courses are given in surgical anesthesia, operating-room technic. X-ray technic, laboratory technic, dietetics, and physiotheraphy. Seven hospitals from over the state send their students, to Grace so that they may gain experience in nursing service which smaller hospitals do not offer. The number of resident students has increased from fourteen in the first class to two hundred sixteen.
The curriculum follows the plan presented by the State Board, but many of the courses are ramified to increase the subject-matter. The first year students go to Cass High School for the basic sciences. The instructors of nurses and the staff doctors give instruction in the remaining courses.
Grace Hospital School has had five superintendents since Miss Hibbard resigned to do nursing during the Spanish-American War. Miss L. J. Gross was superintendent until she resigned to become superintendent of nurses in Buffalo General Hospital, Buffalo, New York. Miss L. A. Chambers next held the position, to be followed by Miss C. P. Van Der Water. Miss Van Der Water was principal for seven years. Miss Harriet Leek was principal during the World War. Miss Laura Meader served ably for eight years. She died while she was director of the training school on June 1, 1928. Miss M. Delta Long is director of the school at the present time. The six nurses who have held this post have instilled into their students their own ideals for the nurse and her service to mankind.
The alumnæ from Grace have gone into every branch of nursing service. Seventy of them served their county in the time of war. Four area now in missionary work in foreign fields. Twenty others are in public health nursing and fifty are holding administrative positions in hospitals. Hospital nursing has made a strong appeal to the present senior class; one-half of them elected the administrative course. The alumnæ who have chosen private duty are serving their communities efficiently, too. This in too brief form is the history of a Michigan school that has always occupied a prominent and enviable place among our best institutions for training nurses.
The School of Nursing connected with the Woman's Hospital of Saginaw was established in 1889. The need for trained women to carry on the work of the hospital was recognized by the altruistic women who founded the Woman's Hospital Association under the presidency of Mr. J. W. Freeman. The association found that it was impossible to supply this need. They decided to answer the difficulty by establishing their own training school for nurses. The school first offered two-year course. This grew into a three-year course. At the present time, in order that the student nurses may receive training in all the services, the school has formed an affiliation with larger hospitals. The class work is organized to meet the requirements of the standard curriculum which the State Board of Registration of Nurses and Trained Attendants recommends.
The entrance requirements are eighteen years of age, two years of high school, good health and a good moral character. At present, nineteen young women are studying nursing in this school. The records of the early classes have been lost in moving from one hospital site to another, therefore, no accurate information has been gleaned concerning the activities of the graduates.
The Women's Board of St. Mark's Hospital held a meeting one summer day in 1890, and received, as its guest, Dr. Reuben Peterson, the first superintendent of the institution. Dr. Peterson, on that occasion, told the good women assemble about the great need for a training school for nurses in connection with the hospital. If the hospital would train its own nurses, it could not only supply the deficiency then existing, but it might also supervise the instruction and mold the student to the hospital's standards. Dr. Peterson was granted the authority to establish a training school, and he accepted three probationers that first summer. Miss Koler, of St. Luke's Hospital, Chicago, was secured as superintendent of the hospital while the school was yet in its infancy. She proved to be an able and sympathetic supervisor, inspiring the confidence of the students, the medical staff and the public. To her must be given much of the credit for the early success of the school.
The length of the training was to be two years, but for some reason the first class was not graduated until 1893. The commencement of the first class was a dignified and charming service. The six young women, in uniforms of blue chambray, white aprons, white caps, cuffs, and collars, with mulls ties, seated under their motto of "Nil Desperandum," took the vows of unselfish and untiring service in carrying for the sick. Dr. G. K. Johnson delivered the graduating address. He advised the nurses always to be scrupulously neat, to maintain control of tongue and temper, to think clearly and to keep command of themselves in the performance of their duties.
The school soon assumed a very important place in the community. It became a leader in the education of the nurse in Grand Rapids and throughout the state. Mrs. Susan Fisher Apted, a woman of superb ideals, untiring energy and great personal magnetism, was among its earlier superintendents. She exerted a very great influence over the school and inspired in her students a marked sense of devotion to duty and of the dignity of a nurse's work. Miss Elizabeth Flaws came to the hospital in 1905. She was a woman of remarkable executive ability and a strict disciplinarian. Those were the days when the duties of hospital superintendent and that of the training school were often combined in one. The hospital flourished as never before and the standards of the nurse's training were made more exacting and advanced steadily. During her regime, she raised the course from two to two and a half years. This was still inadequate, and the training was later increased to three years.
Miss Flaws was deeply concerned with the subject matter and the teaching of the academic portion of the curriculum. She brought in teachers to lecture to the student nurses. The probationers were sent to Central High School for a course in chemistry in 1912. Miss Gertrude M. Smith, and interested citizen, conducted classes in dietetics in her home for the seniors. Every efforts was made to give the students a careful training, in order that they might be able to meet any situation in the field of nursing.
Miss Flaws realized that a school can do better work if its graduates feel a sincere interest in its welfare. She also knew that graduates felt more responsible when the school kept in touch with them; consequently the Butterworth (the hospital was renamed in 1894) Alumnæ Association was organized. Miss Flaw's resignation in 1912 was a severe loss to hospital and school. The seven years of her service were momentous ones in the history of the institution.
No history of the hospital training school should neglect to mention Mrs. Eugene Boise, who, was president of the Lady Board of Managers, directed their affairs for so many years. A large part of their success is due to her who so loyally and intelligently led the way, always toward higher standards.
In 1917, the conditions of war were making such a drain on the trained nurse supply that the problem arose as to how the sick were to be cared for in the home hospital and student nurses continue their training at the same time. Grand Rapids, under the influence of the public health supervising nurses and the superintendents of the hospitals, agitated the sending of the probationers from the three local hospitals to the Grand Rapids Junior College for instruction in the basic sciences. Such a departure in nursing education was not without precedence since the Central School of Nursing was already established in the Kansas City Junior College and Vassar was offering a nursing curriculum. Miss Elizabeth Seldon, the superintendent of Butterworth, was deeply interested in the project and evolved a practical working plan for its operation. The difficulties were overcome and matters went forward. Since 1918, Butterworth has sent it first year nurses to junior college. Miss Grace F. Ellis was appointed by the Board of Education to be the director of this Central of Nursing.
The next progressive steps to be taken by the Butterworth Hospital School for Nurses were under the direction of Miss S. Belle MacCallum, a former student and associate of Miss Flaws, an alumna of the school, and its superintendent of nurses since 1925. The student nurses have been placed on an eight-hour schedule. A system of electives is offered the seniors. The nurse who wishes to enter into private duty service is permitted to go on twelve-hour special duty and so gain experien