During the Spring 2019 term, students in Nursing’s Past as Prologue engage in group projects in which they researched the historical development of the healthcare specializations in their clinical capstones. In the coming weeks we will post them here.
The History of Hospice Nursing
Sarah Turner, Marcela Nelson, Johanna Wolfe, Devin Lancaster, Stephanie Meany, and Amy Lynch
During the Spring 2019 term, students in Nursing’s Past as Prologue engage in group projects in which they researched the historical development of the healthcare specializations in their clinical capstones. In the coming weeks we will post them here.
The History of Cardiovascular Medicine
Turner Bouley, Alba Correa, Lhamo Dolma, Carly Flannery, Robin Ford, and Kylie Meiggs
As the UConn School of Nursing celebrates its 75th anniversary and prepares for its gala celebration later this month, we take a moment to listen to the School’s first full-time nurse faculty member, Josephine A. Dolan (1913-2004), interviewed here in April 1995 by another professor emerita and nurse historian, Eleanor Krohn Herrmann (1935-2012).
ELEANOR KROHN HERRMANN: I am in Holliston, Massachusetts, meeting with Dr. Josephine Dolan in her home.
JOSEPHINE A. DOLAN: You know, Eleanor, I’ve done a lot of thinking about what was my goal. What really was I chasing after all my professional years? And I think it started in the forties, when I was studying at B.U. [Boston University] and being turned on by the faculty who saw a tremendous need for changing the image of nursing because it was a servant image, and also for changing the delivery of nursing care which was just carrying out the doctors’ orders. Health was – forget it. It was just a sickness-oriented image and function. So that when I came to UConn in 1944, I was suddenly shocked by and aware of the lack of acceptance by faculty in every college or school on campus –every one of the schools and colleges in our university academic family. And many of them said openly, “You people must realize that we never expected to welcome a technical school on campus.” We got this all the time. Our students were told, by mainly the science faculty, that with their brains, they certainly shouldn’t continue in the School of Nursing, to be prepared to carry out a servant function. And if that wasn’t a hard enough challenge, when I got to the clinical area, I was aware of the fact that I wasn’t accepted as a person, nor were the students by clinical staff. And the Director of Nursing – I was absolutely an anathema to her —Miss Elsa Storm – and it’s funny that I remembered her name yesterday as I was thinking about this. She called Laddie [Carolyn Ladd] Widmer, our Dean, every single day to report me.
EKH: That is while you were at Backus Hospital?
JAD: At Backus Hospital, in Norwich, in the clinical area. And I told the students that they were not to stand aside and wait until everyone got on the elevators, or they’d never get to the dining room to eat. So we went ahead and barged in. I had them go first and then I followed them in which, of course, from a social point of view, was wrong. Physicians were horrified, and so were all the staff nurses who expected to go first. Good luck to them –they went, as far as I was concerned, first come, first served. [laughs] In the clinical area, when a doctor expected everyone to jump to attention, I told these students to sit down and do what they were doing. If they were spoken to, to remember they were ladies. But the doctors did not have arms amputated –they could get their own charts. So after a while of knowing that Miss Storm was calling Laddie every single day, I went up to tender my resignation, and she said, “Are you unhappy in the clinical area?” I said, “Well I realize that I’m not in agreement with their ideas, and I’m making you unhappy.” And she said, “My unhappiness has nothing to do with it. I hired you to be a change agent.”
So keeping that in mind, then there was much that needed to be done. We decided –the Dean and I – that we better endeavor to recruit very bright students, so to change the milieu on campus. But it was not only recruiting them. We had to retain them which meant fighting with faculty and other schools who were trying to wean them away from us. Gradually – and I came in 1944 – by 1948 we recognized the need for an Honor Society, and brought it into being.
Now, in talking with Laddie, I said, “I don’t think we should just grab some Greek letters like Alpha, Beta, Delta or something – it should have meaning. It should represent our philosophy of what we want the Honor Society to do.” So I conferred with a professor who taught classical languages – notably Greek at Harvard – and sat down with him and shared with him the need for Greek letters which symbolized our philosophy of nursing. He came up with the idea of Tau Pi Epsilon, which, strangely enough, represented healers and builders of health. Now, this was an entirely different connotation from the function of nurses. In the first place, they were not considered by anyone, including themselves, as healers. And, God forbid that they’d be builders of health. So, you see, what we were proposing in our symbolism was a much broader connotation than the current role. Now, this again showed – and I guess with a lack of humility – my desire to have a background for what we were doing. I guess my historical research was beginning to emerge. The faculty colleagues in other schools on campus were impressed by our scholarly approach, and our breadth of the professional role. Now, that’s our introduction to the Honor Society set-up.
I went to B.U. and received my master’s degree in 1950. I carried a full teaching load on campus, then went down to Willimantic, took the train to Boston and took night classes at B.U., and came back, was picked up by faculty on campus who felt bad for the load I was carrying. Now, it’s interesting that I attended [the] Association of Collegiate Schools of Nursing meeting in May of 1951. It was at Saybrook. I heard some fantastic speakers talk about how poorly prepared and what an inadequate function nurses were carrying. And one in particular, the lady who was in charge of the Veterans Administration Nursing Service, said that she visited the nursing care that was given, and she was appalled at the fact that the role that was seen by nurses was that they carry out doctors’ orders. It was as simple as that. This is in 1951. It was at that particular conference that Annie Goodrich encouraged deans and faculty to hold their schools together – that baccalaureate schools were in a very untenable spot. And that it was important that even though they felt they needed a doctorate, they needed, most especially, to put their finger in the dike and hold it together while supporting young faculty getting an enriched education. My master’s thesis at B.U. was planning for an honors program in nursing. I was still trying to change the image, and to recruit and retain bright, scholarly nurses. It was interesting that almost immediately UConn Honors Program developed.
EKH: Do you mean the university?
JAD: UConn’s Honors Program developed right after I did my master’s thesis. [laughs] My master’s thesis had nothing to do with their plan, it just happened to be concurrent. It’s interesting when the UConn Honors Program developed, our School of Nursing had more students eligible per school size than any other school on campus.
EKH: Isn’t that interesting!
JAD: This came as an absolute shock to other schools on the campus – and faculty. Now then, meanwhile, I became an author because I was invited by Saunders to take over Minnie Goodnow’s History of Nursing textbook in 1953. I saw this was a terrific chance to show a stronger image through an historical image, to reclaim what was in print, and this role could at least be in print for people to read. The chapter images were my way of showing historical evidence to strengthen our perspective, and that’s why I did it. I had a lot of response. It’s amazing how many people wrote and said, “I had no idea.” It’s interesting how many people on campus would tell me of things about nursing that they found in pursuing and perusing historical documents. So that I got terrific help, and all of a sudden, I realized that the faculty had somehow or another done an about-face, and we were really not the illegitimate people that we started out to be.
I became a member of Sigma Theta Tau, Theta chapter, in 1954, and founded a chapter at UConn, which was Mu chapter. It’s interesting that when I accepted an invitation to wherever, whatever school, I always said whatever I felt was significant to say about the image of nursing, supporting it with historical data. And when I went to Indiana State, they had an historical series for faculty and for students of medicine and nursing. I was the first speaker, and I floored the assembly when I said, “Physicians were the first nurse extenders.” I thought there would be some CVAs [cerebrovascular accidents, i.e., strokes] in the audience. Many of the medical faculty totally ignored me afterwards, but many of them came up to me and said, “You’re absolutely right. Unless somebody recognized there was a need, we never would have been called in.” Which is true, but certainly hadn’t been recognized by nurses. It was interesting to me to realize that faculty on our own campus were changing their attitude toward us.
When Sister Charles Marie Frank decided that she was no longer going to continue the revisions of her book because, she said, “I think your book is much better. I agree with the philosophy and I’m not going to continue mine.” The next was Dr. Shryock, who told me, “No way. I’m not going to continue my revisions because I like yours better, and it’s historically sound.” When the history faculty members on our campus, many of whom had studied for their doctorates under Dr. Shryock, — when they invited him to come for a big event to thank him for all he’d done in helping them to get doctorates, he said he would come if the nurse historian on campus was invited, which floored that august group of PhDs in history. But I was invited, and he spent his time talking to me, which bothered them a bit. When the Art Department was asked by Smith College to identify the artist of a painting that had been given to them, they turned over the data about the painting to me to help them identify it. They said, “Our nurse historian could identify it better than we could.” This, to me, was just a real thrill. [laughs]
EKH: And recognition!
JAD: And recognized that we had achieved a different image, as far as nursing, as far as our school was concerned. I have so many things that help me to realize that bit by bit, we did change the image.
EKH: A question, Jo: Was your agenda, which is really from start to finish, a very progressive one and one that progressed in sequence- did you see it as clearly in the beginning, or was it an evolving thing where you recognized that there was indeed a broader scope? I think sometimes the differentiation we don’t always see in the very beginning.
JAD: I don’t think I could see the forest for the trees. I was living from day-to-day, having a terribly heavy teaching load, but somehow it was intuitively that I tried to change what I saw as being wrong. I’m doing it today working with seniors [senior citizens]. They’re very concerned here in Massachusetts that the catastrophic things that are going on – like at Dana Farber and several outstanding Massachusetts hospitals. It indicates that there’s somebody who is not a patient advocate. I know that we know that well-prepared nurses are being relieved of their duties and supplanted by poorly prepared people. Actually the wheel – the pendulum is coming back. And what we’re going to have to do is begin to emphasize [that] we have a different role. We are needed. The patient and the physicians have to realize that it’s the doctor who saves the patient’s life; it’s the nurse who helps the patient to live. But it can’t be a trained attendant or somebody that’s just making a bed. The role of a well-qualified scholarly nurse – compassionate nurse – is still needed.
EKH: I think that’s a really fine point. And I think we most recently have seen that in the Oklahoma City disaster, just this past Wednesday, when the firefighters and policemen and all the people who were in the rescue operation were greatly recognized, and duly recognized. And at the same time the nurses were recognized because they are the ones who are going to be giving the on-going care, either to the survivors or to the families of the survivors.
JAD: Actually, Eleanor, I think you’re right, and I’m glad you brought that up. Because I truly think that now that we know that many states have these hate groups that are evolving, I think we have to go back to the preparation that we’ve given to nurses for a long time, and, that is an emphasis on the Judeo-Christian background of caring for others and loving, as He has loved. And this love used to be very over-powering. It’s tremendously significant, and we’re going to need it again.
EKH: Very definitely.
JAD: Eleanor, recently I went to a memorial service at UConn. When I say UConn, it’s University of Connecticut. And afterwards some people came up who knew me. I didn’t think I’d know a soul. But one Associate Dean of the School of Education came up and she said, “So good to see you. We think of you often whenever we have a Pi Lambda Theta meeting because you helped us. You pushed us to have a chapter, and you’re one of our charter members.” And I thought, “Well, thank God I wasn’t just selfish. I’m glad I helped somebody else.”
But there’s another thing. Long after we had a chapter of Sigma Theta Tau, the august faculty in the College of Arts and Sciences decided that they needed a chapter of Phi Beta Kappa. And when they polled the faculty on campus to see if they could find anybody who had been elected to Phi Beta Kappa, they were astounded to find that the Dean of the School of Nursing was a member. And not only did they have a female, but the Dean of that technical school called the School of Nursing. Now, when she went to the meeting, she of course, had her father’s key because her father was Phi Beta Kappa from Williams, as was her sister from Radcliffe. So she was from a family very much aware of Phi Beta Kappa. They were so impressed with her, she was elected archivist for the historical files. And, again, it was a chance to show nurses do achieve.
End of Interview
One of the advantages to the UConn School of Nursing of having the Josephine A. Dolan Collection of Nursing History is its ready availability for faculty and students on campus.
Jo Dolan’s and founding dean Carolyn Ladd Widmer’s long-standing commitment to grounding students’ clinical expertise in the knowledge of nursing’s history has been embedded in the curriculum from its inception, with a survey of nursing history. Once taught as a first-year nursing history and theory course, today it is placed as one of the capstone courses in seniors’ final semester.
But how to make the Dolan Collection accessible in a guided, directed way, especially to undergraduates?
Associate Professor in Residence Thomas Lawrence Long, curator of the Dolan Collection and instructor of the nursing history course (Nursing’s Past as Prologue) met that challenge during the spring 2016 term by assigning each student an artifact, document, photograph or other ephemera from the collection, both items stored in Storrs Hall and those in the University’s Archives and Special Collections.
Early in the semester, students spent one class session examining the object assigned to them using a rubric developed by the American Studies Association Material Culture Caucus, Twenty Questions to Ask an Object.
In addition to seeking answers to questions about nursing’s material culture, students were also prepared to search relevant published literature related to those objects, conducted by Valori Banfi, nursing librarian.
All of this data collection was preliminary to each student writing a blog post on the object assigned to them, which they submitted for a grade.
In the months to come, you will be able to read the product of their work, with two blog posts per week published here.
The Law of Unintended Consequences is deeply etched in the history of nursing and other health professions. And teaching first-year nursing students how to critique modern technology can employ nursing history and its artifacts, as Assistant Clinical Professor Lisa-Marie W. Griffiths, MA, MSN, APRN, recently demonstrated to her students in Introduction to Health and the Discipline of Nursing.
Reading an article last winter in the Hartford Courant, “Global Call for the Use of ‘Smart’ Syringes,” Griffiths reflected on the changes in this basic instrument, from the glass syringes she used early in her career in the U.S. Navy in the 1980s, to the disposable plastic syringes commonly in use now, to the new “smart” syringes that self-destruct after one use.
Older glass syringes could be readily sanitized in an autoclave or even boiling water in order to be reused. Glass syringes can admittedly be fragile but may be reused many times when handled carefully, requiring only the initial investment in the instrument. Disposable plastic syringes may seem like a perfect solution, but they should be replaced after each use, which adds an additional cost to healthcare settings that are often resource constrained in many locations around the world. As a result in developing countries, “disposable” syringes are often reused, but because they cannot be boiled, and bleach is often not available, they are not adequately sanitized.
The Courant article brought to Griffiths’s attention that “25 percent of the 18 billion medical injections performed worldwide each year are done with dirty needles. Unsafe injections cause as many as 1.7 million new hepatitis B infections annually, 315,000 hepatitis C infections and 33,800 HIV infections” according to the World Health Organization.
Aware of the complexities of global health, Griffiths decided to explore these issues with her first-year students using glass syringes from the Dolan Collection and a plastic syringe of her own.
As she explained to her students, “What will happen to third world needs when syringes are destroyed after one use? There are communities that wash latex gloves and hang them to dry to have ‘clean’ gloves to use. Not enough donated medical supplies arrive for the needs of communities in Haiti and Africa, so people have to make do.” Single-use syringes may be in short supply, preventing administration of life-saving medications. Plastic syringes also create more hazardous waste, which entails both environmental impact and economic costs.
Griffiths showed her students how glass syringes were handled and sterilized. Then she invited them to brainstorm strategies for remedying the unintended consequences of innovative syringes: Advocating for the remanufacturing of glass syringes? Strategic donations of bleach and isopropyl alcohol? Developing a new cleaning product or mechanism?
Single-use self-destructing syringes are currently pre-loaded for vaccines, but there has been difficulty for optional dose sizes (e.g., 0.5cc to 1.0 cc).
Concluding this class, Griffiths reminded her students, “Nurses need to be involved in all health care innovations and think globally, not just nationally, because what we do in America does affect the world and those in most need.”
Each fall term, Board of Trustees Distinguished Professor Cheryl Tatano Beck, a world-renowned qualitative and mixed-methods researcher, introduces UConn School of Nursing Ph.D. students to historic archives and documents in her qualitative methods course.
Preparing her students in advance with a discussion of alumna Mary Ann Cordeau’s 2000 doctoral comprehensive examination paper “The Water-Cure Experiences of the Wolcott Family,” Beck arranges for a tour of the UConn Archives and Special Collections with Betsy Pittman, University Archivist and the archivist for nursing history collections.
Pittman provides manuscript material, part of the Josephine A. Dolan Collection of Nursing History, related to Ella Wolcott, who was both a nurse and a patient in the nineteenth century, which students review in a study room of the Thomas Dodd Center.
The doctoral students in Introduction to Qualitative Methodology (this semester including a student from the School of Business) “look through two archival cartons of historical documents of the Wolcott family and see the actual papers, letters, and photographs” on which Cordeau’s study was based, Beck explains. “Historical research comes alive for them.”
As one of Cordeau’s professors and as a colleague of the late Eleanor Krohn Herrmann, Beck leveraged her interest in nursing history (she is a member of the American Association for the History of Nursing) with their expertise in devising this pedagogical innovation.
Archivist Pittman explains, “The materials in the Dolan Collection pertaining to Civil War nursing are the most frequently requested nursing materials we hold.” And she also reminds us that this “collection also complements our ongoing interest in documenting the experiences of nurses during times of war or military nurses, particularly those with an association to the University of Connecticut or Connecticut in general.”