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lANE MEWC/IL UBRm OF 

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300 FASTtUR mj 
PALO ALTQ, CALirORNiA 



REMINISCENCES OF 
LINDA RICHARDS 



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REMINISCENCES OF 
LINDA RICHARDS 

AMERICA'S 
FIRST TRAINED NURSE 



SECOND PRINTIlfO 




WHITCOMB k IIAttttnW^ 
BOSTON, lyi^ 

V.' 









COFYKIGHT 191 1 

By LINDA RICHARDS 



Thomas Todd Co., Pkintzm 
14 Beacon Strzkt, Boston, Mass. 






1\5\ 



CONTENTS 



IV 

V 

VI 

VII 

VIII 

IX 

X 

XI 

XII 

XIII 

XIV 



Introduction 



I Ancestry and Early Life 
II The First American Training School for Nurses 
III Bellevue 



Training School of the Massachusetts General 
Hospital . . • • 

Experiences in English Training Schools 

The Visit to Miss Nightingale 

King's College Hospital 

Edinburgh Royal Infirmary 

Boston City Hospital . • • 

Japan ...... 

Second Year in Japan 

Work of Organization in Several Schools 

Experiences in Hospitals for the Insane . 

Reflections ..... 



Chronology of Linda Richards' s Service 



Vll 



9 
i6 

24 

3* 

37 
40 

47 

54 
66 

83 

100 

108 

113 
118 



557 A (f\ 



INTRODUCTION 



Those of us at whose urging this little 
book has been written believe it to be not 
only a very interesting story but also one of 
great historical value. For Linda Richards 
has been a pioneer. She has blazed the 
pathway for a distinct advance in civiliza- 
tion. Many American nurses likewise are 
entitled to high honor for what they have 
done in establishing the new profession of 
nursing and in extending the field of its 
beneficence; but Linda Richards, as her 
sisters all acclaim, outranks them all, not 
only in priority of her diploma's date, but 
also in the wide extent and variety of her 
services. 

For those whose knowledge of Miss 
Richards enables them to read between 
the lines of her reminiscences no more is 
needed. Her simple, direct narrative gives 
the outline that her friends will well know 
how to fill in. And so, too, those who 
have known only some small part of her 



t 




vm INTRODUCTION 

life work, will from that knowledge rec- 
ognize the great measure of her useful- 
ness. But for those who have not known 
Miss Richards, and perhaps have never 
heard of her, and especially for those who 
know little or nothing about the wonderful 
development of modern nursing, something 
more is needed than her own modest story. 
Such readers will naturally want to know 
what her colleagues thought of her, and 
how her work is rated by those competent 
to judge. 

These introductory pages have been 
written to supply in some small measure 
this needed testimony. But not until the 
book is published will Miss Richards her- 
self know what her friends here say of her. 

When, in 1877, Miss Richards went to 
Edinburgh to study the school of nursing 
in the Royal Infirmary, she was introduced 
there by Florence Nightingale, who at the 
same time wrote of her to the matron, Miss 
A. L. Pringle, as follows: 

"A Miss Richards, a Boston lady, train- 
ing matron to the Massachusetts General 
Hospital, has in a very spirited manner 



•it A •^_ . 

INTRODUCTION ix 

come to us for training to herself. She 
would have taken the ordinary year's train- 
ing with us, but her authorities would not 
hear of it, and we admitted her as a visitor. 
I have seen her, and have seldom seen any 
one who struck me as so admirable. I think 
we have as much to learn from her as she 
from us." 

No other physician is so well able as 
Dr. Edward Cowles to estimate the value 
of Miss Richards's life work; for not 
only has he known her work from start 
to finish, but he himself has done more 
than any other physician to advance the 
profession of nursing in America. With 
Miss Richards's help he established the 
great school of nursing of the Boston City 
Hospital; and afterwards, at the McLean 
Hospital, he started the best and for many 
years the only training school for nurses 
for the insane. When asked for his esti- 
mate, he writes as follows: 

"I am glad to give my appreciation of 
Miss Richards and her noble work in the 
reform of nursing as it has been known to 
me. Our lifelong friendship began when 




J 



^^h. 



INTRODUCTION 



^^^1*3 



she was at the Massachusetts General Hos- 
pital. The Boston City Hospital was then 
the only other one having an established 
medical management, and I sought Miss 
Richards's advice about the nursing there. 
Preparations were being made for the in- 
troduction of a system of training nurses 
and for the adoption of the best method of 
organizing a school. The time and circum- 
stances had created a new opportunity; the 
way in which Miss Richards met it and 
used it revealed, as I now can better see, the 
greatness of the qualities that made her a 
leader. It was an important event in the 
history of nursing reform, and to testify to 
her guiding part in it is justice to her and 
a pleasure to me. 

"In a hospital service certain methods 
are now so common that it is forgotten how 
the working principles came to prevail; 
the many medical administrators of the 
hospitals of today, physicians and educated 
nurses, hardly realize the slow beginning 
and the mutual dependence of the two great 
movements — nursing reform in these hos- 
itals and their medical management. The 



first training schools, being organized for 
work in the hospitals by outside associa- 
tions, did an admirable service that was 
needed in the crude conditions of lay man- 
agement. These schools were notable insti- 
tutions, giving dignity and importance to 
the personal position of those in charge of 
them, and they enjoyed a certain otBcial 
independence naturally due to their being 
separate organizations. This relation to 
the hospitals, though liable to provoke dis- 
harmony, was gradually overcome only 
after many years. Miss Richards began 
her experiences as an organizer and teacher 
under such circumstances. 

"The new conditions at the City Hos- 
pital raised the question of following the 
existing method by inviting the formation 
of an outside association to be brought into 
the hospital to conduct the nursing service. 
The founding of a nursing institution 
seemed a great undertaking in those days. 
The alternative was to make the nursing 
service a constituent part of the whole 
hospital business, without external encum- 
brances. Miss Richards's judgment was in 




J 



Xll INTRODUCTION 

favor of this solution of the question, and 
it was so decided. The school thus founded 
in 1878 was the first of its kind. It be- 
came an example of the simple, practical, 
harmoniously working system that now 
prevails in all forms of hospitals in this 
country. 

"It was an opportune time in the forma- 
tive years of the nursing movement when 
Miss Richards made possible and success- 
ful the initial experiment at the City Hos- 
pital. It was characteristic of her that with 
clearness of insight and singleness of pur- 
pose she accepted at once the principle of 
unity of institution control. With a clear 
conception of her own responsibility to be 
held accountable for the conduct and disci- 
pline of her own subordinates, she could 
understand and aid the larger responsibility 
that included all departments. No argu- 
ment was needed; she knew at sight. She 
saw no reason against subjecting the head 
of the department of nursing to the larger 
coordinating medical control. There was 
no pride of authority, no thought of per- 
sonal sacrifice. With quickness of insight 



I 



INTRODUCTION xiii 

her aim was direct; under all sorts of ad- 
verse influences she always did the best she 
could; never contentious, she could work 
with anybody for the main object, though 
she stood always for the saving principle of 
strictness of responsibility. Thus it came / 
to be her mission — the founding of many ^ 
new schools and the healing of troubles in 
others suffering from disorders of author- 
ity. She was in sympathy with every appeal 
to her ability to aid; a sense of duty went 
with her insight — it took her to Japan, 
where the learning of a difficult language 
was merely incidental to her purpose. 
Clear-minded, direct in method, easily and 
steadily efficient, enduring in patience and 
kindness, loving her work, her patients, her 
pupils, she won their affection and the high 
regard of all who have known her. 

"The devotion with which Miss Rich- 
ards gave her life's labors to the cause she 
served was so unassuming and unconscious 
of itself that the greatness of it was not seen. 
But the history of nursing will always bear 
the strong impress she has made upon it, 
and the worth of her service will not be 



XIV INTRODUCTION 

obscured when we come to understand its 
full measure. The title of her leadership 
is secure. Her work well done, she has the 
honor and love of hosts of friends. Her 
early influence will be lasting; her work 
will carry its blessings to all who enjoy the 
fruits of her wisdom and faithfulness, and 
she will ever live in grateful memory." 

After several years of practice as a sur- 
geon and director of hospitals in Japan, 
Dr.JohnC. Berry' appealed to the Woman's 
Board of Missions, Boston, Massachusetts, 
for help in building a hospital and estab- 
lishing a nurses' training school for Jap- 
anese women; and he begged them to send 
out a matron who could start and manage 
such a school. 

As she tells in the following pages, 
Miss Richards heard the appeal and 
answered it. How well she succeeded and 
why she succeeded, let Dr. Berry tell us: 

"Miss Richards's work in Japan, as 



I 



Director ind Si 
, Medical DirtcM 

^^^^(cfectural Hoi; 



INTRODUCTION XV 

elsewhere, was thoroughly efficient and 
wholly self-sacrificing, and I know of no 
one who could have accomplished more in 
the time she was there. The prestige which 
she brought to the undertaking contributed 
much to its success, while the thoroughness 
of organization made the school a pattern 
for other schools which were later estab- 
lished in the empire. 

"It was early determined not to erect 
our buildings until our Japanese friends 
were sufficiently interested in the enter- 
prise to furnish money for the purchase of 
the necessary land. This necessitated con- 
siderable delay. In the meantime, how- 
ever, Miss Richards opened her own apart- 
ments for pupils and for patients. In these 
restricted quarters she labored until the 
more commodious buildings were ready. 
In so doing she contributed much to deepen 
the interest of the people in the undertak- 
ing and to demonstrate its worth. The in- 
fluence of her devotion to the welfare of her 
patients was strong, both upon her pupils 
and the public. I recall the case of a Japa- 
nese child under her care at that time, suf- 



w 



XVI INTRODUCTION 

fering from a severe attack of ophthalmia 
neonatorum. Proper treatment had been 
neglected before coming to the dispensary, 
and, in order to save the corneae from 
destruction, it was necessary, during the 
twenty-four hours following admission, to 
carefully cleanse the eyes every twenty min- 
utes. Her nurses had not then had suffi- 
cient training to do this with safety, and so, 
without saying a word to me, she remained 
by the child all night, performing this duty 
herself. The next day a decided change 
for the better had taken place, and both eyes 
were saved. This incident was shortly 
afterward related by Dr. Neesima at a pub- 
lic gathering, and, needless to say, the audi- 
ence was profoundly touched by it. 

"Though Miss Richards's stay in Japan 
was comparatively short, she will long be 
remembered there with gratitude." 



CHAPTER I 

ANCESTRY AND EARLY LIFE 

a J the Richards side I am of English 
descent. Seven of ten brothers came 
to America in 1630. Many of our Richards 
ancestors were ministers and doctors. A 
cousin of my father's founded the Meriden 
Academy in Meriden, New Hampshire, 
and there is a hall in one of the buildings 
connected with the school which was named 
for him. My mother was a Sinclair, and 
sprang from the Sinclairs of the Orkney 
Isles. These people were great fighters. 
One fought in the English army when Que- 
bec was taken; later he served as colonel in 
the American Revolution. I know very 
little of my remote relatives on either side. 
Many Sinclairs still live in the Middle 
West and in New England. On the Sinclair 
side of the house there was considerable 
musical talent, but it did not reach so far 
down the line as to include our family. 
My father and mother were married in 



2 REMINISCExVCES OF 

Newport, Vermont. They went to live in a 
little town near Potsdam, New York, which 
has long since been absorbed into the city of 
Potsdam. I and my three sisters were born 
there. 

When I was four years old, my parents 
moved to Wisconsin, where father bought a 
tract of land on which Watertown, Wiscon- 
sin, now stands, and which, had father lived 
longer, would have made him a rich man. 
But he died six weeks after reaching his 
Western home. Mother's younger brother 
then came to her rescue. He settled father's 
business and took mother and the children 
to her father's home for a visit. When, a 
little later, my grandmother died, grand- 
father wished mother to live with him as 
his housekeeper, which she did, remaining 
there till he married again. 

We had in our grandfather's house a 
very comfortable and happy home. He was 
my most intimate friend. I would sit upon 
his knees brushing his snow-white hair, and 
would confide to him all my school joys 
and sorrows. I received much valuable 
advice from him during these talks. My 




AMERICA'S FIRST TRAINED NURSE 

grandfather was a very religious man, and 
we always attended church and Sunday 
school. On Sunday afternoons grandfather 
always went for a walk. He was thin and 
over six feet in height, and I was small and 
stout, and had to trot to keep up with him. 
He seldom talked to me on these long walks, 
but I could not have been hired to remain 
at home. There was nothing hard in my 
young life; hardships began with hospital 
life, where the first years were indeed very 
hard. 

How the sick were cared for in the 
days before there were training schools and 
trained nurses is a question I have often 
been asked. My answer has always been, 
"by the so-called born nurse." Today we 
hear it said that no such person exists or ever 
did exist, and this is true, of course, if the 
words are used literally. But those women 
who by their kindness of heart and cheerful 
service gained for themselves this title were 
by no means wholly untrained. Experience, 
which is a most excellent teacher, together 
with the instruction of older women and of 



L 



4 REMINISCENCES OF 

the family doctor, provided a practical and 
efficient training. A love for the work and a 
strong desire to alleviate suffering had made 
most of them excellent nurses. 

These women, one or more of whom 
could be found in every village or commu- 
nity, like the district emergency nurses of 
today, were always subject to call. In the 
country, if any one within a radius of many 
miles around was taken sick, some one was 
sent in haste for the "born nurse," and only 
personal sickness ever prevented her from 
responding to the call. If she were a mother 
with a family of her own, some one was 
called in to take her place in her own home, 
while she cheerfully hurried away to care 
for the sick one. No compensation did she 
receive, save thatof an approving conscience 
and the honor of bearing the title of "born 
nurse," the true meaning of which to my 
mind is the possessing of qualities which, 
with proper training, go to make the ideal 
nurse — a love of ministering to those in 
need, a quickness to observe symptoms 
which should be reported to the doctor, a 
gentle touch, a sympathetic nature, and 




AMERICAS FIRST TRAINED NURSE 5 

a love of nursing work for the very work's 
sake. 

Generally a member of the patient's 
family would become nurse by day, calling 
upon neighbors for night watching. Quite 
early in my teens I was called upon for such 
service, and I recollect with what pride I 
heard some one say of me, "She will be a 
real born nurse some day." When, before 
I was out of my teens, I was asked to take 
complete charge of a patient, because I was 
really a "born nurse," it made me very 
proud indeed. As I look back upon those 
early days of crude ministration, I wonder 
that I found such favor in the eyes of my 
patients and their friends. 

My desire to become a nurse grew out 
of what I heard of the need of nurses in the 
Civil War. Long before the organization 
of training schools in America I had a fixed 
purpose to devote my life to the work of 
caring for the sick and suffering. Though 
there seemed no way open by which I could 
be instructed in my desired vocation, I did 
not give up hope, but decided to enter, if 
possible, some general hospital where I 



6 REMINISCENCES OF 

could really learn the art of nursing. Even- 
, tually I found myself in the Boston City 
Hospital as assistant nurse in a large ward. 
No one can tell how great was my disap- 
pointment when I found my work to be 
only that which is today done by the ward 
maid. After a few days I confided my dis- 
appointment to the head nurse of the ward, 
a woman of middle age, who from the first 
had been very kind to me, treating me as 
one might a daughter and making life as 
pleasant as possible. She, in the most un- 
selfish way, said, "You will make an excel- 
lent nurse, and I will help you all I can." 
For days at a time this woman would take 
my work in exchange for her own, which 
was, however, not the work of a nurse of 
today. To be sure, she gave the medicines, 
of which she knew nothing, either of name 
or desired action. She was not told nor in- 
structed how to watch symptoms, and only 
keen eyes and good comjflon sense told her 
the signs of danger. 

I there learned how little care was given 
to the sick, how little their groans and rest- 
lessness meant to most of the nurses. There 



I 



AMERICA'S FIRST TRAINED NURSE 7 

were a few who, like my own head nurse, 
did the worlc to the best of their ability 
because they loved to serve humanity; but 
the majority were thoughtless, careless, and 
often heartless. The wards were badly 
kept. Nurses were not respected, most of 
them being addressed by their first names 
by doctors and by every one about the hos- 
pital. They had fairly comfortable rooms 
off the wards in which they worked. They 
were poorly fed in the great dining room 
in the basement. They had little time off 
duty, and no one seemed to have any super- 
vision over them, or to care in the least what 
their conductwas, provided they performed 
their duty with a certain degree of credit. 
At the end of three months, when I 
broke down in health and had to leave this 
first attempt at training in the wards of a 
hospital, I was offered the position of head 
nurse if I would go away and rest and then 
come back there. But this offer of promo- 
tion only added to my discouragement. I 
knew I did not know enough for such a 
position. I felt that I could not be of use 
in a place where really good work was not 



8 REMINISCENCES OF 

required. But my determination to learn to 
be a real nurse was not in the least changed, 
and a few years later an English book, 
entitled, "Una and Her Paupers," the his- 
tory of the training of a young woman at 
St. Thomas's Hospital, London, and her 
subsequent work in charge of nurses at the 
Liverpool Workhouse, set me again seeking 
for a place in our country where I could 
be trained. I was directed to one of the 
doctors of the Hospital for Women and 
Children in Boston, who told me that in a 
few months a school would be organized 
in that very hospital, and advised me to file 
my name as an applicant. 



CHAPTER II 

THE FIRST AMERICAN TRAINING SCHOOL 
FOR NURSES 

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

Although only twenty-five years of age, 
she showed wonderful administrative abil- 
ity, in addition to her unusual gifts as a 
physician. Previous to this date, Septem- 
ber I, 1872, nurses had received instruction 
in the care of obstetrical cases only. Now 
the work was regularly organized for the 



lO REMINISCENCES OF ^H 

definite training of young women in general ^H 

nursing. ^H 

The hospital was originally in two small ^| 

houses, one fronting on Pleasant Street, the ^H 

other on Warrenton Street, Boston; and it ^H 

was there that I was the first student to en- ^H 

 roll my name in the first class of five nurses ^H 

in the first American training school. On ^H 

September 15, only two weeks after the ^H 

opening of the school, we moved out to ^H 

the new hospital where it now stands, on ^H 

Dimock Street, formerly called Codman ^H 

Avenue. ^H 

We nurses did very different work from ^H 

that done by pupil nurses nowadays. Our ^| 

days were not eight hours; they were nearer ^H 

twice eight. We rose at 5.30 A.M. and left ^H 

the wards at 9 P.M. to go to our beds, which ^H 

were in little rooms between the wards. ^H 
Each nurse took care of her ward of six 
patients both day and night. Many a time 
I have got up nine times in the night; often I 
did not get to sleep before the next call 
came; but, being blessed with a sound body 

and a firm resolution to go through the ^_ 

training school, cost what it might, I main- ^H 

t i 



AMERICA'S FIRST TRAINED NURSE II 

tained a cheerful spirit. We wore no uni- 
forms, the only stipulation being that our , 
dresses should be washable. 

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

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

The course was for only one year, and 
embraced training in medical, surgical, and 
obstetrical nursing, but the kind and amount 
of instruction was very limited. Twelve 
lectures were given by the visiting staff of 
physicians, and the only bedside or practical 
instruction we received was from the young 
women internes, who taught us to read and a 
register temperature, to count the pulse and 




\ 



REMINISCENCES OF 

"respiration, and the methods of performing 
the various duties as they were assigned. 
We were supposed to understand and act. 
If complaint was made that we did not do 
well, we were called to account, and an in- 
terne was directed to give further instruc- ' 
tion. This instruction usually amounted to 
a consultation between interne and the nurse 
as to the best way to do the service in ques- 
tion, the interne often being no wiser In the 
art of nursing than the pupil nurse. Great 
care was taken that we should not know the 
names of the medicines given. All bottles 
were numbered, not labeled. We had no 
text-books, nor did we have entrance or final 
examinations. Each nurse was quietly given 
her diploma as she completed her year of 
training. Any distinction which has come 
to me as the first trained nurse in America 
arises solely from the fact that I was the 
first student to enter the newly organized 
school, and so the first to graduate from it. 
Dr. Dimock sent me to nurse one outside 
patient during my year of training. It was 
a case of pneumonia, and I was to do the 
day nursing, leaving the sisters to care for 



an 



AMERICA'S FIRST TRAINED NURSE 1 3 ' 

the patient at night. The doctor made daily 
visits. My orders were all verbal. I ap- 
plied poultices to the chest once in three 
hours, bathed the patient, gave the medicine 
and the prescribed food. After one week, 
till the patient recovered, I went twice daily 
to see thai all things were done properly, 
and daily made a report to Dr. Dimock. 
Nurses were sometimes sent to bring in 
maternity case, and were always sent home 
ith such. I was often sent from the hos- 
pital upon errands for Dr. Dimock. One 
rainy Sunday she requested me to take a 
message to a physician in Roxbury. The 
office was new and the young man had not 
the appearance of having more patients 
than he could attend to. Mistaking me for 
a medical interne of the New England Hos- 
pital, he received me most graciously, read 
the note I handed him, and was about to 
give me a verbal message for Dr. Dimock. 
I asked him if he would be kind enough to 
write his reply. I cannot help smiling even 
now when I think of the instant change in 
is manner when he learned that I was a 
,urse and not a doctor. He wrote his reply 




I 



L 



14 

and, with the air of having received an in- 
sult, handed it to me, and turned in silence 
to take up work at his desk. Student nurses 
were a novelty then, and had frequent proofs 
that they were not highly thought of. 

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

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



AMERICA'S FIRST TRAINED NURSE 1 5 

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



CHAPTER III 



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

The course of Bellevue Training School 
was at that time two years. There was no 




L 



AMERICA'S FIRST TRAINED NURSE XJ 

class work, and lectures were given only 
irregularly. After my arrival at Bellevue, 
I spent a day and a half Jn the wards, to 
become familiar with the methods of work 
before taking charge of night duty. For- 
tunately, in those days so long ago, I was 
blessed with a retentive memory and a ^ 
faculty for quickly learning the location of 
wards. But in the short time given me, 
my powers were taxed to the uttermost to 
become familiar with one hundred patients, 
to learn the names of the doctors and the 
division of which each had charge, to know 
where each senior doctor roomed (for only 
the night superintendent was allowed to 
call a doctor at night), to know where to 
find the supplies in each ward, and to learn 
many other things too numerous to mention. 
It must be known that the patients in 
Bellevue Hospital at that time were from y 
the slums of New York, a class of people 
with which I had never come in contact 
before; and very different from those in 
the New England Hospital, where most of 
them were private patients, refined and 
educated. At first I had a feeling of fear 



i 



1 8 REMINISCENCES OF 

of these poor sick, most of whom came into 
the hospital more or less under the influ- 
ence of stimulants. But this feeling soon 
passed away, giving place to one of pro- 
found pity, and later in many cases to one 
of tpue affogtion. There, in the midst of 
all the sin and poverty, were found real 
pearls; and no true woman can come in 
daily touch with a ward filled with patients 
without soon learning to look for and find 
the jewels, and thereby make of herself a 
stronger woman. 

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



AMERICA'S FIRST TRAINED NURSE 19 

one in the wards. How cold and dismal 
were the hours between midnight and three 

o'clock in the morning! 

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

Written night orders and reports were 
at that time unknown. Night nurses went 
on duty at 8 p.m. I was on duty at 7.30 P.M. 
I saw each head day nurse as she left her 
ward, received her orders, and transmitted 
them to the night nurses. In the morning 
I gave reports to the head nurses as they 



L 



20 REMINISCENCES OP 

began their day duty. All this was verbal. 
When I had been on duty nearly a year, I 
kept notes of one case to be written up by 
a nurse for Sister Helen. Each nurse was 
required to write up a case. The doctor of 
the division saw the report and thought it 
was for him. He was glad of it, as it helped 
him in his notes on the case, and after that 
he asked me to write reports of all serious 
cases. This was the beginning in Bellevue 
of a custom now considered an elemental 
necessity in all hospitals, and in all serious 
cases of illness under the care of trained 
nurses. Class instruction at Bellevue began 
in the autumn of 1874, on the return of 
Sister Helen after a summer spent in Eng- 
land. Bellevue Training School sent nurses 
out for private duty during the first years of 
its existence. Even graduate nurses of the 
New England Hospital who went there to 
take charge of wards had this experience, 
but I was given no outside duty while there. 
During one month of my time in Belle- 
vue, my services were transferred to the 
lying-in wards. The medical staff would 
not allow the training school to have these 



uld J 

ese 1 



AMERICAS FIRST TRAINED NURSE 21 

wards unless a woman who had had train- 
ing in that branch of nursing could be put 
in charge. The New England Hospital 
gave this training to their students, so I was 
placed in charge of the lying-in wards, and 
another New England Hospital graduate, 
Mrs. Walhaupter, who went to Bellevue as 
head nurse of a ward, was given charge of 
the night duty in these wards. We had the 
wards just twenty-seven days, when all the 
lying-in and waiting women were moved to 
pavilions on Blackwell's Island, and I was 
changed back to my original work as super- 
intendent of night duty. During those . 
twenty-seven days we had twenty-seven 
births. I was obliged to be present at all 
births, night and day, and I was the only 
nurse allowed to be present. The reason 
for this was the prevalence of an epidemic 
of puerperal fever, which of course caused 
a very high death rate. At first, under this 
arrangement, there was marked improve- 
ment; but it did not last, and the removal 
above spoken of was decided upon. There 
the pavilion accommodations were rough, 
but the dread fever was stamped out No 




b 



22 REMINISCENCES OF 

one who saw the old ward for waiting 
women would have wondered at the amount 
of fever or the large death rate. Another 
grewsome feature was that the waiting 
women had to sit there and make shrouds. 
I used to wonder if they speculated as to 
whether they were making their own. 

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

I have always been glad that I went to 
Bellevue, because of the very valuable ex- 
perience I gained there, though the train- 
ing did not compare favorably with what 
we had had in the New England Hospital, 
where far greater nicety in caring for pa- 
tients was required. I have often since told 
my nurses, during my long life in hospital 
work, that experience comes only in hard 
work, and I certainly had my full share of 
that while at Bellevue. My perfect health 
stood me in good stead. Many was the time 
I went into the wards at 7.30 in the evening 
and did not sit down until 8.30 the next 



AMERICA'S FIRST TRAINED NURSE 23 

morning, when I changed my shoes to go 
home. When I came away, two people 
were given my work to do and my respon- 
sibilities to carry. 

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




CHAPTER IV 

TRAINING SCHOOL OF THE MASSACHUSETTS 
GENERAL HOSPITAL 

IT was the personal care of the sick which 
occupied all my thoughts during my 
year of training at the New England Hos- 
pital and also during the year as night 
superintendent at Bellevue. It was there- 
fore a great surprise to me when I was 
offered the position of assistant superin- 
tendent of the training school of Bellevue, 
and was urged by Sister Helen to accept, 
because of the ability she recognized in me 
to carry responsibility and to undertake the 
work of organization. During the few 
days' time I asked for in which to consider 
the matter, I received an urgent call from 
the training school board of the Massachu- 
setts General Hospital. I went to Boston 
on a short visit and was asked to meet the 
board. After due consideration and con- 
sultation with those who knew the needs 
of the place and had some acquaintance 



AMERICA'S FIRST TRAINED NURSE 2? 

with my capabilities, I consented to under- 
take the work. 

It was on the first day of November, , 
1874, that I went to the Massachusetts 
General Hospital as superintendent of the 
training school and entered upon the work 
of organization in which I was to continue 
during the following thirty-five years. The 
training school, which had then been in 
existence for one year, was not, as it is now, 
a part of the hospital. It was organized 
and conducted on the same plan as was the 
training school of Bellevue Hospital, under 
the control of a separate board of trustees. 
Some of the ladies of the board were sisters 
of some of the trustees of the hospital, and 
to this fact may be attributed the success of 
the school in a hard struggle for existence 
during its first year. The medical and sur- 
gical staff had said: "Put it out; we do not 
want it; it is no good; our former way was 
better." But finally the trustees yielded to 
the pleas of the ladies, and the school had 
been given one year more of life provided 
a graduate nurse could be found to take 
charge. 



26 



REMINISCENCES OF 



This short but stormy history was for me 
then a sealed book. It was not until later, 
when I learned the story in all its bearings, 
that I realized the significance of the hope 
expressed by the board that in time the 
school might prove by the excellence of its 
nurses their superiority over nurses who 
were untrained. This begot in me a strong 
determination to prove the truth to them by 
my own personal work as nurse, in addition 
to my work as superintendent of the school. 
So it came about that I often took charge at 
night of some specially serious case, and 
sometimes I would be on night duty three 
nights in succession while doing my regular 
work during the day. 

It may prove of interest to describe just 
how the work was arranged there on my 
arrival. The hospital, although it was 
wealthy, was very economical in many ways. 
For instance, all poultice cloths which had 
no discharge upon them, and all the band- 
ages which were considered clean, were 
washed and ironed by hand and used again. 
They might be washed several times. Now 
it fell to the lot of the nurses to do this wash- 



^ 



AMERICA'S FIRST TRAINED NURSE TJ 

ing, and I assure you it was all of it hard 
work. 

There was, moreover, the strangest 
division of labor. For instance, a nurse 
would begin a day by washing poultice 
cloths and bandages, and it would often be 
two o'clock before her work was finished. 
She then went off duty for the afternoon. 
The second day the same nurse helped in 
the dining room service and in washing 
dishes. After this was done, she was ready 
to do little incidental things as need arose. 
The third day she went into the wards, 
washed the patients' faces, made beds, swept 
floors, and did this, that, and the other duty 
until night. The fourth day she would act 
as head nurse. The fifth day she would 
begin as general utility nurse, but at nine 
go off duty to sleep, so as to be ready to go 
on duty that night. The sixth day she had 
to herself. Then the same rotation of serv- 
ice began again. 

The doctors complained that nobody 
knew anything, and surely it was no wonder. 
We had many trials before order was 
brought out of confusion and a regular 
system finally settled upon. 



2S REMINISCENCES OF 

We at once began class instruction as a 
regular part of the nurses' education, and 
very soon we changed the routine of work. 
From its beginning the school had had an 
excellent course of lectures, given, not by 
the Massachusetts General staff, who, as 
has been said, were not in favor of the 
school, but by physicians from the Boston 
City Hospital and other outside lecturers, 
whose services were secured through the 
untiring efforts of the committee of lady 
trustees. 

The giving up of the personal care of 
the sick, of which I was very fond, for that 
of training nurses was a great cross to me, 
and about this time I told one of the doc- 
tors of the training school board of this 
feeling which was pressing hard upon me. 
He took time to talk with me of the matter, 
and told me that any woman having the 
ability to instruct others should not shirk 
her responsibility, as, by so doing, she would 
detract from her larger usefulness. 

During the first year I was connected 
with the training school, the nurses lived 
in a house on McLean Street, only a few 



AMERICANS FIRST TRAINED NURSE 29I 

Steps from the hospital ; but it was too small 
to provide a room for the superintendent of 
the school, and so one was secured for me 
near by on Allen Street. When I was too 
anxious about a case to leave the hospital, 
I stayed anywhere I could find a place. In 
the spring I was given a room off one of the 
wards. While it was less comfortable than 
my room on Allen Street, it was vastly more 
convenient, for I could now be called at 
any hour of the day or night. 

Before the end of the first year the 
hospital trustees had decided to adopt the 
school and to make provision for the nurses 
inside the hospital grounds. "The Brick," 
a building in which were the "foul" wards, 
was made over into a very comfortable 
nurses' home, where we had a good dining 
room, and in the basement a convenient 
kitchen, which was used as a diet kitchen. 
Here the nurses had their cooking classes, 
in connection with a course of twelve lessons 
given during my second year. I often won- 
der if the nurses of today enjoy their elegant 
homes as much as we did the one into which 
we moved in 1875. 



L 



30 REMINISCENCES OF 

At the end of this year I had nurses 
sufficiently well trained to be intrusted with 
responsibilities, and the work of the super- 
intendent was made easier. The school had 
increased in size, and served all the wards 
of the hospital, except that for private pa- 
tients, a small ward of separate rooms. 

From this time on, the hospital staff 
lectured to the nurses, and Dr. H. J. Bige- 
low began the practice of taking the nurses 
with him on his visits to the wards. Mem- 
bers of the staff frequently spoke of "our 
school " with interest and pride. The change 
was marvelous. Dr. Norton Folsom was 
superintendent of the hospital the first two 
years I was there, and but for his patience 
and kindness I doubt if the growth of the 
school would have been so rapid. In our 
conversation on the first day when I entered 
upon my duties with fear and trembling, he 
said to me, "If the school is properly con- 
ducted, I think it will prove a good thing, 
and I believe you will make it a success." 
This expressed faith in me made me more 
than ever determined to do all in my power 
to fill my position to the very best of my 




Before going to England 



AMERICA'S FIRST TRAINED NURSE 3 1 

ability. I never applied to him for help in 
vain, and he always suggested expansion in 
our field of work. At the end of the first 
three months, when he came to me and said, 
"Miss Richards, the trustees have voted to 
give you an additional ward," I told him 
of all the doubts and fears under which I 
had been laboring. He replied, "I felt sure 
you would succeed, and now that the first 
step has been taken, it will not be long be- 
fore you have full charge of all the nurses 
and nursing in the hospital." So the black 
cloud showed me its silver lining, and time 
fulfilled his prophecy. 

I spent two and a half happy years at the 
Massachusetts General Hospital Training 
School, and saw many important changes 
take place. There is a very warm spot in 
my heart for this my first school, which 
claims many excellent women for its gradu- 
ates. Some of my own nurses I am justly 
proud of, though I am sure the ability of 
the women and not my training is responsi- 
ble for the good work they have done and 
still are doing. 




CHAPTER V 

EXPERIENCES IN ENGLISH TRAINING SCHOOLS 

IN the spring of 1877 I was successful in 
carrying out a long cherished plan of 
going to England to spend some months 
in hospitals, to learn from them methods 
of training school work. I shall ever re- 
member with gratitude the kindness of the 
Massachusetts General Hospital trustees 
and also of the training school committee, 
both during my connection with that insti- 
tution and also in helping me to arrange for 
my visit abroad. 

Mr. Martin Brimmer, president of this 
committee, entered into a correspondence 
on my behalf with Mr. Rathbone, a cousin 
of Miss Nightingale, and chairman of 
the St. Thomas's Hospital Training School 
committee, which resulted in an invitation 
for me to go to St. Thomas's Hospital 
Training School as a visitor for as long a 
time as I might wish, or to go there to take 
a six months' course. 



AMERICA S FIRST TRAINED NURSE 33 

Soon after my arrival in London, I called 
at the home of Mr. Rathbone, and received 
instruction as to my course of action. On 
the following beautiful May morning I 
presented myself at St. Thomas's, and was 
shown into the office of Mrs. Wardroper, 
the matron of the hospital. Seated before 
a desk was a small lady, dressed in black. 
Upon her head was a cap of lace with long, 
flowing strings, which were not tied in front, 
but hung down her back nearly to the waist. 
Upon her hands were black kid gloves. 
During my stay at the hospital I never saw 
her in any other dress. I think it was her 
uniform, and she was as much at home writ- 
ing in gloves as is the ordinary individual 
without them. The few moments of my 
interview with Mrs. Wardroper served to 
impress upon my mind the remarkable char- 
acteristics which enabled her, during her 
long years of service, to play so large a part 
in developing the usefulness of this great 
institution. 

I was presently conducted by an attend- 
ant to the Nurses' Home, and placed under 
the charge of Miss Crossland, the Home 



34 REMINISCENCES OF 

Sister, or, as we should say, matron, to whom 
Mrs. Wardroper had given instructions re- 
garding my movements. Miss Crossland 
was a graduate of St. Thomas's Hospital 
Training School ; and to her was given the 
care of the nurses in the Home, together 
with a good deal of the technical instruc- 
tion. She was a most excellent disciplin- 
arian, a splendid woman, and a great favor- 
ite of Miss Nightingale. I lived with her 
when not in the wards, and she gave me 
much valuable information concerning the 
management of the school. 

The general plan of my work was that 
I should visit the eight different wards in 
turn, spending a week in each, and work- 
ing or not as I chose. I had no stated hours 
of duty. I was invited to be present at all 
operations; the surgeons were very kind 
indeed, and in some instances invited me to 
stand with the medical men, that I might 
have a better view of the operation. 

Many things were strange to me at first; 
for instance, Mrs. Wardroper was always 
called "matron" by every one in the hos- 
pital, never being addressed by her name. 



AMERICA'S FIRST TRAINED NURSE 35 

The head nurses were called Ward Sisters, 
and were known by the names of the wards 
of which they had charge, as Sister Albert, 
Sister Victoria, Sister Ophthalmia, and so 
on. 

The dining room in the Home was 
large and airy; in its open fireplace, morn- 
ing, afternoon, and evening, a cheerful fire 
burned, and on the large, fiat fender boiled 
and sang the large teakettle. One could not 
but be cheered when one saw the large tables 
surrounded by nurses, each with her indi- 
vidual teapot with its steaming tea which 
she had just made at the fire; and when one 
heard the lively talk accompanied by the 
clink of the dainty cups and saucers. The 
strangest sight of all to me at first was the 
glass of beer allowed each nurse at lunch, 
dinner, and supper. But soon the strange- 
ness gave place to a feeling that I had always 
lived as I lived there. 

The happy, instructive months at St. 
Thomas's passed quickly. Some two or 
three years after my visit there, a friend 
who was visiting at the hospital wrote me 
that Mrs. Wardroper had spoken most 



36 REMINISCENCES OF 

kindly of me, saying that she thought me a 
very good woman to have gone over as the 
first American nurse, that I made no trouble, 
and seemed to appreciate the advantages 
given me. 




THE VISIT TO MISS NIGHTINGALE 

MISS NIGHTINGALE had from the 
first known all about my plans for 
visiting St. Thomas's Hospital, and had sent 
me a message of welcome soon after my 
arrival in England. It had never occurred 
to me that she would honor me by asking 
me to call upon her, so great was my sur- 
prise when I received an invitation to visit 
her at her home. I had been only four days 
at the hospital, and was as yet a stranger to 
English ways. Even now I can distinctly 
recall with what fear and trembling I 
walked toward the house of the woman 
who had for years been such an inspira- 
tion to me and to countless others. Was it 
really I myself who was walking up the 
steps of her houseP Was I really to behold 
Miss Nightingale's face, to look Into her 
eyes, to hear her voice, to feel my hand 
clasped in hers? It seemed indeed too 
strange to be true. Before I hardly real- 
37 



38 REMINISCENCES OF 

ized the fact, I found myself face to face 
with a small lady clad in black silk, lying 
upon a couch, for, as is well knQwn, she 
had been an invalid for years. ^A small 
hand was held out to me, and a low, pleasant 
voice bade me, an American nurse, a cordial 
welcome to England and to her home.^ The 
sweet face, with the deep blue eyes, and the 
beautifully shaped head, I saw at a glance. 
The one dream of my nursing years was be- 
ing fulfilled : I was indeed talking with the 
one woman whose name and the record of 
whose good works were known throughout 
the civilized world. I see her now as I 
write these words. Such consummations of 
our desires are never to be forgotten. ^ 

So interested was I in our talk that I had 
to be twice reminded before I touched the 
dainty luncheon which had been brought. 
With a wide comprehension of my reasons 
for visiting England and its hospitals, she 
made two important suggestions: one that 
I should visit King's College Hospital, in 
charge of the Sisters of St. John ; the other, 
that I should visit the Royal Infirmary of 
Edinburgh ; and she most kindly offered her 
assistance in securing admission for me. 



AMERICA'S FIRST TRAINED NURSE 39 

^ Many and varied blessings have come to 
me through the years of my hospital life, 
but never one greater than the privilege of 
having seen and known Miss Nightingale.^ 
I have never ceased to appreciate the bene- 
fits derived from that first visit. I was very 
sorry to leave, and very grateful for all the 
kindness received. 

// What a work for suflFering humanity has 
been accomplished through herl What a 
beautiful and beneficent life hers has been! y 



CHAPTER VII 

king's college hospital 

IN -accordance with Miss Nightingale's 
suggestion, Miss Crossland kindly ac- 
companied me on my first visit to King's 
College Hospital. The Mother Superior 
greeted me cordially, but said that while 
they would gladly show me through the 
hospital as often as I chose to come, they 
could not entertain visitors from outside the 
Church. Three days later, when paying a 
second visit to the hospital, I was delight- 
fully surprised to have the Sister in charge 
say to me, "The Mother Superior wished 
me to give you an invitation to spend one 
month with us as a visitor." A date was 
arranged which followed closely upon the 
completion of my work at St. Thomas's. 

Life at King's College Hospital was 
very strange to me, and the new experiences 
were full of interest. I was welcomed to 
the hospital by the Sister in charge, Sister 

Ami by name, a striking looking woman of 

40 



AMERICAS FIRST TRAINED NURSE 41 

very dignified appearance. After a few 
pleasant words, a sweet little Sister took me 
to my room, and, while instructing me in a 
few little guiding rules, she assisted me in 
arranging my hospital uniform. I had pro- 
vided myself with a black alpaca dress, like 
those of the lady probationers with whom 
I was to be classed. Over this was worn a 
brown linen apron, with strings which were 
crossed in the back, brought around the 
waist, and tied under the apron in front. 
Upon my head was placed a cap of white 
linen, not thin in texture, and made with a 
fluting some two inches wide, which was 
turned back over the front and across the 
back. The hair, with the exception of a 
strip an inch wide in front, was entirely 
covered by the cap, the strings of which 
were tied in a double bow under the chin. 
The out-of-door uniform provided for me 
consisted of a long, black alpaca cape and a 
close-fitting bonnet. This I was not re- 
quired to wear. I could do so if I liked. 

I had for years lived "under rules," 
according to my interpretation of rules, but 
I found that my knowledge was very super- 



I 



REMINISCENCES OF 

ficial and incomplete. Here I learned what I 
pvas meant by yielding an absolutely willing I 
!as well as implicit obedience. This lesson | 
' once well learned, hospital life goes much 
more smoothly. 

I cannot refrain from mentioning here 1 
how I broke a pjj^ the very first day of | 
my stay, and with what great kindness I 
Sister Ami spoke to me about it. Wishing 
to go from the second to the first floor, I 
used the front stairs, having seen no others. 
Later Sister Ami said to me in the sweetest 
possible manner, "You broke a rule this 
morning, which I am sure you would not 
have done had you known," I said, "In- 
deed I would not; please tell me what I ' 
did." She answered, "You went down the 
front stairs, which are used only by the 
doctors." I thanked her for telling me, and 
gladly promised not to break that rule i 
again. I learned also that sisters and nurses I 
always went and came through the back 
garden. The probationers lived in a sepa- 
rate home presided over by a Sister, who 
always accompanied them to and from the 
hospital, where they had their meals. Both 



AMERICA'S FIRST TRAINED NURSE 43 

on arriving in the morning and on leaving 
at night, the roll was called and the names 
checked off. I do not think the nurses had 
a whole afternoon free each week, as is the 
general custom in American hospitals; but 
certain hours daily they did have, and time 
for churchgoing on Sundays. Daily serv- 
ices in the chapel of the hospital gave ample 
religious opportunities to all. Nurses were 
not allowed gentlemen visitors; the door 
leading from the reception room into Sister 
Ami's ofKce was always open, so it was well 
understood the conversation was not to be 
of a private nature. Such were some of the 
rules known and respected by all. 

Here, as at St. Thomas's, my daily life 
was planned for me, save that I might work 
or not as I chose. To me, work is always 
the more pleasant, so it soon came about 
that the head Sister of the male medical 
ward gave me two patients at the opposite 
ends of the room, one a man with typhoid 
fever, the other a ten-year-old boy witli 
scarlet fever. In these days of isolation of 
patient and nurse, this will sound strange 
indeed. Well do I remember the three 




REMINISCENCES OF 



times dally bath of permanganate of potash, 
solution, followed by an anointing with 
carbolized vaseline! I must record that no 
bad results followed the scarlet fever patient 
being cared for in the open ward. 

Every nurse seemed to know and do her 
own duty, and that with few words. No 
one assumed the duties or responsibilities 
of another; for instance, in the absence of 
the ward Sister, the only answer given to a 
visiting doctor concerning a patient would 
be, "Sister will be here directly." I gave 
this reply several times. Sometimes the 
doctor waited to see the Sister, and some- 
times he did not. 

Among the unusual duties which occa- 
sionally fell to my lot was that of saying 
grace before meals. I remember a nurse 
coming to me one day with the request that 
I would come and say grace, so the meal 
could be served while hot. 

At King's College Hospital there was 
not the hurry and rush that one usually sees ; 
the work was always done in season, wards 
were in order at the proper time, and every- 
thing went on smoothly, I was allowed to 
spend a few nights with the night superin- 



I 



AMERICA'S FIRST TRAINED NURSE 45 

tendent as she made her rounds, and in that 
way came to know the work done by the 
night nurses. In a double ward of twenty- 
four beds there were two night nurses; each 
nurse had her midnight meal on her own 
side of the ward, nor did they ever visit 
each other. Each ward had two very elab- 
orate fireplaces, which were kept clean by 
the night nurses, who also had charge of the 
medicine closets, the pantries, and the bath- 
rooms. One custom new to me was the 
serving of tea and bread and butter at about 
five o'clock in the morning. Each patient 
had a bedside locker, where were kept 
his teapot, cup and saucer, knife, fork, and 
spoon, which he brought from home when 
entering the hospital. A second custom 
even more odd was that of boilmg potajpes 
before the ward fire, so that they might be 
served hot. The youngest probationer had 
this duty in charge. All this made more 
work for the night nurse of twelve beds 
than for our American night nurses of 
twenty beds. Nevertheless, I heard very 
little complaint from nurses, either as to 
work or as to strictness of discipline. A 
spirit of loyalty seemed to prevail, and an 




_i- 



46 REMLMSCENCES OF 

ever present cheerfulness, which is a very- 
beautiful feature of the Sisters' religion. 

Every morning after breakfast all the 
nurses who could be spared went to prayers. 
No one was compelled, but I think all were 
glad to go. The chapel was pervaded by a 
quietness very restful to the weary. 

The influences of my month at the 
King's College Hospital have continued to 
be of the greatest value to me. Rules have 
never seemed either irksome or out of place 
since I learned from the Sisters to obey 
cheerfully and unqueslioningly. The nurs- 
ing was most excellent, and the entire place, 
as Miss Nightingale told me I should find 
it, was immaculate from garret to cellar. 
Here I gained my first real knowledge of 
the self-sacrificing work of the Sisterhood, 
and daily contact increased my respect 
for the Sisters individually and for the 
character of the work done by them. To 
Miss Nightingale for suggesting it, and to 
the Mother Superior of St. John's Sister- 
hood for allowing me to visit King's Col- 
lege Hospital Training School, I have 
always been profoundly grateful. 






CHAPTER VIII 
EDINBURGH ROYAL INFIRMARY 

WHEN my visit to King's College 
Hospital came to an end, I went 
directly to the Edinburgh Royal Infirmary. 
What a crowd of pleasant recollections does 
that name bring to me I How happy I was 
there, and how valuable was the experience 
I gained I 

I arrived at Edinburgh in a pouring 
rainstorm one morning near the middle 
of August, 1877. The beautiful city was 
hidden from view by the heavy mist. After 
a short drive through narrow streets with 
brick houses on either side, the cab stopped 
at one of the smaller of several gray stone 
buildings grouped in an inclosure. Enter- 
ing a hallway I was met and cordially wel- 
comed by Miss Prlngle, the superintendent 
of the training school, through whose kind- 
ness I had been invited to make this visit. 
iMiss Pringle was a graduate of St. Thomas's 
Hospital Training School. Miss Nightin- 



REMINISCENCES OF 

gale, who held her in high esteem, spoke of 
her to me as "a real general," and such I 
found her to be. 

Through Miss Pringle I came to know 
the opinion generally held regarding my- 
self. We were one day talking over train- 
ing school matters when she said; "You 
know, before you came here, I did not sup- 
pose that you were a trained nurse, but a 
woman interested in training school and 
hospital work who had come to England 
and Scotland to study our methods for a 
few months, and then to go home to organ- 
ize a training school. On the contrary, I 
find you a superintendent of a training 
school, and one who is well trained and 
seems to understand her work well." This 
was to me one of the greatest compliments 
I received while I was awav. Little did I 
think, when in 1877 she gave me so cordial 
a greeting in Edinburgh, that twenty-eight 
years afterwards I should have the pleasure 
of welcoming her to America. 

The location of the Royal Infirmary of 
Edinburgh, like that of so many old hospi- 
tals, was not at all desirable. It was, how- 



AMERICA S FIRST TRAINED NURSE 49 

ever, convenient to the medical schools, 
and students were there on week days from 
morning till evening. The wards were not 
very well lighted, but there was a homelike 
air about them, which is seldom to be found 
in a hospital. Each ward had its large fire- 
place, in which a bright fire always blazed, 
giving an air of comfort and good cheer. 
Though the wards were often too well filled 
for comfort in caring for the patients, they 
were kept spotlessly clean, and no one was 
ever heard to complain of overcrowding. 
Convalescent patients cheerfully accepted 
"shakedowns" — straw beds, either In long 
baskets or on the floor. One morning as I 
wandered about the wards, a privilege 
granted me, I came upon a man in bed in 
a little side room with a year-old baby 
peacefully sleeping upon his arm. I said, 
"You had a bedfellow last night, did you 
not?" "Aye," he said, "I get on fine with 
the bairnies." I wondered what would be 
the result of an experiment of that kind in 
one of our American hospitals ; not pleasant, 
I am sure. I heard no complaints of poor 
food or of want of attention, though the 



I I am sur 

food or 



number of nurses in proportion to patients 
was less than we have in our American 
hospitals. 

One custom which was exceedingly 
strange to me, but immensely enjoyed by 
the men patients, was the privilege of smok- 
ing for an hour twice a day, morning and 
afternoon, at which times one could hardly 
see across the room for smolie. 

In the well-equipped Fever House, 
separated as far as possible from the other 
buildings, I saw my first case of typhus 
fever. For the first time I saw here tiled 
walls in the wards. Every possible precau- 
tion was used to prevent the spread of the 
disease. As is well known, it was in the 
Royal Infirmary that Professor Lister in- 
augurated his wonderful method of treating 
wounds, a stepping-stone to the greatly 
improved methods with which all nurses 
of today are so familiar. At the time of 
my visit, Professor Lister had just gone 
to introduce his methods at King's Col- 
lege Hospital, while in the Royal Infir- 
mary Dr. Joseph Bell was carrying on 
advanced aseptic treatment of wounds. 



J 



AMERICAS FIRST TRAINED NURSE 5I 

Professor Bell's Sunday morning clinics, 
given to the nurses exclusively, were a won- 
derful privilege. He had a class of medical 
students every week day, but on Sunday he 
gave the nurses the opportunity of going 
with him on his rounds. Miss Pringle 
appointed two nurses to act as "house sur- 
geons," and the other nurses were listeners 
to this most interesting instruction at the 
bedside of the patients. 

In looking back upon my English visit, 
I am very fond of thinking of the religious 
services in the chapels of the hospitals of 
Great Britain. One heard a good sermon 
and good music at the regular Sunday serv- 
ice, which was attended by the convalescents, 
accompanied by nurses, who always wore 
the chapel uniform, which to the English 
nurse in training is as essential as the ward 
uniform. Nurses who were off duty were 
also often in attendance. The hospital 
chaplain held weekly services in each ward, 
and these I found very enjoyable. Such 
privileges seem so appropriate to the sick 
and suffering. I often wonder if in our 
American rush and hurry we do not too 



REMINISCENCES OF 

often forget the souls of the patients under 
our care. 

The close of my all too short month at 
the Royal Infirmary had come, and I said 
a reluctant good-by to the warm-hearted 
people of the beautiful city, with its cluster- 
ing historical associations and its lovely and 
interesting surroundings. 

Miss Nightingale had invited me to visit 
her at her country home at Lea Hurst, on 
my way home from Edinburgh to London. 
One evening about the middle of September 
found me at a little station, where I was met 
by her coachman, and after a drive of two 
or three miles reached her lovely home. 
The few days spent there were a beautiful 
closing to my visit in England and Scotland. 
Miss Nightingale showed the truest inter- 
est in our American training schools, and 
it was a marvel to me how she went to the 
very bottom of everything concerning their 
needs and the relative value of American 
methods in comparison with those used in 
the English and Scotch hospitals. How 
kindly were all her criticisms, and how care- 
fully did she question me concerning all I 



d 



L 



AMERICA'S FIRST TRAINED NURSE 53 
had seen while in England and Scotland! 
Her advice to me concerning the future 
was absolutely invaluable; and when in the 
course of the years memory brings forward 
helpful words spoken by her, I have an ever 
new sense of gratitude for the great oppor- 
tunities granted to me in this very unusual 
experience of intimate intercourse. 

From Miss Nightingale's home I went 
to London, and after two days there to 
Paris, where I spent a month visiting the 
many and fine hospitals. A position in one 
of the largest of these was offered me by a 
resident American physician. Whether my 
refusal was wise or not, who can say? 

As I was leaving the old world and 
turning my face homewards, I received a 
letter from Miss Nightingale wishing me a 
pleasant voyage home, and saying, "May 
you outstrip us, that we in turn may out- 
strip you." These generous, inspiriting 
words filled me with pleasant anticipations 
and hopeful courage in making use of all 
the knowledge gained during the months of 
absence, and in helping forward my loved 
work of nursing, with all its joys and trials, 
in my own dear land. 




BOSTON CITY HOSPITAL 

WHILE Still connected with the Mas- 
sachusetts General Hospital, I had 
once visited the wards of the Boston City 
Hospital with a member of my own train- 
ing school committee, and had said to her: 
"I hear that the superintendent here advo- 
cates training schools as a means of pro- 
viding better care for the patients. If it 
were done, how I would like to help in the 
organization!" At that time I had not 
the slightest Idea my wish would ever be 
granted, but later, when about to leave for 
study abroad, I received a hint suggesting 
such a possibility in the future. Therefore, 
when in the late autumn of 1877 I returned 
from England, I was not unprepared for 
the request from Dr. Cowles, superintend- 
ent of the Boston City Hospital, to assist 
him in organizing a training school for 
nurses in that institution. In accepting the 
offer, I rejoiced with a joy not unmixed 





AMERICA'S FIRST TRAINED NURSE 55 

with fear lest I should fail in what I knew 
to be a great opportunity. The work of 
organization had a great attraction for me, 
but I was well aware of the hard, trying 
labor involved in the formation of a new 
and large school. Desire and dread filled 
my mind with conflicting hopes and fears 
while I waited for the first day of January, 
1878, when I was to enter upon the duties 
of my new position. 

It was a very cold, gray morning when 
I found myself in the large reception 
room of the Boston City Hospital, looking 
from the window across the brown leaves. 
Dr. Cowles, for whom I was waiting, soon 
gave me his cordial welcome. He himself 
showed me to my rooms, and a little later 
conducted me through the wards and oiBces 
of the buildings, taking great pains to intro- 
duce me to the nurses and to explain my 
position, which was that of matron of the 
hospital and superintendent of the prospec- 
tive training school. Dr. Cowles was in 
perfect harmony with my ideas as to the 
character and importance of the undertak- 
ing before us, and as to the methods to be 
employed to attain the end in view. 



1 ciiipiu^cu 



56 REMINISCENCES OF 

Dr. Cowles had struggled long before 
he convinced the board of trustees that a 
change in the methods of nursing was either 
desirable or necessary. That their approval 
had finally been won was shown by my 
presence there. But this approval was not 
shared by the ten house officers and their 
three assistants whom on that January day 
I first met at table, where I presided, the 
only woman among thirteen strange men. 
If they did not object to my presence, they 
certainly had no cordial welcome for me, 
nor for the work I was there to organize. 
Why do we all oppose new measures before 
first testing their virtues? These men were 
still very young, but they were doctors; 
they felt they had a knowledge of what was 
needful for the sick under their care, and 
most of them had a feeling of opposition 
to all changes. Nevertheless, although in 
the beginning they succeeded in making my 
trying work much more difficult, several 
of them became warm friends of the cause 
before they left the hospital. 

I spent some days quietly acquainting 
myself with my new and extensive sur- 



A 



roundings. Looks of bare tolerance rather 
than of pleasure greeted me on my rounds, 
and plainly expressed the feeling that my 
suggestions were an interference. 

Conditions had not changed for the 
better since my former experience there. 
Only a small portion of time was given to 
the care of patients; the household duties 
were considered of far greater importance 
than the nursing. When the wards were in 
order, those nurses whose kindness of heart 
prompted them to an interest in suffering 
humanity gave some attention to the sick; 
but to the majority of the caretakers moans 
of suffering had very little meaning, and 
the ignorance displayed in matters of ob- 
serving and attending to the needs of the 
patients was a great mystery. How a rea- 
sonably intelligent woman can be twelve 
hours a day in a ward of thirty ill people 
and learn nothing is to me a matter past 
comprehension. There were, however, shin- 
ing exceptions; women who, without train- 
ing other than that gained in the wards, 
had become excellent nurses, women whose 
hands were ever gentle, whose eyes were 



58 



REMINISCENCES OF 



ever open to detect the slightest change, 
whose ears were never closed to the most 
feeble groan. The rareness of such "pearls 
of great price" thirty-five years ago in the 
City Hospital of Boston greatly enhanced 
their value, and no words can convey an 
adequate impression of how much their 
services were prized. 

The board of trustees were in frequent 
conference with me as superintendent of the 
new and much desired school. There were 
many problems to be met and solved, and 
much patience and determination were 
necessary on every side. I shall never for- 
get the spirit of kindness and interest that 
some of the men showed, and the help and 
the support they gave me in times of crying 
need. 

At the end of a month we were ready 
for the formation of classes. Dr. Cowles 
then called the nurses together and gave 
them a plain, simple talk. He set forth 
the object of the training school, as a means 
of present benefit for patients and for the 
nurses, and then led their thoughts to the 
larger blessing for our country that would 



w 
w 



america's'first trained nurse 55^ 

ultimately come through the possession of a 
body of earnest, educated women, who, by 
thorough training, should have finally estab- 
lished a noble profession peculiarly their 
own. He closed the address with an invi- 
tation to the nurses of the hospital to enter 
the training school. 

The first lecture by a member of the 
hospital staff was well attended; but on 
learning that notes for examination and cor- 
rection were required, many nurses found 
the work too hard, and declared their in- 
tention of leaving, so that vacancies grew 
frequent. Six, however, completed the 
course and became very valuable to the 
school. There were numerous applicants 
for entrance to take the two years' course, 
but because of the great needs of the hos- 
pital service many were admitted who were 
not altogether desirable, and had to be 
dropped later on. Little by little, however, 
suitable candidates presented themselves 
and remained with us. The old condition 
of mere ward work being the only legiti- 
mate duty of the nurse passed away, ward 
maids being employed for that work; and 



4 



REMINISCENCES OF 

doctors forgot their conviction that young 
women could never take temperatures cor- 
rectly, nor keep bedside notes, nor prepare 
dressings properly. These duties and count- 
less other minor offices were now cheerfully 
accorded to nurses, and faithfully fulfilled. 
How opinions changel The trials and diffi- 
culties passed, as do storms, and the sun of 
successful achievement shone in due time. 
Early in the history of the school we 
secured two graduate nurses from Bellevue 
and one from the New England Hospital. 
These all did excellent work in charge of 
the most important wards. Head nurses 
were selected from among the most promis- 
ing of our first students, and their help 
proved very valuable, both during their 
training and after its completion. Before 
the end of the first year our friends far 
outnumbered our opponents, and we could 
look upon our school as a success. While 
we had not a long list of desirable appli- 
cants from which to fill vacancies, all of 
our nurses belonged to the training school, 
and many of the roughest places in our daily 
work had become smooth. One surgeon 




I AMERICA'S FIRST TRAINED NURSE 6M 

P said he could not see how the work hadl 
been done under the old system, and that 
it already would seem to him impossible to 
run a hospital without a training school. 
 That first year was filled with anxiety | 
pand vexation of spirit, but at the end the I 
sun set in a comparatively clear sky. As I 
I recall the days of toil and the nights of I 
worry, as I pass in review the fearful fore- " 
bodings regarding the final outcome, and 
as I dwell on the success which crowned 
I the work, I feel that I was greatly blessed 
■to have been associated with Dr. Edward 
"Cowles in my first attempt to organize 
a training school from its foundation. 
Dr. Cowles, far more than I, was the 
I greatest factor in bringing about the enor- 
Imous and fundamental changes required in 
rthe hospital administration. His sound 
judgment, his invariable justice, his cordial 
sympathy, and his unfailing support, to- 
gether with his quickness to act, were more, 
yes, many times more, the reason of our i 
success than were my own efforts. 

On the first anniversary of the establish- 
Iment of the Boston City Training School, 



62 REMINISCENCES OF 

the hospital was in better condition than it 
had ever been, the tone of the place had 
materially changed, and the patients had 
far better care. The board of trustees 
had become firmly convinced of the wisdom 
of the step taken one year earlier. But with 
all our rejoicing, not one among us could 
look far enough into the future to see the 
great work that was to be done by that in- 
fant school. The present pupil nurse, with 
all her up-to-date advantages, will do well 
to pause and to study carefully the early 
years of her own school, and to think 
seriously how it has grown and become 
famous, and what that growth and fame 
have cost. How many of her daughters 
have been the founders of new schools since 
I sent the first graduate nurse to take charge 
of a small hospital in 1880! And who can 
tell the numbers yet to be trained in its 
wards, and to be sent forth to do glorious 
work! 

At the end of a year and a half of the 
life of the school. Dr. Cowles was appointed 
superintendent of the McLean Hospital, and 
Dr. G. H. M. Rowe entered upon the duties 



AMERICA'S FIRST TRAINED NURSE 63 

which for many years he so ably performed 
as superintendent of the Boston City Hos- 
pital. Two months later, Miss Almira 
Davis, a very able and well-trained nurse, 
took my place as substitute. My proposed 
three months' rest developed into a pro- 
longed illness, and it was three years and 
three months before I returned to relieve 
Miss Davis, who in turn was obliged to 
resign on account of ill health. She died 
some years ago, leaving behind a record of 
large and faithful service. 

Great changes had taken place in this 
interval of three years' absence. At first I 
felt like a stranger. My nurses had all 
graduated, but some of the stand-bys had 
remained in the hospital, which had been 
much enlarged and improved. I was very 
happy to notice a higher type of woman- 
hood represented among the increased num- 
ber of pupil nurses. The standard was 
higher than at first was possible, and the 
steady growth in every way resulted in 
active steps being taken to obtain funds for 
building a much needed Nurses' Home. 
Friends came to our aid, and a sufficient 




64 REMINISCENCES OF 

sum was finally obtained. It was a great 
pleasure to watch the growth of the struc- 
ture that was to bring such comfort into the 
daily lives of our nurses. Two years later, 
the first Nurses' Home in Boston was for- 
mally opened. A reception was held in the 
large and pretty parlors, and the public 
showed great interest in the comfortable, 
well-equipped building. 

Among our graduate nurses, Miss Lucy 
Drown has held for many years an impor- 
tant place. After being my able assistant 
for a time, she succeeded me as superintend- 
ent of the training school, and through a 
long period of years did better work than 
I could ever have done. It is a privilege to 
have been followed by such a woman, "one 
of the saints of the earth," as she has been 
called by a physician who was one of the 
most true and loyal friends the nursing 
profession has ever had. 

The wonderful transformation in hos- 
pital and training school methods had con- 
tributed largely to the rapid growth of this 
school during the first eight years of its 
existence. That this was only a beginning 



^ 



AMERICA'S FIRST TRAINED NURSE 65 

I dimly realized even then. Today the 
beautiful Vose Home, the South Depart- 
ment Home, and the Relief Station Home 
are added to the first old home, and all are 
part and parcel of the Boston City Hospital. 
It is difficult to conceive what this statement 
means in measure of work accomplished by 
a whole army of nurses. And the end is not 
yet. May the power for good continue to 
increase in proportion to the size and num- 
ber and strength of our growing institutions ! 
The training school of the Boston City 
Hospital has always remained very dear to 
me. No other school has ever taken the 
place in my thoughts of this one which from 
its very foundation was the fruit of my first 
efforts in organization, and the graduates 
always have a peculiarly warm place in my 



CHAPTER X 



IX Fcbniar\% 1885. while my heart and 
hands were more than full with my work 
in the Boston City Hospital, some one told 
mei that the American Board of Missions 
was seeking an experienced nurse to go 
to Japan to organize a training school for 
Japanese women nurses. The remaik made 
no impression upon me at the time, but later 
I found this statement facing me at every 
turn. I was powerless to put the thought 
away from me, and finally, as an act of 
seeming duty, I went to the rooms of the 
American Board and offered my services. 
The matter rested there for some months, 
and it was with something like surprise that 
in August, 1885, I received word from the 
secretary of the Board that I had been 
appointed for the work. I immediately 
resigned my position in the Boston City 
Hospital, but it was late in November 

before my place was satisfactorily filled by 

66 



AMERICA'S FIRST TRAINED NURSE 67 

Miss Drown, of whose excellent service I 
have just spoken. 

On December 14, 1885, I started alone 
for Japan. Taking the Southern Pacific 
route, I spent Christmas with an old 
friend in Los Angeles, and then sailed from 
San Francisco on the 30th of December. 
Though it was an uncommon occurrence in 
those days, our steamer sailed by way of 
Honolulu, and I had the pleasure of spend- 
ing the 6th of January in that beautiful city. 
On going ashore with steamer acquaintances, 
I had the good fortune to meet an old friend, 
who devoted the day to our entertainment. 
We visited the hospital, which was beauti-. 
fully situated among palms and orange 
trees. Though so attractive on the outside, 
on entering the wards my fingers ached to 
put things in order. Since that time modern 
methods have worked great changes and 
brought about the most beneficial results. 
After the pleasant day on shore, we 
I returned to the steamer to find my state- 
I room a bower of beautiful flowers. There 
I were also generous gifts of the island fruits, 
land I remember the Honolulu oranges as 



J 



REMINISCENCES OF 

l»urpassing in flavor any others I have ever 
asted. 

Two weeks of uneventful steaming 
across a seemingly endless waste of waters 
brought us to Japan. We did not see a 
single sail from Honolulu until the last 
morning of our voyage. On that afternoon 
we had a heavy gale and a rough sea; but 
in the evening, on entering Yokohama har- 
bor, the storm had passed. Going on deck 
after dinner, we found the sky a deep blue, 
and the moon shining with a soft, beautiful 
light. The clouds were disappearing in 
great masses of mist, which alternately hid 
and revealed the approaching shore. As 
spellbound we watched the rapid changes, 
a great veil seemed to part and disclose 
before our wondering eyes the mountain 
Fujiyama, in all the marvel of her snowy 
garments, and her stately height of more 
than twelve thousand feet. Words fail me, 
but while memory lasts the beauty of it all i 
will never fade from my mind. 

As we neared the land, the floating mists 
closed in again, and we saw but dimly the 
city's lights upon the water's edge, though 



AMERICA'S FIRST TRAINED NURSE 69 

higher up and farther away the moonlight 

revealed the Bluff, where Americans and 
English live, and where were shining more 
and brighter lights. I was one of the few 
who remained on the steamer until the fol- 
lowing morning, and I was rewarded by a 
strange and interesting sight. The ship was 
fairly surrounded by flat-bottomed boats 
rowed by natives, talking vehemently in 
their language, which was most strange to 
me, and struggling violently to get along- 
side to secure baggage or passengers. The 
officers were kept busy preventing them 
from reaching the deck. 

About nine o'clock the steamer's launch 
arrived and took the passengers ashore. 
The custom house official, who spoke a few 
words of English, opened and quickly closed 
my trunks and marked them to be trans- 
ferred to a steamer going to Kobe, my real 
landing place. 

I shall never forget that day in Yoko- 
hama, my first day in Japan, my first ride 
in a jinriksha, drawn by a little brown man 
much smaller than myself, and my first 
shopping in the attractive little shops where 



d 



70 REMINISCENCES OF 

polite little men with but few words of 
English made me understand so easily the 
price of the wares. I could not keep my 
eyes from the women with babies strapped 
upon their backs, or, yet more strange, the 
children with still smaller children tied 
upon their backs. I kept wondering why 
the little serious-faced babies never seemed 
to move or cry. The clatter of the wooden 
shoes upon the macadamized roads, the 
bright sunshine and the clear blue sky, the 
sparkling waters of the beautiful harbor — 
all these mingled sights and sounds seemed 
to make a fairyland for me, where I dreamed 
happily away the few hours at my disposal. 
Friends living in Yokohama had invited 
me to visit them, so finally I started in the 
direction of the Bluff where their home was 
situated. When the foot of the steep hill 
was reached, the little man who drew me 
put down the shafts of the carriage and said, 
"Take a walk." I cheerfully obeyed, and 
getting out of the jinriksha climbed beside 
him to the summit, whence I looked far out 
upon the great sea so recently crossed and 
exclaimed in the universal words of all 



AMERICA'S FIRST TRAINED NURSE 71 

travelers, "Beautiful Japan 1" After a few 
hours happily spent in the home of my 
friends, who accompanied me to the custom 
house and thence to the wharf, I embarked 
in one of the countless small, flat-bottomed 
boats, and was rowed silently over the still, 
dark waters to the steamer lying a mile and 
a half away. 

The journey from Yokohama to Kobe ' 
takes about twenty-four hours. The weather 
was fine but cold, and we had occasional 
glimpses of Fujiyama. It was eleven o'clock 
on Sunday morning when we landed, and 
a jinriksha quickly took me through the 
strange town to the home of friends, where 
I received a most hearty welcome. 

I spent a few days in Kobe and then 
went to Kyoto, where I was to begin my 
work. Two and one-half hours were re- 
quired to make the journey of fifty miles 
on the railroad train, but the scenery was 
so beautiful that the time passed only too 
quickly. 

During the first few months of my life 
in Japan, my entire time was given to the 
study of the language. A portion of this 



72 REMINISCENCES OF 

period I passed in Okayama, a town of 
about thirty thousand inhabitants, situated 
about one hundred miles southwest of 
Kyoto. Soon after my arrival there, cholera 
broke out, and we were quarantined for six 
weeks. Mr. Carey, one of the missionaries, 
being willing to accompany me as inter- 
preter, I was able immediately to offer my 
services at the cholera hospital. After three 
days of deliberation, the authorities called 
on me and thanked me cordially, but said I 
was a foreigner, living under a passport 
which promised me safety, and they could 
not allow me to go into so much danger. 
They did not, however, allow the matter to 
drop there, but published an article in the 
papers, telling of the offer of a foreigner to 
enter the cholera hospital to help to nurse 
the sick, and expressing the deepest grati- 
tude for what they regarded as surprising 
and even overwhelming kindness. 

Only a few years earlier Japanese mis- 
sion schools for girls had seemed a startling 
and doubtful experiment, and even now the 
most advanced Japanese doubted if the time 
had fully come to establish a training school 



AMERICA'S FIRST TRAINED NURSE 73 

for nurses. It meant a complete revolution 
in the domestic customs of Japan for young 
women to carry into practice the profes- 
sional work of the trained nurse. The 
greatest care was taken in the selection of 
our probationers. Two had had all the 
advantages of a graduate course in the best 
of the mission schools. One of these, who 
had made great progress in English, acted 
as my interpreter for the first three years of 
my stay in Japan. The other three were 
married women and much older. 

Miss Gardiner, a member of the mission, 
whose health prevented her for a, time fronj 
engaging in her regular work of teaching, 
remained here as my companion. Though 
not a nurse herself, she was thoroughly 
interested in the training of these young 
women, and to her influence and excellent 
advice was largely due the success of our 
first winter's work. 

Two American missionary physicians, 
Dr. John C. Berry, who acted as superin- 
tendent of the hospital, and Dr. Sara C. 
Buckley, who was a general practitioner, 
with several Japanese physicians, constituted 



74 REMINISCENCES OF 

the hospital staff, and the success of the 
school was largely due to their valuable 
services. 

We organized our school abreast of the 
times, with the usual two years' course. 
Lectures on the various needed topics were 
given by members of the medical staff, and 
the customary American text-books were 
used. The lectures on anatomy and physi- 
ology were given by a Japanese doctor, 
and the text-book used for this branch was 
Cutler's Physiology, which had been trans- 
lated into Japanese. Other class instruction 
was given by myself, with the aid of an 
interpreter. I would seat myself on the 
floor, in my place of honor, alone on one 
side of a long, low table in the nurses' 
dining room, and the nurses in a row oppo- 
site me would busily write out the notes, 
which later they would learn by heart and 
recite aloud. I gave also the instruction in 
massage and in dietetics. This last meant 
not a little work, owing to the essential 
difference of food between the two coun- 
tries. In this matter teachers were often 
forced to become pupils, and to learn to use 



AMERICA'S FIRST TRAINED NURSE 75 

the native products for many things which 
would seem strange to nurses in England 
or America. 

The practical experience was gained by 
a routine of service (i) in the wards and 
among the private patients of the hospital, 
where there was a great variety of medical 
and surgical work, eye diseases being espe- 
cially prevalent; (2) in the large outpatient 
department, which we considered most 
valuable training; (3) in nursing patients 
in their homes under the daily supervision 
of the superintendent. 

It is interesting to look back on our first 
small accommodations. On the first floor 
of the lightly built Japanese mission house 
were six rooms, divided only by sliding 
paper screen doors. The largest of these 
rooms was used as an outpatient depart- 
ment; two very small ones were set aside 
for the five nurses; while the dining room, 
sitting room, and kitchen accounted for the 
other three. Two of the five bedrooms 
on the upper floor were occupied by 
Miss Gardiner and myself. We usually 
managed to accommodate five patients in 



REMINISCENCES OF 

the three remaining rooms, which were 
heated by little open stoves of foreign make, 
but bought in Japan. 

Certain problems in the training of the 
nurses which gave me especial difficulty at 
first were the result of my ignorance of the 
people and of their customs, and of my 
slowness in realizing that the habits of a 
lifetime were not to be overcome in a few 
weeks or months. After fully comprehend- 
ing that in the Japanese house the floor is 
the table, that practically there is no fur- 
niture, and that perhaps the only ornament 
to be found in a room will be a vase of 
flowers in one corner, I was no longer so 
greatly surprised or troubled at finding 
dishes upon the floor at every turn, and a 
lack of order and neatness in the necessarily 
intricate care of the wards. Experience 
soon proved, however, that the little Jap- 
anese women would make good nurses. 
Among the many natural qualifications 
which they possess, one of the most valuable 
is their wonderful patience, which seems to 
have been instilled into their very being. 
Always cheerful and courteous, they win 



tig- 



americaTfirst trained nurse 77 

their way where they could not enforce it. 
Then the ability to copy perfectly enables 
them to profit rapidly by practical instruc- 
tion. The little nurses were very patient in 
learning their new work, and never com- 
plained even of their rooms, which were not 
pleasant. However, in the middle of the 
winter we rented a Japanese house which 
was within the hospital grounds, and in half 
of this was established a nurses' home, while 
the other half was occupied by the family 
of our Japanese resident physician, who was 
also our apothecary. 

After the first few months the nurses 
went into the uniform commonly seen in 
American training schools for nurses— blue 
striped gingham dress, white apron with 
bib, and white muslin cap. These little 
women looked very sweet in their foreign 
dresses, which I, their superintendent, at- 
tempting dressmaking for the first time in 
my life, had cut out and made with my own 
hands. I allowed them to continue the use 
of their straw sandals, as they were much 
less expensive, more quiet, and more com- 
fortable than American shoes. It was amus- 



n 
4 




78 REMINISCENCES OF 

ing to see how quickly when off duty the 
foreign uniform was exchanged for the 
Japanese dress, in which they could sit upon 
the floor and lounge with ease. 

The following anecdotes illustrate the 
Japanese powers of quick comprehension 
and of adaptation. I was one day obliged 
to hold the class in my bedroom. The lesson 
was upon operations, and I laid particular 
stress upon the need of after quiet for the 
patient to make a good recovery. As a case 
in point,, I spoke of my anxiety lest one of 
cur patients might by her own willfulness 
in refusing to obey lose the sight of her eye, 
which had recently been operated upon for 
cataract. The recitation ended, one of the 
nurses went in to attend to some want of this 
woman, whose adjoining room was sepa- 
rated from us only by a very thin partition. 
"Nurse," said the patient, "I heard what 
the teacher said in the other room. I heard 
Ito San (the interpreter) tell it all. I will 
lie very still after this. I did not know that 
I was in so much danger of losing my eye, 
or that the teacher was anxious because I 
did not keep still." She faithfully kept her 
word, and the operation was a success. 



AMERICA'S FIRST TRAINED NURSE 79' 

In the care of women and children, 
Japanese nurses excelled, but it was difficult 
for them to use their professional responsi- 
bility to enforce orders with men. In Japan 
it has been an undisputed truth for ages 
that man is the lawgiver, and that it is the 
woman's part to obey unquestioningly. The 
first time a nurse came to tell me that a 
man had objected to taking his medicine, 
I said, "Tell him the doctor says he must 
take it." She hesitated a little and replied, 
"I could not say that to a man." From one 
of his own countrywomen he would not 
have received my explanation that he could 

Ljiot be cured if he did not assist the doctor 
by obeying the directions which must be 

' carried out by the nurse. But to me he 
pleasantly replied, "All right; I did not 
understand." With this patient there was 
no further difficulty, though on many and 
many another occasion it was needful for 
me to help the little nurses to command, 

■and to make the men patients obey. 

I During the first six months we had no 
thought of outside work as part of our 
training, but in the spring a Japanese of 



4 




REMINISCENCES OF 

high social and political standing called 
upon us for a nurse for his wife, who was 
ill with diphtheria. Feeling that this was 
an opportunity not to be lost, in answer to 
the doctor's request I sent a capable little 
probationer, with the understanding that I 
should visit the patient daily. Of course 
we took every precaution against infection. 
The little patient did not at first realize that 
the nurse was there for actual work, other 
than to direct the servants in the necessary 
details of waiting upon her; but when I had 
made clear what was included in profes- 
sional nursing, she gladly and most appre- 
ciatively accepted the nurse's services, and 
expressed the greatest comfort and satisfac- 
tion in the new experience and beautiful 
care. On my second visit, the little Jap- 
anese lady begged me to come without my 
interpreter, saying she could understand me 
and could make me understand her. It was 

1 charming to hear the simple Japanese words 
fall sweetly from her lips, and it was also 
charming to see the exquisite politeness with 
which she would change my crude Japanese 
into correct sentences. We became greatly 
 



J 



V 

N 



8ii 

;ttached, and through the nearly five years "^ 
that I was in Japan she and her husband 
were among my warmest friends. 

From this time on we did private nurs- 
ing while the nurses were in training, 
■allowing the nurses to keep the money 
earned. Our work became better known 
as these women went into the houses, cared 
tenderly for the sick, and thus gained loyal 
.and valuable friends both for themselves 
'and for the hospital and school. People 
learned through help given in time of need 
the true meaning of the trained nurse, and 
we always felt that the work done outside 
the hospital was as important as that done | 
within the walls. 

Notwithstanding our want of appliances 
and our cramped quarters, which forced us 
to hold classes in any room temporarily 
vacant, much good work was done during 
that first winter. 

It must be understood that primarily I 
was appointed to go to Japan as a mission- 
ary, and that strictly missionary work was 
ixpected of me outside of as well as in con- 
ection with my training school work. So J 




82 REMINISCENCES OF 

it came about that with the beginning of 
the second year, when I had acquired some 
familiarity with the language and the peo- 
ple, I began Sabbath school work through 
the aid of an interpreter. I was asked to 
go to adjoining towns weekly to give ad- 
dresses and to conduct Bible classes for 
older women. This most interesting work 
I continued to carry on while I remained in 
Japan. 



CHAPTER XI 

SECOND YEAR IN JAPAN 

THE Japanese people availed them- 
selves of the opportunity offered 
them for the education of their women in 
the care of the sick and suffering with such 
wonderful responsiveness that, even while 
we were still struggling with the difficulties 
of organizing a new work in a foreign land, 
plans were undertaken and were being 
carried out for greatly enlarged facilities 
and accommodations. And so when in 
September, 1887, we began the second year 
of work, we had comfortable rooms for 
thirty patients, a separate home for twenty- 
nurses, a small house for the superintendent 
nurse and her associate, besides generous 
provisions for the outpatient department. 
Of course the climate and customs of Japan 
permit buildings very different from those 
thought necessary in England and America. 
They are lightly constructed, cheaply built, 
and quickly completed, but they are per- 



REMINISCENCES OF 

fectly adapted to all needs. The funds for 
all this work were provided by the Woman's 
Board of Missions, in cooperation with the 
American Board. 

We had two pavilion buildings, on the 
sunny side of which, running their entire 
length, were piazzas where we had reclin- 
ing chairs, on which we put patients who 
were too ill to be up and about, and yet 
well enough to benefit by open air and 
sunshine. Each pavilion had a small ward 
and a few private rooms. The Japanese are 
a very social people, and suffer extremely if 
left alone, especially when ill ; consequently 
in Japan no private patient goes to a hos- 
pital without a relative or friend, who re- 
mains throughout the illness and must be 
provided with a small room opening out 
from that of the patient. 

The nurses' home was a long, two-story 
building, with broad, sunny piazzas, which 
gave outdoor accommodation for both floors. 
The nurses' rooms were small, but each one 
had a window opening out to the pleasant 
porch. The main feature of the home was 
the fine large room on the first floor which 



,1 

J 



AMERICA'S FIRST TRAINED NURSE 85 

Served as dining, assembly, class, and Sun- 
day school room, as occasion demanded. 
Provision was made for all necessary 
conveniences. 

The old mission building was renovated 
and enlarged as an outpatient department, 
and to it was added the excellently adapted 
apothecary shop. We rejoiced in the more 
ample space and the increased comfort with 
which we could carry on the important 
outpatient work. Upstairs we could ac- 
commodate several patients in a ward and 
in single rooms. The little house for the 
superintendent and her associate was placed 
between the home and the hospital, in the 
center of things, so to speak. 

The furniture of the hospital was very 
inexpensive. A Japanese carpenter made 
the beds, which were simply a framework 
of wood, with canvas stretched across to take 
the place of springs. The mattresses con- 
sisted of two thick comforters made to fit 
the bed, and for covering two light-weight 
comforters were provided. The small pil- 
lows were filled with the outer shucks of 
wheat. In summer each bed had a large 




86 



REMINISCENCES OF 



Each ward had a large table 



mosquito r 

in the center, and each patient was provided 
with a chair. The floors were covered with 
the customary straw mats, which were never 
soiled by the tread of shoes or sandals worn 
out of doors. The Japanese preferred usu- 
ally to sit upon the floor, especially when 
a cheerful fire was burning on the hearth, 
by which each ward was warmed. 

The nurses followed the national custom, 
and used only comforters on which to sleep, 
with wooden headrest or pillows of wheat 
shucks, as they preferred. These accesso- 
ries were their personal property. A small 
chest of drawers and a low table for writing 
completed the furnishing of their bedrooms. 

We began the second school year with 
a junior class of thirteen young women, who 
were as well educated, and of as good social 
-standing, as were our five seniors. It was 
not so strange a thing to enter on such work 
as it had been a year earlier, and a spirit of 
great enthusiasm prevailed. How wide- 
spread was the newly awakened interest 
may be gathered from the fact that within 
the year several training schools had been 



AMERICA'S FIRST TRAINED NURSE 87 

established in other towns by the Japanese 
themselves, in connection with already es- 
tablished hospitals. These schools at first 
existed without a superintendent of nurses, 
but our nurses, even before graduation, 
were secured for these positions. 

In 1888 Japan for the first time pos- 
sessed graduate nurses of her own. In June 
of that year we gave diplomas to four young 
women, well fitted for their profession. As 
the second school year came to a close, the 
teaching faculty gave examinations in each 
branch of instruction. At the public grad- 
uation the nurses demonstrated in the pres- 
ence of the guests. The exercises were held 
in the assembly room of the Nurses' Home, 
and, as on similar occasions in our own 
homeland, they consisted of an opening 
prayer, music, speeches, and the giving of 
diplomas. There were many more people 
present than could be accommodated in 
the charmingly decorated house, and seats 
shaded by awnings had been arranged in 
the garden. The reception following the 
exercises was a memorable pleasure to all. 
There was only one shadow on the happy 



aa REMINISCEXCES OF 

day. The class had originally numbered 
five, but during the year one student devel- 
oped lung trouble, and was obliged to give 
up all thought of completing or carrying on 
the work she had learned to love. 

After graduation, two of the nurses 
remained with the school as assistants and 
head nurses. Two were soon happily mar- 
ried. One of these was my first teacher of 
the Japanese language. She was my assist- 
ant as well as pupil during her two years 
in training, and she has continued to be my 
best loved friend among all the Japanese 
women I have known. Her story was in- 
teresting. Two years before I went to 
Japan her husband had sent her away 
because she had become a Christian. The 
missionaries were interested in her and sent 
her for one year to the Bible school, where 
I applied for a teacher in Japanese, and 
was advised to engage this young woman. 
She came to live with me, and soon became 
not only dear to me, but very necessary, as 
she showed amazing cleverness in assisting 
me through the many difficulties of daily 
life and work in this foreign land. Six 



AMERICA'S FIRST TRAINED NURSE 89 

months before her graduation, her former 
husband became a Christian. His awak- 
ened conscience told him he had greatly 
wronged the little woman whom he had 
divorced, and he was filled with an ear- 
nest desire to make amends. After the 
many and formal deliberations customary 
in Japan on matters of even far less im- 
portance than this, she finally decided to 
consent to a renewal of the marriage 
bond when she should have completed her 
course of training and received her nurse's 
diploma. As soon as was possible after the 
great event of the graduation, I accom- 
panied my little friend to her home where 
she was to have her second wedding, this 
time a Christian ceremony, to the same 
man. Bride and bridegroom were of the 
upper middle class, and I shall never forget 
the charming sight of the twenty women 
guests, all save one in flowing robes of dove- 
colored crepe with white silk linings. On 
the sleeves and on the back between the 
shoulders was the family crest embroidered 
in white silk. One single friend wore a 
black robe, decorated like the others, and 



90 



REMINISCENCES OF 



seemingly contrived to bring into greater 
relief the general effect. An elaborate mar- 
riage feast followed, with many speeches 
long drawn out. The heat had been intense, 
and after three hours of sitting on one's feet, 
it was, to the foreigner at least, a great relief 
to assume the upright position, to go out 
into the cool midnight air, and finally to 
bring the exciting experiences to a close by 
a long rest and sleep. 

My summer vacation was spent with a 
friend and three nurses at Maiko, a charm- 
ing seaside resort, where I grew familiar 
with the wondrous beauty of Japan's fa- 
mous pine trees and the marvelous coloring 
of sea and shore in all the changing atmos- 
pheric effects peculiar to this lovely land. 
I came closely into touch with many new 
phases of the national life. There was 
friendly intercourse with a delightful Jap- 
anese family who showed us much kindness. 
Hours were spent watching the fishermen 
at work. The customs of hotel life in the 
small seaside town were full of interest, 
and we made excursions by boat, on foot, 
or by jinriksha. The daily bathing here 



J 



AMERICA'S FIRST TRAINED NURSE 91 

was delightful, and the month of rest most 
helpful. 

It was during the month there that the 
Japanese celebrated a great two days' feast, 
when every year the spirits of departed 
relatives or friends are supposed to return 
to visit their dear ones in the flesh. Great 
preparations are made in advance, and no 
cooking or other work which can possibly 
be avoided is allowed during the prolonged 
celebration. On the evening of the second 
day we noticed a peculiar looking object 
dancing upon the waves far out from shore. 
On inquiry we were told; "That is the boat 
which takes the spirits back after they have 
visited their friends; if it should be driven 
upon the shore in front of any house, some 
person in that house would die within the 
year." The next morning the boat had 
landed high and dry before our hotel, where 
it remained all day. After dark some one 
pushed it far off from shore, and tide and 
wave carried it we knew not where. Only 
spirits could have sailed in the small but 
perfect model of a Japanese boat, complete 
in every detail, even to the lantern hung in 



92 



REMINISCENCES OF 



the middle to light the voyagers on their 
way. The next winter a nurse came to me 
one day and asked if I remembered the 
spirit boat at Maiko, and told me how the 
landlord's daughter-in-law had died, and 
reminded me of the sign. These little 
people are very superstitious, and cling 
tenaciously to all signs. 

Early in the autumn we were back at 
work, with a junior class of thirteen and a 
senior class of seven. These with the two 
graduates gave us twenty-four nurses, and 
we fell well equipped for the year's labors. 
The wards were constantly full and the out- 
patient department was large. The calls 
for nurses in private homes were now fre- 
quent, as the Japanese had quickly realized 
the value of the service thus brought within 
their reach. The reputation of the school 
was all that could have been desired. From 
the first the graduate nurses were treated 
with much greater respect in Japan than 
were our first trained nurses in America. 
The Japanese often outdistance us in their 
quickness to take advantage of any really 
good movement, and this was no exception 
to the general rule. 



' I 

on 



AMERICA'S FIRST TRAINED NURSE 93 

A demand now arose for home instruc- 
tion to mothers and grandmothers. As 
superintendent of the training school, I 
arranged to give a course of talks and 
demonstrations in the home of one of the 
leading women of a prominent church. 
These little meetings were well attended 
and much interest was displayed. 

It was pleasant to see the intense interest 
manifested on every side as an occasion was 
offered to learn something new. I remem- 
ber one instance when, on making a visit to 
a patient under the care of a junior nurse, 
I suggested and prepared a new dainty. It 
was a hot evening, and I was most grateful 
to the two kind women of the household 
who sat on either side of me and fanned me 
vigorously, while watching my every act in 
the preparation of the invalid's food. The 
hospital patients very much liked many of 
our American dishes, and outside patients 
showed great appreciation of any dainties 
we carried to them. 

In the following incident is shown even 
more plainly the widespread desire for all 
available information. One of the nurses 




94 



REMINISCENCES OF 



was taking care of a Japanese high in social 
and political ranks. On one of my daily 
visits I was conversing with him on the 
topic of hospitals and trained nurses, when 
the doctor came in. I was immediately 
silent and stepped back, but the gentleman 
said, "Doctor, please wait one moment; I 
am much interested in what the teacher is 
saying to me." The doctor bowed and 
waited, while I tried to hasten my answers 
to the many questions which followed. 
This home remains pictured in my memory. 
It was simple in the extreme, but yet con- 
tained many objects of wonderful artistic 
beauty. Out of thoughtful regard for a 
foreigner, a comfortably high seat was al- 
ways prepared for me by folding silk com- 
forters and piling one on top of another. 
The bed of the patient, which was on the 
floor, was of silk comforters, as were also 
his bed gowns. 

Through the gratitude and politeness of 
another interesting patient, I was given the 
privilege of being shown through his estab- 
lishment, where silks for the emperor were 
in process of making. Above the hand- 



J 



» 
^ 



AMERICA'S FIRST TRAINED NURSE 95 

looms were stretched the patterns, and the 
weavers wove the intricate designs of the 
lovely webs upon the wrong side. One 
workman uncovered and showed to me a 
portion of the carefully protected right side 
of the marvelous fabric, growing under his 
fingers at the rate of two inches a day of 
finished material. Thinking of the patience 
which must be exercised in daily perform- 
ance of such labor fills me with ever re- 
newed wonderment. Later the merchant 
sent me a very beautiful silk handkerchief, 
which, in true Japanese fashion, I at once 
gave away, thus showing my appreciation of 
the gift. The constant receiving and mak- 
ing of gifts sometimes becomes a trial, when 
thanks must find expression in repeated and 
varied forms. Until fully impressed with 
the importance of the custom in Japan, one 
is apt to forget; but to forget is to be im- 
polite; and to be impolite is to sin. For- 
tunately the warm hearts of the people 
make generous allowance for the failings 
of foreigners. 

The prospective graduates of the second 
class of nurses were engaged for other hos- 



96 REMINISCENCES OF 

pitals before they were sure of passing their 
final examinations, but fortunately all were 
successful. Those who left the hospital in 
June, 1889, to fill these positions, reflected 
credit on their school. 

On October 15, 1890, I left Japan, and 
not very long afterwards the school passed 
into Japanese hands. It is a pleasure to 
know that in making this change the high 
standard already attained was in no way 
lowered. 

The school came into existence under 
advanced ideas. The beginning was small 
and the developments gradual, but the 
methods of work were always along the 
most highly approved lines, and to this 
may be attributed its steady growth. 

From this school, at the time of the 
Chinese-Japanese war, a body of graduates 
with a good matron went to the front, and 
for months cared for the sick and wounded 
soldiers. The work done by them was 
excellent, and received recognition from 
high army officials. 

These little Japanese women, so unaccus- 
tomed to relying upon themselves, showed 



A 



y 



AMERICA'S FIRST TRAINED NURSE 

marked ability in organizing and conduct- 
ing societies in their own profession. Their 
Red Cross organization is complete in its 
method of work. Their Alumns Associa- 
tion exerts an active and useful influence. 

As time went on and advice or help was 
wished for from outside their own land, 
capable nurses would be sent for study and 
investigation to America or to England, 
and such students would know well what 
they wished to learn, and would choose very 
carefully between the wheat and the tares. 
They have shown remarkable skill in select- 
ing what could advantageously be used in 
their own country, and in adapting to their 
needs, in the wisest possible way, methods 
or means which often became almost unrec- 
ognizable in the final forms in which they 
were utilized. 

Our hospitals still seem magnificent in 
their eyes; but they are keeping pace with 
us in the quality of their work and in results 
obtained, if not in the grandeur of buildings 
and in elaborateness of equipment. 

I tell the following little story to show 
how keen is their appreciation of what has 



REMIMSCEXCES OF 

been done for them. I had the pleasure 
some time ago of showing a young Japanese 
woman through the Boston City Hospital. 
We saw the wards, the operating rooms, 
the Icitchen, storerooms, and the many and 
varied appliances. When we had finished 
our journey and were resting, she looked 
earnestly at me and said, "You make me 
think of Moses." I answered: "Why? I 
see no resemblance." To which she re- 
plied: "Yes, Moses gave up all the wealth 
of Pharaoh's court to go and live with his 
own poor people, and you left this beautiful 
place to go to live in Japan, where every- 
thing is so small and poor. The difference 
between you and Moses is that he went to 
his own people and you went to strangers." 
It was indeed an important moment in 
the history of Japan as a nation when, in 
June, 1888, those four Japanese women 
^ received in their hands the handsome di- 

 plomas which declared their fitness to enter 

I the profession of nursing. Long years of 

I self-sacrificing, missionary labors had pre- 

I pared the way, and now the nurses' training 



AMERICA'S FIRST TRAINED NURSE 99 

women of Japan out of the old life of com- 
plete subservience into a new atmosphere 
of progress and self- development. This 
knowledge is very gratifying to Ameri- 
cans, to whom, through the initiative of the 
American Board of Foreign Missions, is 
(iue the honor of having begun this grand 
work in the Island Empire of Japan. 



CHAPTER XII 

WORK OF ORGANIZATION IN SEVERAL 
SCHOOLS— ^ 1 890- 1 909 

IN the autumn of 1 890 I left my work in 
Japan to return to America. My health 
had suffered from the Japanese climate, 
and, in addition to other complaints, an 
ear trouble had become so serious that the 
doctor ordered absolute rest and a change of 
climate. I concluded to seek these needs, 
first, in the two months' journey by sea 
through the Suez Canal to France, and then 
in a visit in the home of one of my dearest 
friends in Paris. I remember with deep 
gratitude the kindness shown me all the way 
by every one with whom I came in contact. 
Being an excellent sailor, I was able to enjoy 
to the fullest the soft, tropical weather and 
the visits of from one to three days in sev- 
eral seaport towns. 

One must live through a typhoon on the 
China Sea fully to understand the meaning 

of the word. It lasts only about twelve 

100 



AMERICA'S FIRST TRAINED NURSE lOI 

hours, but those hours seem weeks in length. 
The wise captain of today turns and runs 
from this terrible enemy, instead of facing 
and battling with the foe, as was once 
thought the right way. 

At Perim Straits, where we enter the 
Red Sea, we saw one of our own line of 
steamships lying wrecked upon a coral reef. 
Our captain stayed by her until other effi- 
cient help came to her aid. From this point 
we were hindered in our course by the fact 
that we fell in with a ship carrying the 
Queen's mail, and the courtesy of the seas 
demanded that our steamer, though a faster 
vessel, must refrain from taking the lead. 

In the Mediterranean Sea we were over- 
taken by a second storm, which lasted thirty- 
six hours and was so severe that, when at 
last we had calm weather, twenty of the 
crew were disabled. Four days later, when 
I landed at Marseilles, six of the injured 
sailors were still in bed. 

We arrived in sunny France two days 
before Christmas, and to one whose travels 
for nearly two months had been in the 
tropics, the cold seemed intense. A fifteen 




J_J 



102 REMINISCENCES OF 

hours' ride by train brought me to Paris, 
where I was met by my dear friend, who 
gave me the warmest of welcomes. She has 
since gone to her eternal rest, and so I re- 
member with peculiar gratitude the delight- 
ful weeks I spent with her. However, rest 
and pleasure must come to an end, and after 
two most enjoyable months I set sail for 
America, where I arrived early in March, 
1891. 

After visiting friends in New York, 
Philadelphia, and Boston, I accepted a 
position as head of the Philadelphia Visit- 
ing Nurses Society, a branch of work at that 
time new to me, but which has been pro- 
ductive of much good, and which has called 
into its service many of our noblest women, 
who have found it the most attractive and 
interesting of all work yet entered upon by 
nurses. This work is still in its infancy, 
and who can tell of the good to be accom- 
plished through such means in the future? 

From April to November of 1891 I 
remained in connection with this organiza- 
tion, and it was with great reluctance that 
I found myself forced, by lack of sufficient 



I 



AMERICA'S FIRST TRAINED NURSE 103^ 

physical strength, to discontinue my happy I 
and interesting labors in this far-reachingi 
work. 

The next four months were spent at 
Kirkbride's, that beautiful place in Phila- 
delphia where the mentally ill are so well 
cared for. I went as matron of the hospital 
and as superintendent of the training school 
to be organized. But I found conditions 
there not ripe for the radical changes in 1 
administration that such an organization J 
required, and therefore felt justified in| 
resigning this position and accepting anj 
offer of similar nature in a new establish- J 
ment, the Methodist Episcopal Hospital of.| 
Philadelphia. 

I had specially fitted myself for training ' 
school work, and here was a fresh field, 
where I found great happiness and deep 
interest in using the experience gathered 
from many years of application. It was 
with much regret that I said good-by when, 
eight months later, illness forced me to take 
a rest. It was, however, a consolation to me 
that one of my own nurses took up the work J 
and carried it on successfully for two years^J 
to a point of permanent organization. 



I04 REMINISCENCES OF 

During the winter of 1893-1894 I re- 
turned to my Alma Mater as superintendent 
of the New England Hospital for Women 
and Children, to be in charge during a 
period of reconstruction. It was pleasant 
to be with old friends who had always fol- 
lowed my hospital life with interest, and 
fifteen months passed happily while the 
training school course was lengthened to 
three years and brought up in all possible 
ways to the best modern standards. 

Upon leaving the New England Hos- 
pital I went to the Brooklyn Homeopathic 
Hospital. The school superintendent had 
been ill for many weeks, and no one had 
taken her place. A member of the com- 
mittee wrote, "We have need of a firm 
hand here." During the two school years 
that I remained, the course was length- 
ened from two to three years, and several 
other much needed changes were made. In 
carrying on the work there, where I found 
already established the practice of sending 
nurses out to private cases while still in 
training, I again gained practical proofs of 
the excellence of this method. The most 



M 



AMERICA'S FIRST TRAINED NURSE I05 

important of these is that a nurse's first 
mistakes are made when she has her own 
superintendent to whom to go for counsel. 
The superintendent in her turn, by having 
complaints come directly to her from the 
patients, learns how best to instruct nurses 
for private duty. I feel sure that in many 
cases the nurse is much more desirable in 
after years for this experience before she 
is wholly thrown upon her own responsi- 
bility. As all education tends to broaden 
one, this practice should make wiser and 
less narrow women. 

The next training school of which I took 
charge was that of the Hartford Hospital. 
This is one of the pioneer schools of the 
country, having been the fourth school 
organized. It was most excellent in many 
ways, but was very conservative and in 
need of radical changes. Much caution 
and tact were necessary if one was to suc- 
ceed in establishing new methods. The 
committee had found, however, that if their 
school was to rank with the foremost, ad- 
vance was necessary. Graduates from one 
or two of the best New England schools 



schools I 



jo6 



REMINISCENCES OF 



were secured, and then, with some of their 
own graduates well adapted to fill difficult 
positions, we soon found ourselves making 
rapid progress. Today I know of few 
schools superior to that of the Hartford 
Hospital. 

While still at Hartford the hospital 
committee gave me a two months' leave of 
absence that I might go to the Long Island 
Hospital, Boston Harbor, to change the 
school there from one for attendants to a 
training school for nurses. The course was 
for two years, and many of the young 
women who had entered the school for 
attendants, and who were sufficiently well 
educated to meet the higher requirements, 
entered the training school and became 
excellent graduated nurses. My assistant. 
Miss Mary Morris, was made superintend- 
ent of the training school when I left, where 
she long continued her efficient work. 

When in 1897, after two busy years, I 
severed my connection with the Hartford 
Hospital, I went to the University of Penn- 
sylvania Hospital to have charge of the 
training school, which had for years been 



A 



AMERICA'S FIRST TRAINED NURSE 107 

well established and ranked among the most 
progressive at that time. I accepted this 
position at the urgent request of the super- 
intendent of the hospital, Miss M. E. P. 
Davis, of whose ability it is needless to 
speak. While neither reorganization nor 
reconstruction was needed, we worked to- 
gether for the advancement of the training 
school to a still higher plane of usefulness. 
After two years, my allotted time in an in- 
stitution. Miss Davis and I resigned- our 
positions there. 



CHAPTER XIII 

EXPERIENCES IN HOSPITALS FOR THE 

INSANE 

SEVERAL times in the course of the first 
twenty-seven years of my nursing life 
I had been asked to organize schools in 
hospitals for the insane. Although I had 
always found grounds for refusal of these 
requests, my judgment finally told me that 
such schools were a necessity, and at last I 
entered upon this branch of work. 

In 1899 I went as superintendent of 
nurses to the Taunton Insane Hospital, 
where I remained four years; then to the 
Worcester Hospital for the Insane, to 
organize a new school ; and finally, in Feb- 
ruary, 1906, to the Michigan Insane Hos- 
pital in Kalamazoo, where I remained until 
September, 1909. 

It stands to reason that the mentally sick 

should be at least as well cared for as the 

physically sick. Several insane hospitals 

had already organized training schools be- 

108 



AMERICA S FIRST TRAINED NURSE 109 

fore 1899, but their standards were far from 
being on a plane with the best schools in 
general hospitals, and nurses graduating 
from them were not recognized by the 
public. Methods had not advanced in pro- 
portion to the increase in the number of 
these schools, which were often conducted 
by the medical staff without a superin- 
tendent of nurses. This surely was a grave 
defect. Certain schools connected with 
private insane hospitals started out in the 
right direction, and were organized and 
conducted as nearly as possible like those 
associated with general hospitals, but com- 
bining training for the physically ill with 
that for the mentally afflicted. One of the 
oldest of these is that of the McLean Hos- 
pital at Waverley, Massachusetts, which 
from the first has maintained a high stand- 
ard. This school has done a great work in 
demonstrating the value of trained nursing 
for the many persons afflicted with mental 
disease. 

State hospitals were thus roused to the 
need of better care for their patients. This 
could be secured only by better training 



M 



t 



no REMINISCENCES OF 

for their nurses. Capable superintendents 
of nurses were sought for and secured; 
regular lectures were commenced; demon- 
strations found a place in the schedule; and 
bedside instruction became a part of the 
every-day work of the head of the school. 

Methods looking to the cure of the 
insane have changed greatly during the last 
few years, and, among other advantages, 
nurses receive a wonderfully good training 
in hydrotherapy. This sounds simple, but 
the practical carrying out of the theories 
is beset with difHculties. Most careful in- 
struction is needed in training nurses in the 
matter of medical baths, and this training 
is given far better in the hospitals for the 
insane than in general hospitals. 

A two years' course in a state hospital 
for the insane often develops a pupil nurse 
in an astonishing manner. The average 
probationer does not possess a very large 
amount of patience or tact — two essential 
qualities in the making of a good nurse. In 
nursing the insane these qualities must be 
cultivated, and must grow under cultiva- 
tion, or the pupil is an absolute failure. It 



J 



AMERICA'S FIRST TRAINED NURSE 1 1 1 

is a truly encouraging sight to see spirited 
young women growing in grace, as day by 
day there is developed in them an added 
sweetness of disposition. This is the surest 
foundation on which to build a strength 
of character that eventually exercises a 
wonderful influence upon the mentally 
sick. 

Schools connected with private hospitals 
for the insane have, from the first, been 
afSlialed with good general hospitals, but 
it is quite a recent thing for state hospitals 
to have this benefit. The advantages to be 
derived from such an affiliation are so un- 
deniably great that it is only a question 
of time when the privilege will be regarded 
as a necessity. In the schools connected 
with hospitals for the insane, where such 
an arrangement has not been established, 
graduates who intend to make nursing a 
profession must qualify themselves for gen- 
eral work by afterwards takinij at least one 
year of training in a general hospital. 

How does the insane hospital of today 
compare with the same hospital twelve 
years ago? A very marked change has 



d 



112 REMINISCENCES OF 

taken place. The number of nurses has 
been increased. The excited wards seem 
much more quiet, yet one sees no restraint. 
Much attention is paid to employment for 
all those who are able to work, and it is a 
pleasure to see with what pride even ex- 
cited patients will show the articles they 
have made, and how much they appreciate 
words of praise bestowed. One state hos- 
pital has provided good sleeping porches, 
where patients can sleep out of doors. The 
refreshment thus afforded at night makes 
even the excited ones quieter and more 
comfortable by day. Hydrotherapy has 
come into general use, and with very good 
results. Surely one may say the insane hos- 
pital of the present is a great improvement 
over that of the past. Advance is in the 
very air, and each year will bring new com- 
fort to mentally afflicted people. The first 
and hardest steps have been taken, and I am 
glad that my nursing work did not end until 
I had become acquainted by actual experi- 
ence with this important class of work. 



L 




CHAPTER XIV 



REFLECTIONS 



IT will perhaps be remembered that the 
first class to be graduated from the New 
England Hospital numbered five members, 
of whom I, being the first to enroll, was 
the first to receive a diploma. My four 
classmates have done work of great value 
in our profession of nursing. Mrs. Wol- 
haupter remained for a time after her 
graduation in charge of the maternity 
wards of the New England Hospital. 
Later she served successively as head nurse 
of a ward in Bellevue, as night superin- 
tendent of the maternity wards in Bellevue, 
and as superintendent of nurses in a mater- 
nity hospital in Brooklyn. When I went to 
England she took my place as superintend- 
ent of the training school of the Massachu- 
setts General Hospital of Boston, and two 
years later returned to the Maternity Hos- 
pital of Brooklyn, where she remained until 
her health failed. She died soon after 
leaving that school. 



114 



REMINISCENCES OF 



f 



Miss Molesca O. Woods's first year of 
service after graduation was given also 
to Bellevue Hospital as head nurse. A 
ward in the Massachusetts General next 
claimed her help until the Boston City 
Hospital Training School was organized, 
when she was called there as night super- 
intendent. After two years of service in 
this important position, she went into 
private nursing. 

Miss Caroline Stapfer and Miss Thayer 
did private nursing in Boston for several 
years. The former then went to Los Ange- 
les, California, where she is still doing good 
work as a masseuse; and the latter married 
and settled in New York City. 

During the last thirty years hospitals 
and training schools have sprung up like 
mushrooms on every side. Connected as I 
have been with the movement since its first 
formative stage; absorbed as I have been, 
not with individual patients nor a single 
institution, but with the organization and 
reorganization of many training schools, 
both large and small, in different 
of this country and in Japan, I have 



portions j 
ive been I 



AMERICA'S FIRST TRAIjNTED NURSE II5 

forced to keep in touch with all new methods 
and new ideas. From these I have endeav- 
ored to select wisely such changes as would 
best tend to develop the working power of 
our profession toward the attainment of the 
greatest possible usefulness in the allevia- 
tion of the sufferings of humanity. 

I find that with all our wonderful ad- 
vantages, and though engaged in so great 
a profession, we nurses frequently fall into 
a rut, and that we need a great deal of pull- 
ing to get us out again. Some of us do 
wonderfully well, when we do get out and 
stand again upon solid ground, and surprise 
even ourselves to find how broad we can be 
and how narrow we have been. What we 
nurses should do to prevent narrowness is 
to find out what other hospitals and schools 
are doing, the large hospitals and the small, 
the wealthy hospitals and the poorer ones, 
and to let ourselves be broadened by this 
knowledge. For instance, students in a 
small hospital have many advantages over 
those in larger schools, one of which is that 
they come in daily contact with the super- 
intendent of nurses, who, if she is the 



ii6 



REMINISCENCES OF 



woman she should be, exercises a great in- 
fluence for good by this close intercourse. 
Sometimes the large school offers such wide 
opportunities that the single student can- 
not grasp all that is set before her, and is 
hindered in her development by the conse- 
quent difficulty of concentrating her efforts 
on fundamental requirements. True prog- 
ress in the largest sense comes most rapidly 
by acknowledging good work wherever it is 
found, and by learning to follow the good 
example. 

Fifty years from now nurses will look 
back and say that we did not know very 
much about nursing in the first decade of 
the twentieth century, even with the twenty- 
five years of pioneer work that lay behind 
us. Nevertheless, the more faithfully each 
one of us does her own individual work of 
today, the more rapid will be the growth 
of this great movement, the art of caring 
for the sick, which already has exercised so 
vast an influence in all countries on the 
social conditions of the state and of the city 
and of the town, and on the social customs 
of the family and of the neighborhood. 



A 



AMERICA'S FIRST TRAINED NURSE II7 

As for my own work, I often feel that, 
for the many years I have served, I have 
accomplished little. Whether I have been 
a wise builder, some one else must decide. 
All I can say is that I have found life full 
of interest in an eamest endeavor to do faith- 
fully my small part in the great movement 
which has resulted in establishing the pro- 
fession of the trained nurse in America. 



CHRONOLOGY OF 

LINDA RICHARDS'S SERVICE 
IN TRAINING SCHOOLS 

September i, 1872, to September i, 1873. 
Pupil Nurse in Training School of 
New England Hospital for Women and 
Children, Roxbury, Massachusetts. 

October i, 1873, to October 15, 1874. Night 
Superintendent at Bellevue Hospital, 
New York. 

November i, 1874, to April, 1877. Super- 
intendent of Training School of the 
Massachusetts General Hospital, Bos- 
ton. 

April to November, 1877. Voyage to Eng- 
land; Resident Visitor in St. Thomas's 
Hospital, London; King's College Hos- 
pital, London; Edinburgh Royal In- 
firmary. 

January, 1878, to August, 1879. Matron of 
Hospital and Superintendent of Train- 
ing School, Boston City Hospital. 



J 



AMERICA'S FIRST TRAINED NURSE II9 

August, 1879, to September, 1 881. Enforced 
rest 

September, 1881, to December, 1885. Again 
Matron of Hospital and Superintendent 
of Training School, Boston City Hos- 
pital. 

December, 1885, to October, 1890. Organ- 
ization of First Training School for 
Nurses in Japan. 

October, 1890, to March, 1891. Voyage to 
France via Suez Canal; Visit in Paris. 

April, 1891, to November, 1891. In charge 
of the Philadelphia Visiting Nurses' 
Society. 

December, 1891, to April, 1892. Matron 
at Kirkbride's Hospital for Insane, 
Philadelphia, Pennsylvania. 

April, 1892, to December i, 1892. Matron 
of Hospital and Superintendent of 
Training School, Methodist Episcopal 
Hospital of Philadelphia. 



4 



120 REMtNISCENXES OF 

January, 1893, ^o April, 1894. Superin- 
tendent of Hospital, New England 
Hospital for Women and Children, 
Roxbury, Massachusetts. 

April, 1894, to October, 1895. Superin- 
tendent of Training School, Brooklyn 
Homeopathic Hospital, Brooklyn, New 
York. 

November, 1 895, to November, 1 897. 
Matron of Hospital and Superintend- 
ent of Training School, Hartford Hos- 
pital, Hartford, Connecticut. 

November, 1897, to 1899. Superintendent 
of Training School and Assistant Super- 
. intendent of Hospital, University of 

 Pennsylvania Hospital, Philadelphia. 

I Se 



September, 1899, to 1904. Superintendent 
of Training School, Taunton Hospital 
for the Insane, Taunton, Massachusetts. 

September, 1904, to November, 1905. 
Superintendent of Training School, 
Worcester Hospital for the Insane, 
Worcester, Massachusetts. 



AMERICA'S FIRST TRAINED NURSE 121 

January, 1906, to September, 1909. Super- 
intendent of Training School, Kalama- 
zoo Insane Asylum, Kalamazoo, Mich- 
igan. 

September, 1910, to March, 1911. Super- 
intendent of Training School, Taunton 
Hospital for the Insane, until retirement 
as Superintendent Emeritus. 



/ 



V LANE MEDICAL LIBRARY 1 


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