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About Google Book Search Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web at |http : //books . google . com/| m jT - ' -; LP ^^; ^ □ " PLEASE DO NOT REMOVE THIS BAND REMOTE STORAGE Please return at the circulation desk. To renew your material call: (650) 723-6691 ext. 3 Date due in Lane Library: lANE MEWC/IL UBRm OF sta:^fg?;'D ummm . 300 FASTtUR mj PALO ALTQ, CALirORNiA REMINISCENCES OF LINDA RICHARDS 1 Portrait of igoo : J..N ij ^\ 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 • To avoid fine, this book should be returned on 1 or before the date last stamped below. 1 - %■; DEC 1 2 196S 1', - ''^^ OCT 21 1«! \ iOV 1 1962 'Of i'^ 190 ii-T^S"'