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lANE MEWC/IL UBRm OF

sta:^fg?;'D ummm .

300 FASTtUR mj
PALO ALTQ, CALirORNiA

REMINISCENCES OF
LINDA RICHARDS

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: 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

VII

VIII

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

37
40

54
66

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

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

^^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

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

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

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-

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

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

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

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

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

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

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

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

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.

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.

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

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-

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-

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.

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

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-

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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-

»
^

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

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

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

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

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

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

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

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.

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

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.

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.

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.

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

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DEC 1 2 196S

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OCT 21 1«!

iOV 1 1962

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