Vacation Teaches About U.S. History of Nursing

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May 21st, 2012

By , BSN, RN

For the past few days I have been discovering Philadelphia, Pennsylvania. Known as the “City of Brotherly Love,” Philly has been a blast. I have visited with friends, seen historic sites, and had the privilege of attending the opening of one of the most fabulous art museums I have ever, ever been in, The Barnes Foundation. And at the back of my mind, as I left town I was wondering, what are you going to write about come Monday?

As we walked around this city that has been the home to William Penn and Benjamin Franklin; seen the very beginnings of this country, from the signing of the Declaration of Independence to serving as the temporary nation’s capital while the District of Columbia was being built; and has its very own signature sandwich (the cheesesteak), it was still there—what are you going to write about come Monday?

And then, there it was. Did you know that the very first hospital in the United States was in Philadelphia? And, two historic nursing programs came out of that same hospital.

Pennsylvania Hospital

Pennsylvania Hospital was founded in 1751 by Dr. Thomas Bond and Benjamin Franklin "to care for the sick-poor and insane who were wandering the streets of Philadelphia." The idea for the hospital originated with Bond. In 1738, in order to further his medical education, Bond went abroad to study medicine in London. While in Europe, he spent time at the famous French hospital, the Hotel-Dieu in Paris, and became impressed with the continent's new hospital movement.

Around 1750, Bond "conceived the idea of establishing a hospital in Philadelphia for the reception and cure of poor sick persons." At the time, Philadelphia was the fastest growing city in the 13 colonies. Although colonial America's urban centers were far healthier than their European counterparts, the Philadelphia region, according to city leaders of the day, was "a melting pot for diseases, where Europeans, Africans, and Indians engaged in free exchange of their respective infections."

The idea was a novelty on this side of the Atlantic, and when Bond approached Philadelphians for support they asked him what Franklin thought of the idea. Bond and Franklin had been friends for many years but he hadn't approached his good friend because he thought it was out of Franklin's line of interest. Because of the reaction he received, Bond turned to Franklin and after hearing the plan, Franklin became a subscriber and strong supporter. Franklin's backing was enough to convince many others that Bond's projected hospital was worthy of support.

The funding to build first hospital in America was signed it into law on May 11, 1751. To illustrate the purpose of the hospital, the inscription "Take care of him and I will repay thee" was chosen and the image of the Good Samaritan was affixed as the hospital seal.

Schools of Nursing

For Women: In the early years of the hospital, the nurses who cared for the sick and injured were untrained men and women. Often these attendants were former patients who had shown some aptitude or desire to nurse others after their own recovery. Such employees were usually the working poor, commanding low wages and having limited access to education.

In 1875, the Hospital's Board of Managers considered plans to establish a training school for nurses. A program was developed, and certificates were awarded for successful completion of a year's worth of training, which included medical and surgical components. Four years later, Pennsylvania Hospital agreed to co-train nurses from the Woman's Hospital of Philadelphia, an arrangement that lasted until 1882.

In 1883, the hospital re-established its independent training school, graduating four nurses in its first year. Lectures were systematically delivered to students by members of the medical, surgical, and outpatient staffs, which supplemented instruction given by the school's superintendent.

Quality training and staff support led to an important precedent in 1885, at which time three female nurses were allowed to work on men's medical wards. The first public commencement of the nursing school happened in 1893, when students received class pins that incorporated the seal of the Good Samaritan in the design.

Among some of the best know nurses associated with Pennsylvania Hospital was Lucy Walker, an English nurse who became superintendent in 1896, and fashioned the nursing school into one of the best in the United States. Margaret A. Dunlop became head of the school in 1909 and was instrumental in the overseas organization of the American Ambulance Service and Base Hospital No. 10 during World War I.

Dunlop’s assistant, Helen G. McClelland, recipient of the American Distinguished Service Cross for valorous service during World War I, succeeded Dunlop in 1933. During her 23-year tenure, McClelland played an important role in the changing dynamics of the nursing profession. She instituted a shorter workday for nurses, comparable to that of other fields; encouraged continuing education; designed nursing educational programs; and solicited friends of the hospital to endow scholarships.

For Men: 
In 1914 the School of Nursing for Men was established at the Department for Mental and Nervous Diseases, located at the hospital's West Philadelphia Campus. It was the first training school for male nurses in the United States to be headed by a man, Leroy N. Craig.

Originally, the purpose of the school was to meet the needs of the community for competent professional male nurses. The educational program was designed to provide an integrated background in general nursing upon which specialization in psychiatric and urological nursing could be developed after completion of the course.

In 1932, an Affiliate Program in Psychiatric Nursing was developed. The School of Nursing for Men was one of nine "diploma" or hospital-based nursing schools that participated in this cooperative program. Approximately 12,000 affiliate students participated in this mental health nursing training program. During the 1950s, through the efforts of Craig and Congresswoman Frances Payne Bolton, male nurses were granted commissions in the armed forces.

The End of an Era

In 1964, restructuring within the hospital's administration and changes within nursing accreditation organizations necessitated the merger of the two schools of nursing. In 1965, the Pennsylvania Hospital School of Nursing for Men was officially dissolved, after having graduated 551 men over its 51-year history. The School for Women was dissolved the same year and a co-educational program was established.

Pennsylvania Hospital's nursing programs was based on the "diploma school" format, in which student nurses divided their time between clinical experience and classroom instruction. Pressures within the rapidly growing nursing profession created an imperative to transition from the hospital-based diploma schools towards academic education.

The faculty developed an improved curriculum in light of the changing patterns in nursing education but, in 1974, the hospital graduated its last class of nurses. More than 2,800 students graduated since the first public commencement in 1893, all proudly bearing their caps and "Pennsy" Good Samaritan nursing pins.

While the schools of nursing no longer exist, the historic Pennsylvania Hospital continues to proved healthcare to the citizens of Philadelphia. It sits in the middle of a thriving 21st century metropolis, a mixture of over 200 years of healthcare innovations in buildings ranging from 200 years old to many new, modern additions. As it turns out, finding something to write about for Monday was as easy as sightseeing down a few historic streets.

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