Copyright 2000 by the Rector and Visitors
of the University of Virginia.
The publication of the University of Virginia School of Nursing’s first one-hundred-year history would not have been possible without the generous support and financial underwriting of several friends of nursing.
Raymond C. Bice, Jr. served the University with great distinction from 1948 until his retirement in 1999. He held many positions at U.Va., including director of college admissions, professor of psychology, secretary to the Board of Visitors, administrative assistant to four University presidents, and University history officer. He has received numerous awards recognizing his contributions to U.Va. and to education, including the Distinguished Professor Award, the Thomas Jefferson Award, and the Meritorious Public Service Award sponsored by the U. S. Department of the Navy. One of the University’s most revered faculty members, he retired from teaching in December, 1994.
Bice’s relationship with the School of Nursing began in 1965, when Zula Mae Baber served as the acting dean of the School of Nursing. Raymond Bice was then associate dean of the College of Arts & Sciences. There was a great deal of attraction/interaction between the students of those two schools. The acting dean and the associate dean had frequent conversations about how to keep this situation under control. In the course of those discussions, romance blossomed. In a relatively short time, the two administrators were engaged and in August of 1966 they were married in the University chapel.
Bice’s support of and commitment to the School of Nursing continued throughout his marriage and after his wife’s untimely death in 1975. He was instrumental in the establishment of the Zula Mae Baber Bice Memorial Lecture, which has become the centerpiece of the nursing school’s continuing education series.
Several University health partners also made generous gifts toward the publication of this book. They are Robert W. Cantrell, MD, vice president and provost of the University Health System; Robert E. Carey, MD, dean of the School of Medicine; and the University of Virginia Health Services Foundation. The School of Nursing gratefully acknowledges their friendship and generosity.
Exploring the history of the University of Virginia School of Nursing has generated new information about Virginia’s programs and about the nursing profession’s spectacular development during the twentieth century. While exploring the social forces, events, and people that shaped this outstanding school, new information revealed how nursing evolved from a semi-scientific domestic vocation into a vibrant profession essential to the functioning of today’s health care system. Although not anticipated in undertaking the study, the vitality and spirit of the school itself quickly became visible. This powerful spirit, enriched by the dreams, aspirations, and sheer daily labor of faculty and students, appeared early in the school’s life and continues today to touch and profoundly influence the lives of thousands of students, faculty, and graduates.
In an attempt to capture the flavor and substance of the school’s dynamic development and spirit, I focused attention on the women who served as its leaders. Known as superintendents, directors, chairwomen, and deans, these women bore the major responsibility to establish and maintain the school’s excellent reputation for service, research, and for educating highly proficient, professional nurses capable of caring for the ills that beset the human body and mind.
I have been in the fortunate position of serving as one of the School of Nursing’s faculty for more than thirty years. In this capacity I worked with hundreds of faculty and students and served with five deans. In addition, I was privileged to know four of the school’s former leaders who served from the 1930s to the 1960s. I also have been aided in gathering information from hundreds of graduates, faculty, and students who shared their stories, memories, photographs, and documents about the school, the hospital, and their leaders. Although I was unable to incorporate all the information they provided, it helped clarify my understanding of the school’s development and its impact on their lives. Too numerous to identify individually, I wish
vi □ MR. JEFFERSON'S NURSES
to express my gratitude to each for their guidance. To all those I have interviewed or worked with, I owe the accuracy of the information presented. The interpretation and shaping of the book’s themes are of my creation and any errors found in the narrative are solely mine.
Two others who have significantly contributed to the book’s creation are Dr. Susan Swasta, archivist for the Center for Nursing Historical Inquiry, and Karen Ratzlaff, director of Alumni Affairs and Donor Relations. Susan organized the school’s extensive historical photographic collection and carefully assembled the attractive images used in the book. Karen served as the book’s editor, a role that called for intelligence, tact, charm, fortitude, and persuasion to keep everyone involved in creating the book on a timeline. She also, as a special interviewer, gathered many of the alumni quotes that are strewn throughout the book. To Susan and Karen, I thank you for contributing your special talents to create this tribute to the school’s one-hundred-year celebration.
Last, I wish to acknowledge and thank my family and friends, especially Annette Gibbs, who heard more about the history of nursing than they ever wanted to know, but who warmly supported me throughout the development of the book. They did this because they believed the work was important.
The history of nursing is bound up with and inseparable from the more general histories of health care and of women. Although physicians generally occupy the limelight in discussions of health care, nurses have historically had the confidence of the people—a truth that virtually every observer acknowledges and that patients know almost instinctively.
As the largest group of health care providers in the nation, nurses have more patient contact than any other provider. When it is our turn or a loved one’s turn to be the patient, we count on a nurse who combines the art of caring with the science of health care. We are grateful that nursing places its focus not only on a particular health problem, but also on the whole patient and on his or her response to treatment. Given the rapidly evolving state of our health care system, nurses have never been more important to health care than they are today.
With those requirements in mind, it is a source of great pride and comfort to know that the nurses educated at the University of Virginia are among the very best in the nation. At the start of the twentieth century, this University joined a movement to make hospitals hygienic and to run them with the disciplinary and operational rigor that came with changes in medical science. To ensure these qualities were in place when it established its hospital in 1901, the University created a school of nursing.
While women had occasionally enrolled in private tutorials with University professors since 1892, nursing students were the first academically grouped women at the University of Virginia. The University saw this as an opportunity to educate women in a new career path under the careful guidance of the male physicians.
Nursing is no longer the sole domain of women. Nor is it isolated as one of the few fields that offer women advancement and recognition in the public eye. Throughout its long history, nursing has been a field in which women and men could contribute to what Jefferson called the “common good.”
viii □ MR. JEFFERSON'S NURSES
The contributions made by nurses and nursing students at U.Va. are immeasurable, and are an important part of the long tradition of service, education, and research at this institution. As just one example, University of Virginia nursing graduates joined physicians to staff military hospital units in both World War I and World War II. Back home in Charlottesville, nursing students literally ran the hospital, ensuring seamless continuity of care for patients and their families. Those young women, accepting weighty responsibilities beyond their years, worked long hours with little complaint to ensure that hospital services were available.
From the early days of the hospital training program to today, the School of Nursing has evolved into a contemporary school that confers baccalaureate, master’s, doctoral degrees, and post-master’s programs. Faculty and students are involved in research and outreach projects that are changing the face of health care, particularly for traditionally under-served populations. The school’s visionary leadership works hard to ensure that graduates and educators alike are well prepared to meet the challenges of the next century.
The University of Virginia is a better place because of the thousands of women and men who chose nursing as their profession and who chose this institution as the threshold to that career. To all the University of Virginia School of Nursing graduates, on the occasion of your 100th birthday, I salute you, and thank you.
As dean of the University of Virginia School of Nursing in 2001, it is my great privilege to pause at the point where our school’s first century meets a new century, and reflect on the noble heritage of this great institution.
One hundred years after those first brave women entered the U.Va. nursing program to staff a new hospital, we look back on incredible change in the profession and in our institution. Over the years we have built on the legacy of competency, compassion, creativity, and commitment demonstrated by those early graduates. The stories I have heard alumni tell about the responsibilities they were given as young women and men, and the skilled clinical judgment they used in a wide variety of settings (in hospitals, clinics, homes, and even on battlefields) attest to both the quality of the students who chose the University and the rigor of their education. This has been an exciting century for thousands of women and men who enrolled at the School of Nursing in search of a meaningful, enriching, and rewarding career.
Now we are poised at the brink of a new century in nursing education at the University of Virginia.
Our attention is focused on building even stronger academic programs while also developing clinical practice and engaging in important patient-centered research. We are becoming increasingly well known for our research programs in mental health services, complementary and alternative therapies, violence against women, critical care nursing, health care history, health promotion, and the key issues surrounding the end of life. Our goal now is to systematically communicate to others—our friends and alumni, other nurses, prospective students and faculty, and the public—what a great school this is.
It is time to build on our current strong programs of education and research by turning our attention to three key areas: acute and critical care, the ethics involved in health care, and care of older populations. We will do this by building strong
x □ MR. JEFFERSON'S NURSES
financial foundations that will help us continue to attract the very best educators, researchers, and clinicians to teach the next generation of professional nurses.
I am confident when I say that the University of Virginia School of Nursing will be at the forefront of designing new solutions to the most pressing health care concerns of the twenty-first century.
We have much to celebrate on this hundredth birthday. The school can boast many firsts, facts and figures, and fund-raising numbers that rival any other nursing school in the nation. But the true story of this school is in the people who learned here, taught, led, served, and worked here, and made innumerable contributions to the University of Virginia, the community, the Commonwealth of Virginia, and the nation.
I invite you to celebrate with me the legacy that is the University of Virginia School of Nursing. Happy 100th Birthday, to us all!
The Early Years
Diploma Training Comes of Age
From Hospital Training to Nursing Education
The Transitional Decade
The Flourishing of Degree Education
The School of Nursing Moves into Its Second Century
I could never have gotten a better education anywhere to prepare
me for my life. The confidence and self-esteem required has been
the basis for everything I have done since.
The nursing students I have met in the last several years have
been so impressive-great intelligence combined with other wonderful
qualities. It will be remarkable to see where nursing is headed!
The story of the University of Virginia School of Nursing’s first one hundred years can be told in many ways. It is, first and foremost, the story of a school that helped lead an educational movement that transformed a female domestic vocation into a vital health care profession. Created in 1901 to provide the University’s new hospital with a youthful, dedicated, and economical nursing workforce, the school has never wavered in its commitment to educate professional nurses capable of providing health education and nursing care to patients of all ages and health conditions.
It is also the story of a partnership between nurses and physicians that led to a transformation of nineteenth-century hospitals from almshouses, with a hint of medicine, into therapeutic institutions where medical science and caring nursing personnel gave patients relief from their suffering and cures for their diseases. The University of Virginia Health System today stands as a visible testament to a century of University nurses and physicians dedicated to the care of the ill, and to the education of generations of health professionals who would continue this tradition throughout the Commonwealth, the nation, and the world.
The school’s story is also an essential component in the history of women’s education at the University of Virginia. Founded as a male institution in 1819, the acceptance of female students into the hospital training program in 1901 marked the University’s first significant commitment to the education of professional women.
Finally, it is the story of the thousands of University of Virginia nursing graduates and faculty who honorably served their country in peace and in times of war, and created, through their clinical, teaching, and research activities, new knowledge and therapeutic ways to stem the ravages of disease and meet the health needs of society.
The steady flow of physicians through the hospital, many simply trying to find the surgical amphitheater, slowed Superintendent of Nurses Charlotte E. Martin in her task of caring for the newly admitted patients. The last few months had been hectic for Martin as she supervised the outfitting of the new University of Virginia Hospital with beds and equipment. Saturday, April 13, 1901, the anniversary of Thomas Jefferson’s birth, had been selected as the official opening day of the hospital. To demonstrate the scientific capabilities of the facility and its physician staff’s ability to provide modern surgical therapy, seven operations were scheduled for the day, including the removal of a large pelvic tumor by Dr. H. H. Buckmaster and a cataract by Dr. Halstead Hedges. Anticipating the post-operative needs of these surgical patients, Miss Martin and her assistant nurse recruited several local women to help them.1
Dr. Paul Barringer, chairman of the faculty, selected Martin from the Nurses Registry in Washington, D.C. to be the hospital’s first nursing superintendent because of her quiet competency. Although little is known about her educational background, she is remembered as a gentle and dedicated nurse. During the next few months, she was responsible for the daily management of the hospital and ensuring that every patient received the best nursing care possible. Unaware of it at the time, Martin’s steadfast commitment to excellence in the nursing care provided patients would become the philosophy of the University of Virginia School of Nursing and the hospital’s nursing department.
6 ◼ Mr. Jefferson's Nurses
Students’ expenses for the training program consisted of the cost of their uniforms, shoes, and books. Their education, maintenance, and laundry expenses were borne by the hospital.
The first student uniform was a long-sleeved, ankle-length, pink dress. The bodice of the dress had a white V-shaped insert that extended from the waist to the neck. The dress buttoned on the left side of the V insert. A stiff white bishop collar and detachable white cuffs extending from the wrist to the elbow were also worn. Over the pink dress was worn an ankle-length, white, gathered half apron. When a student successfully passed the requirements of the probationary period, she was awarded at a special ceremony the newly designed University of Virginia nurse’s cap. The small cap was made of white organdy with a fluted flat brim. Students were required to wear black shoes and hose throughout the program.
The newly constructed twenty-bed University hospital not only served patients, but also doubled as the residence for the staff, including the nursing pupils, medical interns, Superintendent Besley, and a nursing assistant. The nursing pupils, graduate nurse, and the interns lived in rooms on the top floor of the hospital and Besley resided in a suite off the main entrance of the hospital. These arrangements ensured that the superintendent and staff were readily available in the event of an emergency.6 Besides providing staff for the hospital, Besley also was called upon to provide emergency nursing help to sick families in the community. During the summer of 1902, typhoid fever swept through the surrounding mountain communities. In response to a plea from a local physician for a nurse to help a stricken family, all sick with typhoid, Besley spoke to Emma Wood, one of the pupil nurses, about the situation. Emma quickly agreed to attend the mountain family, but Besley remained apprehensive about her fledging ability to care for a whole family alone in a small remote cabin.
“She went, but my sleep was troubled. She was so young and had so little training. There was no way to keep in touch with her... I could only wait and pray. Three weeks later, Emma breezed in one morning as fresh and rosy and cheerful as ever. I nearly burst into tears.” When Besley asked how she had managed, Emma confidently responded: “Oh, I got along fine! I slept outside the house on a cot. The doctor came twice. I boiled everything anybody ate or drank. I cooked my own food and washed dishes. My patients are now well enough to go on with what I taught the one daughter who did not have the fever.”7
The students contributed immeasurably to the success of the hospital’s first year of life, and in response to this success the medical faculty petitioned and were granted permission by the University to operate the hospital all year. The major reason the University built the hospital for the medical school was to provide medical students clinical educational experiences. Thus, in the original discussions about opening the hospital, the board assumed that it would close during the summer months when medical classes were not in session.8 To keep pace with the hospital’s rising patient census, two additional pupils were admitted to the school in fall 1902.
The Early Years: 1901-1924 ◼ 7
In June 1903, three pupils completed their training and, at the school’s first pinning ceremony, they received their University of Virginia Hospital School of Nursing pins. Dr. Stephen Hurts Watts, a professor of surgery, designed the school pin. To make it distinctively a University of Virginia pin, he placed a Rotunda in the center of a gold round pin. Around the Rotunda he added gold laurel wreaths to remind the graduates to remain loyal and true to the University. The words “University of Virginia” were placed at the top of the pin and “Hospital” was written on the bottom.9 In recognition of the school’s first graduates, the University of Virginia’s Board of Visitors officially sanctioned the school’s existence within the University community by declaring its mission: “Aim of the school was to give young women, desirous of acquiring the art of nursing, the same careful and thorough training in their calling as was afforded men studying the science of medicine.”10
The school’s first graduates, Emma Wood, Alice Leathers, and Naomi Besley, began their careers as private duty nurses. They also were among the first Virginia nurses to take
the newly created Virginia Registered Nurse Licensure Examination in 1904. Virginia, seeking to protect the public from uneducated women claiming to be trained nurses, was one of the first states in the country to license registered nurses.11
The hospital’s growing reputation for excellent medical and nursing care encouraged more families to use the hospital when their loved ones became seriously ill. In 1905, Pavilion Two and in 1907, Pavilion Three were added onto the main building thereby increasing the hospital’s capacity to almost one hundred beds. The hospital’s expanding annual census, from 186 patients in 1902 to 482 in 1906, plus its new clinical services, generated a request from the medical faculty that the school quickly admit more student nurses.12 In addition to providing inpatient services, students were dispatched to homes to provide care to ill patients. The income collected by the hospital for the students’ services was used to defray the cost of the training school.
Superintendent Besley, sensitive to the needs of ill patients and committed to making the University of Virginia Hospital one of the best in the state, agreed that the school needed to grow. She was, however, dismayed that the physicians expressed little concern about the quality of the students’ training. Experience had taught her that physicians believed student nurses, contrary to medical students, needed little education beyond that learned from working in the hospital and following medical orders. The fact that students often missed their nursing classes because they were required to remain on duty with patients, or that the
The Early Years: 1901-1924 ◼ 9
long hours and demands of the work frequently left them too weary to remain awake for their evening classes seemed of little concern to the physicians. Besley, following the lead of other nursing superintendents struggling to find ways to balance the demands of nursing service versus the pupils’ education, recommended in 1906 that the program be increased in length from two to three years.13 Unfortunately, the additional year failed to yield an increase in the educational hours for the students. For most of the additional year the students staffed the clinical wards and served as head nurses for younger students.
After six years as superintendent, Besley resigned in a dispute over the role of medical residents in managing the hospital. Her contributions to the growth and vitality of the hospital and school were impressive. In addition to her tasks as an educator, she was responsible for the establishment of the hospital’s basic management system, which included ordering supplies, assisting physicians developing new clinical services, hiring porters and cooks, admitting patients, and developing a patient record system and hospital fee collection procedure.
In July 1907, Mary Jane Hurdley replaced Besley as the superintendent. Hurdley, a graduate of Harpers Hospital in Cleveland, had recently served as the superintendent of nurses at Lakeside Hospital in Cleveland. Friendly, poised, and committed to quality patient services and nurses’ training, Hurdley convinced Dr. Watts, the director of the hospital, to add two registered nurses to the staff. Night and operating room supervisors were employed to meet the needs of physicians and patients, and to ensure some clinical supervision of nursing students.14 With thirty students now in the program and classes admitted three times a year, Hurdley grew concerned about the nurses’ overcrowded living conditions. She petitioned Watts to find new quarters for them as quickly as possible. Although Watts supported this request and passed it on to Mr. Alderman, the president of the University, it would be years before new living accommodations were found.
Hurdley revised the school uniform and cap to resemble her own student uniform. The pink dress retained its stiff white bishop collar, but the white V insert was removed and its hemline was raised by one inch. The dress now buttoned down the front and the original long white attachable cuffs over the long sleeves were replaced with a permanent two-inch soft white cuff. The white gathered half-apron’s hemline was raised two inches. At the conclusion of the probationary period, the student was given a tapered, white, round-necked bib that did not touch the collar and, at the capping ceremony, a new stiff flat-brimmed cap. (This newly designed cap would be worn until the 1970s when caps were discontinued as part of the students’ daily uniform.)
In 1911, Hurdley began one of the school’s most enduring and engaging social traditions, a senior dance to which graduating nursing students invited members of the medical staff. The event began with the dancing of the Virginia Reel by the nurses and their invited physician partners. Held at Madison Hall, the eight seniors and their escorts, the invited physicians and their wives, and the nursing faculty attended the dance in celebration of the seniors’ pending graduation.15
During Hurdley’s six-year tenure, the training program was strengthened in several ways. She increased the students’ monthly stipend to seven dollars and fifty cents and eliminated evening classes by moving them into daytime hours. She also added classes in Materia Medica (pharmacology), Chemistry, Anatomy and Physiology, Nursing History, and Dietetics. She also introduced newer nursing techniques in the Nursing Arts course. During the summer of 1913, Hurdley resigned her position to be replaced by a 1912 graduate of the University of Virginia program, Tabitha Grier.
The Early Years: 1901-1924 ◼ 11
Selected because she had proven to be a successful operating nurse supervisor in the University Hospital, Grier was a loyal Virginia graduate who wished the best for the hospital. Described by a student as “a heavy-set, kind-hearted, and rather fierce-looking nurse,” Grier quickly recognized that she needed more than loyalty to the University to function as a successful superintendent.16 The conflicting demands placed on her to manage the hospital efficiently, provide patients good nursing care, and train students to become professional nurses proved overwhelming. Her lack of organizational and educational skills soon began to be felt throughout the hospital and training program.
In 1914, a shortage of patient rooms and a case of measles in a surgical patient further tested Grier’s endurance and administrative skills. To isolate the contagious patient, a number of the nursing students had to be removed hastily from their hospital attic rooms. Until Varsity Hall could be converted into a nursing residence, the students lived in tents set up on the East Range.17 Originally built in the 1850s as a student dormitory, Varsity Hall served as the University’s Students’ Infirmary in the 1890s. This facility relieved some of the overcrowding of the nurses’ quarters and gave the students a needed sanctuary away from the hospital. Because Grier was required to reside in the hospital, a matron was employed to supervise the students in the hall. The private lives of student nurses of the era were closely monitored. After completing their hospital assignments, they were expected to spend their evenings studying. Students were required to be in the nurses’ residence by 8:00 p.m. on weekdays, and by 10:00 p.m. on the weekends if they were off duty. Socializing with medical or University students was frowned upon and students were required to inform the housemother of their destination when they left the nursing residence. This scrutiny of the students’ private lives was extended to the hospital’s graduate nurses who also were required to live in the nurses’ residence. In a move to establish some autonomy and distinction as graduate nurses and because they needed contact with fellow graduates, they created the University of Virginia Nursing Alumnae Association in 1916.
The outbreak of World War I in Europe in 1914 spurred the growth of the U.S. economy and increased the numbers of patients in the hospital. A gift from U.Va. alumnus Charles Steele allowed the hospital to solve its patient overcrowding problem by building the Steele Wing next to Pavilion Three. This large wing, opened in 1916, increased the hospital’s capacity to 200 beds and provided space for the Outpatient Department.18 Painfully aware that under her leadership the hospital and school standards had deteriorated, Grier requested in June 1916 that she be relieved of the superintendency and allowed to return as the hospital’s operating room supervisor. The hospital board accepted her resignation and undertook the task of finding a new superintendent with experience in successfully running a hospital and school.
Margaret Cowling, a 1905 graduate of the University of Maryland Hospital School of Nursing with eleven years of hospital experience, was employed as superintendent in July 1916. As part of her agreement to take the position, she brought a colleague, Isabele Craig-Anderson, RN, to serve as her assistant superintendent. Finally acknowledging that the daily management of the hospital required more expertise and time than the superintendent of nurses could devote to it, a business manager was hired to function as the hospital superintendent.19
Cowling quickly recognized that additional students were needed to staff the hospital and that the nursing training program had not kept pace with advancements in nursing education. She immediately began to revise the school’s admission requirements and curriculum. In 1918, applicants to the school could be between nineteen and thirty years old but they were expected to have a minimum of two years of high school education. (Although many students met this criterion, it would be almost ten years before all the students possessed two years of high school education.) Hoping to attract better-educated women to the program, preference for admission was granted to graduates of high school and college. To improve the students’ education, the probationary period was increased to four months and student groups were admitted only twice a year, autumn and spring.20 Prior to this time individual students might be admitted at any time in the year as a replacement for a departing student. The curriculum revisions Cowling instigated consisted of integrating lectures throughout the three years of training and adding classes in Obstetrics, Pediatrics, Communicable Diseases, Mental/Nervous Diseases, Gynecology, and Venereal Diseases. Although the six-and-one-half-day workweek with its twelve-hour nights and ten-hour days remained, students were granted three weeks of vacation a year, and their
monthly stipend was increased to eight dollars and fifty cents for the first two years, and ten dollars for their third year.21
To attract more young women to the program, the uniform was again revised. In place of the long-sleeved ankle length pink uniform, a chambray-blue, mid-calf-length dress was adopted. The long-sleeved dress was without cuffs until the student completed her probationary period of the program. The bishop collar was replaced with a softer white Buster Brown collar and the white apron that encircled the waist was made shorter and trimmer. At the conclusion of the probationary period, the student received a white bib that was worn with ties crossed in the back. As part of the probationary ritual, she cut her uniform sleeves above the elbow, pinned on white stiff cuffs and received a wider brimmed U.Va. cap. In her senior year, the tradition of adding a black band to the cap began. Students still wore black hose and shoes throughout the program.
America’s entry into World War I in 1917 interrupted Cowling’s tenure as superintendent. As a Red Cross nurse with administrative experience, she was recruited in 1918 to serve as the nursing superintendent of the newly formed U.S. Army unit known as the University of Virginia’s Base Hospital #41. Several of the school’s alumnae also volunteered to serve as Army nurses in the unit. In June 1918, the unit was sent to France to care for the wounded from the nearby battlefields.22 On Cowling’s departure, the hospital board named Isabel Craig-Anderson as acting superintendent.
16 ◼ Mr. Jefferson's Nurses
Born in Scotland, Craig-Anderson was a graduate of Leeds Hospital School of Nursing. She emigrated to the United States to take post-graduate work at the Presbyterian Hospital in New York City, and it was there she met and worked with Cowling.23
In response to the country’s wartime need for nurses, many young patriotic women entered nursing programs across the country. By 1918 there were sixty-eight students in the University’s program and the students’ living conditions had once again become intolerable. After an inspection visit by the Virginia State Board of Examiners of Nurses, Dr. Theodore Hough, chairman of the Hospital board, was warned that the students’ living accommodations did not meet the minimal standards for schools of nursing.
Smarting from the state board’s chastisement and aware that several excellent students had withdrawn from the program because of living conditions, Hough requested that the Board of Visitors allow Randall Hall to be transferred to the hospital and made into the Nurses’ Residence. Randall Hall, built at the turn of the century, served as a dormitory for University students. Agreeing to the hospital’s urgent request, Randall Hall was converted into the Nurses’ Residence in 1919, and many of the nursing students assigned to crowded hospital attic rooms and Varsity Hall moved into the new quarters.24 For the first time since the training school opened, a living facility with a sitting room and a basement classroom was available for nursing students.
Although Superintendent Cowling, with Craig-Anderson as her assistant, had devised successful ways to correct some of the school’s educational deficiencies, Craig-Anderson’s tenure as superintendent proved to be a stormy one. Despite a personal commitment to provide students an excellent education, her personality struck students and colleagues as being aloof, harsh, prickly, and often too strict. In November of 1918, a disciplinary incident resulted in the student nurses petitioning the hospital board to discharge Craig-Anderson because of incompetence. Shocked by the students’ boldness and offended by their audacity to presume they had any competency to judge or power to remove a superintendent, the board chastised the students and publicly reaffirmed their support of Craig-Anderson.25
After this incident, although the board promoted her from an acting position to the superintendent of nurses in April 1919, they were no longer receptive to her suggestions about ways to improve the training program or reduce the students’ grueling day from ten hours to eight hours. Frustrated with the physicians’ demands that students be solely assigned to specific physicians’ services instead of allowing them to rotate to different hospital units (so that they “could receive good fees at the expense of the overworked students”), Craig-Anderson abruptly resigned in June 1920. She left the University
The Early Years: 1901-1924 ◼ 17
convinced that the medical board was committed to retaining the school’s apprenticeship system solely for the hospital’s benefit.26
Margaret Cowling, who had been employed in New York City since her discharge in 1919 from the U.S. Army Nursing Corps, offered to return to the University. Pleased that she would resume the superintendency in July, the board was disappointed that she was unable to bring replacements for the staff nurses who left the hospital because of the University’s low salaries. The cost of operating the University’s 200-bed hospital and providing free care to indigent patients had grown more quickly than had the hospital’s revenues or its state financial appropriations. To keep pace with medical advances, the hospital had purchased expensive equipment and added personnel, including more physicians, interns, and residents. In an attempt to balance the hospital’s costs with its income, the board instituted a number of actions, including raising the cost of private hospital rooms, seeking more state funds for indigent hospital care, limiting the number and salaries of registered nurses, and once again, using students as private duty nurses to care for paying hospital patients. This last practice allowed the hospital to collect a patient fee of fifteen dollars a week for each student’s service.27 Although sympathetic to the board’s need to be judicious in spending hospital funds, Cowling believed that the two practices involving nurses jeopardized the quality of patient services and the students’ education.
To cope with the 7,487 patients admitted to the hospital in 1923, classes of nursing students were admitted in September, February, and June. The ninety students in the
18 ◼ Mr. Jefferson's Nurses
My education at the U.Va School of Nursing has guided me throughout my life, not only my pursuit of many facets of my nursing career, but it has influenced and guided me in my values and dedication in service to others. The educational experiences I had as a student have been a favorable and desirable influence on every aspect of my life.
program, however, once again created a shortage in housing.28 Randall Hall’s forty rooms seemed spacious in 1915 but now it was so overcrowded that many students were forced to return to the old hospital’s attic wards. This lack of decent student living accommodations deeply concerned Cowling because she believed they deserved better, and poor housing jeopardized the school’s ability to recruit additional students to staff the newly opened McIntire building. In addition to housing problems, after a recent visit from the Virginia State Board of Examiners of Nurses, the school was notified that it was in danger of losing its state accreditation status unless the nursing curriculum was revised in accordance with the Board of Examiners’ newly adopted Revised Curriculum.29 To solve the nursing school’s serious problems, the hospital board was forced to re-examine its financial and educational commitment to the nursing training program.
Although the hospital was unable to resolve immediately the crowded student living conditions, nursing education had to be improved to keep pace with the continuing advancements in medicine. New information in the basic and medical sciences in the 1920s was rapidly changing the medical school curriculum. To ensure quality education for medical students, Dr. James Flippin, dean of medicine, sought financial help from the General Education Board of the Rockefeller Foundation for a new medical school building and to add several clinical specialists to the faculty.30 The arrival of clinical specialists on the medical staff signaled a slight change in the physicians’ expectations of nurses. The physicians who initiated the training program in 1901 required that nursing students be taught two things: to follow medical orders and report their observations of patients to the doctors, and to keep patients comfortable and their environment clean and orderly. Modern medical practice, however, demanded that nurses be aware of the basic scientific principles behind the new diagnostic and treatment modalities. Lacking this level of scientific understanding, nurses found it difficult to intelligently follow medical orders, thus jeopardizing the physicians’ ability to medically manage their patients. The stage was now set for a radical change in the school’s training program from its original domestic vocational apprenticeship orientation to an educational program that included a basic understanding of the biological and social sciences.
Cowling, weary of a six-year struggle to provide patients with healing nursing services and to educate students to become competent and caring graduate nurses, believed that the time had come for the school to find a new type of superintendent: a superintendent who possessed the vision, energy, and experience to represent nursing in the University Hospital and among the medical faculty, and one who would develop a training program that educated students to become professional nurses. Offered a position in a Lynchburg hospital, Cowling planned her departure to take effect in June 1924. After an extended search, Josephine McLeod was selected to become the superintendent in July 1924.
A native of Virginia, McLeod earned a baccalaureate degree from Randolph-Macon Women’s College in 1903 and was a 1911 graduate of the Johns Hopkins Hospital School of Nursing. After years of serving as a superintendent at several major hospitals she believed that the destiny of professional nursing was to function in a collaborative relationship with physicians. She shared in Florence Nightingale’s view that nursing provided a unique and essential service that enhanced the patient’s ability to recover from illness and learn ways to remain well. Blessed with social position, intelligence, education, poise, and experience as an educator, nurse, and hospital administrator, McLeod possessed the self-assurance, vision, and charm needed to convince others to trust her judgments. At times, when she failed to convince physicians that specific changes needed to be made in hospital practices that hindered the quality of patients’ care or the students’ education, she could also be a querulous Nightingale. These personal characteristics endeared her to the students who saw her as the embodiment of a professional nurse and as a champion for patient care and nursing education. As director of the hospital’s nursing service, she believed that patients should be well cared for and that this was possible only if the nursing staff were well educated. As director of the school, she maintained that the responsibility of the University of Virginia’s School of Nursing was to provide nursing students with the same excellent education that the medical school provided the medical students.
One of the first actions initiated by Superintendent McLeod was the implementation of the recommendations made to the University by the State of New York’s State Board of Nurse Examiners. After its 1924 inspection, the board identified four school practices they believed detrimental to the health of Virginia students.31 (New York State’s Board of Nurse Examiners’ accreditation was sought because it was believed it would help the University recruit excellent students.) The recommendations included reducing the ten-hour student
20 ◼ Mr. Jefferson's Nurses
My experience has given me a commitment to academic rigor along with Jeffersonian ideals of maintaining friendships and ties forged in the shared experience of that academic focus. The idea of giving something back to your "community" was fostered at U.Va. and is a big part of my life. I feel fortunate and blessed to have to have the personalized education I got at U.Va. and feel a debt to pass it along.
working day to eight hours, limiting night duty assignments to one month, providing students with sick time, and instituting student health records and annual physical exams. In 1924, McLeod also helped solve the overcrowding of Randall Hall by encouraging the hospital to rent the Glinn House on Jefferson Park Avenue, across from the Chained Gate entry to the University (now the entrance to Hospital Drive). Unwilling to live in the confines of the hospital, she occupied a small suite of rooms in the Glinn House.
The opening of the McIntire Building next to Pavilion Two in 1924 and the adjacent building known as the Teachers’ Preventorium in 1927 raised the hospital’s bed capacity to 300 and created McLeod’s next challenge. Her solution to staff the hospital was to develop a strategy for acquiring additional numbers of graduates and students that did not significantly add to the hospital’s fiscal budget or jeopardize the quality of the students’ education. Over the next few years she enlarged the school’s enrollment and arranged for nursing students from several Virginia schools to affiliate with the University for educational experiences lacking in their own hospitals. She also established post-graduate courses for registered nurses seeking special certification as Operating Room nurses and Nurse Anesthetists. To lessen the hospital’s claim on students for their labor and to acquire the financial resources needed to employ two additional graduate nurses, McLeod recommended that the hospital cease providing nursing students a monthly stipend in 1928.32 The nursing students, affiliates, and post-graduate nurses provided the hospital valuable nursing labor and added little to its operating costs. This was possible because students were willing to exchange months of labor for their nursing training, maintenance, and laundry. Only the post-graduate nurses, who worked a sixty-hour week, received a small monthly salary of twenty-five dollars. So successful was McLeod’s strategy that by 1930, there were 135 nursing students, twelve affiliates, and eighteen graduate nurses working in the hospital.33
Following the standard practice of prior nursing superintendents, McLeod began her day at 5:30 a.m. After a 6:15 a.m. breakfast, she met with students at 6:55 a.m. for Assembly outside the hospital nursing office to check their uniforms and shoes, recite a prayer or scripture reading, then assign them to their clinical duties. She toured the hospital wards daily, in the morning and afternoon, checking on the patients and students. The patients’ welfare was first addressed then the students’ work was reviewed and commented upon. If the students’ work failed to meet McLeod’s standards, rather than publicly chastise them, she encouraged them to explain why they had been unable to perform as expected. Her method of teaching, quite different from previous superintendents, motivated students to assess their behavior and develop more effective ways to provide nursing care. Even when disciplining students for infractions of the school’s rules, her sense of justice, tempered with kindness, inspired them to believe in themselves and their ability to become professional nurses. To engender the students’ pride in their school and uniform, McLeod added a dark blue wool cape to be worn over their uniform dress when outside`
Diploma Training Comes of Age: 1924-1946 ◼ 23
and her assistant, and eight suites of two rooms for graduate nurses and the housemothers. In the hall’s basement there was space for reception areas, where students could entertain guests, a library, faculty office, and several classrooms. A telephone was installed so that the housemothers could receive messages for the students.
The 1931 probationary class of fifty-three students, the largest in the school’s history, not only moved into a new school building but was greeted by the school’s first full-time faculty, Ruth Beery, who taught basic science courses in a laboratory and nursing skills in a nursing arts classroom.35 The student uniform also underwent a minor revision. The revised “probie” blue uniform now had short sleeves with white cuffs and a waist-high white apron, mid-calf in length. At the successful completion of their pre-clinical period, students were permitted to add a white bib to their uniform, and at a capping ceremony they received their U.Va. cap. The tradition of wearing black hose and shoes was retained.
The changes in roles for women in society and the growth of the hospital were not the only factors shaping the school’s development. In the 1920s, a desire for graduate nursing education led Virginia’s registered graduate nurses to devise a plan to create an undergraduate nursing education program at the University of Virginia. Its creation was in response to the dramatic changes in the American health care system. The ability of modern medicine to treat successfully many illnesses and the willingness of more families to seek hospital care stimulated an unprecedented growth in the number of hospitals and student nurses. Between 1910 and 1927, the number of hospitals in the nation grew by fifty-six percent, the available beds by 102 percent, and the number of student nurses jumped 138 percent.36
The constant search for nurses capable of successfully assuming positions as superintendents, directors, teachers, head nurses, and public health nurses propelled nursing leaders to intensify their efforts to upgrade training programs and develop opportunities for graduate nurses to acquire a college education.
In 1923, the Graduate Nurses Association of Virginia (GNAV) assumed the task of raising sufficient funds to create a nursing graduate program at the University of Virginia. To establish the program, the GNAV spearheaded a three-year fund-raising drive to endow a chair of nursing, named in honor of Virginia nurse pioneer Sadie Heath Cabaniss. Two of the most compelling reasons for this program were based on the unavailability of nursing graduate education in the South, and the tendency of southern nurses who, after attending northern schools in search of such education, failed to return to the South. At the successful completion of the fund drive, led by Agnes Randolph, a great-granddaughter of Thomas Jefferson, the GNAV presented President Edwin Alderman a $50,000 check in 1926. President Alderman was a staunch supporter of the nurses in their quest for a University nursing graduate program, but after he accepted the money, the College of Arts & Sciences’ faculty expressed serious questions about creating such a program. After listening for two years to the college faculty arguing about the wisdom of admitting women to the University and, if admitted, which department would be forced to take the school, Alderman terminated the discussion by assigning the program to the Department of Education. In April of 1928, Louise Oates was appointed professor of nursing and chair of the Sadie Heath Cabaniss Memorial School of Nursing Education. The school officially opened to students in the fall of 1928.37
The Cabaniss program was designed to prepare administrators, teachers, supervisors, and head nurses to become effective nursing administrators and educators. The three-year program was quite innovative because it offered courses in the Department of Education and many elective courses in the College of Arts & Sciences. Although Oates, with a bachelor’s
Diploma Training Comes of Age: 1924-1946 ◼ 25
degree in nursing education and master’s degree in nursing history from Teachers College, Columbia University, possessed the academic credentials to lead the school, she lacked the vision, personality, and leadership skills necessary to attract large numbers of students or make the school known beyond the state. The economic depression of the 1930s that denied nurses money to attend school, followed by the demands of World War II for nurses to serve in military and civilian institutions, retarded the school’s growth. In 1946, however, with the additional enrollment of ex-military nurses, financially supported by the Veterans Education Bill (G.I. Bill), enrollment rose to twenty-five students a year until 1950. The school’s diminishing enrollment in the 1950s and the University’s plan to merge all of nursing education into one school terminated the need for the Cabaniss school. In 1952 Louise Oates retired and the school graduated its last student in 1954.38
Although the school did not attain the national prominence hoped for by the Virginia nurses who generously donated funds to create the Cabaniss school, it did provide advanced education to almost 200 students, and approximately eighty-five graduates were awarded bachelor of science in nursing education degrees during its twenty-six-year existence. In addition to on-Grounds courses, from 1946 to 1953 the school provided, through the University’s Extension Division, baccalaureate courses to over one hundred nurses employed in the Richmond and Roanoke areas. The school also was successful in meeting its goal of educating southern nurses who remained employed in institutions in the South. Many of the school’s graduates became directors of schools of nursing, hospitals, and public health departments in Virginia and other states in the South.39
The Cabaniss School’s success also can be measured in its ability to change the views of the University’s academic faculty regarding the intellectual dimensions of nursing and the capabilities of nurses to meet the academic standards of the college. The Cabaniss students, by demonstrating their academic prowess and ability to articulate the role that professional nurses were playing in health care, helped pave the way for the University to re-think where nursing education should reside; did it belong in the hospital or in the academic community?
The hospital training school, although established in 1901, and designated the University of Virginia Hospital School of Nursing, was not viewed as a unit of the academic institution. It was not given an academic designation because the practice of nursing was assumed to be a female vocational activity and as such, it lacked the intellectual foundation necessary to be an academic program in the University. The nursing school’s existence at the University was based on its ability to provide an essential patient service needed by the hospital. It was assumed by the College of Arts & Sciences’ faculty that the training of nurses was best left to the supervision of physicians and the few graduate nurses employed by the hospital to supervise the students. For almost twenty-five years these assumptions remained intact. But
26 ◼ Mr. Jefferson's Nurses
with the arrival of Josephine McLeod and the Cabaniss Memorial School of Nursing Education, the situation changed. McLeod’s philosophy of nursing and her ability to raise the standards of nursing care and education, and the success of Cabaniss’ students to meet the University’s academic standards challenged the view that professional nursing was solely a womanly vocation devoid of intellectual substance. Indeed, their successes would set into motion the actions that moved the training school from the hospital’s jurisdiction to one of the ten independent academic schools within the University.
Students still lived under strict rules that guided their lives in the hospital and in the nursing residence. As stated in their student handbook, their conduct on and off duty “must be such that it did not bring discredit to their chosen profession or the school.” They were expected to be in their rooms, if not on night duty, for study hours from 8:00 to 10:00 p.m. and to retire by 10:30 p.m. They also were responsible for the care of their rooms because it was considered part of their training. Cleaning their room was labeled “housekeeping experience” and the housemothers, in their daily visits to student rooms, graded the students on the orderliness of their rooms. Special emphasis was placed on students’ physical attire and behavior both on and off-duty. Uniforms were worn only on duty and while in uniform students were not allowed to wear jewelry or makeup. Their hair was to be kept clean, neat, and pinned up so it did not touch their collars and their nursing caps were to be firmly affixed to their heads at all times.40
Diploma Training Comes of Age: 1924-1946 ◼ 27
The depression years left students with little spending money, but quite capable of finding inexpensive ways to entertain themselves when off-duty. Dating of medical students or interns was still not encouraged, but since the nursing students worked closely with them in the hospital, dating frequently occurred. Attendance at medical dances or social events required that the students obtain a permission slip from McLeod, and the housemother collected these slips as the students departed from McKim. Infractions of the school’s rules might bring dismissal from the program or a restriction in the student’s ability to leave the nursing residence. One student, found smoking by McLeod, was suspended for four months while another, caught attending a fraternity party, was dismissed.41 Marriage was forbidden, and if it occurred, the student was immediately dismissed from the program. In spite of the rules, students developed friendships among their classmates and enjoyed a wide range of social activities, including dating and University parties, football games, and movies. Many courtships between nursing students and medical and University students led to marriages that lasted a lifetime.
With the announced retirement of Ethel M. Smith, secretary-treasurer of the Virginia Board of Nurse Examiners, in spring of 1937, state officials quickly offered the position to Josephine McLeod. Her reputation as an expert educator and superintendent of patient services made her the ideal replacement for Smith. Reluctant to leave the University, but excited about the opportunity to strengthen the educational experiences of all Virginia nursing students, McLeod accepted the offer and moved to Richmond to assume the position on June 1, 1937.42 As the director of the state board of nursing, McLeod continued to exert a powerful influence on the University’s School of Nursing and hospital. Her frequent visits to Charlottesville, both professional and social, kept her close to University activities and allowed her to offer support and suggestions to faculty on ways they might continue to keep the program current.
The challenge of finding McLeod’s replacement was compounded by several factors, including the hospital’s serious economic problems and the growing influence of nursing’s educational accreditation organizations: the National League for Nursing Education, Board of Regents of the State of New York, and the Virginia State Board of
28 ◼ Mr . Jefferson's Nurses
Nursing. The hospital, in the late 1930s, was in the midst of another building phase and 170 more beds and six operating rooms were expected to be in service by 1941. These new buildings had placed a serious strain on the hospital’s financial resources. In addition, the school’s educational accreditation agencies began to demand that the student workweek be decreased to fifty-two hours. This demand, coupled with the requirement that several new supervisory nurses be hired, was considered outrageous by many of the medical school’s physicians. Dr. Carlisle Lentz, the new hospital superintendent, was sympathetic to the nursing profession’s quest for higher educational standards but he was aware that many medical faculty opposed this idea. Working closely with the hospital’s executive committee, he searched for a superintendent with a master’s degree to replace McLeod because he believed it would take someone with this level of education to win national accreditation for the school. After numerous interviews and increasing the position’s salary to make it competitive, Claire Wangen was selected for the position in 1937. Wangen, a 1924 graduate of the Johns Hopkins Hospital School of Nursing, had a bachelor’s degree from the University of Washington and a master’s degree from Teachers College, Columbia University.43
One of Wangen’s first actions was to direct, at the National League for Nursing Education’s recommendation, that the pre-clinical portion of the program be increased to six months. This change intensified the medical staff’s pressure on
Wangen to increase the numbers of student nurses in the school and to train them quickly to care for patients. Physicians also wanted students taught the new medical tasks they had recently delegated to nurses, such as taking blood pressures. Wangen, unfortunately, lacked McLeod’s style of leadership and her power of persuasion. In addition, her authoritarian ways denied her cordial relations with the medical and nursing staff and students. McLeod, during her thirteen years as superintendent, earned a strong measure of respect for all nurses at the University, and because of her leadership talents, was invited to attend some hospital executive committee meetings when nursing matters were discussed. Wangen, however, was never granted an opportunity to represent nursing at hospital meetings. In addition to these internal factors, the outbreak of war in Europe in 1939 led to a resurgence of the American economy and an increase in employment opportunities for young women and registered nurses. Nursing school enrollments nationwide plummeted and hospitals experienced, for the first time, difficulty in employing graduate nurses to supplement the diminished numbers of student nurses.
In an effort to recruit more students in 1939, Wangen, in collaboration with McLeod, attempted to have the school be among the first officially accredited by the National League for Nursing Education. Unfortunately, when the idea was discussed with Dr. Lentz he rejected it because he deemed
Diploma Training Comes of Age: 1924-1946 ◼ 29
the $250 accreditation fee an “exorbitant expense.”44 McLeod suggested that Wangen seek the necessary funds from the University of Virginia School of Nursing Alumnae Association. The alumnae were very receptive to the request and paid for the NLNE accreditation visit. In 1940, the school was granted a conditional accreditation ranking. The school’s NLNE conditional accreditation status marked a significant milestone in its struggle to be seen as an educational institution versus a school primarily viewed as the hospital’s nursing workforce.
The nurses’ delight in the school’s NLNE accreditation status was not shared by many of the physicians. Among physicians there was mounting criticism that nursing students were being overeducated and too much of their time was spent in the classroom rather than in the hospital caring for patients. Puzzled by this reaction, Lentz noted in a letter to the dean of medicine that the medical faculty quickly accepted the dictates of the American Medical Association and the Association of American Medical Colleges regarding the training standards for medical students and interns. In response to the recommendations of nursing’s educational accrediting organizations, U.Va. physicians, however, rejected the authority of nursing organizations to comment upon the education standards of Virginia’s program.45 After four years of dealing with the increasingly strident demands by physicians for more student nursing services for their patients, and being thwarted in her attempts to increase the graduate staff and student enrollment, Claire Wangen grew tired of the battle. In June of 1941, she resigned her position to take the superintendency at the University of Oklahoma Hospital School of Nursing at an increased salary.46
The threat that the country would soon be involved in a war that was engulfing the world was uppermost in the thoughts of the nation’s leaders in 1941. In 1940, Congress enacted the Selective Service Act to draft young men for military service. The military’s need for physicians and nurses was beginning to thin the ranks of hospital staffs across the
The sense of family we developed in the program persists to this day and continues to bind us together as professional colleagues and friends
country. The nation’s challenge to keep its civilian hospitals functioning and meet the needs of its military was uppermost in the plans of government and hospital officials. To ensure that the University’s 403-bed hospital continued to provide essential services for a growing patient census, Lentz believed he needed a nursing leader who had the intelligence and personality to recruit students, keep the hospital’s nursing services intact, and be able to adapt quickly to wartime conditions. He found such a leader in Virginia H. Walker.
Virginia Walker was a native Virginian who graduated in 1926 with a BA from Westhampton College of the University of Richmond then entered the Johns Hopkins Hospital School of Nursing. After her graduation from Hopkins in 1929, she held several clinical and supervisory positions at Hopkins and at a Washington, D.C. hospital. Walker was offered the University of Virginia’s superintendent position in 1937 but family illness forced her to decline the invitation. Employed as the nursing supervisor of the Out-Patient Department at
Hopkins when again offered the U.Va. position, she accepted it in July 1941. Her new title was director of the School of Nursing and superintendent of Nursing Services. The responsibilities of this dual position were magnified a hundredfold when the Japanese bombed Pearl Harbor on December 7, 1941.
One of Walker’s first actions, in cooperation with Lentz, was to convince University President John Newcomb to implement the NLNE recommendation to create a School of Nursing Advisory Committee. In its 1941 accreditation report, NLNE noted that the school’s status as a service unit under the supervision of the hospital’s executive committee, a group composed of male physicians, left the school voiceless and powerless to act on its own behalf. In May 1942, the newly formed nursing advisory committee, composed of nursing and medical faculty plus representatives from the University and community, began to review issues pertinent to the education of nursing students. For the first time since the
Diploma Training Comes of Age: 1924-1946 ◼ 31
creation of the school, nursing faculty had access to an independent influential group (outside of the hospital physicians) to discuss educational issues. It was a committee that would be very instrumental in helping advance nursing education in ways that had been denied it for forty years. Aware that federal officials had recently requested that all nursing schools increase their enrollments, the committee’s first recommendation to the University was that they find additional housing for potential students, and that the hospital employ more graduate nurse supervisors.47 These recommendations were quickly acted upon because the hospital was experiencing difficulty in caring for patients because of the departure of so many of their nursing and medical staff for military service.
Wartime made it more difficult to attract young women into nursing because of the availability of well-paying industrial jobs. In addition, those wishing for a more active role in the military could now join the newly formed female WAVES and WACS military units. The inability to attract
adequate numbers of nursing students, plus the departure of thousands of graduate nurses and physicians from hospitals for military duty, were seriously compromising the quality of the nation’s civilian health care system. To relieve the problem, several new federal initiatives were instituted, including the provision of funds to nursing schools for student scholarships, the training of nursing volunteers, and for graduate nurse refresher courses to prepare them to return to nursing practice.48 In 1942, Walker obtained $20,000 from the government for student scholarships and $4,000 from the Kellogg Foundation for student loans. These funds, available to students unable to pay for their education, marked the first time financial aid was given to nursing education.49 To accommodate the thirty-eight new students admitted to the school in March 1943, the hospital rented the Page House on Elliewood Avenue. Also during this period the school was actively planning its participation as one of the newly funded U.S. Cadet Nurse Corps training programs.
In 1943, the nation’s need for nurses reached a critical level. It was estimated that to meet the military and civilian need for nurses during the year, 65,000 more students were needed. This figure represented nearly twice the number of nursing students admitted every year.50 After intense planning among nursing and health leaders and the government, Congresswoman Frances Bolton, a longtime friend of nursing, introduced in Congress in March of 1943 legislation to establish the U.S. Cadet Nurse Corps. The purpose of the corps was to create a wartime student nurse reserve to avert the country’s nursing crisis. The Bolton Act, as it was known, became public law on July 1, 1943.51
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For a school to qualify for cadet training status it had to have NLNE and state nursing accreditation, be capable of increasing its enrollment, and its curriculum must follow NLNE guidelines and be no longer than thirty months. If the school agreed to these requirements, it received federal funds to construct and equip its laboratories, classrooms, and libraries, and to enroll its faculty in post-graduate courses. In addition, federal funds were available for the construction or rental of student housing.
Students in schools with cadet status were given the option to become a cadet. If they chose to join the Cadet Nurse Corps they were required
after graduation to serve as registered nurses in a military or a community health care agency in an under-served area for the duration of the war. During the last six months of the nursing program, the cadet could serve in her home school, a government veterans’ hospital, or in a community health agency. As compensation for their services, the government assumed all costs for the cadets’ education, uniforms, books, and maintenance. Cadets also received a generous monthly stipend.52
In September 1943, the University of Virginia became a Cadet Nurse Corps school and eighty-eight percent of its current students opted to become cadets. By the end of the war in 1945, when the Cadet Nurse Corps ceased enrolling students, of the 293 nursing students admitted to the school since 1943, 274 or ninety-four percent opted to join the corps. To accommodate the increased numbers of students, Walker sought government funds to build an addition on McKim Hall. In 1944, the $294,000 building project was started. Both the federal and state governments each contributed $147,000 to complete the building, which opened in 1946. While waiting for the McKim addition to open, another private home, the Kelly House on University Avenue, was rented in 1944 to help accommodate an entering class of 138 students. From 1944 to 1946, four nursing residences housed the school’s 340 students, thirty-five graduate nurses, two dietitians, and six housemothers: McKim Hall, plus the Glinn (and Annex), Page, and Kelly Houses.53
The war years (1941 to 1945) posed many challenges to Walker in her role as school director and superintendent of nursing services. The shortage of hospital personnel not only involved professional staff but also housekeeping and clerical staff. To ensure that the students, in their shortened program, were well educated and the patients received safe and effective nursing care despite the shortages, Walker and her graduate nurse staff had to be extremely creative and diligent. She counted on the
Diploma Training Comes of Age: 1924-1946 ◼ 33
students to be responsible and productive, and often during their student years they were assigned a ward of thirty or more patients to care for by themselves. But she also protected them from being exploited by insisting that more supervisory nurses be employed and that students work no more than a fifty-two-hour week. With the backing of the Advisory Committee, she initiated several new ventures that drew the nursing school closer to the University. These ventures included arranging for members from the academic faculty to teach sociology and physical education courses to students, placing the students’ health care under the University’s Student Health Services, and incorporating the nursing library’s books into the University’s system.
Knowing how arduously the students worked and how young they were, Walker was concerned about their social lives. She was, however, respectful of the students’ ability to assume responsibility themselves. Under her guidance, in 1943 students inaugurated a plan for student
government that included living under the University of Virginia honor system. To help students relax on their off-duty time, federal funds were used to hire a social director to work with student government to arrange extracurricular activities, including picnics, dances, and weekly afternoon teas in McKim Hall.54 Walker also accepted the offer of the owner of the Fry’s Spring Club to allow students to use the club’s facilities.55 As a wartime accommodation to the school’s rules, students received permission to marry and wear their wedding rings during their
senior year if their husbands were being shipped overseas. Students also were permitted to serve as hostesses at the U.S.O. dances held at the downtown Armory and in Madison Hall for the many servicemen attending the U.S. Army Officer Training School at the University. Because of civilian wartime food rationing, students turned their ration cards over to the housemothers so that the hospital could acquire the food to feed them. Students also were expected, in case of an enemy air attack, to observe blackout periods in the hospital and their residences. Learning to cover all windows and to function with only tiny lights both challenged students and provided for many interesting stories to tell during the war.56
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In addition to Walker’s day-to-day responsibilities, she was involved in the planning for two 500-bed evacuation hospitals in the event of mass casualties from the Washington, D.C. and/or Norfolk areas. The University’s gymnasium and Lane High School were designated as the emergency hospital sites. In recalling the war years, Walker noted, “It was an extremely busy time and the work never seemed to end. I remember times when I helped in the kitchen after Sunday lunch to make sure there were enough clean dishes for supper that night. But it was also a wonderful time to see how cooperative everyone was in doing our part of the war work.”57
Continuing the tradition begun with Base Hospital #41 of sponsoring a medical unit for war service, a University of Virginia Army unit was created shortly after war was declared. Commanded by Colonel Staige Davis Blackford, medical class of 1923, the unit was composed of 417 personnel, including forty-seven commissioned officers and fifty-two commissioned nurses. The personnel for the 750-bed hospital unit, known as the U.S. Army 8th Evacuation Hospital, were quickly assembled in spring of 1942. Captain Ruth Beery, a 1925 graduate of Emory and Henry College and the U.Va. School of Nursing, Class of 1928, served as the unit’s chief nurse. To her fell the responsibility of recruiting fifty-one experienced University graduate nurses capable of adapting to military life and willing to serve in the Army. Activated in July 1942, the unit had four months of basic training before
being sent to Casablanca in North Africa. For the next three and one-half years “the 8th Evac. Unit” followed the U.S. Fifth Army in its military engagements in North Africa and Italy. Living and working in the unit’s movable tent-hospital from battlefield to battlefield, the nursing staff, affectionately referred to as “Mr. Jefferson’s Nurses,” served with courage and dedication.58,59 In addition to these alumnae, more than one hundred U.Va. nurses served during World War II as officers in the Navy and Army Nurse Corps. Each, forgoing their personal careers and dreams, brought the knowledge and skills learned at Virginia to their military assignments in countries across the world.60
The efforts of Walker and her nursing assistant, Miss Roy C. Beazley, to involve members of the School of Nursing’s advisory committee in the school’s quest for a basic University-based program yielded a wonderful harvest in July of 1945. President Newcomb, responding to the committee’s recommendation, appointed a special committee “to study the needs of the Nursing School in relation to a proposed incorporation of the school as part of the University.” This special committee, chaired by Dr. George McL. Lawson of the medical school, included members of the nursing advisory committee, University administrators and faculty, and Professor Oates and Assistant Professor Lois Austin from the Cabaniss Memorial School of Nursing Education. The committee, after a year of studying Walker’s and Beazley’s plans for upgrading the school, recommended to the University’s new President Colgate W. Darden, “the establish-
36 ◼ Mr. Jefferson's Nurses
ment of a Collegiate School of Nursing at the University of Virginia.” Before creating the collegiate school, however, the committee recommended that the diploma program be strengthened to meet NLNE accreditation standards, and that it “remain open until the enrollment in the college program is sufficient to provide limited service to the University of Virginia Hospital.”61
This landmark report, while stating that the education of nurses belonged in the University, also reflected the opinion held by many medical faculty who viewed the value of the school primarily in light of “the amount of bedside service rendered by the nursing students.”62 The significance of the report lay in its acknowledgment that nursing students had a legitimate claim on the University for a collegiate education that would prepare them as professional nurses. To fully implement the recommendation to establish an autonomous and independent collegiate school of nursing, however, would require years of struggle to eliminate the hospital’s dependency on student nurses, and for the hospital to employ adequate numbers of professional nurses to care for its ill patients.
The report marked Walker’s last major action as director of the school and superintendent of nursing services, and as a professional nurse. In June 1946, she resigned her position to return home to care for her dying father. She would leave her nursing career after his death to manage the family’s insurance business and care for her semi-blind mother.63
Post-war America was a far different world than that of the 1930s and early 1940s. Following the severe austerity of the depression years and the restriction of personal choices imposed by the war, Americans sought opportunities to live their lives in peace and prosperity. One of the benefits they wanted was medical care and, because health insurance was now a part of employment benefits, they possessed the financial resources to pay for hospital care. In an effort to fulfill the public’s wishes, hospitals moved quickly to enhance their medical services, and nursing schools intensified their efforts to prepare an adequate supply of well-educated nurses.
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For the University of Virginia to accomplish this task, the school needed a leader who understood and appreciated the traditions and values of the hospital’s past but who also was open to new ideas and methods to educate nurses for a rapidly changing health care system. As Virginia Walker’s professional colleague for five years, Roy Beazley had proven she possessed the intelligence, experience, administrative skills, and vision to make nursing education one of the academic missions of the University.
In July 1946 Beazley was appointed the school’s eleventh leader. Given the title of director of Nursing Education and Nursing Services, Beazley lost no time in creating a plan to upgrade the diploma program’s educational standards and develop a baccalaureate program. She also initiated steps to transform the hospital’s nursing service department from a student nurse staff to one composed of professional nurses. Beazley (given the name Roy because of a promise her mother made to her uncle to name a child after him) was born in Virginia in 1902. The third of five girls, she graduated with a BA in education from Mary Washington College of the University of Virginia in 1921. Her first positions were as a teacher in Orange and Albemarle County schools where she taught for six years. In 1927 she and her younger sister, Edith, entered the University’s training school and graduated in 1930. As was the norm of the time, she began her career as a private duty nurse. After a few years she decided to return to the University Hospital as a night supervisor. In 1936 she resumed her teaching career as a faculty member in the school under Josephine McLeod. Because of her belief that nursing students deserved to be taught by well-educated faculty, she earned another bachelor’s degree from the Cabaniss School of Nursing Education in 1941, and a master of arts in nursing education degree from Teachers College, Columbia University in 1951.
Beazley recognized that the post-war problems facing the school and the Department of Nursing Services required new solutions. As director of the school she assembled a small but talented faculty capable of developing two excellent programs: a diploma program that would meet all NLNE requirements, and an undergraduate baccalaureate program that would satisfy the University’s requirements. As director of the nursing services department she began the arduous and complex task of convincing key hospital and medical school personnel that the time had come for professional nurses to be in charge of patients’ care rather than students. The creation and development of the hospital’s Department of Nursing Services composed of professional nurses required twenty-three years of Beazley’s energies and talents but it was accomplished by the time she retired in 1969.
Dr. Lentz, a close professional colleague for years, proved to be a valuable ally in Beazley’s quest for a University-based school of nursing and a professionally-staffed nursing service department. As the hospital’s administrative director, Lentz was frustrated and
From Hospital Training to Nursing Education: 1946-1956 ◼ 39
perplexed at the school’s continuing failure to attain full national accreditation status. He believed the training program’s conditional accreditation ranking contributed to the school’s difficulty in recruiting sufficient numbers of students and graduates to staff the University’s 557-bed hospital. He was also embarrassed by the school’s inability to attain full NLNE accreditation status because it reflected poorly on the hospital, the medical school, and the University’s national reputation.64 To attain full accreditation for the school, he recommended that funds from the hospital’s increased revenues, particularly from private health insurance, be used to hire additional faculty and staff nurses. This decision helped the school comply with several of NLNE’s newest requirements, including hiring graduate nurse supervisors for students in every clinical area, and adding community health nursing content and clinical experiences to the curriculum.65
Lack of national accreditation was just one of the difficulties faced by the school in its attempt to recruit students. Nursing school enrollments across the nation plummeted when the war ended in 1945. Virginia saw its student enrollment drop almost fifty-eight percent, from 312 students in 1945 to 138 students in 1948.66 Not only were there fewer women entering the school, but the student attrition rate had increased from ten percent in the early 1940s, to twenty-three percent in 1948. Many factors accounted for these figures. Female high school graduates in the late 1940s had many career options from which to choose, including attractive and well paying employment choices, marriage, and opportunities to earn a nursing degree in a college program where there were fewer restrictions on social lives. Adding to these factors was the nation’s small pool of eighteen- to twenty-two-year-olds, the age-cohort that nursing traditionally drew upon. This age-cohort was smaller than it had been in the early 1940s due to the economic depression of the 1930s, when couples married later and had fewer children.
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The years I was in the doctoral program as U.Va. were some of the most challenging and stimulating years of my life. I had become burned out with what I was doing (teaching an undergraduate Program) and felt that I was not making any contribution to nursing or society. I also knew that I did not have the skills that were becoming essential to a challenging and rewarding career in nursing- that is, research and writing skills. I not only gained those skills, but became much more confident in myself and what I could accomplish
The faculty, under the guidance of Margaret Sanner, RN, MS, the school’s assistant educational director, developed a formal recruitment plan aimed at making a nursing career more attractive to young women. They encouraged Virginia nursing school graduates to return to their former high schools to talk about the rewards of being a nurse and to show films and slides depicting student life at the University of Virginia. School catalogues with photos of the University and students’ living accommodations in McKim Hall were mailed to hundreds of young women who expressed an interest in becoming a nurse. In an effort to decrease the nursing program’s high student attrition rate the school screened potential students with an NLNE-constructed psychometric test that evaluated their intelligence, skills, and aptitude for nursing. To attract those who could not afford nursing school, tuition expenses were kept very low and fifteen state nursing scholarships were made available to financially needy students. In 1948 the cost of diploma education was $275: $177 the first year, fifty-two dollars the second, and forty-six dollars the third year. Students were required to buy their uniforms, shoes, and books, estimated to cost between fifty and eighty dollars, but the hospital provided them with full maintenance and laundry services.67
With the 1946 opening of the McKim Hall addition, with its one hundred new student rooms, the Page and Kelly Houses were closed. In addition, McKim Hall now had a large, well-equipped auditorium, a large reception area, faculty offices, labs, an enlarged library, classrooms, and a mailroom. In 1948 the Glinn House and its Annex were also closed and the graduate nurses residing there moved either into McKim or, now that the hospital no longer required them to live in hospital housing, into apartments or rooms in the city. Beazley decided not to reside in McKim Hall, but chose to live in an apartment close to the hospital.
In the fall of 1948, the major academic problems that for eight years had prevented the diploma program from being fully accredited by the National League for Nursing Education (NLNE) were resolved. Not only was the program placed on NLNE’s list of fully accredited diploma schools, but in 1949, when the national accrediting organization did a nationwide school survey, the University’s program was rated in the top twenty-five percent of diploma schools in the country.68 Encouraged by this achievement, Beazley and the faculty, with the full support of the nursing school’s Advisory Board, which now included University President Darden, focused their energies on the creation of an undergraduate baccalaureate nursing program. Excited about the prospect of making nursing education a University undergraduate academic offering, the faculty intensified their efforts to create an innovative program and develop educational liaisons with officials of the state’s women’s
From Hospital Training to Nursing Education: 1946-1956 ◼ 41
colleges. The nursing faculty accepted that the University of Virginia was a male institution that did not admit women into the first two years of college. To ensure, however, that the future nursing baccalaureate students had the needed academic sciences and humanities courses, the faculty proposed that the first two years of the academic program be taken either at Mary Washington College of the University of Virginia in Fredericksburg or at other women’s colleges.69 The colleges expressed interest in the University’s plan because they had students interested in nursing as a major and only the Medical College of Virginia in Richmond offered a baccalaureate nursing program.
In January 1949, Beazley presented the Advisory Board a plan for a five-year baccalaureate program consisting of two years of academic college work followed by the University’s three-year nursing program. The proposed program called for nursing courses to be introduced during two six-week summer sessions; one after the students’ first year and the second after their sophomore year of college. The Advisory Board accepted the proposed plan and, in anticipation of its implementation, President Darden directed the hospital’s
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comptroller to undertake an analysis of the costs of operating the School of Nursing, including the housing and living expenses of nursing students. He also requested Dr. Lentz to assemble a committee to study the feasibility of developing a practical nurse program. The idea for the practical nurse program stemmed from the physicians on the Advisory Board who expressed serious concern about the availability of adequate numbers of baccalaureate student nurses needed by the hospital. The physicians noted that a solution to the diminishing availability of student nurses for patient care could be found in the training of practical nurses. They particularly liked the fact that practical nurses could be trained in a year’s time and believed that they would be capable of carrying out, under the supervision of a registered nurse, routine care of the patient.
In March 1949, the Advisory Board accepted the faculty’s proposed plan for an independent school and baccalaureate program curriculum. The committee next recommended to the “President of the University and the Board of Visitors that a University of Virginia School of Nursing under the Department of Medicine be established, and that as soon as expedient, the School become an independent school on the same status as other schools in the University.” The Advisory Board, still unsure of the impact of a baccalaureate program on the hospital’s ability to provide nursing care to patients, reaffirmed its position that the diploma program be retained until the University Hospital had “a sufficient number of
collegiate students available to maintain the needed ratio of students and graduates” for patient services.70
The proposal to establish an undergraduate nursing school was granted Board of Visitors’ approval in June 1949. Across the state, nursing leaders reacted favorably to the news. Mabel E. Montgomery, former U.Va. faculty member and now secretary-treasurer of the Virginia State Board of Nurse Examiners, wrote a strong letter of support for the University’s decision to open a School of Nursing at the University.71 With the Board of Visitors’ approval, the University of Virginia joined the vanguard of university-based programs opening across the country. Hearing of the University’s approval of the baccalaureate program, Dr. Alvey, dean of Mary Washington College, informed Beazley that there would be at least eight Mary Washington students ready for the University’s 1950 summer session.72 In April of 1950, after receiving approval from the University’s Faculty Senate for the Bachelor of Science in Nursing’s curriculum, the undergraduate program was ready to admit students. Twelve Mary Washington College students enrolled in the University’s 1950 Summer Nursing Session, thereby becoming the first students in the new baccalaureate program.
U.Va. provided me with a super academic education as well as a network of classmates, friends, and mentors who have influenced me throughout my career and continue to do so. ... Nursing is one of the few professions that offer such a wide range of career opportunities and the opportunity to make a difference in life
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At their fiftieth anniversary in 1951, the University of Virginia Hospital and School of Nursing appeared dramatically different in size and complexity than when they were created in 1901. The original twenty-bed hospital, with its staff of two graduate nurses, four nursing students, eight medical faculty, and four interns, plus a cook and a porter, had struggled for several years to entice local families and physicians to use its facilities and personnel. By 1951, it had grown into a 547-bed multiservice hospital staffed by fifty-four graduate nurses, 137 nursing students, fifty-two medical faculty, numerous interns, residents and other health professionals, plus a large clerical, dietary, and maintenance staff. Not only had the hospital increased in size and complexity and the medical care provided patients drastically changed from that given in 1901, it was now recognized as one of the premier medical facilities in the Southeast. Its reputation for advanced medical care drew patients from many states in the nation seeking cure and relief from their medical problems. Patients were attracted to the University Hospital because of its medical specialists, its nursing staff, multiple health services, and its modern scientific technology and medical therapy.
The changes that occurred in the School of Nursing were as dramatic as those in the hospital. Admission into the diploma program was now restricted to four-year high school graduates. Once admitted, students no longer learned the art of nursing through a physically arduous apprenticeship system that consisted of caring for patients six and one-half days a week, for ten to twelve hours per day. In 1951, nursing
students enrolled in an educational program designed to provide them with nursing and medical information either prior to or in conjunction with their patient clinical assignments. In the six-month preliminary portion of their program, students were taught information from the biological and social sciences, plus given opportunities to learn basic clinical nursing skills in a laboratory. Only after this preparation were they then assigned hospital patients under the guidance of graduate nursing staff and faculty, some with nursing degrees. The students’ workweek, including their academic classes, was about fifty-two hours, and each student was rotated through multiple clinical specialties, including psychiatry and outpatient services. Students were provided vacation and sick time throughout the program, and their health status was monitored by the University’s Student Health Department.
Rather than being crowded into the hospital’s attic dormitories, students lived in single
or double rooms in the nurses’ residence and attended classes in modern well-equipped classrooms. By 1951, the faculty recognized that the students’ social lives were an important aspect of their development, and attention was given to designing activities that helped these young women develop socially and profes-sionally. Although the rules under which the students lived were not as flexible as those found in college women’s residences, their lifestyles (including the entertaining and dating of young men) were respected. The students’ frequent use of the roof of McKim Hall for sun-bathing reflected the faculty’s understanding that such things as acquiring a “health tan” were important to young women. In addition, activities such as student government meetings, dances, picnics, social clubs, teas, and parties occurred throughout the year. Although student marriages were still not permitted, in special circumstances official permission to marry was now given to students if they were in the last three months of their program.
The factor that had not changed in the school’s fifty years of existence was the nursing students’ commitment and desire to help those in need. Although women’s apparel and society’s expectations of them differed from those found in 1901, the personal motivation that guided students to enter the University of Virginia Hospital School of Nursing had remained the same. Nursing students were eager to learn ways to help those ill and in need of nursing care. Although not all entering students were sure they had the necessary aptitude or talent for nursing, they were determined to see if they possessed the fortitude, intelligence, and dedication to become a professional nurse.
There were other things that changed only slightly over the fifty-year period. The student uniform and cap had been modified several times to reflect changes in women’s fashions from 1901 to 1951, but the tradition of wearing black hose and shoes remained intact. In 1951, however, students began to replace their dark hose and shoes with white in the last six months of their program. This event became another important developmental milestone in the life of a student nurse and as such it was celebrated in a special way. Such milestones as “capping” (receiving a U.Va. cap after the preclinical portion of
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the program), “banding” (receiving a band for the cap after the second year), wearing white shoes and hose, and “pinning” (receiving the University of Virginia nursing school pin at the conclusion of the program), plus graduation marked the passage of a student in 1951 into the role of graduate nurse. The senior dance, in which the Virginia Reel was still featured, marked a tradition begun in the 1920s when senior students danced with their invited hospital staff partners. This special event remained for three decades a rich Virginia tradition that was enjoyed by students, medical and hospital staff, and nursing faculty.
In recognition of the school’s golden anniversary, the University of Virginia School of Nursing alumnae sponsored several activities in 1951. In an effort to learn where Virginia graduates were employed, a questionnaire was sent to 1,200 diploma graduates. Responses from 754 known alumnae indicated that 418 of the graduates (primarily single women) were actively engaged in nursing as either general duty nurses, administrators, teachers, or as private duty nurses.73 These results were consistent with national nursing survey results that indicated that married nurses found it difficult to balance family and professional responsibilities.74 The nursing alumnae also sponsored a special luncheon at The Cafeteria, a restaurant on University Avenue across from the medical school. In addition to the alumnae
From Hospital Training to Nursing Education: 1946-1956 ◼ 47
and nursing faculty, special invited guests included Charlotte Martin Mehring, the first superintendent of nurses, and the graduates of the Class of 1951. It was a well-attended joyful event that reminded the alumnae of their school’s strong tradition of service to others. One of the new nursing graduates touched by the event was Lorraine Bowers Albrecht, Class of 1951. Albrecht, who was twenty years old at the time, noted that “After listening to the speakers I was delighted to be at this wonderful event and impressed by the early nurses who had accomplished so much. I hoped I would do as well as they but I doubted I would live long enough to see the 100th-year anniversary of the nursing school!”75
Energized by the school’s fiftieth anniversary the faculty redoubled their efforts to convince the University’s academic and medical faculty to create an autonomous School of Nursing within the University. To this end, the nursing faculty focused their next efforts on gaining administrative control of the three existing professional nursing programs. Although nursing faculty were responsible for the specific academic content in each program, the diploma program was under the control of the hospital, the nursing baccalaureate program under the School of Medicine, and the baccalaureate nursing education program was directed by the School of Education. It was an opportune time to
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resolve this issue because the School of Education in 1951 was revising its academic programs and raising questions about the placement of nursing education in their school. In addition, Louise Oates, head of the Cabaniss Memorial School of Nursing Education, was scheduled for retirement in 1952. After much discussion among nursing, medicine, and education faculty and the hospital’s administrators it was agreed that a Department of Nursing Education be established that incorporated the three current programs under one director. In February of 1953, the Board of Visitors approved the establishment of the department and named Roy Beazley as its chair.76
Unfortunately the administrative control for the new department was placed under the joint control of the School of Medicine, the School of Education, and the University of Virginia Hospital. Although assigning supervision of the new Department of Nursing Education to a joint committee composed of members from the three units may have seemed reasonable to University officials at the time, the decision proved cumbersome to nursing faculty because it left nursing education in an ambiguous and vulnerable position.
By 1953 the day-to-day responsibilities of directing a busy hospital nursing service department began to divert much of Beazley’s energies and time away from nursing education. Not only was she dealing with a constant shortage of nurses because of the hospital’s low salaries for graduates, she was grappling with learning how to work effectively with a profes-
From Hospital Training to Nursing Education: 1946-1956 ◼ 49
sional nursing staff who functioned very independently compared to student nurses. Many of the new registered nurses were not Virginia graduates and thus unaware of hospital procedures. Whether Virginia graduates or not, many of the nurses were married, with children, and their work schedules could not be changed easily to accommodate the hospital’s fluctuating needs. In addition, nursing personnel turnover rates ranged around thirty-five percent a year as graduate staff left to marry, begin their families, follow their husbands, or take other positions.77
Adding to her hospital responsibilities was Beazley’s commitment to initiate a practical nurse program for high school students in Charlottesville’s new Negro Vocational High School. Her dedication to this project was based not only on the hospital’s need for more nursing personnel, but also because she believed that the program provided an opportunity for young black women, unable to attend one of the few Negro nursing programs in the country, to enter nursing. Racial segregation was a part of Southern culture at the time and even the hospital’s clinical patient wards were racially segregated. From its opening in 1901, the hospital assigned Negro patients to basement wards. The medical and surgical care provided Negro patients was the same provided white patients, but the Negro wards’ physical surroundings were much more sparsely furnished. There were also no Negro nurses or physicians on the University’s faculty or professional staff, or enrolled as students. Beazley believed that the training of Negro high school students to become practical nurses was a crucial first step in the integration of the nursing profession.78
The few students remaining in the Cabaniss Memorial School of Nursing Education program in 1953 did not justify retaining Mary Walker Randolph as its administrator. Freed of this position Walker was able to assume a role in the new Department of Nursing Education. Her availability to co-direct the department encouraged Beasley to resign her position as its director and devote her energies to directing the nursing services department. Given a new title as the associate director of nursing services, Beazley retained her faculty appointment. In this capacity she controlled the placement of all students during their hospital clinical rotations including their evening and night duty assignments. Mary Walker Randolph, a great-great-granddaughter of Thomas Jefferson, graduated in 1928 from the Los Angeles General Hospital School of Nursing. She was the first graduate of the Cabaniss Memorial School of Nursing in 1931, and earned a master of arts degree from Teachers College, Columbia University in 1937. After serving three and one-half years in the Army Nurse Corps during World War II, she returned to the University in 1946 to become a faculty member in the Cabaniss School of Nursing Education. Randolph’s tenure as co-director of the nursing department was brief, only one year in length. Offered the position as the educational director at Duke University Hospital, she resigned her University of Virginia position in June of 1954.79
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Moving quickly to find a qualified nursing educator to replace Randolph, Beazley turned to Evelyn Bacon, a faculty member who had taught off-Grounds nursing courses in the University’s Extension Division since 1951.
Evelyn Bacon’s nursing credentials and professional experiences were impressive for the era. Born in Iowa in 1916, she graduated with a baccalaureate degree in 1937 and a master’s degree in 1940 from the University of Iowa School of Nursing. Offered a faculty position at Iowa in 1941, she functioned as an instructor only for a year before she enlisted in the Army Nurse Corps. As a neuro-surgical nurse she was sent to England in early 1942 to help open a large Army hospital. Her medical unit followed the assault troops onto the beaches of Normandy in 1944, then through France and into Germany until the war ended. Discharged with the rank of captain in 1946, she taught at the University of California at Los Angeles and the University of Iowa before enrolling in 1949 in a doctoral program at the University of Chicago. In 1950, after completing half of the doctoral coursework for a degree in education, she married Franklin Bacon and moved to Charlottesville. Mr. Bacon, an assistant professor in charge of extension teaching in the University of Virginia’s Extension Division, worked closely with the Cabaniss School of Nursing Education to bring nursing courses to graduate nurses off-Grounds. George Zehmer, director of the Extension Division, recognized Mrs. Bacon’s educational talents and quickly employed her in 1951 to teach nursing courses throughout the state.80
As acting chair of the Department of Nursing Education, Bacon was the school’s first married director. She brought to the school a wealth of expertise in designing nursing curricula and a talent for energizing the faculty to become more responsible for teaching the medical content of the program. Traditionally, physicians taught all medical content and the nursing faculty were restricted to instructing students on the specific nursing techniques associated with the medical regimes. Under Bacon’s guidance the faculty integrated medical and nursing content in their lectures to demonstrate that professional nurses needed to master the art and science of nursing care. Her recent experience in the Cabaniss Memorial School of Education also helped her guide faculty in the conversion of the BSNEd program into the school’s new RN to BSN program. Her activity in the National League for Nursing (the NLNE renamed in 1952) and service as the president of the Virginia League for Nursing Education provided Bacon with a strong network of nursing leaders. Through these professional connections she met Margaret Tyson, and enticed her to join the faculty in 1955. It was a wise decision because Tyson was an experienced educator and versed in the management of nursing schools. All of the faculty’s expertise was quickly needed in the summer of 1955 to resolve a fiscal oversight that threatened the existence of the baccalaureate program. When Bacon received the school’s 1955–56 academic budget, she found that there was no allocation in the University’s budget to operate the baccalaureate program.
From Hospital Training to Nursing Education: 1946-1956 ◼ 53
The nursing education department had submitted a budget to President Darden’s office for both the diploma and baccalaureate programs, but for unknown reasons the state’s allocation to the University lacked funding for the degree program. Undaunted by this oversight, nursing faculty including Bacon, Beazley, Tyson, and Zula Mae Baber received permission from President Darden to travel to Richmond to seek support for a special legislative bill to fund the baccalaureate program. To ensure success for the bill, the faculty drew upon the state’s nursing organizations to mobilize nurses across Virginia to contact their state legislators to vote in favor of emergency funding for the program.81, 82 The nursing faculty’s stunning success in obtaining state funding impressed University officials. Recognizing their new political strength, nursing faculty used this incident as additional evidence of their ability to manage the educational and budgetary functions of the proposed University-based School of Nursing. In spring of 1956, nursing faculty met in a special session to endorse a recommendation to President Darden for the University to establish an independent School of Nursing.83 In September 1956 the Board of Visitors, accepting nursing’s claim that the education of nurses was a responsibility of the University, created the School
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of Nursing as one of the independent schools within the academic community. The board, in response to a request from the hospital, directed the faculty to keep the diploma program open until the student enrollment in the baccalaureate program reached sufficient numbers to help staff the hospital.84
In September 1956, Evelyn Bacon resigned her faculty position for personal reasons. After her resignation, Margaret Tyson was selected by the Board of Visitors to be the school’s first acting dean.85 Bacon, after a few years hiatus from working as a nursing educator, returned to undergraduate education. She was invited in 1960 by Dr. Doris Yingling, dean of the School of Nursing of the Medical College of Virginia in Richmond, to join their faculty. Bacon remained a leader in Virginia nursing education until she retired as director of the Nursing Program at the J. Sargeant Reynolds Community College in Richmond in 1985.
The transference of leadership for the school from Evelyn Bacon to Margaret Tyson flowed smoothly because of their mutual belief that the University of Virginia was poised to move nursing education into the university setting. Both believed the time had come for nursing education to leave the corridors of hospitals and enter the halls of higher education where other professions educated their future practitioners. They assumed that, because of the University’s academic strengths and excellent medical facilities, the nursing school had the potential to become a leader in undergraduate and graduate education in the South. In addition, the school’s new academic status within the University encouraged Tyson to believe that the University fully shared in the faculty’s dreams of making the nursing school, as the medical school was, a top-ranked university in the South. She considered herself privileged to help the school reach this status and hoped that the baccalaureate program would soon attract adequate numbers of students to allow closure of the diploma program.
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Since her graduation in 1943 from the Baltimore Hospital for Women School of Nursing, Tyson had come to view college education as the key to advancement of the profession and of nurses. Earning both a BSNEd in 1953 and an MA in 1956 from the University of Maryland School of Nursing, Tyson was well-versed in nursing education’s new reform agenda. This agenda and its plan of action promised to sever the hospital’s control over nursing education and place it in the capable hands of nursing faculty with advanced degrees. Using sociologist Esther Lucile Brown’s recent analysis of nursing education as a guide to evaluating Virginia’s programs, Tyson continued to upgrade the academic content of the school’s three major programs: the diploma, baccalaureate, and the RN to BSN programs.86 She recruited faculty with advanced nursing degrees from outside the University to diversify and strengthen the academic programs. She also encouraged and supported faculty to pursue additional education. She believed it would
increase their ability to educate students to become responsible adults and competent professional nurses. The benefits of this strategy were revealed in the school’s newly developed educational philosophy and goals for the programs. Since its founding in 1901, the school’s primary goal was to prepare students to become legally licensed, registered nurses capable of providing “safe and effective nursing care” to patients. By 1957, the faculty had broadened the school’s educational mission to include the “development of the potentialities of young women to prepare them to attain personal satisfaction as individuals, to function effectively as professional nurses, and as citizens in a democratic society.”87
Changes in society and the expectations of young students encouraged the faculty to examine the school’s rules and regulations that might impede the personal development of students. One of the first rules examined was the school’s ban on students being able to marry while in the program.
During World War II, Director Virginia Walker granted special permission to students to marry in the last six months of their program if their husbands-to-be were in the military and being sent overseas. After the wartime emergency ceased, the school’s ban on student marriages was reinstated. It was a ban, however, that grew more difficult to enforce. Students did marry in secret and as long as their marriages remained unknown they were able to complete the program. With the arrival of Evelyn Bacon in 1954, the school’s first married director, the rule that banned student marriages began to be examined by the faculty. After Bacon left, Tyson continued this examination. Faculty agreed that students matured and grew more professionally responsible as they progressed through the program but they still hesitated on the matter of student marriages. It would be the questions posed by the baccalaureate students who had attended colleges where the issue of a student’s marriage was a personal, not an academic, issue that finally forced the faculty to acknowl-
The Transitional Decade: 1956-1966 ◼ 57
edge that it was time to remove the ban. As a first step in eliminating the ban, a policy was instituted that permitted students to marry in their senior year if they could prove they were “mature enough.”
In fall of 1956, the new marriage policy was broadened to include more of the student body. Students could seek permission to marry at the end of twelve months in the school if they had a “B” grade in all their courses and they “demonstrated evidence of being mature.” To initiate the process, the student submitted a written request to the dean and faculty. A letter from the student’s parents or guardian giving consent to the proposed marriage also was sent to the dean. At this point, the dean interviewed the student’s fiancé. The purpose of the interview was to assure the faculty that the couple had carefully considered their decision to marry, and that the future husband understood his responsibility to help his wife finish her nursing program. Once all the information was gathered, faculty voted on the student’s request to marry.88
At the same time the marriage policy was created, a maternity leave policy was also adopted. This policy required that the student inform the faculty of her pregnancy as soon as she was “diagnosed as pregnant.” Maternity leave began in the fifth month of her pregnancy and ended two months after the birth of the child, unless her physician extended it. At the completion of the maternity leave, she was expected to reenter the school and complete all remaining program requirements.89
Under Tyson, in 1960 the faculty also examined the school’s policy on excluding male students. The bias against admitting males into most of the country’s nursing programs had existed for over seventy-five years. In the 1940s, male registered nurses (graduates of the nation’s few co-educational or all-male schools) formed the Men’s Nurses Section of the American Nurses Association. The group initiated a national campaign to alter society’s and the nursing profession’s belief that men were unfit to be professional nurses.90
After exploring the school’s rationale for excluding men, only one major barrier could be identified; the nursing residence would not accommodate male students. A discussion with hospital administration led to the school being granted permission to house male students, as space permitted, in the male Interns Quarters. In 1962, the school opened its door to male applicants. Thomas Watters, an ex-Navy corpsman, applied to the school when he learned that the ban on male applicants had been removed. Admitted into the diploma program in fall 1963, he would become the School of Nursing’s first male student. He proved to be an outstanding student nurse and his leadership talents were tapped by his classmates when he was elected the class president in
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their senior year. Upon graduation in 1966 he joined the U.S. Army to enter its nurse anesthetist program.91
In these two historical decisions, admitting a male student into the school and accepting the students’ right to marriage and children while enrolled in the program, faculty moved away from two of the most rigid rules that had governed the nursing program since it opened. These actions also revealed the profession’s growing acceptance that being a male nurse or a married nurse with children were no longer insurmountable obstacles to a professional nursing career.
On July 1, 1958, Tyson’s title as acting dean was changed to dean of the School of Nursing. The growth in graduates from the basic baccalaureate and RN to BSN programs had risen from eleven in 1954 to sixty-one in 1959. In addition, the basic degree program’s NLN temporary accreditation status had been upgraded to a provisional accreditation level. These results were the direct outcome of the faculty’s efforts to raise the standards of the program and increase the student enrollment to help augment personnel in the hospital’s nursing services department. Aware of the hospital’s difficulty in recruiting and retaining adequate numbers of registered nurses to staff the hospital, the faculty also accepted Miss Beazley’s suggestion to enlarge the school’s affiliation program. By 1959, there were twenty-one affiliating students from three hospital nursing programs enrolled in diploma courses in obstetrics, pediatrics, and psychiatry.92
The faculty’s task of providing quality education to students in four different programs and the challenge of finding time to plan for the future grew more difficult as the accreditation standards rose. This was especially true for the
baccalaureate program. To acquire full NLN accreditation for the degree program the school had to make three major changes: develop a community health experience outside the hospital, employ a separate nursing faculty with advanced degrees in the clinical specialty areas in which they taught, and the faculty had to be responsible for all of the students’ clinical assignments. This last requirement meant that the hospital hours worked by baccalaureate students had to be part of their program, and the hospital nursing staff no longer could serve as their instructors. The responsibility for fulfilling these new NLN requirements fell directly on Tyson. Believing that the school had met its obligation to the hospital to increase baccalaureate student enrollment to an adequate level to assist the
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nursing services department, Tyson guided the nursing faculty in seeking permission to phase out the diploma program.
There were additional reasons why this request was made in 1959. The NLN also began to voice concern regarding the University’s treatment of the nursing school as an autonomous, independent unit in its academic community. More succinctly, NLN noted that other academic schools in the University possessed the authority to limit their programs to degree students and were not required to use students to provide service to another department.93 In addition to finding it very difficult to meet these requirements, faculty were struggling to cope with the complex logistics involved in offering three different nationally accredited educational programs, plus a growing affiliate program, in the same hospital setting. Often the different programs’ clinical requirements caused scheduling problems on the hospital units and raised the question about which program had priority for student patient assignments. More difficult for the faculty to handle, however, were the student morale problems that surfaced among the different groups. Affiliate students, enrolled in senior-level diploma courses and living in the nursing residence, felt isolated and questioned whether faculty favored U.Va. students over them in their courses. RN to BSN students, many with years of clinical experience, questioned whether faculty recognized their strengths and planned the program for their special educational needs. Basic baccalaureate students often felt that their clinical assignments were dictated by the needs of the hospital rather than their educational needs. They questioned the faculty about the number of hours they worked and why they had hospital assignments when the faculty was unavailable to them. Finally, diploma students questioned why they worked more hours per week than did the degree students, and why the faculty believed their program should be closed. Baccalaureate and diploma students often questioned faculty as to how the two programs differed and voiced concern that the faculty might be favoring one group over the other. As one faculty member remembered: “When the students got to know me, they would quietly ask how they were different from the other group. Sometimes a diploma student would directly ask if diploma students were as well prepared as the degree nurses. I told every student, whether they asked or not, that all U.Va. students were well prepared to function as professional nurses.”94
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These concerns disturbed the faculty because no matter how frequently students were assured that the academic standards were the same for all students and that faculty were dedicated to educating all students to become professional nurses, the students’ concerns remained. After nine years of offering a diploma and degree program in the same institution, the faculty concluded that students’ concerns would not cease until the school offered one undergraduate degree program.
Unfortunately, the hospital’s need for the students’ clinical services was still so acute that the faculty’s request to phase out the diploma program was denied. Although the hospital had mounted a major campaign to employ more nursing personnel, including graduate and practical nurses and aides, the nursing students represented an essential component of its nursing workforce. As director of the nursing department, Beazley’s ability to draw on the diploma students for thirty-three hours of clinical work per week, and twenty hours per week from the degree students provided her with the personnel necessary to staff the University’s newly built 477-bed hospital (built in 1961). Students were especially needed on weekends, evenings, and nights, and often were the sole providers of nursing care during these times.95
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The school’s request to close the diploma program was also a contentious issue with many of the hospital staff. The medical faculty and Virginia graduates on the nursing staff believed that the closing of the diploma program was erroneous and foolish. They pointed out that the diploma program was a sound educational program that had proven its ability to prepare excellent graduate nurses for almost sixty years. They feared that the baccalaureate program, with its emphasis on theory rather than clinical bedside care, was an unknown entity that may not be of the same quality as the diploma program. Fearing the destruction of the school’s excellent reputation as an educator of professional nurses, and seriously concerned about the University’s ability to staff its newly constructed multistoried hospital, Dr. Thomas Hunter, the director of the Medical Center, discussed the school’s request with Edgar Shannon, the recently appointed president of the University. In response to Hunter’s plea to keep the diploma program open, Shannon denied the nursing faculty’s request.96
With some reluctance, but assured by Shannon that it was a temporary decision, the faculty continued its efforts to cope with the student problems and keep the programs academically sound. Using their limited planning time as judiciously as possible, the baccalaureate faculty initiated a plan to develop a clinical master’s program for the future.97 The nation’s need for university nursing schools to create advanced practice programs had intensified over the last few years because of the rapid changes transpiring in medical and nursing practice. Society’s demand for nurses with more advanced knowledge and skills had risen over the years, and with the availability of new federal funding for nursing education in the 1960s, there was a pool of baccalaureate graduates seeking master’s education.98 Tyson wisely understood that the time was right for the University of Virginia to open a graduate program. She had heard from nurses across the state that they expected Virginia to be the leader in graduate nursing education. She also was aware that in establishing graduate education at the University, the school increased its ability to attract better students and entice doctorally-prepared nurses to join the faculty.
Tyson’s belief that university nursing programs would soon be taught by faculty with doctorates led her to enroll in a doctoral program in 1958. Over a three-year period of time she used her summer vacations, plus several weeks of unpaid leave, to take doctoral courses in the department of nursing at Teachers College, Columbia University. In June 1961 she sought and was granted a year’s educational leave from her position to complete doctoral degree requirements in nursing education. To ensure that the school had adequate leadership while she was on
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academic-leave, Tyson had been grooming Zula Mae Baber, her assistant since 1958, to assume leadership of the school. In July of 1961 Baber was appointed the acting dean of the School of Nursing.99
Zula Mae Baber was an excellent choice for the role of acting dean. She was an intelligent, poised, and knowledgeable professional nurse who had great credibility as an educator and clinical nurse among faculty and the medical staff. Virginia born, Baber was a 1940 graduate of the University of Virginia diploma program and a 1950 graduate of the Sadie Heath Cabaniss School of Nursing Education. In addition to her educational credentials, she had years of experience as a staff nurse and a nursing supervisor. During World War II she served three years in the U.S. Navy Nurse Corps. In 1955 she was invited by Evelyn Bacon to join the faculty and within a short time her leadership talents earned her the role as assistant administrator under Acting Dean Tyson.100 Her three years of close association with Tyson allowed her to lead the school through a successful NLN baccalaureate accreditation in 1961. She continued the school’s drive to recruit academically strong faculty and students to Virginia. Understanding that, as an acting dean, she served as a caretaker of the school, she undertook no new initiatives but worked quietly behind the scenes to build alumni and medical staff support for the school, especially for its future plan to establish a
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graduate division of nursing education. Her genuine devotion to the University of Virginia and her clear understanding of the hospital’s critical need for a professional nursing staff led her to work closely with Beazley to increase the salaries of registered nurses. Using her talent to gather information about nurses’ salaries in the commonwealth, she and Beazley supplied Dr. Thomas Hunter with vital data needed in the hospital’s quest for state approval to raise the low salaries of its professional nurses. The nurses’ employment benefits in 1961 were so inadequate that the hospital was unable to compete with other hospitals in attracting or retaining sufficient numbers of professional nurses to keep open the hospital’s beds.101
After an exciting year of full-time study at Teachers College, Tyson returned to Virginia eager to explore opportunities to create intellectually stimulating new educational programs, including doctoral level education. In 1963, after a year of working with the faculty to adopt new educational tools to measure the effectiveness of their teaching, Tyson again faced opposition from the hospital
when she revisited an educational issue that had been discussed in 1961: the inclusion in the degree program’s curriculum of the hospital nursing service assignments. Over the years the hospital had retained an arrangement with the students whereby the hospital absorbed most of the diploma students’ cost for their tuition, laundry, and lodgings in return for thirty-three hours of work each week in the hospital. For example, in 1960 diploma students in their second and third years only paid forty-six dollars a semester in fees. This sum included fifteen dollars and fifty cents for Student Health, eleven dollars and seventy-five cents for hospital insurance, and a fifteen dollar nursing school activity fee, plus three dollars and seventy-five cents for NLN achievement tests.102 This financial arrangement was very beneficial to the hospital because it needed the students to care for patients, and it was helpful to many students whose families lacked the resources to pay for their nursing education.
The hospital’s arrangement with the degree students, however, was not as generous. The hospital decided that the degree students’ tuition plus fees, $740 for the 1960 academic year, was too costly to absorb. To obtain additional clinical services from the degree students, the hospital developed a plan referred to as Nursing Service Assignments. In exchange for their room, board, and laundry costs, degree students worked 162 days annually for the Department of Nursing.103 The nursing service assignments, although listed as part of the curriculum, had nothing to do with the academic requirements of the degree program. The faculty, as required by NLN and the Virginia State Board of Nurse Examiners, had designed a sound educational program that provided adequate clinical and didactic content that prepared students, at graduation, to be clini-
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cally competent professional nurses. The educational program also met all University degree requirements. The faculty believed it was deceptive to portray a business arrangement between students and the hospital for room and board as an academic requirement. In 1961, when the issue was first addressed, the faculty achieved a partial resolution to the problem when the University agreed to publish the terms of the lodging and board agreement between the student and the hospital in the 1963 School of Nursing University of Virginia Record. “Students in the baccalaureate program have the option of paying room, board, and laundry at the regular University rates, or receiving same by electing nursing service assignments one day a week, one week at Christmas, ten weeks between third and fourth year, and eight weeks following graduation.” The University insisted, however, that two additional sentences be added to the statement: “All students applying for transfer to the School of Nursing for the baccalaureate program are strongly urged by the faculty to elect these nursing service assignments. The University of Virginia Hospital offers unique experiences in nursing practice enabling the student to increase her knowledge, skill, and competence in the practice of nursing.”104 In agreeing to publish this information President Shannon reserved the right to withdraw immediately the option “if the care of patients, or the operation of the hospital, be seriously affected” by too many students selecting not to work for the Department of Nursing.105
In 1963, when the hospital’s nursing shortage lessened and almost all the baccalaureate students were opting to take advantage of the hospital’s offer to pay for their room and board, the faculty again attempted to remove the nursing service assignments from the published curriculum. Hospital administrators again objected to this proposal because they knew the degree students were voicing objections to the eight-week clinical assignment after
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their graduation. The hospital feared that if the students recognized that the nursing service assignments were not essential to official completion of the program, they might leave the University immediately after graduation. Once again, after listening to the concerns of the Medical Affairs Policy Board and Dr. Hunter about the hospital’s inability to provide safe patient care without the degree students’ services, Mr. Shannon rejected the nursing faculty’s request to remove the nursing service assignments from the degree program curriculum.106
The number of clinical hours in the diploma program also began to be questioned by the Virginia State Board of Nurse Examiners. The state examiners in December 1962 strongly recommended that the diploma faculty decrease the number of student clinical hours in the program, and that they assume academic control over the students’ clinical assignments.107 The adoption of these recommendations met stiff resistance from the hospital, most notably from Beazley. As director of nursing services she needed the power to assign students to clinical units and shifts to meet the needs of patients. When the University failed to comply with the recommendation of the State Board, Tyson believed she had lost her effectiveness as dean. In October 1963, Tyson announced her resignation to become effective in June 1964. The nursing faculty’s lack of autonomy to control the academic programs, and President Shannon’s support of the hospital administration’s position that nursing students had an obligation to provide nursing patient services convinced Tyson that it was time for the school to find a new dean. “I really tried to explain to Mr. Shannon and Dr. Hunter where professional nursing education was moving but they were not interested. When I came back to Virginia after doctoral work I quickly found out nothing had changed. No one wished the school to be an independent school, it was still
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treated as a hospital training school. Virginia was one of the last university schools to offer simultaneously a degree and diploma program, and they did this only because the hospital needed students. I knew I had to leave.”108
In December 1963 Margaret Tyson was awarded a doctoral degree and offered a faculty position at Teachers College, Columbia University. Committed to helping Virginia quickly find a new dean, Tyson provided President Shannon with a list of candidates who were knowledgeable about university nursing education. Tyson also worked closely with Zula Mae Baber who would resume the position of acting dean of the school.
In July 1964, Baber quickly reassumed the role as acting dean. She devoted her efforts to working closely with the faculty to keep the academic standards of the programs intact and prepare for a school accreditation visit from the Southern Association of Colleges and Schools. The Southern Association’s report echoed some of the concerns of NLN. In addition, it strongly recommended that the University find an experienced, doctorally prepared educator to serve as the school’s next dean. It also recommended that the school establish a self-study committee to evaluate the University’s rationale for continuing the diploma program.109
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The search committee for the dean of the School of Nursing, appointed by Shannon and chaired by Raymond Bice, associate professor of psychology, began its task of recruiting and recommending a new dean in the fall of 1964. In spring 1965 four qualified candidates visited the University, but after discussing the school’s future with the nursing faculty, President Shannon, the hospital administrators, and the search committee, none of them were interested in the dean’s position. All of the candidates believed the school had great potential but they questioned the University’s commitment to degree-based education for nurses. Each of the candidates strongly advised the dean’s search committee and President Shannon that the University must close the diploma program before it would be able to find a well qualified dean.110 As Dr. Mary Mullane, dean of the University of Illinois College of Nursing at the time, noted, “Many in the profession knew of Tyson’s experience at Virginia and no one wanted to be hired to close the diploma program because they recognized their effectiveness as a dean was finished after the task was accomplished.”111
Acting on the dean candidates’ comments and the recommendations of the school’s Self-Study Committee on the Diploma Program, the faculty voted to recommend the closure of the diploma program. Although convinced that the diploma program needed to close, it was an emotionally difficult decision for the faculty to make. The faculty’s loyalty to the University, respect for the diploma students and graduates, and their deep concern for the hospitalized patients’ need for nursing care accounted for their recommendation that the school not
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be closed too quickly. They recommended that the September 1965 class be the last group accepted into the diploma program. This decision would ensure the hospital three years to acquire sufficient numbers of registered nurses to assume total responsibility for nursing patient services. President Shannon accepted both recommendations in July 1965.112
In September the reactivated search committee for the dean of the School of Nursing learned that there were many excellent candidates available for the position when informed that the diploma program would close in 1968. Within six months Mr. Bice reported to President Shannon the committee’s recommendation that Dr. Mary Lohr be appointed as the school’s new dean. In January 1966, the Board of Visitors officially appointed Dr. Lohr as the fourteenth leader of the School of Nursing.113 Administrative responsibilities at the University of Illinois College of Nursing, Chicago prevented Lohr from assuming the deanship until October 1, 1966.
Mary Lohr’s reception by the school and University was a far different experience than had been her predecessors’. Her academic appointment was at the full professor rank and she was named the first Sadie Heath Cabaniss Professor of Nursing.114 The need for nursing students to provide essential patient services was ending. Nursing faculty now had the opportunity to forge a new relationship with the hospital and move further in the process of transforming the hospital- based school into an academic
unit of distinction in the University and nursing profession.
A Midwesterner by birth, Lohr, at age forty-one, had been selected as dean because she possessed the intelligence, energy, vision, and the academic credentials and experience to lead the school on its new academic path. A 1946 diploma graduate of Chicago’s Presbyterian Hospital School of Nursing, Lohr understood how unpopular was the decision to close the diploma program among alumni, hospital staff, and some nursing faculty. She believed, however, that her academic background, which included a BSN (1949) from the University of Pittsburgh and an MA (1951) and EdD (1962) from Teachers College, Columbia University, plus twelve years of faculty experience, would help her deal with those displeased about the closure of the diploma program. To alleviate their concerns about the institution’s educational reputation she assured them that the school’s new collegiate mission would meet the needs of society and would continue Virginia’s tradition of educating well-prepared nurses.
Lohr, a little over six feet tall, was an imposing figure, but her quick smile and gentle manner softened her image, won her friends, and disarmed her critics. Working closely with President Shannon and Zula Mae Baber to increase the school’s financial support, Lohr began a drive to increase the numbers and academic credentials of faculty. She believed that only if the nursing faculty were offered competitive salaries and professorial rank comparable with other University faculty could she recruit the kinds of faculty needed to advance
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the school’s educational programs. She especially needed doctorally prepared faculty capable of obtaining federal funds available through the Nurse Training Act of 1964. These funds offered schools unprecedented financial resources to improve the quality of their nursing education through such measures as student scholarships and loan support, educational facilities improvement funds, and more nursing research aid.115
Lohr’s success in attracting qualified faculty, in a time of intense competition among schools of nursing, was impressive. When she assumed the deanship in October 1966 the school had twenty-two full-time faculty: nine with master’s degrees and thirteen with bachelor’s degrees. By fall of 1968 there were thirty-seven full-time faculty: five with doctoral degrees, fifteen with master’s, and seventeen with baccalaureate degrees.116 The
addition of doctoral faculty quickly changed the pace and direction of the school as they developed federally funded research and graduate educational programs, produced scholarly publications, and participated in national and international conferences.
The first of the doctoral faculty recruited in 1968 were Drs. Vernita Kay and Phyllis Verhonick. Kay, as an expert psychiatric nurse educator, was recruited to develop a psychiatric-mental health specialty focus in the school’s future master’s program. Verhonick’s strength as a nurse researcher and educator was teaching both graduate and undergraduate students the principles of nursing research. Verhonick and Lohr quickly joined forces to develop several major federal and state grants, including a construction proposal for a new School of Nursing educational/research building, a student nurse scholarship and loan
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application, and a faculty research development proposal. These grants, funded in 1969, attracted new faculty and students to the school and inaugurated faculty research activities. To help beginning faculty researchers develop their projects, Verhonick was appointed the school’s first director of research.
The year 1968 was bittersweet for the nursing faculty. Their success in enrolling almost 150 baccalaureate students, developing a plan for graduate programs, and undertaking research projects pleased them, but knowing that the school’s diploma program was drawing to a close saddened them. Although each of the faculty possessed one or two academic degrees and they believed in baccalaureate nursing education, they were keenly aware that they had begun their own nursing careers as diploma graduates. Their memories of their classmates and the rich traditions associated with hospital programs, plus their deep respect for the U.Va. diploma students, colored their feelings about the closure of the diploma program. Betty Norris, a 1949 U.Va. graduate and faculty member in 1968, remembered, “We took special care to be at their capping, banding, pinning, and graduating ceremonies and attend their senior dance where the last Virginia Reel dance was performed.”117 In spring of 1968,
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after sixty-seven years of training diploma nurses, the last class of twenty-six diploma graduates received their University of Virginia Hospital nursing diplomas and school pins. The closure of the diploma program also brought to a close the school’s forty-four-year tradition of serving as an affiliate school for other diploma programs in the state. The University hospital’s facilities remained available for these schools’ use but no longer would affiliate students be taught by U.Va. nursing faculty.
Early in Mr. Shannon’s presidency he committed the University to addressing the past discriminatory practice against admitting black students. His plea to schools to recruit black students was warmly supported by the nursing faculty. Lohr and faculty crisscrossed the state making recruitment visits to Negro high schools and nursing programs. In 1967 Mavis Claytor, a graduate of Baltimore’s Provident Hospital’s Helene Fuld School of Nursing, applied to the RN to BSN program. Born in Franklin County, Virginia, and the great-grandchild of slaves, Claytor learned of the University’s recruitment efforts to attract Negro students. Fearing that she still might be excluded because of her race she decided not to include a personal photo with her admission application. Within a few weeks she received a letter of admission to the University and was assigned a room in McKim Hall. When she arrived in Charlottesville in fall of 1968 and attempted to move into McKim, however, a housemother informed her that there was no space available for her. Undaunted by this news, she lived at the Holiday Inn for two weeks and searched for suitable housing accommodations in town. When her search proved unsuccessful and her
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personal savings no longer could support a motel room, she visited Dean Lohr to discuss the problem. Lohr, learning of Claytor’s experience, immediately secured a private room for her in McKim. Aside from this racial incident, Claytor believed the program met her expectations and the faculty and fellow students treated her fairly. In addition to being the first black nurse admitted to the School of Nursing, she also was one of the first black professional nurses to be employed by the University of Virginia Hospital. “When I graduated in 1970, I could say that neither as a student nor as a registered nurse did I experience racial discrimination at Virginia. I had learned from my family, especially my grandmother, that you treated people like you wished to be treated yourself. This advice helped me throughout my career.”118
In an effort to increase enrollment in the baccalaureate program, Lohr and Baber Bice (recently married) traveled across the state to speak at women’s colleges about a nursing career and about Virginia’s program. The inability of women to attend the University during their first two years of college hampered the school’s ability to recruit highly qualified students. Many bright students attending distant women’s colleges, who as first-year students registered as pre-nursing majors, lost interest in a nursing career as they became engrossed in other academic pursuits. This loss of students, plus the nursing faculty’s belief that coeducation would strengthen the University, underpinned their recommendation that women be admitted to the College of Arts & Sciences. This recommendation was conveyed to the University faculty committee exploring whether the institution’s 153-year tradition of admitting only males into the college should cease. After spirited and lengthy discussions throughout the University and state, the committee recommended that qualified women be admitted to the College of Arts & Sciences as soon as feasible.119 The Board of Visitors accepted the recommendation in 1969 and directed University administration to make the necessary arrangements to admit women effective with the 1970 entering class.120
In 1970 the University received state funds to match the federal construction award and ground was broken across Jefferson Park Avenue for the new School of Nursing building. Recognizing that the University also planned to build new student housing to accommodate the increases in the student population, the nursing faculty requested that one of the residences be built close to the medical center. The faculty believed that it was time to free nursing students from the isolation of McKim Hall and give them the opportunity to reside in University housing among other college students.
Dean Lohr’s energy and creativity were not restricted solely to educational activities. From the moment she assumed the deanship she worked closely with Beazley to recruit sufficient numbers of professional nurses to replace the services of the departing diploma students. Both women were dedicated to ensuring excellent nursing care for the hospital’s patients.
My years as a student at U.Va. were very difficult. I believe I "grew up" and that I learned a great deal about myself. It was a time that required me to draw on strengths that I did not know I had!
It is a constant joy to see former students' names periodically show up in the literature, news, etc. I had the great honor of being involved in the education of many, many impressive students.
Dressed in starched white nursing uniforms and caps, Lohr and Beazley periodically visited the hospital units asking questions of patients and nursing staff about the patients’ care. To recruit and retain professional nursing staff, both worked closely with state officials to introduce a forty-hour week and overtime pay for registered nurses, and to secure the financial resources necessary to create a hospital employee daycare facility.121
In January of 1969, anticipating Beazley’s retirement in spring and seeking University acknowledgment of her contributions to the institution, Lohr gained President Shannon’s support for professor emeritus status for Beazley, the first University woman faculty member so honored. Lohr also chaired the nursing search committee that selected Kenneth L. Rinker to become the hospital’s twelfth director of nursing services. Rinker, an ex-Navy hospital corpsman with a BSN degree from the University of Missouri and a MSN degree from Emory University, was the hospital’s first male director of nurses. In addition, his appointment as an associate professor made him the school’s first male nursing faculty member.
Quickly moving to upgrade the nursing staff’s professional credentials to keep pace with medicine’s drive toward clinical specialization, Rinker, with Lohr’s support, hired the hospital’s first clinical nurse specialist. In September 1970, Barbara Haas, MSN, RN, an orthopedic clinical nurse specialist, was jointly appointed to the hospital’s nursing department and School of Nursing. This dual appointment ushered a new nursing model of advanced clinical practice into the hospital and established a new educational relationship with the nursing school.122
The speed and success of the nursing faculty to attract federal funds plus its ability to obtain University approval for a nursing master’s program impressed the academic administration. University Provost Frank Hereford invited the faculty in 1969 to consider developing a doctoral program. Lohr informed Hereford of the school’s intent, after launching the new master’s program, to offer a nursing doctoral program in 1972.123 Unfortunately, the Virginia State Council for Higher Education refused to grant permission for the program in 1967 and again in 1968. In fall 1968, the council had granted permission to the Medical College of Virginia School of Nursing (MCV) to open a master’s program with clinical tracks in public health and medical-surgical nursing.124 The council believed that until the MCV program was well established no other master’s program should be opened in the state. Undeterred by this temporary setback, Lohr continued her drive to establish nursing graduate education at Virginia. In 1970 Drs. Mary Reres and Barbara Brodie were recruited to develop graduate studies in psychiatric/mental health and pediatric nursing, respectively.
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Dr. L. Claire Parsons, a noted nurse physiologist researcher, joined the faculty in early 1971. The existence of a cadre of highly qualified graduate faculty enabled the school, in February 1972, to gain the state council’s approval to open a master’s degree in nursing program in the fall term.125
The spring of 1972 was filled with many happy events. Several faculty research projects and a nurse practitioner training grant were funded by the federal government and additional doctoral nurses joined the faculty. To accommodate the multiple changes within the school, Lohr devised a new administrative structure. Dr. Betty Norris (a recent EdD graduate) became the director of the undergraduate program; Verhonick assumed leadership of the graduate program; and Dr. Parsons was appointed director of nursing research. In addition to these changes, the faculty, eagerly awaiting its move to the new five-story nursing education/research building in June, viewed the school’s future with great expectations. It was, therefore, a considerable surprise to faculty and the students when Lohr announced that she was resigning her position immediately to become dean of the University of Illinois College of Nursing in Chicago in June.
Although Lohr’s sudden departure stunned the faculty, her contributions to the school proved to be visionary and profound. In acquiring the much needed educational building and doctoral faculty, she enabled the institution to fulfill two major missions of a University school—offering graduate education and conducting nursing research. She also quietly and effectively aided the nursing service department in securing a registered nurse staff. In accomplishing these tasks, she moved the school from a hospital training program into a recognized comprehensive educational unit within the University and the state. To ensure that the school’s academic and research momentum did not falter, Phyllis J. Verhonick was appointed as acting dean. In June 1972, Verhonick assumed the deanship and a search committee began its task of finding a new leader.
The decision to appoint Verhonick as acting dean, although made quickly, was a wise decision. Her five-year experience in the school and her twenty-three-year U.S. Army Nurse Corps career, begun after she graduated in 1945 from the University of Portland School of Nursing, had prepared her for the position. The Army Nurse Corps quickly recognized her intellectual and leadership abilities and promoted her in rank and sent her to Teachers College, Columbia University for additional education: an MA (1956) and EdD (1958). In 1968, after retiring from the Army and coming to the University of Virginia, she joined forces with Lohr to craft the school’s new academic mission. Verhonick’s talents as an innovative and effective teacher, researcher, and scholar were widely recognized in the University and profession. Her passion and belief in the power of nursing
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research to discover effective ways to care for patients had been nurtured while serving at the Walter Reed Army Institute of Research in Washington, D.C. As a Virginia faculty member she taught both an undergraduate honors elective and a nursing research course. Her research course was one of the first offered to baccalaureate students in the country. Her intelligence, vitality, warmth, humor, and charm, visible in her teaching and interactions with colleagues, endeared her to the students and faculty alike.
Verhonick, a youthful fifty-year-old brimming with energy and ideas, eagerly embraced the challenges of being the dean. Using the dean’s suite in McLeod Hall as a command center, she worked closely with faculty and University administration to prepare for a historic year in the life of the school.
In September 1972 McLeod Hall opened to welcome 368 students in the baccalaureate program and twenty-eight graduate students into the new master’s program. In the ranks of the new third-year class were four young women who had been admitted into the University’s first co-educational undergraduate class in 1970. Among the new master’s students, eleven were enrolled in the three-semester psychiatric-mental health track and seven were in the four-semester pediatric track. The pediatric track included a semester in the newly created Pediatric Nurse Clinician Certificate Program (renamed the Nurse Practitioner Program in 1978).126
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Little change had been made in the basic student uniform since the mid-1950s when white hose and shoes replaced the traditional black stockings and shoes. In 1970, students asked the nursing alumni association to add an orange band to the school’s official nursing cap, and the alumni voted to adopt this change. Students then added an orange band to their cap in their third year and a blue band during their fourth year. A major change in the uniform, however, followed the hospital’s decision in 1971 that it would no longer provide uniform laundry services to the students. Reflecting the permissive spirit of the time, the faculty encouraged the students to select the school’s next uniform. Exercising their new freedom, students voted to discard the uniform that had been in service for over fifty years. The heavily starched blue chambray dress and the full gathered white cotton apron with its white bib were replaced in 1972 with a dark blue knitted polyester fitted dress. A one-piece white bib apron, slipped over the head and buttoned on the sides, completed the uniform. The polyester fabric was selected to make it easier for the students to maintain their uniforms. The wearing of white hose and shoes was retained. In 1974, as graduate nurses’ uniforms became more casual, white and dark blue knitted slacks became an optional part of the student uniform. The cap, however, ceased to be an official part of the student uniform. It was retained for formal ceremonies such as capping and banding, but the cap was no longer required in clinical settings.127
The uniform of male students also changed in 1972. In place of a white cotton jacket and trousers, they wore white slacks and a light-blue, ribbed, short sleeved shirt or lab coat. All students wore name pins on their uniforms that identified them as University of Virginia students.
In the mid-1980s the use of a standard student uniform disappeared. In its place students chose to wear white slacks and colored tops. A white loose jacket also was added as an option to the uniform. To identify them as University students, an orange and blue U.Va. logo patch was attached to their jacket or colored top.
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On November 10, 1972, a dedication ceremony marking the official opening of the Josephine McLeod Nursing Education and Harvey E. Jordon Medical Education Buildings was held in McLeod Hall’s auditorium. Fay Abdellah, EdD, RN, assistant surgeon general of the U.S Public Health Service, gave the nursing keynote address and Roy Beazley, professor emeritus, provided a eulogy on the life of Josephine McLeod. In addition to Virginia’s Governor Linwood Holton, President Shannon, alumni, faculty, and students, there were many dignitaries from national and state government, health professions, and industry at the ceremony.128
Following the building’s dedication, the University of Virginia School of Nursing’s Beta Kappa Chapter of Sigma Theta Tau was inaugurated. Sister Rosemary Donley, RN, PhD, first vice president of Sigma Theta Tau, presided at the chartering ceremony. A charter group, composed of forty-five new members, was inducted into the new chapter. The events, widely reported in the state’s newspapers and health professional journals, signified a new level of professional recognition for the school in the state and nation.
Throughout 1972–73 several new academic initiatives were undertaken, including an innovative venture with Hampton Institute and Norfolk State College to attract academically-talented minority leaders into the nursing profession. The project led to more minority students entering the profession and new collegial relations between Virginia and two historically black Virginia educational institutions.129 One of the school’s emotional highlights in April 1973 was celebrating with Verhonick her induction as a charter fellow into the newly created American Academy of Nursing. She was selected into this prestigious
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group because of her research expertise and commitment to the advancement of nursing knowledge. As pleased as she was with this honor, she was even more delighted to participate in the University’s summer graduation exercises for the school’s first graduates of the master’s of science in nursing degree program. To each of the nine psychiatric-mental health graduates she joyfully distributed their diploma and master’s academic hood.
By the summer of 1973, the search committee for the dean of nursing was poised to recommend Phyllis Verhonick be appointed the school’s next dean. Unfortunately, she suddenly developed a health problem that threatened her ability to function as the dean. In response to Verhonick’s unstable health status, the search committee believed it prudent to continue their task. During the fall 1973 term, Verhonick assigned many of the dean’s administrative responsibilities to other faculty to lessen the stress on her health. By late November, her health problems intensified, forcing her withdrawal as a candidate for the dean’s position. She chose, however, to remain in the acting dean’s position until her replacement was appointed.
The University’s need to find a replacement for Verhonick was intensified because of a NLN school accreditation visit scheduled in spring 1974. In February the search committee recommended that Dr. Rose Marie Chioni, a professor at the University of Wisconsin School of Nursing in Madison, be appointed the school’s next dean. The Board of Visitors quickly appointed Chioni dean and the second Sadie Heath Cabaniss Professor of Nursing.130 Although Chioni’s responsibilities at Wisconsin prevented her from assuming the position full-time until September 1974, she worked closely with Verhonick and the faculty to prepare for the school’s NLN visit. The accreditation review proved successful and both the baccalaureate and the new master’s of science programs were awarded accreditation status.131
Stepping down from the deanship, Verhonick attempted to return to her teaching, research, and service activities. In 1974 she was elected vice president of the American Academy of Nursing and undertook several national and international consulting activities. Although her commitment to the profession and the University of Virginia never faltered, during the next few years her ability to lead a productive professional life was compromised by her deteriorating health status. In October 1977, at age fifty-five, Verhonick died. Denied the opportunity of a full nursing career, she did significantly contribute to the school and profession through her research and teaching activities. In recognition of her pioneer research contributions to the profession the school inaugurated a research conference in her name and the U.S. Army Nurse Corps initiated a Phyllis J. Verhonick Award and Research Conference in 1980.132
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Dr. Chioni was attracted to Virginia because it offered a wonderful opportunity to create innovative educational programs and research projects. “When I first heard about the deanship I did some investigation and everything I heard or read about the University of Virginia indicated the school was committed to becoming a premier educational institution. When I came for my first interview, I was impressed to find the faculty and University administrators, from President Shannon to the Vice President of Health Affairs Dr. Hunter, were solidly in support of the school reaching this goal. Throughout my entire time as dean, administrative support for the school never wavered.” 133
The University found Chioni an excellent choice as dean because of her educational preparation and national reputation as a talented educator and administrator. Chioni, a native of Illinois, began her career as a 1953 diploma graduate of St. Francis Hospital School of Nursing in Peoria. Interested in becoming a nursing educator she quickly set upon a path to acquire the educational credentials necessary to teach at a university level. The path included earning a BSNEd in 1956 from the University of Minnesota, an MA in nursing from the University of Chicago in 1958, and a PhD in higher education from Ohio State University in 1964. She also acquired excellent training as a teacher and administrator in several major universities, including experience as an associate and acting dean at the University of Wisconsin. Moreover, her ability to guide faculty in designing innovative programs that prepared graduates to function in acute care and community health settings was known throughout the country. It was for this expertise that she was inducted, along with Phyllis Verhonick, as a charter fellow of the American Academy of Nursing in 1973.134
Quickly picking up the reins of leadership from Verhonick, Chioni, at age forty-two, began her deanship by challenging and energizing the faculty to design new programs to meet society’s need for an intelligent and skillful nursing workforce. Accepting her challenge, the graduate faculty intensified their efforts to broaden the clinical majors in the master’s program and expand nurse practitioner education. Undergraduate faculty, aware of the rapid changes occurring in acute and community health settings, began the exciting process of redesigning the baccalaureate program.
To expedite the school’s academic and research activities, Chioni created in 1975 a new administrative structure. She appointed three assistant deans: Dr. Judy Bancroft for the undergraduate program; Dr. Barbara Brodie for the graduate program; and Dr. Betty Norris for the newly created Office of Student Affairs. The growth in programs and enrollment demanded that the school provide student services beyond educational concerns. Norris’ knowledge of the University and her interpersonal skills with students made her the logical choice for this new position. Dr. Parsons continued to serve as director of nursing research.135
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During the next few years the school hummed with faculty and student activities. In the graduate division, during a four-year period, the school doubled its master’s program options and quadrupled the nurse practitioner certificate programs. Beginning in fall 1976, a Medical-Surgical track was added to the master’s program. Co-directed by Drs. Ann Taylor and Karen Johnson, seventeen graduate students were admitted to the clinical field. To meet the state’s critical need for medical-surgical advanced clinicians, the school joined forces with VCU/MCV’s School of Nursing on a federally-funded grant to bring master’s education to the Tidewater and Southeast Virginia areas. Fifty-five graduate students from Virginia and Tennessee enrolled in the University of Virginia’s outreach program and thirty-four completed the program by 1982.136 The nation’s need for advanced practice medical-surgical nurses and the quality of the program soon made the clinical track the largest in the master’s program.
In fall 1978, under the direction of Dr. Jean Goeppinger, the Primary Nursing Care in Society (community health) track was opened. This clinical major, with the admission of six students, allowed the school to prepare graduate nurses for leadership positions in community health agencies.
In concert with the expansion of the master’s degree program, three new nurse practitioner programs were added to the school’s certificate program. In response to the severe shortages of trained personnel in the country’s emergency departments, an Emergency Nurse Practitioner program was started in the spring of 1975. The program, the first in the country in a university school of nursing, and under the direction of Denise Geolot and Dr. Richard Edlich, educated nurses to provide primary and emergency care to patients in emergency facilities. Two years later the Family and Adult Nurse Practitioner programs were administratively moved from the School of Medicine’s Department of Medicine to the nursing school.137 The four nurse practitioner certificate programs remained open to degree and certificate students until 1982 when the certificate program was closed and the family practitioner program became a post-master’s option.
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As dramatic as was the expansion of graduate education, the undergraduate faculty created a bold new approach to baccalaureate education. The revised undergraduate program, inaugurated in the 1977–78 academic session, offered fourth-year students an opportunity to focus some of their clinical learning experiences in two areas. Their options, an acute illness or a health management/chronic care focus, were devised to provide the public with professional nurses equipped to function more competently in these specialized areas immediately after graduation. In addition to this change, to introduce nursing content to pre-nursing majors prior to entry into the school, a nursing course was taught to the second-year students.138
The changes occurring in the school were not solely limited to curricula matters. Life for undergraduate students also was undergoing many positive changes. Two of the more significant concerned where they lived and their participation in University student life. In 1974, when the University’s Brandon Avenue dormitory opened, nursing students were offered living accommodations within it (it was renamed Bice House in 1997). McKim Hall, after serving for forty-three years as the nurses’ residence, was taken over by the hospital for office space. By 1976 nursing students could elect to live in any on-Grounds undergraduate housing or live off-Grounds. A mark of the full integration of nursing students into the University’s student activities occurred in 1978 when Amy Easter was assigned a room on the Lawn as her fourth-year residence because of her leadership in student organizations.139 Over the years, nursing students have participated in many college activities, from student government to athletics, and several have earned the prestigious privilege of living on the Lawn.
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After the death of Zula Mae Baber Bice in 1975, the School of Nursing Alumni Association, in cooperation with the school, established an annual lectureship in her honor. Financially supported by Baber Bice’s family, friends, and colleagues, the lectureship invites eminent nursing leaders to speak on pertinent health issues of the day. Eleanor Lambertsen, EdD, RN, FAAN, dean of the New York Hospital School of Nursing, Cornell University, spoke at the inaugural Bice lectureship on September 24, 1976. This event helped revitalize the nursing alumni association and paved the way for a more active and productive partnership between the school and its alumni.140
The growth of students enrolled in the school during the 1970s was impressive. In 1969 there were 217 undergraduate students, but this figure ballooned to 483 in 1976 (402 undergraduate and eighty-one master’s students).141 The enrollment growth was fueled by several factors, including the admission of women to the college in 1970; the numbers of eighteen-year-olds seeking college entry; the government’s financial incentive program that encouraged nursing schools to prepare more nurses to ease the nation’s nursing shortages; and the school’s opening of the master’s program. The struggle to enlarge and develop additional graduate clinical fields and accommodate the learning needs of 402 undergraduate students challenged the faculty’s ingenuity to sustain Virginia’s high educational standards. The task of ensuring the students quality clinical experiences within the limited resources of the hospital and community was difficult. In 1977, to resolve the dilemma, undergraduate enrollment was reduced.142 This reduction led to an improved student learning environment and allowed Chioni and faculty the necessary resources to begin the long-awaited process of moving Virginia into the ranks of nursing schools offering doctoral education.
To expedite the task of creating a doctoral program, Chioni created a doctoral steering committee in 1978 and authorized a feasibility study to explore the need for doctorally prepared nurses in the Southeast. The steering committee, utilizing data from the study, prepared a tentative nursing program under the auspices of the Graduate School of Arts & Sciences.143 In fall 1979 the Virginia State Council of Higher Education informed the University that because VCU/MCV also was seeking permission to open a doctoral program, they had decided that the two schools should develop a joint/cooperative nursing program.
Although neither school was pleased by the council’s directive, over the next eighteen months they frequently met to work on the joint proposal. A Tri-State (South and North Carolina and Virginia) Doctoral Program Consortium of nine graduate schools also was created to aid in the development of the program. In spring 1981 Doris Yingling, the MCV nursing dean, informed the consortium group that their university had decided against participating in the proposed joint program. It would, however, submit a VCU/MCV doctoral proposal to council for review. In response to this action, the council agreed to review doctoral proposals from each school.144 In fall 1981, the University of Virginia was granted permission to initiate a PhD in nursing program the following year.145
After years of dreaming about utilizing the University’s superb academic resources to prepare doctoral nursing students to become scholars and researchers, the faculty welcomed to the 1982–83 academic session three young women into the first PhD nursing program in the state. Dr. Sara Knight completed the
program in August 1985, thereby becoming the school’s first nursing doctoral graduate.
As the 1980s slipped by, another nationwide nursing shortage surfaced. Many of the factors that were central to previous shortages—demanding work schedules, lack of auto-nomy over nursing practice, and inadequate salaries—once again drove nurses away from the profession and acted as a deterrent to attracting nursing recruits. In hopes of addressing the medical center’s serious lack of nurses and the school’s diminishing student enrollment, the faculty joined forces with the Division of Nursing to design strategies to recruit more registered nurses and students, and to resolve some of the nursing staff’s practice concerns.146
To attract and retain hospital staff nurses, the RN to BSN program was revised to include a master’s degree (RN to MSN program). A new program, the Second Degree to MSN, was designed to entice non-nursing college graduates into nursing. In addition, to stem the loss of U.Va. pre-nursing students into other majors during their first two years in the college, students were admitted as first-year students into the school. All three academic decisions were successfully implemented in 1988.147
The school’s administrative structure also was revised to reflect a closer relationship with nursing clinical practice and the faculty’s maturing approach to fulfilling the missions of the institution. Four new associate dean and two assistant dean positions plus one directorship were created and filled by 1988. The four associate deans were Dr. Faye Raines for Academic Programs; Dr. Betty Johnson for Community Service/Faculty Practice; and Dr. Judy Ozbolt for Research (also director of the new Center for Nursing Research). Dr. Jean
Sorrells-Jones, recently appointed director of the Division of Nursing, served as the associate dean for In-Hospital Services. The assistant dean positions were for Student and Alumni Affairs and for the school’s administration. In recognition of the University’s decision to mount a capital campaign to seek financial support from alumni and friends, Linda Davies was selected from the faculty to serve as the director of nursing development.148
With this administrative team in place and a successful school NLN accreditation review accomplished, Chioni decided it was the ideal time to resign from the deanship and return to a faculty position, effective December 31, 1988. Chioni, as the longest-serving leader of the school—1974 to 1988—left a splendid legacy of achievement. During her tenure, the faculty’s credentials had been strengthened, undergraduate education revitalized, and, with the initiation of doctoral education, the school had moved into the elite ranks of schools offering doctoral education in the country. The ability of faculty during her tenure to devise funded innovative educational and research projects that improved patient services and nursing education enhanced the school’s reputation for excellence. As dean, Chioni officiated at fourteen graduation ceremonies on the Lawn and Rotunda steps and gave almost 2,500 U.Va. diplomas to nursing graduates. When Chioni retired in 1995, after twenty-one years of University service, she could look back at two decades of significant achievement for the school. She, as dean, had provided the leadership needed to move the organization closer to becoming one of the premier universities of academic and research distinction in the nation.
Dr. Faye Raines, because of her administrative experience in the organization, was appointed acting dean in January 1989 to replace Chioni. Raines, a 1971 graduate of the U.Va. BSN program and a 1974 graduate of the MSN program, also possessed a PhD in nursing from the University of Maryland (1987). A close associate of Chioni for many years, she worked effectively with the University administration and nursing faculty to ensure continuity in the educational programs until a new dean was selected. As leader of the nursing school, she participated in the official dedication ceremony for the opening of the new University replacement hospital on April 14, 1989.
After an extensive review of candidates, the search committee recommended that Dr. B. Jeanette Lancaster, professor and dean of Wright State University, Miami Valley School of Nursing, be appointed as the school’s new dean. The Board of Visitors appointed Lancaster dean and the third Sadie Heath Cabaniss Professor of Nursing, effective September 1989. Raines, after leaving the dean’s office, assumed her previous role in the school as the associate dean for academic programs. In July 1990 she resigned her position to become the dean of nursing at the University of Arkansas at Huntsville.
The school’s need for an experienced administrator who possessed a vision of the role nursing must play in the changing health system and the intellectual and personal skills to lead the school into the twenty-first century was paramount in the University’s quest for a new nursing dean. Having recently completed a successful five-year term as dean of Wright State University, Miami Valley School of Nursing, Dr. Jeanette Lancaster possessed these qualities plus an impressive level of academic scholarship. In addition, she was refreshingly enthusiastic about establishing new partnerships within the University and medical center that would enrich the educational and research strengths of the school. The challenge of enlarging the amount of clinical research and scholarship being done in the school was particularly attractive to her.
Similar to previous Virginia deans, she knew early in her career that she wanted to be an educator and dean, especially at a distinguished Southern school.149 A 1966 baccalaureate nursing graduate from the University of Tennessee, she quickly acquired a master’s degree in psychiatric-mental health nursing from Case Western Reserve University in 1969. In 1977 she completed PhD requirements in public health at the University of Oklahoma. Along her path to Virginia she also gained valuable faculty and administrative experience at Texas Christian University and the University of Alabama, Birmingham.
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Unlike prior Virginia deans, however, Lancaster represented a new type of nursing leader—a married woman who had managed a successful professional career plus the responsibilities of marriage and parenthood. Her husband, Wade, was professor of marketing and her two daughters, Melissa and Melinda, were college students. As dean, Lancaster served as an excellent role model for nursing students at all levels to emulate in their own professional careers.
Working closely with faculty to master the operation of the school and navigate the complexities of the medical center and the University, Lancaster focused her energies on developing a strategic long-range plan for the school. Two immediate objectives of the plan included increasing the number and diversity of the student body and securing additional faculty noted for their ability to devise innovative nursing research. In her role as associate director of Patient Care Services in the medical center, she actively supported the director of the Division of Nursing, Dr. Sorrells-Jones, in creating a new model of professional nursing. The model they developed provided staff nurses the autonomy to set clinical nursing standards and it rewarded expert nurse clinicians for remaining involved in patient services and serving as mentors for young staff.
Unfortunately the downward trend in the state’s economy in the early 1990s forced drastic cuts in the University’s budget and diminished the school’s ability to build academic and research depth in many of its clinical areas. Faced with the knowledge that the state’s support of its public universities was diminishing, the University committed its resources to mount a major fund-raising campaign beginning in 1993. Lancaster quickly recognized that the school’s plans to sustain its academic excellence and become a nationally recognized research institution depended on its ability to acquire additional funds. At this point she became the architect of a radically new role for a nursing dean in a public institution, that of chief fund-raiser. She, with Linda Davies, the director of development, set the stage for the school’s participation in the University’s fund drive by launching two major initiatives: the creation of a School of Nursing Advisory Board and the development of a vigorous partnership with the Nursing Alumni Association. The Advisory Board, created in 1991, was composed of alumni, faculty, business, and professional leaders interested in serving the school. Chaired by Rebecca Rimel, president of The Pew Charitable Trusts and a 1973 U.Va. nursing baccalaureate graduate, the board quickly assumed its task of providing the school with advice on ways to approach, cultivate, and acquire financial support from corporations, philanthropic foundations, and private donors.150
Recognizing the accomplishments of the alumni and their pride in being U.Va. graduates, Lancaster joined forces with the nursing alumni association to develop a closer bond between the school and its graduates. By 1992 the first signs of success from the initiatives were visible when almost one million dollars in private gifts was committed to the school and $75,000 was raised through the alumni annual giving program. The funds quickly
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flowed into new student scholarships, faculty research and teaching awards, and needed educational technology.151 Clearly, a mechanism was in place that ensured the school financial benefits from the University’s campaign drive. In 1995, at the public announcement of the University’s Capital Campaign, the Advisory Board boldly declared that the school’s goal for the drive was $5.1 million.152
In a move to make the school more visible in the University community, Dean Lancaster accepted the Board of Visitors’ invitation to reside with her family in Pavilion II on the Lawn. Her move to the Pavilion, in August 1991, marked the first time in the history of the University that a nursing dean lived on the Lawn. Having the dean in residence on the Lawn generated a sense of pride among the nursing alumni, faculty, and students, and it provided the school a wonderful opportunity to showcase many of its educational and social events in the heart of Mr. Jefferson’s University.153
In 1990 several faculty research initiatives received federal funding. The initiatives examined a variety of methods to provide needed mental health services to patients in rural communities. The research led to an improvement in the health services available in the community and it provided excellent opportunities for doctoral students to embark on their research careers. To further capitalize on the research strength in the school, Lancaster supported several faculty in developing research centers of excellence.
The creation of research centers was a mechanism many nursing schools had found helpful in increasing the productivity and quality of their nursing research. In addition, the ability of centers to initiate and sustain innovative interdisciplinary research that led to improved patient care had earned national prominence for several of the schools.
Two faculty groups accepted Lancaster’s invitation to establish a center. In doing so they accepted the conditions under which a center might exist: it must produce significant nursing research/scholarship and generate the funds necessary to sustain its operations. The first center opened in the school was the Center on Aging and Health in 1990. Directed by Dr. Ivo Abraham it was funded by the Department of Health and Human Services, Health Resources and Services Administration. In 1991 the Center for Nursing Historical Inquiry, directed by Dr. Barbara Brodie and co-directed by Dr. Arlene Keeling and Sylvia Rinker, was opened. The history center represented the school’s first research enterprise that was primarily
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dependent on private donations and foundation support. The centers, one focused on the clinical needs of the elderly and the other on the preservation and study of nursing history, represented the diversity of nursing scholarship found within the faculty.154
The Southeastern Rural Mental Health Research Center, opened in 1992 and directed by Dr. Jeanne Fox, and the Center for the Study of Complementary and Alternative Therapies, opened in 1995 and directed by Dr. Ann Gill Taylor, were two highly innovative nursing research enterprises. The rural mental health center, funded by the National Institute of Health, National Institute of Mental Health, represented a joint effort between the University and rural Virginia mental health and medical clinics to improve the health care of impoverished minority patients, the elderly, mentally ill, and women and children.155 The Center for Complementary and Alternative Therapies, funded by the National Institute of Health, National Institute of Dental and Craniofacial Research Division, represented nursing’s commitment to examining the use of complementary non-medical therapy in the treatment of patients. Its major focus was on exploring the possible effectiveness of alternative therapies in the treatment of patients with chronic pain or cancer pain.156 Both centers represented a unique form of nurse-directed interdisciplinary investigative enterprises.
To help support the research productivity of the centers and that of individual faculty members, Lancaster also revitalized the Center for Nursing Research in 1994. In addition to appointing Dr. Barbara Parker as its director, she provided additional funds to support faculty in the initial stages of their research projects. Through these measures the quality and quantity of the school’s research reached new heights. Information from these projects soon made its way into the school’s educational programs and the profession, and it helped to improve the quality, accessibility, and efficiency of nursing care provided patients.
For years the faculty had wrestled with ways to become more directly involved with patient care so they might utilize this experience to better educate the students and focus their research. In the early 1990s several faculty practice plans had been tried and found fruitful but limited. In 1993 the school created its first faculty practice center as a formal method by which faculty were afforded the opportunity to independently provide health care to patients in the community. This center, known as the Primary Care Nursing Center, was directed by Dr. Doris Glick and funded by the Department of Health and Human Services, Health Resources and Services Administration.157 The nursing center was a nurse-managed group of three health clinics based in Charlottesville and nearby Greene County. In the two Charlottesville clinics, health services were provided by nurse practitioners to the elderly and disabled in a city-subsidized low-income facility, and to mothers and young children in
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a low-income neighborhood. The Greene County clinic provided free health care to school-aged children in the Greene County school system. The primary care center and the research centers, for over a decade, provided unique educational opportunities for undergraduate, master’s, and doctoral students interested in acquiring beginning clinical research skills or in caring for patients in nursing clinics.
Throughout the 1980s the school responded to requests from Radford University and Clinch Valley College of the University of Virginia for help in developing their nursing programs. U.Va. faculty taught several off-Grounds master’s level courses in 1989–90 to aid Radford in developing a nursing graduate program. The school’s history of working with Clinch Valley College of the University of Virginia in Wise County dated back to the mid-1950s.158 For many years Clinch Valley students interested in nursing transferred as third-year students to the U.Va. program, but in 1989 a formal request for help in creating a Clinch Valley undergraduate program was conveyed to Lancaster. For the next two years the dean and Dr. Betty Johnson provided curriculum consultation and manpower to develop the program. In fall 1991, Johnson resigned from the University to accept the chairmanship of the Department of Nursing of Clinch Valley College.159
Responding to the dramatic changes occurring in the health care system, the faculty assiduously engaged in evaluating the quality and pertinence of the educational programs throughout the 1990s. Faculty was guided in this endeavor by two educational principles.
The School of Nursing instilled in me a sense of pride in the nursing profession ... Something that is not always valued as much as it should be. It has served as a firm foundation for me to build upon. The accessibility and mentorship of professors, clinical experiences, and friendships with other students helped to support me on my journey.
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First, the nursing programs had to remain academically and clinically rigorous to prepare graduates to meet the current health needs of patients. Second, they must be visionary enough to ensure that the graduates were capable of developing new nursing interventions as therapies changed. To accomplish these tasks, the faculty renewed their efforts to generate in the students a sense of pride in their ability to provide nursing care and an understanding of the scientific and psychological theories that supported the growing sophistication of patient care.
One of the more significant academic changes that took place in the 1990s involved the integration of electronic technology into courses. The development of computer-based courses and distance learning telecommunication programs allowed nursing students easier access to academic opportunities. Two innovative distance learning telecommunication projects, developed by Dr. Julie Novak and funded by the Virginia Health Foundation in 1996 and the Department of Health and Human Services, Health Resources and Services Administration in 1997, brought nurse practitioner graduate education to the southwest and northeast areas of Virginia.160, 161
University of Virginia President John Casteen’s interest in further expanding the University’s international educational programs in the early 1990s encouraged Lancaster and the faculty to seek ways for the school to establish an international health care program. A result of this exploration was the creation in 1995 of a unique experience for students interested in broadening their knowledge about health care systems in other countries. Using the University’s Office of International Studies’ Summer Study Abroad Program at Oxford, England as its sponsor, a six-week academic program was co-designed by U.Va. and Oxford faculty. The program, Comparative Health Care: Britain, Europe and North America, provided an overview of many of the factors involved in the delivery of modern health care in different Western counties. In 1998, admission to the program was opened to students from other American universities, thereby broadening Virginia students’ contact with fellow health care students. Since its initiation the program has attracted second-year and third-year students, faculty, and alumni, and the nursing alumni association has generously provided scholarship aid to the nursing students.162
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As the school moved into the twenty-first century, the benefits of the Campaign for the School of Nursing began to surface. Lancaster’s decision in 1994 to delegate the administration of the academic programs to Associate Dean Dr. Doris Greiner while she devoted a substantial portion of her time to the task of securing additional funds proved quite beneficial for the school. The school’s original goal of $5.1 million to be raised by the year 2000 was exceeded in 1997, three years ahead of schedule. A new goal of $10.2 million was established and the campaign timeline extended through 2001. In June 2000, the school had raised $12.9 million in donations, with eighteen months remaining before the campaign ended on December 31, 2001.163
To appreciate the success of the campaign, the funds need to be viewed as a financial investment in the school’s future. The school’s private assets before the initiation of the campaign were quite limited—especially in two areas that are crucial to assuring the organization the ability to recruit the nation’s best students and faculty to Virginia: student scholarships and endowed professorships.
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In the 1986–1987 academic year, only seven nursing students received private scholarship aid of $1,000 each. By the 1999–2000 year, 121 students (undergraduate and graduate) received private scholarship support totaling more than $220,000. This support was crucial for many students because the rising tuition costs had begun to limit the ability of families to send their children to Virginia.164
In 1991, the school possessed only one endowed professorship, the Sadie Heath Cabaniss Professor of Nursing. The chair, established in 1928, has been held by the school’s dean since 1966. By 2001 there were eight endowed professorships established.165
The results of the campaign gave the school the academic edge to attract established nurse researchers nationally known for their ability to create new nursing knowledge and transmit it to the next generation of nurses. In developing a cadre of eminent scholars the school will be able to move into the vanguard of distinguished institutions. The student scholarships already have proven successful in the school’s ability to attract academically gifted students, regardless of their financial abilities, who possess the greatest potential for leadership in the profession.
This historical examination of the school has focused primarily on the school’s directors and the advances in nursing education that have occurred during their tenure. It is recognized, however, that the school’s successes over the decades were the result of a dynamic interaction among the directors, faculty, and students. It was this triad that gave life to the institution in 1901 and shaped its progress through the century. Fortunately the school has a rich tradition of attracting dedicated professional directors, educators, and intelligent students eager to learn the science and art of nursing.
A brief review of the demographics of the student body in the 1999–2000 academic year serves as an example of the students’ academic qualifications and ethnic and racial diversity. There were 488 students enrolled in the school’s three degree and one post-master’s nurse practitioner programs. The largest program in the school was the undergraduate program, with 312 students (their average Scholastic Aptitude Test score was 1220). The program was
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composed of three groups: generic, second-degree, and registered nurse students. Although the second degree and registered nurse students were older (on average thirty years of age) than the typical student, the average age of a baccalaureate student at graduation was twenty-four years. The average age of baccalaureate graduates in the nation, in 1996, was twenty-six years.166 Virginia graduates were two years younger than the norm. The University of Virginia’s reputation as a premier public educational institution accounts for this age difference. The University’s academic prestige appeals to large numbers of bright, talented eighteen-year-old applicants and allows the school to admit many of them into its first-year class.
The master’s program had ninety-nine students enrolled in seven different tracks: Adult Health; Critical Care Clinical Nurse Specialist; Acute Care Nurse Practitioner; Community Health; Psychiatric-Mental Health; Primary Care (Family and Pediatric Nurse Practitioners); and Health Systems Management. The students were graduates of private and public universities; most were married or divorced and had young children. They had over a dozen years of professional experience prior to their returning to school and about twenty-five percent of them were part-time students. In addition, about twenty percent of students were commuters with homes and jobs in distant Virginia localities. Their average age at graduation was thirty-five years.
The doctoral program, with thirty-nine students, had the most experienced group of professional nursing students in the school. Many of them held bachelor’s and master’s nursing degrees from universities outside Virginia and most were employed as nursing faculty in universities and colleges in Virginia. About ninety percent of the doctoral students were married or divorced and had children who were either high school or college students. The doctoral graduate student’s average age at graduation was forty-five years.167
In the University of Virginia May 2000 graduation ceremony, 121 graduates received nursing degrees: ninety-nine baccalaureate; nineteen master’s; and three PhD.168
Although the student body was primarily female (ninety-three percent) and white (eighty-four percent), the number of minority students (sixteen percent) indicated an increase in the
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The memories [of my time at U.Va.] will last a lifetime. The walk down the lawn was very emotional for me. Each step reminded me of the hardwork, the long nights, and the incredible satisfaction of realizing my dream
last few years.169 During this period the University intensified its efforts to recruit African American, Asian, Hispanic, Pacific Islander, and Native American students to all of its schools. The changing nature of the country’s ethnic and racial populations, plus the profession’s need to replace the large number of nurses retiring from the labor force, expected to begin in 2010, will ensure a steady increase in the number of minority students in the school over the next few years.170
Having examined pertinent demographic information on the current student body, it is worthwhile to go beyond this data and explore how today’s students might differ from previous generations of nursing students. At first glance it is easy to observe that contemporary students, especially undergraduates, dress differently than previous students of even a dozen years ago. In place of attractive skirts and blouses, dresses for the women, and shirts and dress slacks for the men, today’s young students’ usual classroom attire is very casual and unisex: a tee shirt, denim pants/shorts, running shoes/sandals, often topped off by a baseball cap. The students’ sense of decorum and attendance at class is sometimes as casual as their choice of clothing until reminded by faculty what is expected of a U.Va. nursing student.
This casualness in dress also extends to their student nursing uniform. Prior to 1998 students did not have a standard uniform but wore a wide variety of colored tops (i.e.
The School of Nursing Moves into its Second Century: 1989-2001 ◼ 99
scrubs, patterned jackets, and polo shirts) with white slacks and shoes. After acknowledging that their casual uniform attire often confused patients and staff who could not identify them as U.Va. nursing students, they decided to again adopt a standard U.Va. student uniform in 1998. The current student-designed uniform consists of white slacks or skirt, a blue short-sleeved cotton polo shirt, a white lab coat jacket, and white shoes. An orange U.Va. nursing school logo appears on the polo shirt and jacket.
These superficial differences in clothing aside, it is important to note in what areas today’s nursing students are comparable with previous students. Current students choose to enter nursing because they want a career that is dedicated to caring for those in need. They view the nursing school as able to prepare them to care for the ill, bring comfort to the dying and chronically ill, and teach them ways to help people remain well. Interestingly, this desire to help others has been a predominant characteristic of every generation of U.Va. nursing students. It was this desire that attracted the first four young women who entered U.Va.’s newly established hospital diploma program in 1901.
The fact that students in 2000 select a nursing career is even more impressive when it is recognized that they have many more career options than previous generations. Intelligent, competent, undergraduate students may select from among hundreds of interesting careers, many of which serve humanity in various ways. The fact that female and male students still select to become nurses indicates that they, like previous generations, possess a personal ethic for altruism and a strong commitment to helping people in need of
100 ◼ Mr. Jefferson's Nurses
nursing care. This same observation can be made for the graduate students. When they decided to return to school, they again had the option of choosing a career other than nursing. In selecting to pursue advanced nursing education, they re-committed themselves to remain in the nursing profession.
A century of U.Va. nursing education has been built on the students’ personal ethic of altruism and sense of responsibility to others. In each decade of the school’s existence, students were taught the latest in medical knowledge and professional nursing care known at the time. Embedded in the nursing program from the very beginning were the core values of professional nursing. The responsibility of nurses to respect the dignity of patients and to treat them in an ethical and just manner were and are two of the more fundamental nursing values consistently taught. These values have guided generations of Virginia graduates in their treatment of patients. These values also have served, for many, as guidelines for
The School of Nursing Moves into its Second Century: 1989-2001 ◼ 101
their personal lives and aided them as they matured into responsible and respected members of society.
The school has offered and continues to offer multiple benefits to its graduates. It prepares them for professional careers that can be practiced across the globe, and it provides many social and professional opportunities for their personal growth and satisfaction. The graduates’ success at becoming leaders in the profession and beyond, and in creating new careers for nurses, can be attested to in many ways: identifying the health organizations administered by Virginia graduates; reviewing the nursing literature written by Virginia alumni; or simply by examining the nursing alumni directory. 171
Students also have taken advantage of opportunities at Virginia to expand their understanding of society beyond nursing and the medical world. Many developed personal friendships with classmates that have lasted a lifetime. A significant number of students have also managed to date, fall in love, and marry other Virginia students. These friendships and marriages have enriched their lives, and the warm memories they have of their student days at Virginia have kept them close to the University.
From the school’s beginning in 1901, when nursing was primarily a domestic vocation with little understanding of medical science, the school’s directors were committed to educating nursing students to become intelligent, dedicated, and compassionate caregivers. Steeped in a long tradition of viewing nursing education as “apprenticeship to duty” that carried obligations to the hospital and physicians, the early directors struggled to hold fast to their belief that nurses would, in time, become full members of the professional health care team. In spite of the many obstacles they faced, the directors built a strong nursing school that prepared graduates to function as private duty nurses, staff nurses, or public health nurses in a variety of institutions and agencies. The directors also instilled in the graduates a sense of confidence in their ability to provide care in multiple settings and under difficult conditions, such as during the country’s major wars. They also instilled in them the competency and confidence to assume nursing leadership positions in education, service institutions, professional organizations, and their local communities.
Although not every early director of the school possessed the skill and courage to balance the hospital’s demand for student labor against the students’ need for a quality educational program, Virginia was blessed with a few visionary talented directors. It was those women who recruited the college-educated faculty and who, by creating nationally-accredited
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programs, sustained the school’s drive to transform the hospital school into an independent, autonomous, University nursing school. In doing so, Virginia graduates continued to be well educated and capable of advancing the profession to the vital position it holds in today’s health care system.
The school’s reputation as being one of the finest nursing schools in the South has endured for a century. Within the last thirty-five years its reputation has spread beyond the South, and faculty and students from across the country and foreign nations now come to the University of Virginia to grow in its rich educational soil. Its reputation as a source of innovative nursing research is slowly growing. As the school extends its success in acquiring the private and government resources necessary to attract talented nursing researchers and sustain their research projects over time, it will take its place in the top-ranked nursing institutions in the country.
The twenty-first century for the University of Virginia School of Nursing will offer great opportunities and pose unknown challenges and problems. The school’s ability to maximize its opportunities and conquer its challenges during the new century may be strengthened by the knowledge of the school’s successful first hundred years of existence. What is clear from examining the past is that the vigor, vitality, and growth of the school is dependent on the intelligence, commitment, and creativity of its directors, faculty, and students and the support of its alumni. It is a living legacy that is graciously bestowed from those who shaped the school for a century to those who will carry it through the exciting and challenging twenty-first century.
Appendix ◼ 105
Charlotte E. Martin, RN
Superintendent of Nursing – Early 1901 to September 1901
(Hospital opened April 13, 1901)
Florence Eugenia Besley, RN
Superintendent of Nursing – 1901 to 1907
(School opened September 1901)
Mary Jane Hurdley, RN
Superintendent of Nursing – 1907 to 1913
Tabitha S. Grier, RN
Superintendent of Nursing – 1913 to 1916
Margaret Beaud Cowling, RN
Superintendent of Nursing – 1916 to 1918
Isabele Ann Craig-Anderson, RN
Acting Superintendent – 1918 to 1919
Superintendent of Nursing – 1919 to 1920
Margaret Beaud Cowling, RN
Superintendent of Nursing – 1920 to 1924
Josephine Sarah McLeod, BA, RN
Superintendent of Nursing – 1924 to 1937
Claire M.J. Wangen, BS, MA, RN
Superintendent of Nursing – 1937 to 1941
Virginia Hassertine Walker, BA, RN
Director of Nurses and Nursing Services – 1941 to 1946
Roy Carpenter Beazley, BSNEd, MA, RN
Director of Nursing Education and Department of Nursing Services – 1946 to 1952 (Last Dual Director of Nursing Education/Services)
Director, Department of Nursing Education – 1952 to 1953
(Diploma, BSN, BSNEd Programs)
Director, Department of Nursing Services – 1952 to 1969
Professor Emeritus – 1969
Mary Walker Randolph, BSNEd, MA, RN
Acting Co-Director, Department of Nursing Education – 1953 to 1954
(Diploma and RN-BSN Programs)
Evelyn Crary Bacon, BSN, MS, RN
Acting Chair, Department of Nursing Education – 1954 to 1956
Louise Oates, BS, MA, RN
Chair/Professor – 1928 to 1952
Mary Walker Randolph, BSNEd, MA, RN
Coordinator – 1952 to 1953
Margaret Gould Tyson, BSNEd, MA, RN
Acting Dean – September 1956 to 1958
Appointed Dean – July 1958 to 1961
Zula Mae Baber, BSNEd, RN
Acting Dean – 1961 to 1962
Margaret Gould Tyson, BSNEd, MA, EDD, RN
Dean – 1962 to 1964
Zula Mae Baber, BSNEd, RN
Acting Dean – 1964 to 1966
Mary M. Lohr, EDD, RN
Dean and Sadie Heath Cabaniss Professor of Nursing – 1966 to 1972
Phyllis Jean Verhonick, EDD, RN, FAAN
Acting Dean – June 1972 to 1974
Rose Marie Chioni, PhD, RN, FAAN
Dean and Sadie Heath Cabaniss Professor of Nursing – 1974 to 1988
Professor Emeritus – 1988
Cynthia Faye Mundie Raines, PhD, RN
Acting Dean – January 1989 to August 1989
Barbara Jeanette Lancaster, PhD, RN, FAAN
Dean and Sadie Heath Cabaniss Professor of Nursing – 1989 to present
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Names of the Nursing Alumni Association are unknown prior to 1934
|Rebecca McGovern Lee||1934|
|Ruth Smith Snavely||1941|
|Lois Houser Deinet||1946|
|Carmen Scannell Bouchard||1949|
|Anna Pollock Hemmings||1950|
|Alice Barnes Taylor||1951|
|Naomi McCormick Coffman||1952|
|Frances Jean Dettor Pultz||1954|
|Emma Jean Apodaca Wilson||1955|
|Pat Lilley Howell||1956|
|Betty Harlow Breeden||1957|
|Betty Norman Norris||1959-60|
|Gladys Walker Harris||1961|
|Ann Beddall Kayan||1962-63|
|Susan Deane Tatum||1967|
|Harriett Lee Nash||1968-70|
|Kathryn McKee Hammond||1971-72|
|Melanie Snell Hitch||1972-73|
|Betty Norman Norris||1973-76|
|Ellen Kattan Herwig||1976-78|
|Ellen Rudy Clore||1980-82|
|Linda Raker Rogers||1982-84|
|Janis C. Childs||1984-86|
|JoAnne Hutchinson Peach||1986-88|
|Susan Gregory Landin||1988-90|
|Mary Eure Fisher||1990-92|
|Linda Custard Gillikin||1997-98|
|Sue Childers Taylor||1998-01|
Eleanor C. Lambersten, EdD, DSc, RN, FAAN
September 24, 1976
Nurses, Patients and Pocketbooks
Vernice Doris Ferguson, MA, RN, FAAN
September 23, 1977
The Authority for Nursing – A Professional and Societal Imperative
Cicely Mary Strode Saunders, OBE, FRCP, MA, MD
October 4, 1978
The Hospice Movement
James F. Childers, BD, MA, PhD
September 28, 1979
Ethical Issues in Human Care
Robert A. Merril, AB, BA, MA, LLB
October 17, 1980 The Role of Government in Regulating Access to Health Care: Freedom of Choice
Marilyn Goldwater, RN
September 25, 1981 The Politics of Health Care
Ingebord G. Mauksch, PhD, RN, FAAN
October 27, 1982 Re-Unification – A Time to Examine the Merging of Nursing Service with Education
Jessie M. Scott, DSc, RN, FAAN
October 19, 1983
Credentialing in Nursing: Past and Future
Rita M. Carty, DNSc, RN
October 12, 1984
Nursing in the 21st Century
Lucie Young Kelly, PhD, RN, FAAN
November 1, 1985
Olga Church, PhD, RN, FAAN
September 19, 1986
From Ambiguity to Autonomy: Historical Disabilities and Future Directions in Nursing
Donna Kaye Diers, MSN, RN, FAAN
September 25, 1987
Changing the Challenge
Appendix ◼ 107
Sue T. Hegyvary, PhD, RN, FAAN
September 30, 1988
Challenges and Opportunities in the Practice of Nursing
B. Jeanette Lancaster, PhD, RN, FAAN
October 27, 1989
Is Anyone Listening to the Future?
Mary Mallison, BSN, RN
November 2, 1990
Celebrating Ourselves – Nurses as Heroes
O. Marie Henry, DNSc, RN, FAAN
October 4, 1991
The Nation’s Health
Mariann Stratton, MSN, RN
October 23, 1992
Nursing 1992: Change, Challenge and Success
Susan Cramer, MSN, RN
October 22, 1993
The Cadet Nurse Corps Revisited: A Celebration of Success
Karen Whipp Connelly, MPA, RN
September 30, 1994
Positioning for the Future: Public Health Nursing Reform
Kristine Gebbie, PhD, RN, FAAN
October 20, 1995
Lessons for Nurses and Lessons from Nursing from the HIV Epidemic
Hila Richardson, DrPH, RN
October 18, 1996
Substance Abuse and Health Care in America
Julia Balzer Riley, MN, RN
October 24, 1997
I’ve Been Upsized, Downsized, Right Sized and Merged, and I Keep Going, Going and Going
Virginia Trotter Betts, MSN, RN, JD, FAAN
October 14, 1998
Health Professional Activism: Securing Quality Care for Patients and Communities
Frances M. Lewis, PhD, RN, FAAN
October 13, 1999
Families and Cancer: Their Lived Realities, Needed Services, and Future Directions for Research
Christine Miaskowski, PhD, RN, FAAN
October 11, 2000
Improving Pain Management: An Ongoing Journey
108 ◼ Mr. Jefferson's Nurses
A full reference citation is given at the first mention of each source. The School of Nursing papers cited are composed of three major groups: 1) the School of Nursing Archives Collection (SON Archives) is found in the University of Virginia Claude Moore Health Sciences Historical Collections; 2) School of Nursing historical papers not yet archived (SON Papers) are in the Center for Nursing Historical Inquiry (CNHI); and 3) the school’s active official documents (SON AD). The SON AD are found in the dean’s suite in McLeod Hall. Taken together, the published works, manuscript collection, interviews, active official documents, and archival record groups cited comprise the complete bibliography of the sources used.
Appendix ◼ 109
110 ◼ Mr. Jefferson's Nurses
Appendix ◼ 111
112 ◼ Mr. Jefferson's Nurses
Note: Page numbers of photographs are in boldface.
Appendix ◼ 113
Barbara Brodie holds an undergraduate degree from Loyola University, Chicago, a masters degree from Boston University with a major in maternal-child nursing and a doctorate in educational psychology from Michigan State University. In 1970 Brodie joined the University of Virginia School of Nursing. In the classroom and in clinical settings, she has touched the lives of hundreds of students. In fact, many U.Va. graduates who are now nurse leaders credit Barbara Brodie for much of their professional development. She is currently the Madge M. Jones Professor of Nursing and director of the Center for Nursing Historical Inquiry.
Brodie is recognized throughout the University and the nursing profession for her many academic accomplishments, including the authorship of numerous publications, presentations, and research on pediatrics, nursing history, nurse practitioners and doctoral education. She is a fellow of the prestigious American Academy of Nursing, and serves on the editorial boards of several nursing journals and publications. She is a member of the University's Raven Society and was elected and honorary alumna of the U.Va. School of Nursing in 1986.
Throughout her career, Brodie has demonstrated a passion for the preservation of nursing history. For over fifteen years she has been actively involved in the American Association for the History of Nursing, serving as its president from 1990 to 1993. Her love of history and the nursing profession were culminated in the creation of the Center for Nursing Historical Inquiry in 1991, a national center dedicated to the preservation and protection of nursing history for the purpose of academic and historical research.
Susan Swasta, PhD
Karen Jordan Ratzlaff
Editor and Project coordinator
Lee Brunjes & Joe Nasevich
This book was printed with private funds.