After 1872, the New England Hospital had a new building and a new doctor in charge of the nurses’ training program. Dr. Susana Dimock, a protégé of Zakrzewska’s who had trained at the University of Zurich and done clinical work in Vienna and Paris before returning to Boston, created a more formal one-year training program, based on the methods used at Kaiserwerth, where Florence Nightingale studied twenty-one years before. Over the course of the year, nursing students rotated through the different departments of the hospital, spending three months each in the medical and surgical wards, the children’s wards, the maternity ward, and on night calls. This practical training was supplemented by a course of twelve lectures on the theory of nursing given by staff doctors at the hospital. At the end of the year, the school required students to work at the hospital for four months before they received their diplomas. The program grew rapidly in response to an expanding demand for trained nurses, and by 1889 the school was successful enough that it required a separate building to house students, who had previously slept in small rooms next to the wards.
In the five years between 1877 and 1882, two hundred women applied for admission; one hundred were accepted. Dimock’s requirements for admission were just as strict as Dix’s requirements had been as for the nursing corps. Like Dix she demanded written character references, but unlike Dix, she wanted students between twenty-one and thirty-one. As she explained her reasoning, “Younger than this, neither physical health nor judgment are sufficiently developed, older, it is not easy to acquire new habits.”19 In short, she wanted women who were younger and less set in their ways than the Civil War nurses who made Americans aware of the need for trained hospital nurses.
In 1873, just as Dimock’s first class of nurses graduated, three new nursing schools opened: the New York Training School, attached to Bellevue Hospital; the Connecticut Training School, attached to New Haven Hospital; and the Boston Training School, attached to Massachusetts General Hospital. All three offered programs based on Florence Nightingale’s school at St. Thomas Hospital in London. Two of the three schools were founded by women who either nursed or worked for the Sanitary Commission.
The New York school was the first of the three to open, on May 24, 1873. The New York Training School for Nurses had its roots in Louisa Lee Schuyler’s work as the chair of the New York branch of the Sanitary Commission. At the age of twenty-four, Schuyler was by far the youngest of the branch managers; in fact, she was chosen over her mother for the position. She would later claim her experience with the commission laid the groundwork for her long and successful career as a reformer, saying the commission “opened my eyes to the great value and the great power of organization.”20 After the war, Schuyler applied her skills as an organizer to reforming New York’s state asylums, prisons, poorhouse, schools, and other loosely defined “charitable institutions.” In 1871, she formed the State Charities Aid Association (SCAA), a formidable group of women who combined intelligence, education, and social position with practical experience from their days with the Sanitary Commission and the Woman’s Central Association of Relief. Schuyler’s organization used a combination of personal inspections by association committees and detailed statistics, sometimes derived from an institution’s own reports, to push through reforms, often in the face of opposition from politicians and administrators.
One of these committees was assigned to investigate Bellevue Hospital and was horrified by what they found. The SCAA reached the conclusion that many of the hospital’s problems were due to the nursing service, which relied on the infamous “ten-day” women serving out their parole for public drunkenness. Meaningful reform of the hospital would require more trained nurses than were available. Inspired by the success of Nightingale’s school in London, the SCAA suggested forming a nursing school attached to the hospital. They received no encouragement from the local medical community, who rejected the idea on the grounds that the quality of the patients was too rough. One doctor said plainly, “I do not believe in the success of a training school for nurses at Bellevue. The patients are of a class so difficult to deal with, and the service is so laborious, that the conscientious, intelligent woman you are looking for will lose heart and hope long before the two years of training are over.”21 Not discouraged, Schuyler’s ladies sent a young physician, Gill Wylie, to London to learn more about Nightingale’s school firsthand. On his return, Wylie recommended to the SCAA that a similar school be established at Bellevue, and that the governing board invite Nightingale’s school to send some of its nurses to New York to help. Doctors associated with the hospital resisted, despite the AMA’s endorsement for training nurses. One of the concerns these doctors raised was the fear that, in the absence of medical licensing laws, women trained as nurses would go out into the country and set themselves up as doctors. Hospital wardens and politicians also opposed the proposed school, wardens because it threatened their control over hospitals, and politicians because they feared it would reveal instances of corruption and abuse. The existing “ten-day” nurses were not too happy about the new program either; they reportedly lived up to their rough reputation by cursing and throwing stones at the student nurses.
The SCAA prevailed. The group raised the money needed to start the school, rented a house near the hospital for nursing students to live in, and hired Sister Helen Bowden of the Sisterhood of All Saints to run the program. Admissions policies were stringent: only twenty-three of the seventy-three original applicants were accepted, and ten of them were dismissed within the first nine months.
The Connecticut Training School for Nurses at New Haven Hospital was also inspired by the absence of trained nurses. A group led by Georgeanna Woolsey met on May 21, 1873, with the purpose of appointing a superintendent of nursing for the hospital. They found it a difficult task because of the small number of experienced nurses available and decided they needed to train their own. They started with a smaller pool of applicants than their New York counterparts. Of the twenty-one applicants for the first class, they accepted six, two of whom withdrew before the school opened on October 6, 1873. The next year they received nearly a hundred applications.
The Boston Training School for Nurses at Massachusetts General Hospital opened in November 1873, and, like their counterparts in New York and New Haven, faced opposition from most of the staff physicians. The school began with six students, who were allowed to work in two wards as an experiment. Mary Phinney von Olnhausen served as the school’s superintendent for a brief time after her return from Europe. She was not a success. Even her nephew, who was a child at the time, “could see that his aunt had not the qualifications essential for the post, which, with unflagging zeal, she was trying so enthusiastically to fill.”22 Von Olnhausen resigned in November 1874, to the relief of all concerned. After holding several other nursing-related positions, she returned to her roots as a textile designer, supporting herself as a designer and maker of embroideries.
Von Olnhausen was replaced by Linda Richards, one of the first women to receive a nursing diploma from Susan Dimock’s program at the New England Hospital for Women and Children. Richards held the position for the next two and a half years. During her tenure, the school assumed responsibility for nursing for the entire hospital, and ten years after its founding, the school had forty-two students and twelve nurse-instructors.
By 1880, there were a total of 15 nursing schools in the United States; by 1900, there were 432. Nursing had become recognized as a skilled profession.
Dorothea Dix Lays Her Burdens Down
During the four years of the Civil War, Dorothea Dix butted heads with officialdom, quarreled with military surgeons and the men who ran the Sanitary Commission, lost weight, and suffered from a variety of ailments, including malaria and pulmonary disorders, but she never faltered. Even after Hammond’s General Order 351, issued in October 1863, gutted her authority, she continued to work on behalf of nurses and hospitals for the duration of the war without a single leave of absence.
Di
scharged along with her nurses on September 11, 1865, Dix wrote to her lifelong friend Anne Heath that, though she resigned from the office of superintendent of women nurses, she had no intention of stopping work. She was eager to abandon what had become a thankless task and return to her life’s work helping the helpless, but she recognized there was little point in resuming her role as an advocate for asylum and prison reform as long as state legislatures focused their time and resources on rebuilding their economies and institutions after four years of war. Instead she stayed in Washington, where she appointed herself a one-woman relief agency, putting in long days calling in small favors from her vast network of contacts. Her favorite task was helping disabled soldiers and nurses left invalided by their work in the war to find their way home. She also helped soldiers collect back pay, found food and clothing for poor veterans and their families, searched for homes for war orphans, and occasionally used her contacts to help families locate soldiers missing in action.
Her last war effort was a granite monument to the Union war dead at Fort Monroe. When a committee of war veterans asked for her help with the project, she not only raised a substantial amount of the needed funds, but played an active role in its design. She spent weeks visiting quarries in Maine in order to choose the perfect granite. A fence constructed of stone and armaments surrounds the sixty-five-foot-high obelisk. General Grant himself approved her request for “1,000 muskets and bayonets, 15 rifled guns, and a quantity of 24-pound shot, with which to construct my fence.”23 With the completion of the monument, she deliberately separated herself from her war experience, which had ultimately proven to be both frustrating and humiliating. She returned to what she considered her life’s work, an assessment shared by her later biographers, who uniformly treat her war work as a footnote to her life.
Some months after the war ended, US Secretary of War Edwin Stanton asked Dix how she would like to have her service to her country honored, suggesting that her efforts be recognized with a grand public meeting or a congressional expression of gratitude. Dix asked for one thing: “the Flags of my Country.”
On December 3, 1866, the War Department ordered a pair of flags made for Dix. They arrived at her home in Boston on January 25, 1867, along with an official order over Stanton’s signature that read: “In token and acknowledgement of the inestimable services rendered by Miss Dorothea L. Dix for the Care, Succor, and Relief of the Sick and Wounded Soldiers of the United States on the Battle-Field, in Camps and Hospitals during the recent War, and of her benevolent and diligent labors and devoted efforts to whatever might contribute to their comfort and welfare, it is ordered that a Stand of Arms of the United States National colors be presented to Miss Dix.”
She wrote in response: “No more precious gift could have been bestowed, and no possession will be so prized while life remains to love and serve my country.”24 She later bequeathed the flags to Harvard and arranged for them to be hung in the memorial hall built by Harvard to honor its Civil War dead.
Harvard lost the flags, perhaps a fitting end to the story of a woman whose contribution to the war effort has often been overlooked.
On June 10, 1903, the American Nurses Association met for its sixth annual convention. At one point in the meeting, the organization’s president announced that by chance another group of nurses was meeting in the building, “an organization of nurses belonging to the Army and Navy of the Civil War.” She suggested that it would be fitting that the convention pay tribute to them in some way. A nurse in the crowd suggested the older nurses be invited to join the afternoon session of the meeting.
Mary Livermore, a Civil War nurse who went on to become a national leader of the women’s suffrage movement, was the next scheduled speaker. She rose to welcoming applause and began her address with a tribute from the older nurses to the new: “I find all that is within me rising up in this presence in a semi-reverential attitude. A congregation of trained women nurses! Something that in my earlier days I never expected to see, that I always thought of, and always felt that it was a desirable thing to accomplish.” She went on to say what many of the younger women in the room were no doubt thinking: “The women whom you have just invited to meet with you are wrecks only, simply driftwood left from the Civil War, stranded here.” Then she reminded her listeners, “They had a great work to do without any of the advantages that you would have if you were to take their places today… It was an impossible thing for those women to do all they had to do… Their own hearts’ desire was that they should be successful, that they should mitigate the sufferings of the men and the community, and they came out from their work—some of them stayed the whole four years—very much better nurses, of course, than they went in.”
Their legacy stood before her: trained nurses who could be called to duty in case of another war. Nurses “who know what to do and how to do it, who have learned to obey, and learned when they must depart from instructions, what rights they have, and when the occasion shall come that they fall back on their own trained judgment.” She proclaimed it “one of the the best things that has happened in the advance that has come to womanhood generally during the last fifty years.”25
Afterword
A Different Viewpoint: Nursing in the Confederacy
Looking at the experience of Civil War nurses through the lens of Mansion House Hospital focuses the attention solely on the North, but it is important to remember that women in the South also volunteered as nurses in the war.
It is even harder to get a good estimate of the number of Southern women who served as nurses than it is to count their Northern counterparts, in part because a portion of the Confederate surgeon general’s records, like those of many other departments of the Confederacy, was lost in the fires that accompanied the evacuation of Richmond in April 1865. In addition to women who worked for the Confederate Medical Department, estimated by one count at 1,666, unknown numbers of women worked in the hospitals as unpaid “visitors” and volunteers at wayside hospitals.1 Others nursed wounded strangers in their own front parlor or the local church; these do not appear in official records at all, though they appear in anecdotal accounts.
Regardless of their numbers, Southern nurses shared some experiences with their Northern counterparts. The hostility of male surgeons to the “petticoat government” of female nurses in hospitals was not limited to the North. In 1862, when Phoebe Yates Levy Pember, a thirty-nine-year-old widow, who applied for one of the newly created matron’s positions to escape an unhappy living situation, arrived at her job at Hospital #2 in the enormous Chimborazo Hospital in Richmond, Virginia, she was greeted by a surgeon who noted “in a tone of ill-concealed disgust that ‘one of them had come.’”2
The South had no equivalent of Dorothea Dix’s selection criteria to limit who could become a nurse, but elite Southern women who wanted to volunteer still had to battle the familiar assumption that “such a life would be injurious to the delicacy and refinement of a lady—that her nature would become deteriorated and her sensibilities blunted.”3 That battle was made harder by an elevated sense in the South of what made someone a lady, including the belief that it was demeaning to work outside the home. Like their counterparts in the North, some elite women who volunteered as nurses not only showed no hesitation in stepping outside the stereotype, but also actively embraced the challenges of the job. Emily Mason, the matron at Camp Winder Hospital in Richmond, Virginia, described several Richmond belles who dragged wounded men from the ambulance, fresh from the battlefield at Petersburg, and set to washing and dressing them,4 apparently close counterparts of the New York socialites who served on the United States Sanitary Commission’s hospital transport ships.
Women on both sides faced the challenge of acclimating themselves to the grim realities of a military hospital. Cornelia McDonald of Winchester, Virginia, tells an anecdote of her first day on the job that in many ways typifies the experience of all the women who nursed in the Civil War: “I wanted to be useful and tried my best,” she
said. But the sight of one man’s face was her undoing. The surgeon uncovered the man’s wounded face and asked her if she would wash the wound. She tried to say yes, but the thought of touching it made her feel so faint that she staggered toward the door. As she went, she stumbled over a pile of amputated limbs heaped up near the door.5
As in the North, amputations were the most difficult thing for volunteer nurses to come to terms with. Some women, like Sara Agnes Pryor, who made the transition from lady visitor to volunteer nurse in Richmond during the bloody Seven Days’ Battles of 1862, fought to overcome what one experienced nurse dismissed as “fine-lady faintness.”6 Others decided after their first fainting fits that their efforts at hospital work were best confined to raising supplies, not a trivial task, especially later in the war when there were shortages of many basic foodstuffs.
Despite these similarities, Confederate women’s experience of nursing in the war differed in several significant ways, which reflected not only differences in the structure of Northern and Southern society but differences in how they experienced the war.
The South was largely untouched by the two events that combined to create the reform-minded class from which many of the Northern nurses came: the growth of industrialized cities with their attendant problems and opportunities, and the Second Great Awakening, a spasm of religious revivalism that spread from New York westward to the Mississippi and south toward the border between slave and free states. Consequently, the Confederacy had no equivalent of Dorothea Dix or Elizabeth Blackwell, with their backgrounds in reform leadership and hospital management. Perhaps more important, the South also had few equivalents of Mary Phinney von Olnhausen, Hannah Ropes, or Louisa May Alcott—members of the educated middle class with an inclination for reform and prior experience of working outside the home. Instead the region had its own breed of women with the habit of command: women who ran large plantation households that were effectively small, or even not so small, businesses.
Heroines of Mercy Street Page 21