THE NURSE'S VOCATION1

ALL of us are born originals; most of us end imitations. That is a fact as true of nurses as of all the rest; and I am not sure but what a fair copy is better than a poor original, when it comes to the question of

nurses.

The master word for you is service, just as service should be the master word for other decent Christians; but it is the nurse's function even more than the doctor's, or the lawyer's, or the house maid's, or the janitor's, to be a decent Christian.? If we lack that sense of service, we are but as sounding brass or a tinkling cymbal. Frankly, I know of no vocation which demands higher training in morals and in ethics than does yours, - a comforting assertion, doubtless, for those who are graduating and about to take up their work.

Let me spend a few minutes in attempting to illustrate what I mean. Let me tell you about nurses as I see some of them, and then tell you something about nurses as I fain would see some of them.

I will admit at once and in all humility that other folks as well as nurses are not perfect. Perhaps I know as many perfect nurses as perfect doctors or perfect clergymen; but the positions and the strivings

'An address delivered before the graduating class of the Lowell General Hospital, June 21, 1905.

long ago

There has

of doctors and clergymen are an old story, defined by Hippocrates and by St. Paul. as yet arisen no prophet of nurses, so far as I know. Doctors and clergymen are striving with more or less feebleness to live up to ideals. What are the nurse's ideals and how is she living up to them?

To gain a proper understanding of your position, you should have some knowledge of the history of nursing. The much-abused, rather mythical, oldfashioned nurse is more or less known to you, but even the old-fashioned nurse had her virtues. Often she was a Sister of Charity; sometimes she was a kindly neighbor; and frequently, of course, she was a paid servant. On the other hand, she was ignorant of many things; she lacked discipline; she was a tattler and busybody, perhaps; she had crude notions of loyalty; sometimes she was a thorn in the flesh. But take her all in all, she was a very normal creature, humane, sympathetic, zealous, given at times to the shedding of tears. Ivanhoe's Rebecca was the goddess of old-time nurses; Sarah Gamp was the head devil.

Now it came to pass as the art of medicine advanced and as physicians and surgeons developed accuracy of method that they found their untrained nurses largely ineffective. Often they did not know, but dangerously feigned knowledge, that common vice of the ignorant; often they adopted measures of their own, at variance with their instructions; sometimes they told fibs. From time to time rough attempts at reform were instituted. The great hospitals of Europe and some in this country gave thought to the nursing

problem, and kept wise women in their employ, but those women were of small service to the community. Rarely some doctor would find a jewel to his hand, like Dr. Goodenough's Little Sister of whom you read in Thackeray's "Philip."

I

Then came Florence Nightingale. Now Florence Nightingale is one of the great ones of this earth. She is a gentlewoman; cultivated in many things; wise, with a vast love of her kind. She has that quality, and without it service is impossible. To her those beautiful words of Thomas à Kempis are true and always present: "Love watcheth, and, sleeping, slumbereth not. When weary it is not tired; when straitened it is not constrained; when frightened it is not disturbed; but like a vivid flame and a burning torch it mounteth upwards and securely passeth through all. Whosoever loveth knoweth the cry of this voice." said you have no prophet, but always you have Florence Nightingale; and since her coming the world has been a better place in which to live. She set a standard, and slowly the news drifted to these shores. While she was still young our own Civil War came, - when good women, by the hundred, took up the care of the sick. A great deal of that was crude work, if you choose, but a new spirit was in it, and the much-talkedof emancipation of women had its share in developing a new ideal. Here, surely, was a task for which women were fit. Quickly and from many quarters there grew up a widespread feeling that in the care of the sick was a great opportunity for a brilliant career; that the old ineffectives must be abolished. The medical pro

fession was earnest for the plan, the more intelligent of the community at large demanded it, now they had had a glimpse of better things. Of course, there were some people who regarded the idea as Utopian. They did not believe that educated, broadly cultivated women could be secured in numbers sufficient to build up this great ideal lay-sisterhood. They pointed out that the work would fall into the hands of time-servers, and that, at best, we should have developed educated machines merely. Enthusiasts for the new movement held a different view. They dreamed dreams and saw beautiful visions; they imagined a great body of educated, devoted, and self-effacing women, forsaking father and mother, and going through the world shedding light in dark places, given to good works, tactful, patient, long-suffering, turning the other cheek also, soothing the sick, comforting the dying. These were pleasant and refreshing thoughts. It is with no cynical intent that I quote them, doubtless they are more or less familiar to all of you. Doubtless with such thoughts in mind many of you adopted this calling.

Accordingly, it came about some thirty years ago that a great concerted effort properly to equip nurses was developed through the establishment of Training Schools for Nurses in connection with Bellevue Hospital in New York and the Massachusetts General Hospital in Boston. Promptly, similar schools were started in other hospitals. In the early days the training was different from what we see to-day. The nurses served for one year, or at the most for two years. The leading thought in their education seems to have been

discipline, subordination, loyalty, learning faithfully to perform a lieutenant's work. They were taught a systematic routine, the careful observation of conditions, the meaning of symptoms, the accurate carrying out of orders, the noting things in books, — indeed a great part of their time was occupied in noting things. Then nurses began to be graduated, and slowly the community came to recognize the new order. Then at once a strange and unexpected thing happened. The community for several thousand years had been accustomed to its untrained nurses of the gossipy, serving-maid type; suddenly the community found that here was a novelty, a class of self-respecting, independent, forceful, and somewhat high-handed women to whom the afflicted ones must be obedient. The situation did not lack elements of the comic. The community gasped, and promptly the gossips and the sewing circles divided themselves into two camps, those who believed in trained nurses, and those who did not believe. Scattered fragments of those camps may be discovered still by the

curious.

It was a difficult position for the first of those trained nurses. The situation was anomalous, and in many ways confusing. In the hospitals they had been educated for subordination and service; outside of the hospitals they found themselves in positions of authority and more or less of independence. In the hospitals they had been accustomed to look up to their staff teachers as wise and almost infallible, and to look down upon the patients as instruments and material. In private practice the positions were reversed.