Historical Review
Nursing at St. Luke’s Hospital, carried out by the Sisterhood of the Holy Communion, predates the St. Luke’s Hospital Training School for Nurses by 30 years. The Sisterhood was started by Anne Ayres, who came to the United States from England in 1836 and settled in New York City. Until 1845 she worked as a governess when, after hearing a talk given by William Augustus Muhlenberg, D.D., she decided to pursue a religious life. Dr. Muhlenberg was an Episcopal clergyman and pastor of the Church of the Holy Communion located on the corner of Sixth Avenue and Twentieth Street. At the time, there were no established religious orders for Protestant women in the American Episcopal Church or in the Church of England, so Ayres was consecrated a “sister of the Holy Communion” by Dr. Muhlenberg. After a few other women joined her in running a parish school and caring for the sick poor, they were formally organized as the Sisterhood of the Holy Communion in 1852, with Ayres as First Sister. The sisters, who made renewable pledges of service instead of taking permanent vows, opened an infirmary in 1853 within the church community. When St. Luke’s was built, they moved into the hospital, where Ayres directed the housekeeping and nursing.
Sister Anne
Ayres 1816-1896
Director of the housekeeping and nursing departments at St. Luke’s
Hospital from 1858 until 1877. The sisterhood and the hospital were
never dissociated in Dr. Muhlenberg’s mind. Without the assurance of
voluntary nurses, he would not have attempted the formation of a church
hospital, often saying: “No Sisters, no St. Luke’s.” Sister Anne died in
the current St. Luke’s in 1896. (Click photo
to enlarge.)
For years Dr. Muhlenberg had cherished the dream of creating a church hospital. He was well aware of the dearth of health care facilities in Manhattan: In 1846, the city had only two hospitals. New York Hospital, or Broadway Hospital as it was sometimes called, had 350 beds, and served mostly seamen, whose expenses were paid by the government; indigent trauma cases; and a few patients who could pay their own way. However, one was admitted only if a cure seemed likely. Bellevue Hospital’s 550 beds were devoted entirely to paupers. Sister Anne Ayres, in her biography of Dr. Muhlenberg, writes that Bellevue "was in reality the sick ward of the Almshouse, and was always crowded, the provision being quite too small for the accommodation of the class who were its sole beneficiaries, and who, it may be readily conceived, made the place more to be dreaded by the decent Christian poor, than the worst privations and disqualifications of their own garrets and basements."
The Reverend
William Augustus Muhlenberg, D.D. 1796-1877
Founder of St. Luke’s Hospital
While recovering from an illness at St. Luke’s, Dr. Muhlenberg said:
“Thanks be to God that I am here, in this house of Mercy, this Lazarus’s
place which I was allowed to build for poor sufferers, and now have for
a home to die in. It’s poetry!” Dr. Muhlenberg died in the first St.
Luke’s Hospital. (Click photo to enlarge.)
On St. Luke’s Day, October 18,
1846, Dr. Muhlenberg took the first steps to turn his dream into
reality: he proposed to his congregation that half of that day’s
offering be set aside as the beginning of a fund to build a church
hospital to care for the sick poor. A little over $30 was raised,
prompting a fellow clergyman to ask Dr. Muhlenberg when he expected
to build his hospital. He replied: "Never, if I do not make a
beginning."
His beginning was one wing and a
chapel on Fifth Avenue at Fifty-fourth Street; the chapel was
finished a year before the hospital wing, and was in use almost
every Sunday. Dr. Muhlenberg writes: "This was done...for the
purpose of bringing out its ground idea and distinctive character as
a church institution. For a year St. Luke’s was resorted to only as
a place of worship, thus proclaiming the Evangelical order--good
works the fruit of faith." Religion and science worked together in
St. Luke’s. Indeed, the motto of the hospital, which every graduate
nurse wears on her pin, is corpus sanare, animam salvare (to heal
the body, to save the soul). The first patients were admitted in the
spring of 1858. Dr. Muhlenberg looked upon the patients as "guests
of the Church--the Hospital a large hotel full of sick guests" with
the care of the guests done voluntarily by Sisters of the Church. A
member of the Sisterhood was in charge of each ward and supervised
the work of paid nurses, considered inferior to the better educated
Sisters.
The first St.
Luke's Hospital at Fifty-fourth Street and Fifth Avenue. The hospital
opened for the reception of patients on Ascension Day, May 13, 1858.
(Click photo to enlarge.)
As the patients increased in
number, nursing care became more complex. The number of applications
to the Sisterhood were no longer sufficient to meet the nursing
needs of the hospital. Lay women were hired, but they functioned
essentially as assistants to the Sisters; it became increasingly
apparent the system must change. Sister Anne retired in 1877; her
replacement resigned because of poor health in 1888. In May of that
year housekeeping and nursing became separate departments and a
graduate of the Boston City Hospital School of Nursing was hired as
Head of the Nursing Department at St. Luke’s. Two months later the
Board of Managers of the Hospital passed a resolution for the
establishment of the
St. Luke’s Hospital Training School for Nurses.
On July 2, 1888, six young women entered the school for a one-month probationary period. This first class of St. Luke’s nurses were taught primarily on the hospital wards, although lectures, recitations and examinations on practical points of nursing were given from time to time. Students were graded on their performances; at the end of the two-year course they were awarded a diploma and a pin.
The blue and white
check dress with white bib and apron remained the student uniform until
the school’s closing in 1974. The St. Luke’s cap, originally fashioned
from that of Massachusetts General Hospital School of Nursing ( as seen
in the above photo) evolved into a taller, narrower organdy cap with
distinctive side pleats; the cap sloped downward from front to back.
Probationers wore a traditional Dutch cap until the ceremony at which
they were "capped" by faculty with a plain St. Luke’s cap. Seniors
added a narrow blue velvet band around their caps; graduates wore a wide
black velvet band. (Click photo to enlarge.)
Within the first ten years of its
existence the school added an obstetric nursing affiliation, a
course in the operating room for selected students, and textbooks
and mannequins were used for the first time. A registry for
graduates who chose private duty nursing was established, and in
1896 the hospital moved to its current site at Amsterdam Avenue and
113th Street. The alumnae association was incorporated in 1898. The
first commencement was held in the hospital chapel on the evening of
January 8, 1901.
Over the years the curriculum
evolved in keeping with advances in the medical and nursing
specialties; as course instruction increased, so, too, did the
nursing faculty and the length of the training period. In 1905, in
conformity to a State law enacted in 1903, the school was registered
with the Regents of the University of the State of New York, marking
the beginning of State supervision over nursing schools in New York
State.
On November 8, 1906, the Margaret
J. Plant pavilion for private patients was opened for reception of
patients. This was a liberating event for the nursing students:
Vanderbilt pavilion was the nurses’ residence; however, as a
temporary measure of perhaps 10 years, two floors were used for
private patients, an inhibiting factor for off-duty students.
Tradition has it that on the memorable night when the patients were
all moved, "the native noise-making inclinations of some 90 normal
and healthy young women...were indulged in that first night of
freedom to the extent of compensation for all past deprivations. And
it is not recorded that anybody was disciplined as having celebrated
beyond the bounds of propriety, in view of the circumstances."
The year 1915 saw the beginning
of yearly appeals for a new nurses’ residence. In 1917, to fill the
gaps left by enlistment of nurses in war service, forty additional
probationers were admitted to the Training School. In order to make
room for these students in Vanderbilt, graduate nurses were offered
a room allowance to live outside the hospital. At the close of the
war, a canvas done by the alumnae association shows that 197
graduates were engaged in war service in 12 countries, and 48
graduates were enrolled in the St. Luke’s unit of Red Cross Home
Defense Nurses.
During the next 10 years an
entrance fee for students was instituted. Hours on duty were
shortened, as was the training period from three years to two and
one-half, although he probationary term remained at six months.
Course lectures in mental and nervous diseases, communicable, skin,
and venereal diseases were added to the curriculum; attention to the
physical condition of the students improved with regular chest
x-rays and immunizations against typhoid fever, smallpox, scarlet
fever, and diphtheria. The fourth floor in Travers pavilion was
turned over entirely for instruction of students and faculty
offices.
In 1928 the system of theoretical
instruction was reorganized. An education director was appointed; a
teaching dietitian and a full-time instructor in the sciences were
hired. In the hospital, a program of employing graduate nurses for
"general duty," was instituted, first on the private floors and then
on the wards. At the same time "ward helpers" were introduced. These
women performed non-nursing duties previously done by the nurses:
brass polishing, caring for the patients’ flowers, sorting and
storing linen as it came from the laundry, carrying food trays, etc.
Student entrance fees were raised
from $25 to $50 in the early 30’s, and the training period was again
extended to three years. Affiliations were added to the curriculum:
a three-month course in psychiatric nursing at the Bloomingdale
Hospital in White Plains, New York, (later named "The New York
Hospital, Westchester Division"), or at he Neurological Institute,
New York City; three months in communicable nursing at Willard
Parker Hospital in Manhattan or a two-month course with field work
at the Henry Street Settlement, New York City. The later 30’s saw
the inauguration of Aptitude and Intelligence Tests for applicants
to the school
Finally, in January 1938, the Eli
White Memorial Residence was occupied by the nurses. The building
was erected at a cost of $1,600,000 as a memorial to the late Mr.
White out of a bequest for such purpose by his daughter, Mary A.
Fitzgerald. Fronting on 114th Street, the residence extended through
to 115th and offered 355 rooms for students, graduates and faculty.
A tunnel connected the residence to the hospital for use in
inclement weather. (A full description of the building’s facilities
can be found in the first Roster in the school archives at the
Foundation of the New York State Nurses Association in Guilderland,
New York.) Health and social-physical education directors were added
to the staff of the school by the end of the 1930’s.
Students with St. Luke's Hospital car. (Click photo
to enlarge.)
Over the next 10 years, the
school was accredited by the National League of Nursing Education,
and remained so until its closing. Chemistry, sociology and
psychology were added to the curriculum with appropriate faculty
employed. During World War II students enrolled in the Cadet Nurse
Corps, a program of the United States Public Health Service.
Hundreds of nursing alumnae participated in government nursing
services throughout the war. The Class of 1947 published the first
yearbook, Triennium, dedicated to the Second Evacuation Hospital
Unit, composed of doctors and nurses recruited from St. Luke’s
Hospital who served in the European theater of World War II. Student
fees increased to $350 for the three-year training period; a student
loan fund was developed and supported by graduates of the school.
On February 3, 1942, the alumnae
association changed its name to "The Alumnae Association of the St.
Luke's Hospital School of Nursing." It is unclear when the school
changed its name from the "St. Luke's Hospital Training School for
Nurses" to the "St. Luke's Hospital School of Nursing," but it was
undoubtedly during the early 1940's.
In 1953, the
obstetric affiliation at Women’s Hospital Division of St. Luke’s
began. 1954 saw the reorganization of the nursing department when
the school and nursing service were put under one director of
nursing. A two-week tour of duty (later a four-week tour) in the
recovery room was added to the students’ rotations. The system of
privileges for all students was liberalized including the marriage
policy. By the late ‘50’s only one class was admitted each year; the
student received her St. Luke’s cap after 10 months instead of after
6. Willard Parker Hospital closed and communicable disease nursing
was integrated into other areas of the curriculum. In 1959 directors
were appointed to both the school and the nursing service; students
were no longer on the staffing roster of the hospital. By the early
‘60’s the faculty and staff of the school had grown to 30. Following
tradition, freshmen were still introduced to ward duty soon after
entering the school, with their on-duty work correlated with
classroom instruction. Junior year focused on obstetrics, the
operating room, pediatrics and psychiatry. The senior year brought
night and evening duty, advanced medical-surgical nursing , special
surgery, i.e., orthopedics, urology, and ear, nose and throat, the
emergency room and the outpatient department.
As the cost of
operating the school rose, it became increasingly difficult to
recruit students who met the criteria set by the faculty. More and
more young women opted for the baccalaureate programs rather than
diploma schools. On April 4, 1972, Charles W. Davidson, Executive
Director of St. Luke’s Hospital, and Ruth E. Dittmar, ‘52, Director
of the St. Luke’s Hospital School of Nursing, announced to faculty
and students the decision to phase out the school. It would no
longer accept new students, but would maintain a quality program for
those already enrolled.
The decision came
after seven years of deliberation. Mr. Davidson said: "...Since its
founding in 1888...the school of nursing has meant quality nursing.
...We believe the reputation of our school to be unmatched and our
graduates have continued to bring honor to the school and to the
Hospital Center to the present day. For all of us, the decision has
been a traumatic experience, but charged as we are with making
difficult choices, we had no real option. The future of nursing
education is in the broader educational environment of the colleges
and universities. We support that view."
The Class of
1974 at graduation in the Cathedral of St. John the Divine. The
first Commencement was held in 1901 in the St. Luke's Hospital
Chapel. It is
unclear when graduation ceremonies transferred to the Cathedral;
however, we do know the Class of 1913 graduated from there. Graduating classes traditionally posed
on the Cathedral steps with the Bishop of New York and the President
of St. Luke's Hospital. (Click
photo to enlarge.)
Until its closing in 1974 the school was constant to its objectives that through a planned program of learning experiences the student would:
1. Understand nursing principles, based on biological, physical and behavioral sciences, that will guide her judgment in ministering to the patient, to the family and to the community;
2. Utilize nursing skills in giving physical and mental comfort to
adults and children with health problems found in general hospitals;
3. Plan, implement, and evaluate the nursing care of the patient by:
a. encouraging participation of the patient in his therapy and
rehabilitation;
b. establishing communication and cooperation with other health workers,
both professional and nonprofessional;
c. understanding the functions of community agencies in the continuity
of patient care;
4. Recognize the value of participation in activities that promote her
growth as a self-directing and self-evaluating person, nurse and
citizen.
During its more than 80
years of existence, over 4000 women graduated from the St. Luke's
Hospital School of Nursing.
For further reading on The Reverend William Augustus Muhlenberg please visit his biography "The Life and Work of William Augustus Muhlenberg" by Sister Anne Ayres.
