St. Mary's Hospital, Tucson
On her first tour of duty in the Sanatorium each student, even the most confident, was bound to be a bit distressed by the tactics and teasing of some of the patients. Many of the tubercular patients had been at St. Mary's for months, even years. Embarrassing student nurses and testing them in various ways were among their favorite hobbies. Occasionally a girl was able to catch them in their own nets to the delight of all. One newcomer who was told by a patient that she could not go into the room next to his without a mask, arrived on duty the next morning all prepared. She had in a bag a pooh-bear hallowe'en mask. Until 1931, when the rooms were numbered alphabetically, the room letters were a source of many quips. The older nurses would not spoil the fun by warning their underclassmates that they might expect questions such as: Do sailors always go to "C"? Do you need ice for "T"? What is the temperature in "L"? and the like -or worse.
Sister Guadalupe tells of her own difficulty due to room lettering. The evening she had a new pantry' boy to help serve trays she sent him out with one tray after another-to R. S. then T. "This is for U," said Sister as she handed him the next one. She had trays ready for V, W, and X. Still no boy. In about ten or fifteen minutes he returned with the tray of empty dishes saying, "Thanks." Noticing Sister's quizzical expression he asked, "Didn't you say it was for me?"
Students shared in some of the hobbies of the patients by taking pictures or posing with them for the monthly progress snap shots which many of the patients collected and pasted in albums or scrap books. They mailed the pen-pal letters some of which were published in the Correspondence Section of the local newspaper under the most atrocious "nom-de-plume." The students also collected news clippings and planned happy surprises for the patients. Best of all were the concerts, both vocal and instrumental, which were presented on the porch or in the patio of the sanitorium. Some of the patients sat on the porch in decklike recliners; others had their beds pulled out onto the porch. Sometimes, by special arrangements, visiting church or civic groups came to entertain the patients.
Sister Guadalupe was in charge of the Sanatorium for many years. When she was transferred to Lewiston, Idaho she was replaced by Miss Elizabeth Keavey who had served eighteen years in the United States Navy Nurse Corps. (There her name is recorded as Keavy and Keavey) Upon retiring she came to Tucson, April 11, 1935, at the request of Sister Mary Charles.
With sincere kindness and patience, but without losing any of her Navy dignity, Miss Keavey, who was a native of County Tipperary, Ireland, was unsparing in her efforts to teach students meaningful details in the care of patients.
Some of the students were in awe of Miss Keavey because of her almost uncanny knack of showing up unexpectedly when she was needed most. When a student was on night duty for the first time she could depend on Miss Keavey paying a late visit to the sanatorium to answer questions or to give assurance. Since Miss Keavey lived in the nurses' home, no one was exactly sure which day she considered as her afternoon off duty. It was not that she did not have a schedule; it was her generous spirit of availability that dictated her free time.
During the ten years that she supervised the sanatorium, the doctors, Sisters and students grew in their appreciation of this remarkable woman. Patients had many personal reasons for esteeming her. Due to ill health she retired in 1944 and in August of that year reported to the Naval Hospital in Oakland, California. She made her home in that area and died at Holderman Hospital, Yountsville, California on October 1, 1967. May her memory be in benediction.
The history of nursing in Tucson changed rapidly in the years between 1935 and 1945. In the early part of this decade the Sisters and the student nurses constituted nearly the entire nursing staff of St. Mary's Hospital. The average number of registered nurses on the payroll was three to five. Registered nurses were most often engaged on private duty.
When Sister Ildephonse Kelly was assigned to St. Mary's as Superintendent and Superior of the Sisters in 1935, she knew from her previous experience in Tucson that each private duty nurse worked a twenty hour shift. If it were convenient the nurse was off duty between one and five o'clock in the afternoon each day. The hospital provided a cot on which she might t nap if the condition of her patient permitted her to do so. Mrs. Bernice Hesidence recalls that when a nurse needed a cot in the sanatorium it was brought to her from the hospital rather than from a storage area in the sanatorium. Mrs. Helen Rivera says that the cots were kept under the patients' beds which were high and had no mechanical apparatus under them to interfere with the cot sliding in and out (11).
According to Miss Ruby McMurtry,, who did private duty in those days along with Mrs. Rivera and Mrs. Hesidence, the doctors, in spite of patients' complaints and nurses' pleas, were convinced that the patient was best cared for by having continual service from the same nurse. The doctors had no effective argument, however, for Sister Ildephonse when she announced that no nurse was to be sleeping on duty in her hospital. A twelve hour shift was the maximum, effective at once.
Miss McMurtry adds that it was some years before twenty hour duty on home cases was discontinued. , However, in general, nursing care throughout Tucson improved as a result of Sister Ildephonse's action at St. Mary's. A couple of years later when nurses asked for an eight hour shift on private duty the doctors raised no objection even though the nurses charged five dollars for each shift. The patients were quick to notice the improvement in the services of the nurses.
Without being too personal, I have selected our class of 1939 as a background against which to give the details of student life prior to World War II. We enrolled in 1936 and studied in the midst of one of the most transitional decades in student nurse life. Before our graduation we were aware of innumerable developments within schools of nursing.
Our class was remarkable in many respects. In addition to the girls from various towns of Arizona there were those from Mexico and California. Two men, the first to train as nurses in Arizona, and three Sisters of St. Joseph completed the group. William D. (Bud) Hill was from Iron River, Michigan; William J. Lewenthal from Del Rio, Texas. Sister Mary Clarine Seibel transferred to Lewiston during our first year and was replaced by Sister Annetta Clare Morin from St. Louis, Missouri. My other companion was Sister Paula Marie Sullivan..
Our daily schedule was comparable to that of previous classes. Rising bell rang at six o'clock. Of course, we Sisters had already been up an hour and were in chapel. Roll call in the classroom was at six-thirty followed by morning prayer and the Nightingale Pledge in common in St. Catherine's Chapel. After breakfast the eight hour work day began. It was broken by free time of three hours plus one-half hour for a meal. Free time was usually 10:30-2:00; 12:00-3:30; or on class days 1:00-4:00 because classes were conducted on off duty time. Occasionally we might be assigned last hours, 3:30-7.00. The weekly half-day off duty began at two o'clock except in surgery. On that assignment we were permitted two half-days off a week. Three students were off each Sunday morning and the other half of the team off in the afternoon, with another free afternoon later in the week.
Classes were conducted nearly every morning during our probationary period of six months. There was a gradual increase in the number of hours we spent each day in the hospital. Then came the formal Capping Ceremony in the chapel. The girls each received the school cap. I don't remember what the men received unless it was their first year pin. We Sisters participated in the program only by singing in the choir. During the first year the girls wore one black stripe on their cap; two in the junior and, three in their senior year. The men had white bar pins with the appropriate number of black stripes. These pins they wore on their pockets.
Nursing responsibilities of our upper classmates differed little from those of registered nurses. Everyone spent long hours in acquiring skills and in serving in a multitude of ways. There were no miracle drugs such as the sulfas or antibiotics. We prepared many of the treatments we administered. We made mustard plasters of one part dry mustard and three parts of ordinary kitchen flour. Some nurses became proficient in always developing a smooth paste; others found this difficult. None of us liked to wash the cloth after a treatment to have it ready for the next use. But this was necessary if we were to get as many uses as possible from an old pillowcase. Babies may still be given scraped apple or mashed ripe bananas for diarrhea. But I hope no nurse today has to prepare fresh tomato juice for her patients.
Maintaining adequate fluids, especially for the post-operative patient was a complicated procedure. When we started our training, proctoclysis, or Harris drip, was the usual method of providing post-anesthetic fluids. For more severe cases of dehydration we often administered fluids by hypodermoclysis in both thighs or even under both breasts. There was always the danger of damage to the tissue from poor absorption; but it was the nurse’s responsibility to see that untoward symptoms were promptly observed and the rate of administration reduced, perhaps to five or ten drops a minute. Toward the end of our student days the most acceptable method for supplying fluids was intravenously.
One of the first lessons we were taught related to professional dignity. While on duty we were to use the title of Miss or Mrs. in addressing a nurse. We should stand when a doctor or other dignitary approached. This kind of instruction did not prepare me for a circumstance I encountered on one of my first days in surgery. Miss Alice Sawaya was instrument nurse for Dr. Edward J. Gotthelf, Jr. who was performing an operation. Repeatedly throughout the operation doctor addressed her by her first name. Nearly every time he wanted an instrument he reached out his hand saying, "Alice, Alice." I was awe-struck by Miss Sawaya’s composure. As far as I could tell she was always giving him exactly what he wanted. That afternoon when, according to Sister Huberta’s instruction, I was trying to learn the names of instruments while drying them, I was told, "This is an allis forceps, Dr. Gotthelf’s favorite instrument."
In line with the lectures on professional dignity, stress was placed on the art of pleasant conversation. Some students were less tactful in chatting with patients than others. Miss L. L. discovered this lack of skill in herself the afternoon she addressed the new patient in the big ward to try to discover his symptoms. Without knowing that he was a Federal Prisoner she asked, "What are you in for?" Unhesitatingly he replied, "Forging checks."
Dr. Clara Webster, who gave us lectures on medical aspects of nursing, occasionally prepared a special treat for us by supplementing the lecture hour with an illustrated art lecture including descriptions of far away places where the art treasures originated, especially the Far East. She was a charming lady and a most interesting speaker.
Nurses had appetites for calories as well as art. The energy they put into their long day’s work and their hours of fun was supplied in various ways. Years later when Bud Hill, our classmate, was inspecting St. Mary's for the State Health Department he surprised Sister Mary Esther McCann,, Hospital Administrator, by opening a closet she did not know existed. He admitted, when she questioned him, that when he was a student he had often hidden eggs in that closet. People are much the same the world over, I suppose. At any rate, we were a fairly normal group of students with normal appetites. None of us gave the appearance of being underweight.
Our pharmacist tells me that today a very few doctors continue to use the apothacary system of weights and measures in prescribing medications. In the mid '30's only occasionally did a doctor use the metric system of weights. But as each new doctor came to St. Mary’s we realized the necessity of our having a working familiarity with both systems so that we could interpret or convert accurately whatever dosage might be ordered. One afternoon Eileen Riordan, an underclassmate, brought me her patient’s chart asking what she should do. "Doctor did not specify the dose of Nembutal oil he wanted this man to have at bedtime." I had never heard of such a medication so together we studied the order carefully. We enjoyed the joke when we concluded that the center letter in oil was only an oversize decimal point indicating Nembutal 0.1 Grams, which is about equivalent to the 1% grain dose with which we were familiar.
Some orders were riot as easy to decipher or carry out as the one above. Take for example the one for SOFT DIET CAT. Of course, it was not so bad when we read the last word as the initials of Dr. C. A. Thomas.
Various teaching facilities were added to the school’s equipment such as mannikins, motion picture projector, library books and charts. The dietetic laboratory, though limited, was adequate. Facilities for the teaching of chemistry came later.
Until Sister Mary Eileen Coady, who in 1941 succeeded Sister Ildephonse Kelly as Hospital Superintendent, established a Central Service Room, we students were responsible for maintaining on our individual nursing units an adequate supply of dressing, kits and the various kinds of trays proper to our area. We washed the syringes and instruments, assembled the kits, took them to surgery to be autoclaved called for them when they were sterile and restocked our dressing room. The surgery staff maintained the intravenous, hypodermoclysis and transfusion needles and rubber tubing.
The blood transfusion was a surgical procedure. The surgeon drew the blood in the operating room. He inserted a large needle in the donor’s vein. Through the short tube attached to the needle the blood flowed into a graduated flask held by the nurse. With a glass rod the nurse gently stirred the blood to mix it with the sterilized citrate solution Sister Mary de Sales Miller had prepared in the pharmacy. When the required amount was obtained the doctor withdrew the needle and filtered the blood through several layers of gauze tied to the top of a salvarsen graduated blood delivery flask. The filter was replaced by fresh gauze before the doctor and two nurses took the blood to the patient’s room. We were among the first to rejoice when the Don Baxter Company put on the market their sealed sterile blood transfusion flask which contained the citrate solution. Two or three years after we graduated, Blood Banking became a specialty at St. Mary’s. Howard Welty, a columnist for the Arizona Daily Star, on April 26, 1942 gave an interesting account of his experience as a blood donor at St. Mary’s. He commented especially on the skill and friendliness of a nurse he called "Pinky."
Miss Shirley Timewell, our instructor, was most generous in coaching us in preparation for our State Board examination. Sister Paula Marie and I took it in the spring of 1939 in advance of the rest of our class because of the early date of our enrollment in the school. The mimeographed examinations prepared by the members of the Board were distributed to us as we sat in the Senate Chamber at the, State Capital in Phoenix. There were eleven sets of questions to cover the eleven courses of the curriculum. Each test contained one hundred questions whether the course was of ten or two hundred hours. We wrote three examinations morning and afternoon for two days. A passing grade of seventy-five was determined by totaling the individual scores and dividing by eleven.
Sister Paula Marie, after she received her State Board grade of 93%, second highest in that test, offered some suggestions to the Chairman of the Board of Examiners recommending a more equitable distribution of questions for the registry examination. Her suggestions were received in a truly friendly and generous spirit so characteristic of the relationships between St. Mary’s and the State Board of Nurse Examiners. How grateful the Board members must have been when machine scored tests were made available and they no longer had to prepare, administer, score and grade all examinations.
As had been the tradition for many years, our graduation exercises were conducted on the south lawn in front of the convent on May 12, the anniversary of Florence Nightingale’s birthday. On a social evening prior to graduation a scrap book was distributed to each of us. In many respects these books were similar to year-books as we know them now. Each contained pictures of nearly every member of the medical staff, group pictures of our class and scenes of the hospital.