Interviewee: Dorothy Smith
Interviewer: Stephen Kerber
Date: March 26, 1979
K: Sounds like you have been busy.
S: Plus I do a lot of volunteer work.
K: As I say, if you have got to get up at any time, just let me know. I can stop this
very easily. Let me finish what I started to say. We will send a copy back to
you so that you can go over it, and perhaps, if we have messed up someone's
name you could help me with the names. Stick that in and then send it back to
S: Well, my Boston accent does not come through.
K: It will be fine. We then send you a copy of the final version and ask you to sign
a legal release so we can put it in the library.
S: Can I change anything?
K: You are perfectly welcome to change anything that is in there. Of course, we
encourage people not to because we try to keep the flavor of the text of the
original, but surely, that is all up to you.
S: What happens to this?
K: Well, we have a collection of, I think we are up to about eighty-seven University
of Florida transcripts which will eventually go in the library. It has not been
worked out yet just where. I guess some part of the special collections, as part
of an overall program dealing with Indians of the Southeast and you name it.
S: All retired faculty?
K: This particular group is almost all faculty, but we do have a few people who are
career service, administrators, and things of that nature. Well, let me start out
with the usual kind of thing by asking you to tell us your full name.
S: Dorothy Mary Smith.
K: What was your position at the time that you retired from the University of Florida?
S: Dean of the College of Nursing, professor, and head of nursing service at
K: I see. When did you retire? We can always stick it in later.
S: Can you shut it off?
S: 1972, I think. I retired as Dean in 1972 and then I intended to stay on. I took a
short leave, three months, and then I intended to stay on working with the same
group of patients and the same group of doctors I had been working with, but I
was a threat to the new dean and I could not do that, so I quit.
K: You were uncomfortable?
S: It was not uncomfortable for me, but I could not. I did not want to be threatening
S: So, after a year I left. Also, there were other factors. The hospital was going to
pot. I had to buy soap for three weeks for my patients and I thought there had to
be a better way.
K: I am going to go back and ask you a few basic biographical questions and bring
you up through your educational background until the University of Florida.
Would you tell us where you come from? Where you were born?
S: I was born in Bangor, Maine on April 28, 1913.
K: Did you grow up and go to grade school and high school in Bangor?
S: No. My father was an electrician and later an engineer. He worked for the pulp
mills in Maine. He was sent to different pulp mills. So up until the time I was
nine or ten I went to about eight different schools, including Van Buren which is
on the Canadian border. I had a sister and two brothers. My father felt, finally,
that was not the best way for kids to go to school. So, we moved to Quincy,
Massachusetts, where he worked for the Boston Edison Company. I finished
grade school and high school in Quincy.
K: I see. Would you give us your father's name and also your mother's?
S: My father's name was William Burke Smith and my mother's name was Florence
Wood Smith. Irish.
K: When did you graduate from high school in Massachusetts?
S: February 1931.
K: Had you been interested in a medical career or in nursing in high school?
S: No, not particularly. I was bright [but] poor. I worked in the five and ten through
high school because this was the Depression. I took a college course and really
wanted to go to college and my aunt would have helped me go to college, but
[with] my family being very Irish, the boys went to school and the girls did not.
My aunt wanted me to be a teacher, and I did not want to be a teacher. So, I
took a post graduate course in high school. I kept on going to high school and
working in the five and ten. My best friend went into nursing. That seemed like
a fairly sensible thing to do because you could usually get work. There is no
doubt I would have gone into something that had to do with making life better for
people because of certain experiences I had as a child. It could have been law.
It could have been anything, but it definitely would have been a helping
profession. So, I went in to the nursing school right there in Quincy.
K: This was affiliated with a hospital?
S: It was. It was the Quincy City Hospital. It was a diploma program.
K: How long did it last? I mean how long was the term?
S: Three years. We affiliated at Belleview in New York. They almost did not take
me because they went around and asked everybody why they were there. Most
everybody said they liked people and they bound up birds and, you know, this
stuff. I was "S" so I came at the end of the line. I though, "Oh my God, what
and I going to say?" So, I said I was there to make a living and they said, "Well,
don't you like people?" I said, "Yeah, I like some. I can't stand others." So
they buzzed and they said, "Well, you are not rightly motivated, but you are bright
and we need bright people. So you can stay."
K: How did your family take this decision? Was this kind of career more acceptable
S: Oh, they were not against any career, but if there was any money, the money
went to the boys. It was right there in my own home town, and it was near. My
mother thought it was sweet and my father did not much care in particular.
K: So, you were in that program from 1931 until 1934?
S: Actually, until 1936 because when I was seven, eight or nine we had diphtheria.
We were living in Van Buren then. I had scarlet fever. We all had scarlet fever
and diphtheria that must have been in the house to which we moved. My sister
and I both got Mastoiditis and meningitis. She got it first and they took her to
Presque which was about a hundred miles away. She was not getting any
better so when I got it, they took me to Bangor, which was about three hundred
miles away and left me. I was there for about six months with a very bad ear. I
did not know she had died. She died in the meantime. So, my ears have
always been bad.
When I was in nursing school at Belleview, I had this bad sinusitis and it ended
up with an ear infection on the other side, the right side. So I came home and
was operated on and I had a rocky time because I got a bad infection. They had
to tie off my jugular. Anyway, so I lost time. I did not finish until 1936.
K: How much of your training was in the local hospital and how much was in
S: It was all in the local hospital except six months at Belleview in New York, and
three months at Charles B. Chapin hospital in Providence, Rhode Island, which
was for the cure of the communicably ill. At that time it was full of polio. That
was mainly what it was.
K: Was the work that you did at Belleview involved with mental health at that time?
S: No. That was really with children and neurology. It was something else.
K: So, these were really to acquaint you with specialties that you would not have
S: Yes, right, in our own hospital.
K: When you finished and graduated, what did you do? Did you stay there as a
S: When I finished, I was one of the few who got a job there. I did staff nursing and
then I became an assistant head nurse. I stayed there from 1936 to 1939.
Then everybody told me that I should keep going to school. So, from 1939 to
1941 I went to Columbia University Teacher's College and got a bachelor's
degree. It was mainly called a B.S. in nursing, but it really was in science. I
had lots of physiology and microbiology, and I worked in a nursery school up at
Washington Heights for a dollar a day and ate on that. I worked in the summers.
K: What this a two-year program?
S: It took me from 1939 to 1941, yes. I had a great time because of things that I
am not going into. I was always the oldest and I never really had an
adolescence. So, in New York, I met up with some people and became
seventeen and eighteen, even though I was twenty-five or twenty-six. Most of
the nurses in the program there were much older because they had stayed for
years to get there. So, they were in their forties and for once in my life I was the
youngest and it was really great. I had a great time.
K: So you took advantage of the opportunities in the city?
S: Oh, yes. Well, on that dollar a day, we went to football games and plays, and
ate jello. Our regular fare was coffee jello. I am one of the few who never had
any federal help because it was way too early.
K: I was going to ask you, was there a specialty in nursing that you were studying at
S: No. I, strangely enough, decided that I had probably better teach, even though I
had not wanted to teach when I was eighteen. I really just got all of the things
that people usually get in college that I never had. I was particularly interested
in teaching sciences, which was why I was heavily loaded with science, although
I had a really good education. In fact, I have been very lucky my whole life. I
have been at the right time at the right place. Columbia, at that time, 1939 to
1941, before [Senator Joseph] McCarthy, there were a lot of, I guess you would
call them now, leftist people. They were very interesting people, and you did not
necessarily have to agree with them or not, but they certainly were
broadening-horizons kind of people. So, I had some fantastic teachers, both in
nursing and in Columbia itself, and very exciting.
K: What did you do when you finished at Columbia?
S: It was 1941. It was before Pearl Harbor. It was September. I got through in
June and I went back and worked at Quincy. I went up to Concord, New
Hampshire, in a teaching job [at] Margaret Pilsbury Hospital School of Nursing. I
went up there to only teach anatomy and physiology and microbiology, and work
with some patients myself because no matter what I have done, I have never
stopped really. That is my first passion: to see that patients are taken care of.
I did not get educated just to get educated or teach just to teach. I wanted to do
something that would make life more bearable for people in the hospital. I saw
some pretty grim things at Belleview and even in my own place, you know, out of
ignorance. I was going to teach sciences and also work with some medical and
surgical patients on some studies that I wanted to do. Well, I got up there and
taught everything in the curriculum. I was supposed to teach everything in the
curriculum except maybe obstetrics, and I had to run the switchboard from seven
to seven thirty in the morning in the hospital. I had to fill the drug basket three
times a week, which I told them was illegal. It was mixing drugs, but, you know,
it was bathing solutions and stuff like that, but I still thought it was illegal. The
drug room was in the basement and it had no running water. You had to use the
water in the men's room across the hall.
I kept about one page ahead of the students in all of this stuff, and would not
dare let them ask a questions because I really did not know anything. I kept
telling them, you know, that is not what I was hired for. Finally, I wrote to a
person at Columbia and said, "How long an I obligated to stay?" I am very
conscientious being the oldest and very responsible, terribly so, neurotically so.
She said that if it was really against what I was supposed to be doing, I did not
have to stay the year. So I quit in February, but learned a great deal. I learned
what not to, and knew that was not the way I wanted to teach.
K: You did not have another situation lined up when you gave notice?
K: You just had to get out?
S: I have never in my whole life stayed in a job that was not fun. The dean's job
was not. Who in their right mind would leave at the age of fifty-nine, when
salaries were going up when I had been here twenty years? If I had stayed five
more years, I would have had considerably more money in my retirement. Who
would choose poverty again, in their right mind? If a job is not fun for me, I am a
survivor because I am still alive, but I am not going to survive in a job. I think
that is terrible. It is no fun.
K: Where did you go next?
S: I went back home, and of course, they were delighted. I have never had any
trouble getting a job. After I left here, I still get them. I guess right away I had
about twelve offers at forty thousand dollars, but I knew I did not want to start
anything again. The director of nursing always liked me and so she hired me as
an assistant instructor, and I was able to work with patients. So I did that and
the lady that I was assistant to was one of the ones who had encouraged me to
go away to school. So it was really nice. Pearl Harbor came in there and I
could not get into any of the services because of my ears. Also, I was
immediately declared. Nursing had a stupid thing that people who had any kind
of education were called--was it 1A? Was that the indispensable? Well, you
probably do not even know about that, but there was draft categories, I guess
you would call them. I think 1A was the indispensable thing. It was pretty bad
because they started the cadet corps in Washington to get more nurses. Almost
anybody could get into nursing and they got paid and the school got paid. They
had uniforms and it was all so rushed that it was a pretty bad education. To me
it was a very bad program. We killed ourselves, really, trying to do the best you
could with shortages and what not.
When I first went into nursing (which was in 1932), the majority of hospitals were
staffed by cheap labor called students. Students were exploited for the most
part, under the guise of education. There were hardly any staff nurses. There
were no curriculum standards. Students had some classes, but in general they
went where they were needed. Just to show you, when they started talking
about eight hour days for labor, the students even came under that classification
when they really were not labor, you know. Then during the Second World War,
the cadet corps did have some standards about how much you could put
students on the units and stuff like that. It was not very sensible, but they had
some standards. So, there were no nurses. All the nurses were over in Africa
or wherever, you know. First they started with Red Cross volunteers who came
in and did certain things and then they began to pay nursing assistants. So, for
the first time, you had people taking care of patients who really were not nurses,
which started sort of a dim thing in nursing, although I do not think it could be
K: But they were doing patient care or attempting patient care?
S: Yes, they were called nursing assistants, but actually they became patient
assistants and not nurse assistants. They were doing things they were not
taught to do, they were not educated to do, and the whole thing got out of hand,
really. It still is out of hand as far as I am concerned.
Somewhere in 1942, the students at my school (this was still the place where I
graduated from) wanted a student organization. The director of nurses was a
New England lady, [a] tremendous lady, refined, as autocratic as all get out, but
still respected. You could respect her. She would have a meeting and she
would think she was doing it democratically, and she would start talking and she
would never stop. You could never get a word in edgewise. A delightful lady,
but very autocratic, which most nursing schools were. But you knew what you
were fighting. She did not pretend to be something else, really. She was the
boss. So we had tried to start a student organization and we got nowhere, but
the students wanted to start a student organization so they asked me if I would
help them. I heard that there was a man called John Brewer at Harvard who
had done a tremendous amount with student organizations. It was his last year,
and I had read some of his stuff. I went in to Harvard at night and took John
Brewer's last class. I am sure you never heard of John Brewer, but you know,
student organizations are something you take for granted, but they have not
always been. So I took his course and everybody said, "What's a nurse doing at
Harvard?" So I told them. After the course, in which I did quite well, somebody
there said, "Hey, you know, you're really pretty good. Why don't you come and
get a master's degree?" I said, "Ho, ho!" So, from 1942 to 1947 I held a
full-time job and went into Harvard by subway three nights a week and
Saturday, and finally got a master's degree in personnel and guidance, or
something like that. It was a very catholic education. I do not mean Catholic
religion. I mean eclectic, or whatever. I had some fantastic experiences there,
K: Which college or department was this in?
K: In education? Was he also teaching in education?
K: I see.
S: But I took stuff from historians. I love history. They let me call the shots
because they were kind of fascinated with this character. I never expected to
get the degree, but I kept on and got it. Then in 1947 I decided that enough was
enough and I needed to get out of New England and away from home. I should
have gone long ago because things were kind of bad. So I looked around for
jobs and I got a job at Duke University in North Carolina, which was like the end
of the world to a Bostonian. I went down there as an instructor of anatomy,
physiology and micro, and also had permission to continue my studies with
patients on the floors. I had kind of a hard time at first. I was five years at Duke
and twenty years here with stuff in between. I still keep my Yankee accent,
pretty much. Especially under stress. They could not understand me and I
could not understand them. Also, this best friend that I had died when she had
her baby. We were all very close. I had gone with the man she went with. It
was a long story. But anyway, she had her first baby and she died of
tuberculosis. They found out she had it when the baby was delivered. And to
help, it was a very complicated situation, a religious situation, a mess. I took the
baby, and my family and I reared the child. I brought her to Duke a couple of
times, but it just did not work out so she went back to my family. Finally, I did
bring her down here when she was a freshman, I guess, and put her in P. K.
Yonge because things were very bad at home then, and I really had to bring her
down or she would have gone crazy. I reared her, got her married down here,
and she is down at Indian Harbour Beach with two kids and a great husband.
But anyway, that was kind of touchy stuff.
I had never seen two water fountains, one marked "colored" and one marked
"white." I had never seen any of that. That was very difficult for me, although I
tried to understand. I did not make too much noise about that, but I did [when]
they would not let me call black personnel or black patients with a "Mr." or "Mrs."
In 1947 to 1952 you had to call them by their first names and they said you just
cannot use "Mr." or "Mrs." I said, "Okay. I will put up with the two water
fountains and the two bathrooms and that garbage, but I refuse. You can fire
me." Well, they did not. We also got the first black head nurse there. I am not
a crusader, but in a quiet way, I manage to make an impact in one way or
K: Were there any black students or any black nursing personnel when you got
S: There were a few. Maybe five or six black nurses who had graduated from
places like Tuskegee or maybe even A&M here, but there was nobody in any
position of authority, and Duke was completely segregated at that time with
wards. All of the black patients were on one ward and the whites were on
another. Really segregated.
K: This was the university hospital that we are speaking of?
S: Yes. I could not see why, since most of the personnel on this black O.B. ward, I
think it was called Provo or Prevost, and the patients were all black, why the heck
they could not have a black head nurse. We finally did get a black head nurse,
but you know, amazingly enough I have to admit that the black staff did not work
as well for that black head nurse, which almost killed me. I said to them, "You
stupid idiots. How do you think you are going to get any place if you do not
uphold your own?" So, I found out that, you know, everything is not neat and
tidy, but I kept working at it.
But anyway, the big problem with Duke was that here in this tremendous
university with the best students I have ever seen in my whole life, because the
standards were high for the students, all over, not just for nursing, they had his
diploma program stuck over on west campus and the girls campus was east.
Essentially, a hospital program rather than a university program.
K: Did it involve very much class work at all in the sciences?
S: Yes, it had some class work, but the thing was that here in this university they
had a chance to really give nurses a university education along with their nursing.
They had no business having a hospital program on this elite campus as far as I
was concerned, and as far as some other people were concerned. We had
Helen Nohn, who is now retired and is on the West Coast, myself, and a few
others who tried to get the university to make a truly university program. It was
under the medical school, the nursing school was, which it never should have
been. We did not win, but we laid down the groundwork so that a couple of
years after I left they did become a university program. One of the first problems
I had when I went there was a student who had been nine months in the
operating room because she was good there and they needed her. This, in the
middle of this great university with its standards, you know. I could understand a
small hospital doing this, but that to me was ridiculous.
Anyway, the fight was kind of bitter. Duke Medical School only started in 1931,
so it was fairly [new]. Most of the doctors had come from Hopkins, and Hopkins
doctors are pretty "macho," I guess is the present word for it. I like men and I
like to be liked by men, but it was all pretty difficult because doctors did not want
nurses to get a better education. I was living with two other people and found
myself right in the middle, which is what happened to me at home. So, with all
of the stress and strain of this, I practically broke. I finally went to a psychiatrist.
A great guy, tremendous. In fact, I have been very lucky with people that have
helped me. He said I was pretty sane [laughter], but if I wanted to keep talking
to him there were things I could learn, and I needed to break away from people
who were trying to possess me, etc. Anyway, he was great for me and I stayed
on a year even after I went to him. Also at Duke I had some other fantastic
experiences. I saw Maury for, oh, I guess three or four years after that. Maybe
once every three months I would drive to wherever he was, and he would never
take any money. We just became very good friends and he was just
tremendous for me.
At Duke, I had the experience also of working with some patients. For example,
there was a Dr. Kempner there. How old are you?
K: I am thirty, actually.
S: Oh, you are? You do not look that old. Well, you might had heard of Kempner,
then. Kempner was the rice diet man for high blood pressure. Do you know
anything about ESP? Rhine was there, too.
K: Not very much. A little bit. They were both at Duke?
S: Yes, but Kempner was a Prussian. My stereotype of a Prussian [is a] short,
bantam rooster kind of guy. He discovered that, well, it had been discovered a
long time ago, but he popularized rice diet for people with high blood pressure.
So, he would have these enormously wealthy, mostly Jewish people from New
York come down. They had rice houses all over Durham. He mostly had
women interns who would carry his suitcases and his paraphernalia for him.
The guy fascinated me because he would go into a room and these patients had
little burners, hot plates, where they heated the rice. Then they had all kinds of
fruit because they could eat fruit. Then they believed in occupational therapy, so
there were looms and all these things all over the room. He would go into the
room and they had to save their urine because most of them had kidney trouble.
He would pick up a bottle of urine and he would say, "You have been eating
chocolate!" You know, nine times out of ten they had not been eating chocolate,
but they had been eating something. This diet has never worked as well for any
other doctor because he really hypnotized them in a sense--you know, bent their
But anyway, the patients were neglected, strangely as it may seem, because the
nurses mostly were white southern Baptists and they did not like Jewish people,
or they did not like their stereotype of Jewish people, and they never tried to find
out if it was true or not. They were wealthy, which was another dreadful sin.
Their rooms were a mess. They questioned everything. So, here were these
wealthy people who were getting terrible care. You know, usually I am for the
poor. So I worked with these patients and I had some pretty good results. It
was really incredible.
Then I left. I had to get out of an intense [situation]. I can deal with conflict and
I can fight, but it is not my usual style. I do not like to. I usually vomit
afterwards, get a headache, or whatever. I can do it, and I have learned to do it
and God knows it did it here. I needed to get out of an intense situation, so a
friend of mine had gone up to New York and joined the accrediting association
which was under the National League of Nursing. Finally, they had got around
to accrediting schools of nursing. So, I went up there and lived for two years in
New York, and traveled all over the country visiting schools.
K: When did you leave Duke?
S: No, not 1947. 1947 to 1952 I was at Duke. I left in 1952. I stayed right there
K: You were in the same position in the University?
S: No. Finally, I became assistant dean before I left.
K: Assistant dean when you left.
K: Thank you.
S: Titles mean nothing to me as you can see. It is what goes on. So, I went up
there and I told them I would only stay two years. They did not believe me
because salaries were fairly good. I did go all over the country and I saw
schools of nursing and I saw hospitals, and I thought things were pretty bad.
But I did leave, at the end of two years, just like I said. I left because you could
stay there forever, you know. You would just be lost.
K: Were you evaluating programs for accreditation?
S: Yes. I was going out to get data that would be presented to a board to evaluate.
I went out on visits collecting data.
K: Did you kind of wander around and observe at will or were you to meet with
people who presented you with their pitch?
S: Both. I am pretty good at observing and also interviewing.
K: Were these both diploma programs and degree programs?
S: And collegiate programs, yes.
K: Did any of this take you into Florida?
S: No. [I] never was in Florida. Took me everywhere else, but it did not bring me
into Florida. Then at the end of two years I left. I took a job at Hartford Hospital
in Hartford, Connecticut. One of the things I had observed as I went around and
which I had known for a long time was that nursing students were being taught
nursing by people who would not know what to do with a patient if they saw one.
They were standing up in a classroom or they were watching the student on the
unit. So students were picking up nursing habits from staff before they were
ready to decide what a reasonable short cut could be. So, for some reason, at
Hartford, they paid me. I took about a four thousand dollar cut from New York to
go to Hartford. I think I got something like thirty five hundred dollars. This was
in 1954 (it was not even called a study) to see if I could get faculty to work with
patients as they taught. I was able to get a few people on fire, some of which I
hired when I came here. It was interesting. I knew I was not going to do it
forever, but I just wanted to see if it could be done and if it made any difference.
At the end of that time, a doctor friend of mine was in Miami and got a job on the
faculty at [the University of] Miami. He wanted me to come to Miami and work
with him. I wanted to get back full-time to patients. I had just about decided to
come to Miami, although that seemed as bad as Alaska to me really, when
somebody had heard that I was available and so they called from here and asked
me if I wanted to be a dean here and to start a brand new school. I said, "No.
No way. I don't want administration. I just can't hack it. I have a frail
constitution." They said, "Well, we know what you have done. You are pretty
good. Would you not think about it?" I said, "No." They said, "Well, would you
just come down and talk to us?" I said, "Well, I do not have any money." I have
never had any money. "I do not have any money. If you want to pay my way, I
want to look over Miami, but if you want to pay my way, that is fine with me, but I
am pretty sure I do not want the job." Meanwhile, I had talked to this psychiatrist
friend of mine. He said, "Dorothy, you know you might, really. That is a great
opportunity to start a new school. You are healthier than ninety percent of the
population." So, I came.
K: Do you remember who that was that you had spoken to?
S: Oh, yes. Russ [Dr. Russell S.] Poor.
K: He was the man who was doing the overall study?
S: He was the man who did the original study to place the shebang here in
Gainesville. He was a non-medical man. I do not know what his degree was in,
something scientific, but I can not remember what. It was not geology.
Probably it was demographics. Is there a degree in demography or whatever?
Anyway, they wined and dined me and took me over to Crescent Beach, and told
me what they hoped. I told them the conditions under which I would come, and
they bought them. Nobody else would have bought them. It had nothing to do
with money, it had to do with philosophy. I took the job in 1955.
K: Did you talk with any one else at that time? Did you talk with the president?
S: Oh, yes. [Dr. J. Hillis] Miller was dead by then. I talked with [Dr. J.] Wayne
Reitz, [Dr.] Fred Conner, [Dr. Linton E.] Grinter, [Dr. Joseph B.] White, who was
in the school of education then, and [Dr.] Harry Sisler.
K: [Dr. Harry] Philpott?
S: No, I cannot remember Philpott. I do not know if he was there. I think I saw
[Dr.] Mama Brady. She was the only woman on campus. All we had were
Quonset huts. At that time there was nothing, no buildings, nothing.
K: None of the current medical center complex?
S: No. It was being built. The medical science building was being built when I
came. I was hired in 1955 and came in January 1956.
K: Had anything been put together as far as the nursing school or the nursing
K: There was just nothing?
S: Nothing and there had not even been anything put together really about the
hospital. There were a few people here in medicine. There was Tom Aaron,
who was already here in pharmacology, and Sam Martin, who is a very good
friend of mine and later became provost. I knew Sam at Duke. Sam was here,
and essentially I am a medical nurse. That is, I work with chronically ill patients
rather than surgical patients because I do not like fast things. I get along very
well with internists and general practitioners. I do not get along as well with
surgeons. So, I am essentially a medical nurse. There were about, I cannot
remember all the names, but there were about eight of us who met all the time;
[one of which was] George Harrell. People sort of make fun of him because
they do not like the buildings he designed, and he was a frustrated architect I
think. But he designed the buildings for the concept that we had for the med
center. Now, for the health center. The fact that concept changed because of
certain things that happened, did not make him wrong. For example, he put no
place for the interns to sleep.
K: It is time? I am having some logistics problems. I think I told you when I spoke
with you that we could stay after five, but as long as we are in this room we
cannot. Could we pick up another day during the week next week or
S: Oh, gee. I would not have stayed if I had known that we were not going to
finish, because I felt lousy.
K: I am awfully sorry.
S: You did not tell me that.
K: I am sorry, you know, that I could not prevent it.
S: Why did you not tell me in the beginning and then I could have gone home
K: I am sorry. I did not realize that you would not want to stick it out.
S: Okay. I am just very direct.
K: No. I appreciate that and I do owe you an apology. I am sorry it is beyond my
S: That is okay.
K: Could we pick it up another day?
S: We will have to, yes.
K: I would very much like to finish it.
S: Is this the kind of thing that you want?
K: It is very much the kind of think I want. It is very much more useful for the
people who will come along and use this to have you tell me your perceptions
than to have me prod you with questions that may be inane sometimes.
S: Well, I think it is very important that the true history of the health center be told.
My second book is about this, how it has turned out in no way, it was meant to be
a little gem, and the specialists have taken over.
K: These are things that I very much would like to talk about with you that I have
had some indication of before from of there people. Also, I not only wanted to
get into the med center with somebody who knew about it, but a woman. We
have not had that many interviews with women on campus in positions of
S: Well, I have been patronized by men my whole life. It was no different in the
university than it was in medicine, but I kept picking, you know, but I was
insulted, many times. If I said anything that was logical, then they told me it was
emotional and that kind of garbage. But that does not really make a story, that
is everybody suffers getting what they want. I think women suffer more
sometimes. But it never stopped me for long. Might [have] for one night. It
K: On with it the next day?
S: Yes. I earned their respect eventually. I think it is harder, but I did.
K: Well, let me put it to you this way. I have been away the past couple three
weeks, too. I have been trying to finish my dissertation. I have not worked at
all. But I have got it where I can handle it now, and my schedule during the
week from eight to five is really free.
S: See, my problem is that I do not have any time really in the day.
K: Well, could we do it sometime at night? I mean I could certainly try to
S: No, because you cannot do it here.
K: Well, maybe I could come to your home.
S: No, if I get those TV people in my home, that is enough. I deliver meals on
Thursday at eleven. I am parked down in the police station. Saturdays--are
they open? No, you do not want to do it on Saturday.
K: Well, I could certainly try and get a key to something. It would require special
permission but I think we could probably work it our to try and make it more
convenient for you.
S: Well, how about next Monday at 9:00 or something like that?
K: Okay, that would be great.
S: That is not very good for me, but I would like to get it over with.
K: Well, I appreciate it.
K: Thank you.
Today is Monday, April 2, 1979. My name is Steve Kerber and I am going to be
conducting the second taping session of an interview with Dean Emeritus
Dorothy Mary Smith of the College of Nursing at the University of Florida. This
interview for the University of Florida's Oral History Project will take place in room
106 of the Florida State Museum at approximately 9:00 a.m.
Well, I really appreciate your coming back to allow us to finish this. Now, I think
you told me last time that when you arrived there were no medical center
buildings put up but there were a few Quonset huts? Were they down in the
same area as the medical center now?
S: That is incredible, but I cannot remember. I do not think so.
K: They were farther up on campus?
S: Yes. The med science building was being built.
K: Under construction?
S: It was under construction, yes. We were up here, up on the hill some place. I
think, but I am not sure about that. I cannot remember, but I do not think we
were on the property down there. I think we were permanently located. They
have all been done away with, but in 1955 and 1956 and for some years there
were many Quonset huts. So I think we were in Quonset huts that were already
there. I do not think they were down there. They were up here some place, but
I cannot remember.
K: Now, I think you also told me that neither the medical or the nursing programs
had actually been started yet, right?
K: It was still in the planning stages?
S: Right. The first students in both medicine and nursing were admitted in
September 1956. I was employed in October or November of 1955, but I did not
come until January 1956. We took our first students in both medicine and
nursing in 1956, and we graduated our first classes in 1960. We had no
problem getting students. One of the things that I was most concerned about,
and which I told the university, I said if we could not get good students and good
faculty, because faculty were on short supply, then you know, after two or three
years I would just leave. Because no matter what kind of programs you
envision, or what kind of ideas you have, if you do not have faculty and students
nothing happens. We had no trouble getting students because FSU had a
baccalaureate degree in nursing before we did. But they had never really, nor
did they, almost up until the time I left, attract the number of students probably
because they did not have their own training facility, a hospital. Nor did they
have the collaboration between university and medical personnel. That probably
was one reason. Also, this campus has always attracted, once it became
co-educations, it tended to attract girls, for the usual reasons. So we had
students already on campus who were just sort of hanging around waiting for the
place to open. I think when I came there must have been about twenty students
who came down and said they were all ready to go and they had taken this and
that and what not. And of course, medicine never has any trouble getting
We did admit as many as we could admit. I said we would take twenty-five in
the first class. That was unheard of because most baccalaureate programs
started with five or ten or fifteen. I do not remember, but I do not believe we had
any attrition with that first class because so many of them had been waiting to get
in that they were highly motivated.
As far as faculty is concerned, I was much better known than I realized. I just
tended always to go about my business and speak my mind, but I never really
knew, and I had done that ever since I had graduated. I had gone to committee
meetings and spoken and what not, but I never really realized that anybody
heard. I had published two articles, I think, by the time I came here. Maybe
three, one at Duke and two at Harvard. The accrediting, going around the
country getting data for accreditation, of course had helped my reputation. But
the first faculty for the most part were people whom I had known in various
places, who felt pretty much the same way that I did.
The unusual thing about our program was that nursing for many, many years,
well nursing has had several revolutions, and started with Florence Nightingale
who statistically proved that nursing care decreased morbidity and mortality rates
for English soldiers in the Crimean War. Then English people, to honor her,
started a school, St. Thomas Hospital, which she did not run but which her ideas
influenced the progress of the school. And so she wanted a real school, and it
was financially independent and control was not in the hospital. It was the first
real honest-to-goodness training program.
So that was the first revolution, and of course those schools took hold, but when
they came to this country the financial independence and the control went by the
board, and hospitals controlled them and financed them, and exploited students
for labor in the hospital. It does not mean that all the education was bad, but it
was almost by accident that the education was good. And it did not mean that
students did not need to work with patients, because they do in order to learn.
So the second revolution really was to get the control of nursing programs into
educational institutions, which hospitals are not, in terms of their primary
purpose. So that has been going on steadily and now we have junior college
programs and baccalaureate programs. This was done not just for control but to
improve curriculum and get decently prepared faculty and choose students who
were not just nice, but who had some brains. In doing this, the second
revolution, which was pretty education oriented, nursing faculty tended to get
their advanced degrees in education rather than in any advanced clinical nursing
practice. They followed the model of colleges of education because the first
higher institution of learning that admitted nurses for advanced degrees was
Teacher's College at Columbia University. Well, I got my bachelor's degree but
it was in sciences, but in the 1940s and 1950s and 1960s and even today, you
can hardly find a school of nursing or a college of nursing, or nursing program
that does not have somebody, and usually it's somebodies, with advanced
degrees from Columbia.
Now they are strictly education oriented. This does not mean they are not good,
you know, but they are interested in curriculum and educational administration.
So most of the nurses who went and got master's degrees, and later doctorates,
when they suffered through this kind of program, even though they said they still
liked nursing the patients, their social and economic rewards came from being
classroom teachers and administrators. When they worked in programs, the
nursing content was not a heck of a lot different than what they had in their
diploma programs because they had no advanced nursing. Follow me?
Now, new medical techniques. Medicine had passed on a few procedures, like,
you know, we did not take blood pressure when I was a student until my third
year and then we were allowed to take blood pressures. So, there were a few
techniques handed on, new technical advances, new machines, new drugs.
Those things sort of made the curriculum a little bit different. But as far as any
research and how to nurse better, zilch, because the brains of nursing were busy
changing curriculum, writing philosophies of education and hating doctors and
administrating. It was so bad when I opened the program that anyone who
worked with students in a clinical area was called [a] clinical instructor, and they
usually did not have very much education. They were second class citizens.
They did not even have very much voting power in the faculty.
Meanwhile, the brains, presumably, were standing in classrooms telling people
what they ought to do, and screaming about how bad things were in the hospital
because the nursing staff did not know anything. Not only were they against the
doctors because they felt put down by doctors (I am sure), and they could not get
over it, or they knew that nursing was not doing very well, and instead of getting
out there to see what could be done, they criticized nursing service.
So my idea was not new. Goodrich back at Yale, way back in the 1930s, had
said that it bothered her [that] at Yale they had a master's program at that time,
that these highly intelligent and educated young women were not able to
advance nursing practice directly. They all seemed to feel that in order to
advance themselves (and I am not putting this down, I mean people need to get
more money) they had to go into teaching or administration even back in the
1930s. And so she said that every nursing program ought to have at least one
model unit where intelligent, brainy, committed nurses were trying to do
something about direct nursing practice. So their program was set up with her
being in charge of nursing service as well as the school. It did not work out. I
think it was before its time, as was ours. I do not know what all the problems
were. I have got her book, but it really does not tell you why it failed, and I could
not seem to find out.
The other thing that nurses in the hospital, the practitioners, the staff nurses, and
whatnot, [had] was a hierarchy. The same went through in nursing practice that
was in schools. Like when I graduated from school, from nursing training, I was
a staff nurse for about six months. I was pretty good so they made an assistant
head nurse and then a head nurse. I had no training in administering or
personnel or whatever, but because I was good, they just appointed me. And of
course, you go because it means more money, weekends better, whatnot. It
was then, after a couple of years of that, I realized I did not know enough and I
had better get out and do something else. But most people did not. I am not
blaming. I am just stating the facts.
S: Those are the facts. The other thing that nurses were doing was that a hospital
found that nurses had to be there. So nurses took over the duties of everybody
else in the institution, when on weekends and at night nurses were managers.
They dealt with the diet kitchen and social service and the pharmacy, and when
those people went off, they did their work because they were there and it would
cost too much to make pharmacy around the clock, or they would go down to the
admitting office. Just as I told you, I ran the drug room three times a week up in
New Hampshire. Well, most nurses said they did not like this; nevertheless, it
was easier in many instances than dealing effectively with hurting, dying,
miserable, sometimes cantankerous patients and their families. If everything did
not go right, then you had clinical problems which nurses were not able to
Now, back when I was a student, there was not much of a problem because
patients came in and stayed in bed forever. You know, if you came in for an
appendectomy, you stayed in bed two weeks. Now patients were gotten up right
away and that posed different kinds of problems. You came in with pneumonia
and you could bathe patients, rub their backs, do all kinds of things and you felt
as if you had contributed. Now there are so many people mucking around that
nurses did not know what their niche was in this very complicated situation.
So, they became managers. They ran a good floor, whatever that means. And
they kept the doctors happy and administration happy, and the complaints to a
minimum and they became managers. Meanwhile, the untrained or partially
trained nursing assistants were running around not necessarily doing bad things
to patients, but if they did anything good it was by accident. Or if patients got
any kind of effective nursing, it was by accident more than by design because
there were no designs. The nursing care plans only contained, for the most
part, the doctor's orders, but nothing about the person who had the disease. It
was disease oriented and management oriented, not person oriented.
As I say, there was not any of that back in the "good old days" either. The
patients were in bed so long that you had to be stupid if you could not get some
kind of a relationship going. Most women were worn out with kids at that time,
and they were delighted to be taken care of and everything went really well if the
disease could be controlled, which sometimes it was. Also, doctors and nurses
got along better. It was very Victorian. The father was the doctor and the
mother was the nurse and the patient was the child, but if you do not think too
much about it, it made for a fairly decent relationship triad. So I came here with
the complete approval of Dr. Poor and George Harrell; I would not have come if I
did not have [it] because it was different. I decided that I would be in charge of
nursing practice in the hospital (which was a horrendous job), when it was built,
which it was not until 1958. No dean had ever done that.
K: Since Yale?
S: Since Yale, except hospital programs generally had this kind of arrangement.
Deans all over the country just thought, you know, this is really terrible. What is
this kook doing, because deaning is so difficult. Well, I did not find deaning
difficult at all. I was a very good delegator, but they had built this up to be a
tremendous administrative job. Incidently, our salaries were lousy. I think I got
something like eight thousand dollars when I came here. And faculty, I was
lucky if I could get them five. But on the other hand, it was sometimes more
than people with PhD's who had written books on campus were getting.
Salaries were pretty bad.
K: Is this the reason--the low salary level--that you were afraid that perhaps you
would not be able to get the higher?
S: No, the salaries were all over bad.
K: It was just generally bad?
S: They were worse here in the South, but they were generally bad. No, the
reason I though I could not get them would be that of the things that I wanted
them to do. [chuckle]
K: So you felt that there were very few nurses that would be willing to go along with
the kind of innovation program?
S: Who had the academic qualifications, because I was not willing to sacrifice that
because I wanted us to be respectable in the University.
K: I see.
S: Both things. I took on this dual responsibility because I wanted to guarantee or
insure faculty practice. Most deans looked for hospitals and agencies where
their students could practice and the faculty could follow them. I wanted a place
where our faculty, including me, could practice and the students would follow.
This is the medical model. I am not saying that I agree with everything in
medicine, but nursing had thrown out apprenticeship completely when they
moved into educational institutions. And I agree that apprenticeship has its
dangers, unless you have master practitioners who are willing to let students
grow and go beyond you. It is a very real danger. But I know of no way for an
art like medicine or nursing because that is what it is, it is based on science, but it
is an art, to be learned without seeing what it is you are supposed to be learning.
S: Now, nursing had done away with that because in order to get away from the
control of hospitals, they have thrown out the baby with the bath water. So I got
faculty. We dickered with state board, we got approved by the state board of
nursing, and I dickered with the University and got as many faculty as I could get
using the state board as a lever.
I got faculty. The first faculty were really great. I was able to get some that I
had or worked with at Duke, a couple from Harvard, a couple from
Massachusetts, and this was a very committed, I guess you would almost hate to
say dedicated (I hate to use the word because it has so many connotations) but,
dedicated faculty who saw their responsibilities as university faculty with not only
the privileges but the responsibilities of being in the university.
Many schools of nursing did things differently than the rest of the university. We
wanted our admissions, our grading system, our credit system to be like the
University's. Now medicine tried to do things differently, but we felt it was
important since we were an undergraduate program to have the same criteria as
the rest of the University. Now, there were little differences, like so much clinical
practice required, a kind of a credit system that was different, but in so far as
possible we went with the University rather than with the health center, which
would have been easy. We felt a part of the University first and secondly a part
of the health center. So, that was their first responsibility.
Their second responsibility was to advance the practice of nursing by practicing
themselves and eventually doing research. Nobody in our faculty, including me,
knew enough about research to really do any honest to goodness research. We
could do descriptive research, but we could not do research that was statistically
oriented. We could do descriptive. We also wanted them to establish a
relationship with at least one physician so that they could show a collaborative
relationship between themselves and that physician with a certain group of
patients. For example, I had a group of patients on the fourth floor, which is a
medical floor. I had excellent relationships with not only the head of the
department but with the chief resident and many of the staff. I worked with Willie
Deal, who is now the Dean of Medicine, and Sam Martin. We worked together
with a group of patients and the nursing students and medical students observed,
really, as well as taking care of those patients later.
Now, George Harrell and some of the people in medicine felt the way to get
collaboration was to put students in a classroom together. I disagreed with this
because first of all our students were undergraduates and the medical students
had already been through college. So there was a knowledge differential which
was in favor of medicine. Putting them in a class together did not seem to me to
do anything. It looked like we were, you know, getting an interdisciplinary team
and it would be easy, but it did not accomplish anything. I felt the only real
collaboration that could come would be with patients, because I think you only
have a team when the team members, even though they may overlap in some
functions, have something that is uniquely theirs, and really requires a look at
phenomena or data that is different because of a different set of values. For
example, a physician would look at a fever: "I wonder what is going on to make
that fever go up? Should I get it down now or should we wait? What is it a
symptom of?" I look at a fever and say, "Gee, you know, she is hot, he is hot,
and when that fever breaks he is going to perspire. How am I gonna make him
more comfortable? He should have fluids." Completely same phenomena but
a completely different frame of reference or set of values (frame of reference
does not make people as uncomfortable as saying a set of values).
Now, you do not get that in the classroom. You know, you can get some of the
things to make patients comfortable in the classroom, but the day by day looking
at the same data or the same phenomena from a different frame of reference is
what brings about collaboration. When the college of health related services, I
guess it was called, was started, we had PT's and OT's and lab technicians,
[and] they also looked at the same data, in some instances from a different frame
of reference. If they do not, you have got a hierarchy rather than a collaborative
team. Of course, even though physicians say they want a team, in a sense, and
I am not blaming them, they have been brainwashed or socialized or educated to
think that they know how to do everything and it is only because they do not have
time that these other people are brought in. To some extent that is right, but
there are other things that they really do not know how to do, nor are they
temperamentally [prepared] or whatever. Not because they are men and we are
women. It is different than that, although that is sometimes used as an example,
but I do not buy that either.
So then the other thing we wanted to do in the hospital was to take away all
these non-nursing [duties]. We wanted to reduce the hierarchy in our hospital.
We did not want head nurses and supervisors and all these characters all over
the place who did not know nursing. We wanted lay people called unit
managers to run the units, the [sort of] people who could fight with the dieticians
and the pharmacy and get the orders transcribed. We wanted clerks rather than
nurses sitting down and copying doctor's orders over. This was all thought out
before our hospital even opened. Everybody agreed, you know; they knew it
was going to be hard, but they agreed we would try it. The system of unit
managers had been tried once before. I cannot remember if it was Detroit or
someplace in the Midwest, and it had failed several years back. We thought it
had failed because the unit manager system was put under nursing rather than
under hospital administration, and we wanted it put under hospital administration.
Mike Wood was the hospital administrator and he left, I think, even before our
hospital opened and went to Jacksonville. We had a terrible time with hospital
K: Where in a kind of line of authority would the hospital administrator be? Under
S: No, this was the other innovative thing that we did which was supposed to
liberate hospital administrators, but it scared them to death, I think because it
never really took hold. In most institutions like this, the hospital administrator
was pretty responsible to the dean of the medical school. In this set up I
insisted--and George agreed and so did Russ Poor--that the health center
council be made up of the provo and the deans and the hospital administrator.
The hospital administrator be a member of the health center council. Now, that
caused some difficulty with George's recruiting faculty because they really could
not see how. If they did not have that little playpen under control, how could
they make out? But that is the way we started. Now, the hospital
administrators that we had, had all been trained, educated the other way and
they were scared to death of this.
K: Too much responsibility?
K: Too much independence?
S: Well, I do not know. I had trouble with faculty, too, because I was a very liberal
dean. That is not really the word.
K: Free reined?
S: Yes, free reined, I guess. I decentralized and really gave the authority with the
responsibility because I did not want to be bothered with it, because I wanted to
work with patients and fight with the University for money and stuff. They would
say, "Well, do we have to be here at seven?" I said, "I don't care whether you
are here at seven. You have got a job to do." They were frightened of the
freedom. I had faculty that were frightened of the freedom. Well, who was
that? Eric Fromm Escape from Freedom? Something like that. And hospital
administrators, I do not know to this day what our problem was with them, but
medicine delegated authority and responsibility to the residents so that on each
unit the chief resident had the authority and responsibility for the medical care on
that unit. I delegated authority and responsibility to the Nurse III. We used
different titles only to get a different image, you know. Whether it was good, bad
or indifferent, I do not know. So I delegated completely.
The hospital administration would never delegate authority and responsibility to
the unit managers. They said they were not trained. They were not bright
enough. Well, I did not have the brightest Nurse Ill's in the world and a first year
resident is pretty lousy, but you know, as long as you have back up you have to
give them the responsibility or it does not work. Hospital administration would
never do this. Hospital administrators were nice people, you know, but they just
could not seem to get out from--they would almost force the doctors to make the
decisions. Which was not hard for them to do. I do not know really what it was.
Also, hospital administrators, more than physicians, seemed to be very bothered
(I hate to use a word as strong as resent) and fearful, almost, of nursing having
so much power. They saw me as a very powerful character. While
administrators and doctors had been screaming for years that nursing faculty
should get into the hospital and practice, when we did, things happened and they
wished to heck we would go back into our classrooms, you see. So we were a
Also, we were getting a tremendous amount of notoriety. We had visitors from
all over. We were very successful in the early days. We got grants by just sort
of blinking our eyes, speeches, you know, whatever. I had faculty publishing
who had never written anything before. We were probably one of the top three,
if not at least five, if not three schools in the country. But it does not mean we
did not have our problems. We even had problems getting accredited because
we were so different, but we went up to New York and we made it. Medicine
was not getting all of this. Oh, they were getting their usual grants, but people
were coming to the health center to see us, not medicine. This was before they
brought in all their high powered specialists. George Harrell felt that he wanted
the focus on, it was not called that in those days, but sort of general practitioner,
family practitioner kind of thing. So all physicians had to work in the general
clinic which bothered them, you know.
K: Before we go on could you explain to me if at the beginning there were
physicians practicing in the hospital who were not on the staff of the college of
K: That had not come about?
S: No, never. It still has not. Really.
K: So in other words, they were hired to be on the medical staff?
S: They felt there were several patterns you can use, but it was felt that doctors who
had a private practice would never really commit themselves to the care of
patients in the institution and to teaching and research. So it was decided that
they would go the way of completely employed by the University. Now, the
salaries were not going to be enough to bring in people who could make more in
private practice. So they got this thing called the academic enrichment fund
which patients' fees went into, and which were supposed to be used to pay
somewhat of the differential between what the doctor could get if he was in
private practice, like that. Now, that has been greatly criticized, and I do not
know enough about it. What the answer is, well, I better not say. I do not know
what the answer is, but that is the way they chose to do it. I believe it is far
better when the physician is employed by the University.
K: At first did they let the physicians bring in any of their own patients to the
K: They did not?
S: No. Everybody was admitted. First of all, you could only get into the hospital if
you did not have a physician and you were from this area, or unless the
physician referred. That was to keep from taking patients away from private
physicians in the community. That was a big fear. So you had to be either
referred but from outside, from all over Florida, Alabama, Mississippi, whatever.
So they came to the clinic generally, and then were admitted or not admitted or
carried in the clinic. [The] second thing was that so that we would not be a
dumping ground for only indigent patients which happens in so many teaching
hospitals. Not that we minded the indigent, but we wanted our students to get a
picture of all the social and economic backgrounds, not just one. I found at
Belleview and sometimes at Duke that nursing students' and medical students'
attitudes are engended through the care of the indigent. They are very casual
toward people because they think these people are lucky to get anything. And
that is just no way to operate a business.
K: So this fit in very much with the concept that had been developed in studies
before the hospital was started of taking an approach to the whole person
instead of the disease?
S: Right, and teaching our students that these were whole people. So in the law it
was stated that the teaching hospital shall be as self-supporting as possible,
which did away with our having to take only indigents. Now, we never knew
which was which and there was a code on the chart, but you know, most people
did not know the code. So patients were intermixed, really. There were no
private rooms, which was probably a mistake, but it was the safest. We did not
want big wards and to keep away from big wards, we decided not to have private
rooms. So there were only four bed wards and two bed wards, which did create
Dr. Harrell felt very strongly that people needed R & R, that they should not stay
in the hospital all the time. There was a tendency for interns and residents in
most institutions to sleep in the wards, you know, if they were on call. This
disrupted family lives, and it is a well known fact that physicians' families have
break-ups. George was a very moral, family-oriented man so he felt that interns
and residents, even if on call, should go home. That is why the graduate
housing is built as near the hospital as it is.
So, there were no rooms in the plan for people to sleep. No beds. There were,
however, on each ward teaching apartments. This was his idea. I did not think
it would ever work. I had worked in so many hospitals where everything was
planned nicely for the patient like lounges and porches, and six months after they
opened the things were taken over for beds so you could bring in more patients.
I just knew that his teaching apartments would not work, but these were places
where you could teach people how to take care of themselves at home if they
had diabetes, or if they had some kind of a handicap. Unfortunately, the doors
to these things were not big enough to put in wheel chairs. You know, things
like that. The idea was humane and good, but it never took hold. The first thing
you knew the interns were sleeping in there and residents were sleeping in there.
They became catch-alls.
The unit manager system. We had problems with nurses not wanting to give up
these, fighting with the dieticians because they were not sure what they were
going to do if they did not. So it took a tremendous amount of patience and
surveillance and what not. Probably the place that it worked best was on the
floor where I was there all the time, practically. We did have a continuing
education program, and one of the things that made people want to come to see
us was that nursing service and nursing education were literally together, for
about, oh, I would say until 1966 or 1967. The staff were supportive of patients
and students. Our faculty was supportive of staff. We were set up in terms of
specialization. For example, we had a medical and surgical section. The
nursing was a college, but it was also a department of the University. We
wanted eventually to departmentalize, but then you have to have people with
doctorates and you have to have research going on, and we were not ready to
departmentalize. Now, medicine was departmentalized. I probably could have
pushed it, but I did not want to do anything that would be different from the rest of
the University. So we called them sections. I did give them budgetary control.
I got it from the University, but we did allocate according to sections. The
section chairman was responsible for the teaching and the practice and research.
That section was responsible, in their particular specialty whether it be O.B. or
Now this was the other thing that was different. Most of nursing was going in a
general way. They did not want to follow medicine anymore and so they did not
want medical, surgical, O.B. or pediatrics. They wanted growth and
development, the child and the adult, anything that would make it different from
medicine. We deliberately chose the medical set up because that is where the
patients were and that is where the doctors were. We wanted practice in
collaboration. If we had a section of adult nursing, you know, where would you
go to find your patients and your doctors. It would have just been a mess. We
were criticized for this. So, the unit manager system finally took hold and began
to work, but not as well as it would have if hospital administration had delegated,
There were several problems that arose during this time. First of all, the clinical
faculty of medicine felt that they did not have enough power, and that it was just
not going the way they wanted. So there was a push to get in a lot more
specialists and to do away with the general practitioner idea. So they began to
get people like Enneking in orthopedics and the eye man, whatever his name
was. I do not know why I forget, but I have not thought of him for a long time.
Medicine began to be broken up into very little small specialties, most of whom
did not work in the clinic. They only worked in their specialized clinics.
Now, that is OK, you know, but then there began to be this tremendous fight over
beds. I mean orthopedic beds and neurology beds, because they brought in all
these interns and residents and they had to have patients. Screaming for more
patients and more beds. One of the most devastating things for us, and I do not
know what else I could have done, was while Sam was provost and he was
getting ready to leave, but we had been promised health center funds. We had
no space. I had an office that was not much bigger than this. Our faculty was
spread all over the place and we just had no space. One of the things that I saw
when I first came here [was] we had no space. But because I wanted so many
other things, I did not fight about the space and maybe I should have. But I had
to fight about so many things, not fight, but take a stand, that I decided eventually
space will come.
Well, actually it did. The little we had did come. I mean we did not have any at
all. I do not know why George did not think of it. They just did not think of
things like that. But we had been promised by the health center, and so had
health related sciences, that we could get federal money they would give up.
You know, we get money from the budget for building. So, we went through all
of these shenanigans and we got a promise of federal money to match or over
match or whatever the money. We were pretty much all set to go and there was
a meeting. Sam took us out to some lake. I guess he felt badly, and come to
find out we did not have the matching money because they had to use it to
expand the hospital or something. I have forgotten which, So they could take
in more students to keep South Florida from opening a medical school, which
they eventually opened anyway. Well, that was a pretty grim day. Of course,
we had to say we did not want the money from the federal government and it was
a big blow. Maybe more than it should have been, but there was nothing we
could do about it. It had been decided by the University and Darrell Mays, who
was in health related sciences, and I knew absolutely nothing about the fact that
this was going on.
K: Well, was this really a University decision or was it that it was empire building on
the part of the medical college?
S: Well, it was empire building on the part of the medical college, but it was to the
benefit of the University to keep the medical students here, rather than having
them building up South Florida.
K: So what you are saying is by this time the University itself, I suppose I am talking
about Dr. Reitz at that time?
S: Yes, I think so.
K: But that it was more important for the prestige?
S: I am not even sure if it was not O'Connell by this time.
K: Was it that late? 1967 or something?
S: It was around there, yes. I do not want to say which one was there, but it was
not just that. I think they would have listened to Darrell and I, but we knew
nothing about it. It was probably one of the few times, and it was deliberately
kept I am sure, because I was by this time known as a very outspoken character,
you know. I did not always win, but I made my views known. Darrell was pretty
well thought of on campus. It was something. Whether it was politics, it was
one of the few times that I know. Now, I do not know what all went on other
times that I did not know about. But it was one of the few times I knew. Sam
felt badly. He could not look at me for a few weeks, but by this time it was
already accomplished. There was nothing that could be done. So, that was a
big blow because we had worked very hard on plans, screaming with the federal
government to get the money and justifying it. That was hard.
We still had no space. So they had all these plans, you know, when this
happened we would get this and when that happened we would get space. We
would get the library which I think they eventually got. I said to them, "You
know, you are ridiculous. South Florida is going to have a medical school. You
can put it off for three or four years, but it is going to have a medical school."
Now, they did not come right out and say that was the only reason, but I do
believe (this is my opinion) that it was the only reason. Nobody refuted it
completely, but they did not ever say yes that is the reason either. So you have
to remember that this is my opinion. I think it is pretty good.
K: Would you explain a little bit more? I do not quite understand about the actual
working relationship between the staff nurses and the teaching nurses.
S: For example, the Nurse III, who was really in charge of the patient care on the
fourth floor, let us say, was in the section of the college. She was a member of
the section of the college. The staff nurses were responsible to her so that she
also had a dual responsibility. I, for example, had A service, and when I made
rounds in the morning with the physicians and the kit and caboodle of them, the
team leader for that group of patients would be there and both of us would work
together on what the students should be doing or what we would be doing the
rest of the time. So, there was a very close working relationship.
Now, some faculty were better at it than others. I am very good at it because I
am interested in the patients and the staff could see that. Also, if it was
necessary for me to do a technique with a patient that I had not done for a long
time, and it was necessary because the patient trusted me or because something
needed to be found out that I probably could find out better than anyone else.
So, I did not do these techniques. It was a waste of the money I was getting, if
other people could do them better. But once in a while it would be necessary for
me to. I would always go to the staff nurse and say, "Hey, practice me. I do not
do this all the time." So they knew that there were some things that they did
better than I did. And there were some things I did not try to bluff that I knew.
K: You were not afraid to admit it to them?
S: Oh, no. Not when anybody's comfort was involved. I would never not admit to
it. Therefore, it was less difficult for them to say when they did not know
something or to come to me for help. The students saw me doing this because
one of the hard things about this kind of a job is that I was never alone with
patients. I had students or staff or doctors or whatever. That is kind of hard,
you know, over a long period of time, but that is the kind of life you take on.
We had no trouble getting faculty and we were beginning to get better educated
faculty, although most of the people with doctorates who came would not know
what to do with a patient if they fell over one. So I just did not take a person to
get a doctorate unless they had come and they would say, well, they want to do
curriculum revision. I would say, "Hell, you know you are not gonna do that."
Or they wanted to do evaluation. I would say we have got an evaluation unit on
campus. So I did not get as many people with doctorates as I would have liked
because I just was not willing to bring a person in just to get the doctorate to sit
there and not promote our goals.
Now, I would bring in researchers if they wanted to research clinical study or
clinical phenomenon. We had not much problem getting staff for a long while
even though the salaries were low, and one of the things that I really worked for
was salaries. Most of my time was spent with patients. I taught a couple of
classes. I let the college to run their own business. The rest of my time was
spent going around the country getting money or by making speeches and stuff,
or working with the University to let them see that nursing was a reputable,
respectable discipline and we needed money. We were probably at one time
three-fourths supported by grants, which is pretty bad. The VA hospital opened,
finally, and their salaries were way higher than ours. So we began to have acute
shortages of staff. Now, meanwhile, we have got all these specialists fighting for
beds and they are upset because when they have got complaints about nursing
service they do not want to come to me. They are not used to going to deans.
They want to go to some nursing service director who is sitting in the basement
someplace who is scared to death of them.
K: And chew them out?
S: And chew them out, and immediately chew everybody else out. I am perfectly
willing to chew people out, you know, but I want to know all the facts. The
situation was bad in the hospital. There was no doubt about it. There were
justifiable complaints. The chain of command was to go to the nurse III on the
floor. Well, she was not called a head nurse, and that bothered them. Then
they could go to the faculty section chairman, but they did not want to do that.
They wanted to go to one person and have everything taken care of magically.
So this was bothering them.
The second thing was that we were short. So they began to say, "You know, we
gotta get these students up here to work shifts." I said, "No, you are not gonna
get these students up here to work shifts. I do not care what you do. You can
limit your patients, you can do anything, but we can pay some students to work,
just like you can pay some medical students to work, but they are just not going
to come up here and work night after night and call it education." Well, that
bothered them. From, I would say, 1966 or 1967 on, we had a perpetual
shortage. There began to be then a very definite move on the part of Ed Ackell.
George Harrell had gone by this time. Sam had gone. One hospital
administrator was brought in for interviews and I knew he was going to be hired.
I had breakfast with him and I liked him. But he said to me, "You know, under
any other circumstances we could get along fine, but I have been brought in here
to get nursing education out of the hospital." I said fine because they wanted to
go back to night supervisors, head nurses, floats. I do not know if you know
what floats are, but you bring nurses in and you send them wherever they are
needed like O.B., pediatrics or ICU. Well, no nurse knows enough to do all of
K: To do all those specialties?
S: They were beginning to fuss about the fact that we collected data from patients in
order to make nursing care plans. We called them nursing histories. In the
beginning we had a full authorization to put them on the charts. They had to be
signed properly and a faculty member had to co-sign them. We had
problem-oriented nursing. We were the first group to put in problem-oriented
nursing, even though the system had been set up by somebody from medicine.
Doctors really never took it over here until they were sort of forced to, and I am
not sure if they are doing it yet. But it shows on the chart, you know, if a patient
has a decubitus and there is nothing in the chart that shows that this has been
led up to. It just appears out of the blue, [and] then something is wrong. Or, if a
patient is getting pain medication and nowhere does it say whether it did any
good or not, then you know, you have to get in there and find out whether this
So a chart is the only practical way to evaluate care. Medicine knows this.
They have been doing this for years, but they wanted nursing to be evaluated on
what the patient said or what they said, not on any documentary evidence. See,
the doctors feel like the chart is theirs. Well, legally the chart is the patient's, but
they have always felt of it as their chart. Here we were, not writing down things
like "slept well, ate well," which does not mean anything. But we were writing
things down that were much more incisive and showed thought. It would have
helped them as well as us and the patient, but it was cluttering up the chart, you
know, here were all of these papers. We had permission to have these charts,
the nursing part of the chart, kept in the record room. Now, I had to fight for that
in the beginning but we got it because in many places the nursing notes are
thrown out (which they should be because they are garbage). I mean, "slept
well, ate well," you know, what is that? So, the record room kept them. We
could send students down to look at charts to learn, just as the doctors did.
Well, one way they thought up to harass us was to get the record committee to
say that these should be destroyed. Doctors were even tearing up the nursing
histories and putting them in the wastepaper basket. That kind of thing did not
bother me as much as not getting the building did. In fact, it was not too bad
because when students would say, "Aaaaaa," I would say, "Well, you know what
you could do." So we taught them little techniques like if the doctor said that
thing, the students should say, "Well, that is very interesting," and walk away.
S: You know, I mean, [so that they would] not get caught in a controversy. So we
helped them learn ways to deal with conflict that were not always confrontation.
That is not bad. I am one to use everything to teach people. But it did get
hairy. You could not help but get mad, and I have a great tolerance for that kind
of thing, but even I have a breaking point. But faculty did not have that much.
Then students began to play both sides against the middle, and the staff began
to play. They could not stand the pressure from the physicians and we became
a house divided, in a sense.
The other thing that was bad was the University, and the state. We had four
years to work with nursing students, which one really needs if one is to socialize
people into a profession. Then the junior colleges began to erupt all over the
state, and the state legislature said we had to admit students from the junior
colleges who had two years of general education. That was very difficult for us.
We had to do it, but we no longer had four years. The students who started
here, we really could not give them anything nursing because that would have
meant that the junior college students would have had to stay another year or an
extra semester, which the legislature frowned on. So we had to really become
an upper division college (which we always were), but we could not introduce
anything into the lower division, and that was very difficult and very bad.
K: With the women students that you started with, I guess mostly from here you
said, they would have had some science background in UC before they came to
K: Are you saying that the women from junior colleges usually did not have a
comparable background, or had you initiated some prerequisites for nursing in
S: No. First of all, I do not know where this is going, but at that time I would not say
they had a comparable background even though the courses had the same
names. That is an opinion. Secondly, we introduced introductory nursing
courses into the freshmen and sophomore years.
K: I see.
S: So we had contact with these students and they had contact with us. Now, then
you do away with that, you have a whole bunch of students coming in as juniors
with really no orientation to nursing, and it was just a different thing. We needed
three or four years to do a proper job of socializing education rather than just the
plain two years, because our classes were getting bigger. Around 1967 or 1968
you had to take in more students if you were going to get more money. You did
not get more faculty, so we were getting more students than we could really
handle. I held the line, but you would have had screaming from parents and
legislators and the University. Because the public still thinks that if you are
pleasant, you know. I would get calls and they would say, "This kid is not very
bright, but she is so nice. I know she will be a good nurse."
S: Also, our admission requirements became much more difficult. In fact, I would
not know today how to have set up criteria. It was not too bad with them starting
here, because if they started here you could somehow have contact with them
and you had grades at the end of the two years with all of them going through
pretty much the same program. So you could do it partially on grades, mostly
on grades. Because I really believe that the only safe criteria is grades. I would
not give you two cents for interviews. I could on you and you con me and you
know. What does an interview do? Nothing. Letters--garbage.
References--you always pick the ones that people you like. So really even
though it may not be completely fair (there are late bloomers), the only valid thing
is grades to me. So it was not too bad when you could use grades with
everybody coming through. Oh, a few [came in as] transfers from other
universities, but they had been in universities too. Then you get the junior
college kids coming. You got all the kids that started here, and we would have
three hundred applicants for seventy-five places. So you got a bunch of them
that started here; you got them. Then you have them from every junior college
in the state, and the junior college kids have all A's, and the kids that start here
have B's and C's and you know that those B's and C's are better than those A's.
What are you going to do?
And so we tried everything. We tried one really bad fiasco of first come first
served, and, my God, kids were killing each other to get in line! Well, of course
that did not work. Then we tried to do it on SAT's and those kind of kooky tests.
Some faculty before I left want to do it with interviews, and I fought it because I
know how subjective interviews are. So the junior college movement (which I
thoroughly agree with) did upset our socialization process with students and it
upset our criteria for admission. It made it much more difficult, and I do not
know to this day how to do it properly. And if anybody says they do, they are
K: What had you all done in the beginning? What made the decisions?
S: We had committees.
K: You had committees?
K: Did you choose the committee?
S: The committee was elected I think, but I am not sure. I did not sit on
committees. I hate committees, and I realize that you need them to do certain
things, but I never went to hardly any. I did the University ones because I had
to, and I did the health center ones, but the college committees were very
autonomous. And the sections were the autonomous unit and they would select
somebody from their section to be on the curriculum committee or the
admissions committee or the promotions committee or whatever. The sections
were very autonomous and they really did that kind of thing.
K: We mentioned the housing set up outside the hospital for med students, but was
there any special area ever set aside for nursing students?
S: No. There was a fight. I mean, our nursing students wanted to have one
dormitory. They kept bringing it up. I said, "No. You are undergraduates.
You will live with everybody else. I do not want you isolated." Well, they
wanted to be nearer the hospital, or whatever, but I just felt they should be with
everybody else. Most of them lived in dorms or they lived in sorority dorms.
Toward the 1960s, when people began moving out, most of them had
apartments with each other. But not always. They had apartments with other
One of the good things about our program too was that we wanted our students
to see the hospital as a learning place, as a library is. In most programs,
students go on the wards from nine to twelve, three to six, or whatever with the
faculty. We wanted our students to work with certain patients and to be there
when the patients needed them. So our students could go into the hospital at
any time and work with their patients, so long as they reported in and said what
they were going to do. Now, this was very unheard of. But this means that our
students had far more clinical time and they did it because they wanted to, not
because they were told to go at a certain time. That was much different.
Then, of course, we began to have difficulty getting faculty because the salaries
were so bad. I had gotten them off, but they still were not as good as they
should be. This was true all over campus. It was difficult to get faculty who
would be willing to lay their life on the line and work for patients with the difficult
situation in the hospital with open warfare with hospital administration and
medicine trying to get us out of the hospital. With nurses not even being
together anymore, it was getting increasingly hard. So we were getting faculty
who wanted to pull away from the hospital and not really work with patients, and
back to hating the doctors and nursing service and stuff like that.
While this was going on, we had the Vietnam War and the student's "revolution."
Nursing students were probably not as belligerent or aggressive as other
students and this campus was not as bad as many, but what happened was that
students began to be vocal about who they liked and what they did not like, and
we had always had problems with our students who came with the idea that
nursing was giving shots and running machines. We told them they had to talk
to people. They said, "Well, when are we gonna learn to give shots?" They
were much more technically oriented because of their previous image of nursing.
They always felt that they did not have enough of this technical stuff which we
told them they could learn very easily once they had to. It was that difficult. So
they began to get more vocal about this, and they began to be lazy, really, [to]
want grades for nothing. We had a couple of faculty members that were really
almost sent over the brink because students did not like them making them think,
and would not give them As. I had a student tell me that I gave her a C, I think,
and justified it. She said, "I never had a C before in my whole life." But I was
not so intimidated and my survival did not depend on students liking me. I did
not like it when they did not, but I could also say if I made a mistake in grading,
which I did.
Faculty somehow with all this began to fall apart and play for the student's
popularity and God, everybody was getting As and it was really mind blowing.
Meanwhile, we were still getting people coming to see us. We were still getting
grants, still publishing, but it was not fun anymore. I can deal with being
controversial and I can deal with being a non-conformist because I am an original
thinker and I can do without the popular vote for a while. But after a while when
you are not getting any feedback at all in your own place. I just thought, you
know, there is no way that either this is before its time or our ideas were no good,
which I did not really think, but you know, it is a possibility. Nursing is going to
go through a bad time on this campus. I am just not willing to put up with it
anymore, even for the money, which was getting a little better.
The bad part of it was I was fifty-nine, and if I just stayed three or four more years
I would have got a lot more retirement because I had been here over twenty
years. But I added up the money and I figured I could make it, survive. Well, of
course, with inflation it has been a heck of a lot more difficult. So I intended, as I
said, to stay on and work with patients because medicine wanted me to. Many
of the physicians believed in what I was doing, especially the medical men.
They wanted me to stay on and they would appoint me and even pay part of my
salary. This was suggested to the new dean but she never replied until a year
later when I said I was going to leave. Then she said, "Well, why don't you do
what they want." I said, "Well, gee, you know, if you had really wanted me to do
that, you would have said." It was obvious that I was a threat, which I can
understand. She has since died, you know. She was afraid of me and I can
understand why, although I really did not intend to do anything about the college,
but just my presence would have been bad. It does not work out even though I
thought it would. I could see it would not.
Meanwhile, the hospital was falling apart. We did not have any soap. We did
not have any supplies. That had always been a problem. I do not know what
the problem is. They think by making it a non-profit institution they are going to
fix that up, but I do not believe it. We ran out of supplies all the time. We must
have had about seven hospital administrators, and each time one would come I
would say, "God, I hope you are gonna fix the supplies." Well, they said, "First
we have to change the billing system." Every new hospital administrator, the
first thing he did was to change the blasted billing system, and then he would be
gone before the supplies were straightened out. I do not know. We have just
had trouble with supplies.
So I just quit for good. Now, there are people who still believe in what we were
trying to do. But increasingly nursing has felt that in order to be independent
they have to break away from medicine. Of course, I fight this with articles. I
do not make speeches anymore, but, you know, in private conversation.
Patients need physicians and nurses and PT's and OT's and the world is
becoming more interdependent and nobody is independent completely anymore.
But the hostility is so great, and most nurses who got educated got educated so
they could move away from patients and doctors and the hassles because it is
very difficult, and nobody realizes, but the most difficult thing in the world is for a
nurse to hang in, as I said before, with dying, complaining, miserable, fearful,
ugly patients and families. Doctors can come and go, but the nurse is always
there. The nurse does not choose her patients. Patients come and she takes
care of whoever comes.
It takes not niceness, you know, it takes education to deal with these kinds of
situations. It may come out as, if you ask a patient, you know, "Well, gee, how
did you feel about Dorothy as a nurse?" "Oh, she was wonderful." They may
not even be able to say anything more than wonderful because what you do is so
much a part of what they expect in their daily lives. There may be little things,
like if they are left handed making sure that the bedside table is on the left hand
side. They make the difference sometimes between complications and no
complications. We have done lots of studies to show. I can watch a patient
come down the hall and I will say, "Gosh, he is gonna have complications."
They say, "How can you tell?" "Well, I am not able yet to tell you how I can tell,
but she is gonna make everybody so anxious that the X-ray machines fail,
medicine is late, everything goes wrong." These things are as real as taking out
There are so many things that we do not know yet of why people get sick. You
know, why did I get the flu and the sinusitis this week instead of whenever I got it
last week instead of three weeks ago or four weeks from now? There are
reasons, you know. My resistance is down. Some of them I know, some are
physical, some are emotional. We can tell almost with every patient that has a
serious illness or even a thing like this, that something has happened in their
lives. We could begin to pinpoint these and there are things that we could
prevent. Probably those kind of things are more important than stopping
smoking, really. Then, why do some people get complications and other stuff?
There are lots of reasons that we do not understand. When I talk like this
everybody says, "Well, you think nursing is psychological," and I say no, because
touch is very important. It is doing physical things for people that is very
important. I cannot distinguish between the psyche and the soma. They are so
intertwined [that] there is just no way of saying this is this or that is that. If I get a
headache part of it is organic and part of it is psychosomatic, which means that it
is both psyche and soma. Sometimes the soma is more important and is the
thing that needs to be dealt with, like in the emergency room. You do not go
tooting around trying to lay hands on people. In the ICU, probably the machines
are more important. In other situations they are not that important. There are
other things that are more important. So people are beginning to see this, but
they cannot set up their programs or they do not have power. I did have power
here. I did have authority. I earned it, God knows, but they are not willing to go
through the hassle.
Most of it is premature teaching. A newly diagnosed diabetic is not ready to
absorb all the facts about diabetes. A man or a woman who has cancer of the
lung is going to have to be operated on. Sure, you can scare them to death to
stop smoking, but what are you going to put in its place? These things are
important. When you take away you have to put something back in, or the
person is going to go crazy. These are important things.
K: Is it possible, in your opinion, to develop the kind of sensitivity and expertise
involved in this kind of nursing as a program gets bigger and bigger as it did
K: In other words, what I am saying is, is it just growth, per se, that can kill the kind
of program that you wanted to develop?
S: Well, I do think you have a point because George and I saw a little gem of model
care, model research, model teaching. I do not think growth in itself would do it.
I think the kind of growth with the specialization, and the fight for beds and the
fight for power [would be needed]. That kind of growth did, I think, hurt all the
educational programs in the health center. I do not think ours was the only one
that was hurt. I think they have all been hurt, but I do not think they know it, in a
sense. So, I would hate to think that it was growth per se, but I think that you
have a point.
K: But there is sort of a limit, say, with any one certain program?
S: There is certainly a limit in the number of students. See, faculty cannot teach as
many students in the way I am talking about. You can put five hundred people
in a classroom all right. See, medicine would have the staff guy, you know, like
Jake Taylor or Hart, and a couple of residents, three interns and two students. I
would have me and the team leader (who is loaded with all kinds of things) and
twelve students. Now, I could do it with ten or twelve students by killing myself,
but beyond that you cannot, and even that is too many. So it has never really
been recognized that to do this kind of teaching you do need a lower
student-faculty ratio. I guess it is lower. I get mixed up, but anyway, not as
many students to one faculty member.
See, one of the things you need to do and one of the things that we were very
successful in doing [was] I could not care about patients unless I had the
experience of being cared about. I am not saying when I was sick; I mean just
the experience of being cared for because you cannot give what you do not
have. So one of the things that we tried to do in our program was two things
really. One, that they could be successful in our program. We did not go with
this "five of you are going to fail out because you are so stupid." But you can be
successful. Secondly, we care about you. So we felt it was very important for a
student to have a caring relationship with at least one faculty member. Because
otherwise they were going to take out their bitterness and frustration on patients
who are low men on the totem pole. One of the things that we did, I hired Sid
Gerrard, who has since died, but who was a great psychologist. He did write
later self-disclosure. Well, Sid was the least self-disclosed man in history, but
you know, he believed in it. He had never worked for a woman and I had never
had a man employee, but we became very good friends. I hired Sid really to
loosen up our faculty, so that they would be more open, because the more open
they were the more open our students would be and the more we could work
together. I had the experience of going to Bethel way back with this open-up
business. It was one of the first. It was not like Esalen and some of these
kooky things that have grown up since, but it was really a tremendous
I sent four of our faculty to Bethel. It was a discipline kind of opening up thing.
It was not taking off your clothes or some of the things that are going on now.
But Sid did a very good job with our faculty and they did a good job with him.
We were able to have a caring relationship. I do not mean sloppy or
sentimental, but you know, we care about what happens to you, with all of us,
which was a very good educational environment for students who were going into
helping others with their brains. If their emotions were all tied up, their brains
would never unhinge.
K: What kind of a graduation rate did you have over the years? In other words,
how many women made it?
S: I do not have the statistics, but for our tenth anniversary we were much more
successful than any other baccalaureate program in the country. We had more
students to start with. We had less attrition. We had more people working after
they graduated. I said, "By God, you go through this program, you are gonna
work," because that is another problem in nursing. Nurses have not been career
oriented. I would say it is okay to get married and have kids, but keep your
career no matter what happens to you. We had a very high, very successful
program from that standpoint. We have had students go on to get doctorates
and the usual honors and what not. We had no problem that way.
K: Did you have anything to do with the start of the Santa Fe program?
S: No, nothing.
S: Nor should I have.
K: I just thought maybe as an advisor or something.
K: How did you feel about their program in terms of what they have done and what
they have accomplished?
S: I do not know what Santa Fe particularly has been. I am very much for two
types, not levels, of nursing practice. I think there is technical nursing and there
is professional nursing. Professional nursing is that which collects data, gets the
problems, makes the plan to solve the problems, assesses, etc. It is more
intellectual. That does not mean that is more intelligent, it is just there are more
intellectual activities involved, but it can only be done with people, with the
patients. It cannot be done from somewhere else. Technical nursing practice
also requires intelligence. This process that I am talking about, the assessment
process for professional nursing, is in a sense technical. Technical nursing is
based on science and involves thought, but it consists of those procedures or
techniques that have been developed and can be taught with precision. You
know, they are known. They could be improved, but in general they work and
they are effective.
So there is less risk [and] less challenge in some ways. They are not as
problem oriented. It is like the difference between a doctor figuring out what
drug to give and writing the order and the nurse giving the pill. Now, to find out
whether it works or not, how often it works, is a different matter. I believe what
really should happen in the junior college programs is that practical nursing
should be done away with and there be the two types. You see, the problem is
that the junior college programs teach pretty much the same kind of stuff that I
had in my diploma program with the new techniques and what not. But at the
same time, they think that the only reason that you have a baccalaureate
program is to get administrators. Junior college people feel, and many people
feel, that there is not enough clinical experience in the baccalaureate program,
which is true. There was in ours but there is not in many. That is true. People
in the junior college programs in general I think feel that there is no place in
clinical practice for somebody trained about the junior college level. You see, I
just happen to think there is, but I do not blame them for thinking this because so
many baccalaureate programs do not teach anything any different than what the
junior college kids are getting, except public health or a few courses in leadership
Then the junior college people want their students to get into the baccalaureate
program in nursing without taking any nursing courses in the university. That is
the old days. That is right back to where we were a hundred years ago. I say
that unless you have some upper division nursing, you should not get a BS
degree in nursing. They see it as repeating, and unfortunately, in some
baccalaureate [programs] it has been repeating. So this is a conflict within
nursing, and I do not know how it is ever going to be solved. I thoroughly
approve of the two programs. I think there is a need for both. I think the junior
colleges do not emphasize the technical aspects as much as they should. They
are trying to teach some of the things that we are teaching.
Baccalaureate programs, on the other hand, well, take somebody like Carol
Bradshaw. Carol Bradshaw graduated from someplace and then she was at
Duke. She got a baccalaureate degree and I guess she got a doctorate from
someplace, but she has not really had any experience in professional nursing,
per se. She worked at our place for a while as a nursing service director, and
she was on our faculty or was on pediatrics for a while. But in general maybe
she is not a good example to use. What happens it that a baccalaureate
[student] graduates, and they need a teacher at a junior college and she has got
a baccalaureate degree, this magic thing called a degree. So she goes to teach
at a junior college, which she should never do because she had not had the
kinds of things that they should be teaching in the junior college. So she starts
to teach them what she knows and it gets all messed up.
What they should be doing is having their junior college graduates go on to get
some kind of a degree in education or something and bringing them back and
teaching in those programs. You see what I get at? The whole thing is messed
up and mixed up. I am writing a new chapter for a book revision that we are
doing and there are so many vested interests in people with jobs that we lose
them if it gets changed. Nursing is its own worst enemy in some instances.
When nurses say, you know, doctors have held us down, I say no way. They
have helped, but I said it is us that have helped. Nurses were against
baccalaureate programs. Diploma graduates are against anything that smacks
of education. Not because they are against education, but because they are
threatened by [the fact that] somebody else is going to be called professional.
What does it make them? And territorial rights. I guess it is true in other
K: Can I ask you one more question? I know you do not feel good and I do not
want to impose too much. Is there anyone that you have not had an occasion to
mention in our two discussions that you feel has been a very positive contributor
toward the development of, not just the nursing program, but the medical center
here at the University?
S: Carol Taylor, who is an anthropologist, was a very great help in getting the unit
manager system started.
K: Did she do studies or something?
S: Well, she called herself a trouble shooter. She would go around and get
feedback so we would know where to focus our activities. She was a people
watcher. She was a very great help in our early days with that. I would say that
everyone on campus, [especially] Wayne Reitz, was tremendous. I have no bad
feelings about this University.
I was here at the time of the Johns Committee. Some delightful person sent my
name to the Johns Committee that I was a Communist and I have forgotten what
all the things were. Of course, I am Catholic which does not set too well with
some people here, but you know, all Catholics are Communists [laughter]. I was
very liberal. I was trying to change the black-white situation. I did hire a maid
to iron. I do not like maids. I do not know how to deal with them. I never had
them and I usually clean up the place before they come, but I needed somebody
to iron and I found out nobody else was paying her social security. The salary
she was getting was just awful, so I told her to go back and get social security
and I was raked over the coals for this. I changed the whole economic situation
of the South. I did kind of controversial things. I pushed for black students. I
had black people in my house once in a while, not just to show off, but you know.
Neil Butler was a very good friend of ours. He was a student.
Anyway, they found out we were using a book by Peplau. I guess maybe way
back she was a Russian. I do not know. Somebody in her family was. It was
called Interpersonal Dynamics in Nursing, or some such title. But anyway,
Wayne Reitz got ten things that I was a Communist, and so he called me up. I
was scared to death. I had never been confronted with anything like the Johns
Committee. I had gone through the McCarthy era without any problems. So he
said, you know, do not worry. So he took care of it. Then I was told to get rid of
two people on my staff who were "homosexuals." I said, "No. I am sorry, I do
not know anything about that." I was not told by Reitz.
K: Not by the administration?
S: By the administration. Rumors were coming to me and even the provost said to
me, "Hey Dorothy. You better get rid of those two people." I said, "No way.
They may or may not be." I do not know how I feel about them. I do not know
what the hell homosexuals [are like], but you know, I do not know if I like or I do
not like them. They kind of frighten me because they are different. I said, "I do
not know if they are or if they are not, and you fire them if you want to fire them.
Let Senator Johns fire them." And so I rode through that. They had
investigators. They came and said they had investigators looking through the
windows of these people's houses. I said, "God." Well, I said, "You get the
evidence, you go and do something with it." I never fired the people. But on
campus people were being intimidated and were being fired, but I did not. I
have gone through some hairy times.
K: Were you asked to testify or did people come and talk to you?
K: Was it all just innuendo or rumor?
S: No, all just innuendo and there were people on campus, deans, who succumbed
to this and did fire. I was scared to death, but I did not. So those were pretty
bad, but you know, the University stood behind me with these things because I
talked to Reitz about it. He said, "You have got to do what you think is best."
Partly because we were women, partly because the salaries were low here,
partly because there was a tendency to give medicine everything.
But on the other hand, I have to say that any time I was in trouble financially I
could go to the department of medicine or the provost office. I scrounged
money from everybody. I have absolutely no pride. If I wanted or needed an
extra faculty member or what not, I would say, "Hey, have you got any money left
over?" They were just tremendous that way. I had absolutely no problem. It
was a good relationship in general. Now, toward the end it was kind of an
embarrassment, you know, because I was still standing. We had comprised, but
beyond a point we could not. They thought everything would settle down. They
were surprised. Nobody wanted me to leave and they were shocked to death
that I did. But I think they thought, "Well, everything will be lovely." Well, of
course, it has not been, you know. But anyway, it was fun and I am very grateful
for the experience and getting a couple of things out. There are indications that,
you know, forty or fifty years [laughter], maybe you will come back. Do you have
any idea what I have been talking about? Do you understand?
K: I think so. I have done some reading in the reports to get the plan and I very
much agree with you about what the med center and the nurses are going
S: See, you say med center. We took great pains to say it should be a health
center [laughter]. It has become a med center. Even the first signs they put
were med center. They forgot, you know.
K: Well, actually did they not kind of steal the name health center away from the
pure concept that was talked about in the report?
S: They did not steal it. They wanted to create that kind of an environment. They
wanted it to be focused on people and health, rather than just disease.
K: What I mean was, I think even at the very beginning, although it came down a
little bit in the expectations that Dr. Poole or Coffman and everybody were talking
S: Right, but you know, the word. It is med center to everybody, almost.
K: But it was intended again on this idea of a holistic approach to the person.
S: Right, very holistic. The first ten or twelve years, it was the right people in the
right place at the right time.
K: I guess as a result of the planning that went into it, would you say, or was it just
S: I think it was just pure luck.
K: Pure luck?
S: It was just pure luck that I was available. [It was] probably just pure luck that
George Harrell or Sam Martin was available. I think it was just a fortuitous
meeting of the right people at the right time at the right place. I really do. I do
not think planning had anything to do with it.
K: In a way I am sorry to hear you say that to me because it seems to me it is less
likely that the concept can be sustained as it was all that lucky.
S: I do not really think Russ Poor or the people that he had even knew the kind of
things that George or I had in mind.
S: They had some glimmer of this holistic thing, but as far as the implementation of
it, it could have been implemented in so many different ways. So to the extent
that they wanted a holistic health people oriented place, that is planning. I knew
lots of people who talked those words that do not do anything about it. I could
give you a hundred deans who would say this and would implement exactly the
opposite. That is where I mean the luck comes in. I think, well, I probably
would not have come if there had been a different dean of medicine [other than
George], but it was just lucky. You know, that is terrible, I guess. That is
because I am Irish, but I really think it is just fortuitous. His ideas, my ideas, the
ideas of other people just sparked off all kinds of creative activity. Now that is
luck. We were trained for it. I was trained for it, but to find that was luck.
K: To have it fall together, yes. Were there other universities since then that have
tried to really copy the approach or were these circumstances duplicated?
S: Yes. Western Reserve tried. In fact, Western Reserve has now taken credit for
K: Starting from scratch?
S: No, they did not start from scratch.
K: They did not start from scratch?
S: There were places that started from scratch like Kentucky. Kentucky started
after we did, and a place in New York, Down State Medical Center in New York.
They tried, but they were not able to get the same kind of nursing dean to really
forge nursing into the place. And the work: they did not find any nurse who
would be willing to take on nursing service. They would want to take it on paper,
but they really would not want to do the gutsy work to do it.
K: I should ask you one quick thing in addition. Was the 242 medical plan ever
S: I do not know what you mean.
K: Well, okay, maybe it was not then. In the reports, Dr. Harrell was talking about
plans which would involve a slow decrease over the middle four years of your
normal eight year medical education in social science humanistic courses, but
still a continuation of those courses into the fifth and sixth years of the medical
studies so that you would not have to break at the end.
S: No, it was never really implemented. Once you get a medical student they have
cut down on the undergraduate education, I understand. You know, you do not
have to be graduated to get into medical school. But you get a medical student,
I mean it is going to be an usual man or woman that will keep on with humanities
or anything else. They just get the grind. Whether the grind is that hard or
whether they think it is, but they just think they have to spend day and night on
medical things. Now, the other thing that made it very exciting: our first
medical classes, like our first nursing class, were superior people for students. I
mean, I had a tremendous relationship with medical students and some of the
doctors did with nursing students. We were really all together. They had some
men in medical school who already had degrees in psychology or sociology and
they were just tremendous people. They were older. So again, those were
lucky things, you know.
K: Because you were starting fresh in the field they wanted to stay in?
S: Yes. When the hospital opened, I mean we waited. You know, I had been a
volunteer at Alachua Hospital for two years on weekends. Every other weekend
I would go down there for nothing because we had to use that place for a while.
Our hospital opened, you know, with maybe like six patients. God, there were
twenty-five nursing students and twenty medical students and a hundred faculty
all leaping on those five patients. It was the most exciting day I have ever seen
in my life when we got our first patient.
K: Well, I want to thank you very much for cooperating.
S: You are welcome. I am sure this is different than other faculty deans.
K: Well, it has been very easy for me.
S: Do you have any more questions?
K: Oh, I have about six million questions, but I really feel like you are one of the few
people I have talked to who has a good grasp of what they felt their role was, and
the more significant things. Obviously, I have not had to pull things out of you.
K: And you certainly have been the viewpoint on more significant contributions.
S: I know I have probably left things out.