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Interview with Betty Hilliard, February 2, 2001

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Interview with Betty Hilliard, February 2, 2001
Creator:
Hilliard, Betty ( Interviewee )
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English

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University of Florida College of Nursing Oral History Collection ( local )
University of Florida -- History

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This text has been transcribed from an audio or video oral history. Digitization was funded by a gift from Caleb J. and Michele B. Grimes.

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Samuel Proctor Oral History Program, Department of History, University of Florida
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This interview is part of the 'University of Florida College of Nursing' collection of interviews held by the Samuel Proctor Oral History Program of the Department of History at the University of Florida
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Made available under a Creative Commons Attribution Non-Commercial 4.0 International license: https://creativecommons.org/licenses/by-nc/4.0/.
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UFCN 1 ( SPOHP IDENTIFIER )

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This Oral History is copyrighted by the Interviewee
and the Samuel Proctor Oral History Program on
behalf of the Board of Trustees of the University of
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Copyright, 2005, University of Florida.
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SAMUEL PROCTOR ORAL HISTORY PROGRAM at
the University of Florida















Samuel Proctor Oral History Program

University of Florida

University of Florida College of Nursing Project


Interviewee: Betty Hilliard

Interviewer: Ann Smith

Date of Interview: February 2, 2001









UNIVERSITY OF FLORIDA

ORAL HISTORY PROGRAM

UFCN-1
Summary

Interviewee: Betty Hilliard
Interviewer: Ann Smith
February 2, 2001


Pages 1-6 Betty Hilliard was born in Framingham, Massachusetts, in 1925. After going to
college in North Carolina for one year, her father told her she would be on her own for any future
educational expenses. This was 1943 and many nurses had been recruited into military service
creating severe staff shortages in hospitals. Options for women at this time were primarily
limited to marriage, teaching or nursing. A stipend, which was created by the Bolton Act
forming a Cadet Corps for additional nurses, allowed her to go to Massachusetts General for
three years. Hilliard spoke of the state of the art of nursing with examples of morphine being
brought to the bedside in tablet form. A variation of a Bunsen burner with an attached
tablespoon would sterilize water to dilute the pill before being drawn up into a glass syringe. She
graduated in 1946.

Page 6 Hilliard worked for a year in Isolation and Obstetrics, gaining a beginning knowledge of
labor and delivery. There were no in-house physicians. This left the assessment of the patients'
status during labor up to the nurse who would call the private doctors and anesthesiologists when
the women were about to deliver their babies. Obstetrical patients were routinely, heavily
medicated during labor, which slowed the process down. Adding insult to injury was the fact
that the medications caused nausea and vomiting. Hilliard states that this was seen as an
additional benefit in the medical community since this would assure the patient's stomach
emptied so she would not aspirate during the use of drop ether. Hilliard was concerned for the
extra discomfort her patients were enduring. Ether was routinely used, making patients deathly
sick to their stomachs. It was a method difficult to regulate as to how deeply the patient was
anesthetized.

Pages 8 12 Hilliard went to Margaret Hague Hospital in Jersey City for three months of post
graduate work in maternity but stayed for a year. In 1949, she decided to join the Navy and had
assignments on Long Island, in North Carolina, and Bethesda, Maryland, during her five years of
service. It was during this time that she was introduced to the concept of rooming-in, based on
the model used at Yale. Her talent in sketching and cartooning was noted, and she was asked to
add artwork to some patient instruction.

Page 13 Hilliard learned of a baccalaureate program in nursing, at Catholic University in
Washington, and she enrolled under the GI Bill in 1954. This was the beginning of the academic
nursing era in the country. She worked and went to school in what was considered an entry level

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program lasting four or five years. She received some credit for courses in her diploma program
but reveled in the liberal arts and science courses she was able to take. When she finished her
program, she moved back to her hometown of Framingham to work nearby in a public health
setting. It was during this time that a whole new world of human relationships with her patients
opened up to her. She valued the personalization and time with each individual and published
her first article during this time.

Page 16 Hilliard left Framingham in 1956 and went into the master's program at Yale on a
grant for maternal-newborn. Unbeknownst to them, her professor, Ernestine Wiedenbach, had
been preparing her students for nurse midwifery from the outset. Then, with their consent for
additional months, they were given the delivery portion of their education, allowing them to
become certified midwives. The various settings in which they practiced exhibited variable
resistance from the physicians toward this new breed of practitioner. Upon graduation, she
found herself with no place to practice in this new field.

Page 18 The Dean of the College of Nursing at the University of Wyoming called requesting
her to interview to teach maternity. She moved west to become exposed to teaching in a
baccalaureate nursing program, to care for a very different patient population, and to confront the
difficulties of finding receptive clinical areas in which students could learn. During the three
years she was in Wyoming, she struggled between the need for her female patients to have more
knowledge about their bodies and physicians' resistance to their patients' need for this
knowledge. Mothers were seeking information about nursing their babies, the birth process,
anatomy and the development of the fetus. This was around 1960 when commotion was building
over the English physician, Grantly Dick-Reed and his book Natural Childbirth. He spoke about
how his patients need very little medication while they were supported through the labor process.
He was highly critical of obstetricians in this country. The controversy intensified.

Page 23 Hilliard was one of three faculty members who were invited to accompany the dean to
a conference in Phoenix. They went via Santa Fe, New Mexico, where she had the opportunity
to visit Catholic Maternity Institute, a birth center and where midwifery was taught. She
identifies this as a major turning point in her professional life. In her words, she was "hooked."

Page 25 Hilliard accepted a position at the University of Florida for $6,000 in 1961 after an
interview with Dorothy Smith. She wanted to move to Florida, having previously visited the
state. The nursing program was still young and could not justify her as a third faculty member in
obstetrics so she began by teaching communicable disease and working on the OB floor. She
learned from the other faculty about all the programs Dorothy Smith was initiating: the Unit
Manager System, faculty privileges, and so forth. She spoke glowingly of the joint
responsibilities for the practice of nursing and the education of any discipline of students who
came to the service. The Unit Manager System gave the clerical responsibilities to non-nursing
personnel, relieving the professional, patient care staff to have more time to take care of patients.

Page 29 The J. Hillis Miller Health Center at the University of Florida was still in its youth.
George Harrell, the Dean of the School of Medicine, Sam Martin, Hospital Administrator and
Russell Poor as the provost, were all in agreement as to the philosophy of the education system

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and the care of patients. This was a new era and extremely innovative. Strong leadership at this
level was important since there were many, particularly physicians, educated in the more
traditional settings, who were extremely vocal in opposition. They were opposed to nurses
becoming less like "obedient handmaidens" as they had been traditionally. They took nursing
histories from the permanent chart, and destroyed them in some cases. They had difficulty with
the trend of including patients in their health plans. Since this was the early 1960s, these
innovative changes were also supported by the changes in society. Controversy within the Health
Center was compounded by the loss of some key leadership. Less supportive replacements in
leadership positions further eroded some of the innovations that had begun to take hold.

Page 31 The College of Nursing and the Shands Hospital Nursing Department, jointly lead by
Dean Dorothy Smith, flourished at the patient unit level. Hilliard spoke warmly of the
relationships that included everyone in the decision-making process. These goals of all were
consistent toward good patient care and optimal education for the students. This included the
non-nursing faculty such as Sid Jourard, a UF psychologist, and bringing in faculty to help staff
learn and adjust in such an innovative environment and cope with outside resistance. Willamae
Whitner was a researcher. She advised nurses closest to the care of patients, how to formulate
and carry out valid patient research from the nursing perspective. Carol Taylor was an
anthropologist with a joint appointment in nursing and anthropology. She was on the faculty for
many years, assisting students and faculty in looking at the complex health care system in the
most creative ways. Hilliard recalls the impact from Howard Wooden, an art historian, who, as
he shared slides of paintings of the old masters, would teach the social issues at the time and the
larger implications of being a human being. Sol Kramer was an ethologist who brought his
extensive knowledge of animal behavior to nursing studies about the effects of touch from
mothers on babies. Hilliard spoke of Sam Shulman, Mary McCaully and others who were
brought in to broaden the perspectives of the faculty and students of Dorothy Smith.

Page 38 Hilliard told of the challenges of changing the student nurse experience in the pre-natal
clinic from routine activities, such as weighing the patients and taking blood pressures to being
assigned to particular patients to follow through the pregnancy process and hopefully be able to
be there at the time of delivery. Since the patients were all told to show up first thing in the
morning, regardless of when the physician would examine them, there was considerable waiting
time. The nursing faculty attempted to use this time with the patients to advantage by having a
corner of the waiting room used as a small teaching session. A birth atlas was placed on an easel
showing a fetus in the uterus. Another patient complained to someone in authority about the
indecency of this and it was ordered to be removed. This was not only the era of very little
patient teaching. It was also still a time of propriety of topics having to do with childbirth. The
nursing faculty members were given a small storage room to convert for the teaching. This was
subsequently overtaken by the medical residents as a study lounge.

Page 39 Jen Wilson, Chairman of the Maternal Child Nursing Section, went to Dr. Daley on the
OB medical faculty about her desire for students to have a richer educational experience. They
drew up a proposal for an independent nursing clinic to be overseen, medically, by him. When
patients had been examined and their pregnancies determined to be uncomplicated, they were
followed by the nursing clinic until their thirty-sixth week of gestation. Initially, they created the

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clinic in the Carver Library and later were absorbed into the Health Department. They had
students from the College of Education who used the opportunity to teach the mothers' older
children. The classes and clinics became so valued by the community, they began a class for
teenagers. Nursing interns (graduates of the baccalaureate program) participated and later
nursing residents (graduates of the masters program) participated.

Page 42 Hilliard told of the national and international recognition the College of Nursing and
Dorothy Smith had achieved at the time. Outside visitors were welcomed to the point that they
began to intrude on the objectives Dean Smith was trying to accomplish. At this time, with the
suggestions of the faculty, they had prospective visitors write objectives for their visit and were
evaluated on this basis before confirming an invitation.
Dean Smith also had research money for faculty development, and each specialty of
nursing was asked for suggestions of prestigious leaders in their field to be visiting faculty for a
trimester. Names she could recall were Ernestine Weidenbach, Vera Keane, Betty Bear and
Gene Cranch. Dean Smith would have faculty members write papers as assignments, give
presentations to colleagues, and publish. Hilliard recalled the generosity and freedom that was
typical of this dean. She would return your paper with comments but was also quite direct in
communicating what she did not like. The dean frequently opened her home for evening
discussions with the small family of faculty or to hear a guest speaker.

Page 46 Dorothy Smith created Nursing Grand Rounds modeled after Medicine. This was the
in-depth presentation of a patient's current status and potential plan of care offered for the input
of the other attendees' suggestions and questions as well as everyone's education about the case.
Hilliard recalls one she was involved with when she invited a group called the Nursing Mothers
of Gainesville. In the 1960s, when mothers had difficulty breast feeding their infants, physicians
had the tendency to order bottle feeding. It was the belief that they merely needed some
experienced resources. The group had formed with the assistance of Hilliard and others on the
faculty. They grew to be successful support persons for the new nursing mothers with a library
of reading material, as well as an offshoot of a preschool group.

Page 50 Marion McKenna was a doctoral student working on role differentiation with Dean
Smith as the Junior Colleges in Florida began nursing programs. Hilliard recalls some of the
difficulties to explain to folks outside of nursing, the differences between the four-year,
professional nurse and the two-year, technical nurse.
She recalls the MIC (Maternal Infant Care) project that took teams of professionals out to
the thirteen-county area to bring poor patients the first prenatal care.
Page 51 Hilliard spoke of the changes in the care of maternity patients over the length of her
career. As a student in Boston, first-time mothers would stay for ten days but patients having
their second child or more would stay for two weeks on the rationale that they would have so
much to do when they got home. It also could be justified that both mothers and babies had been
heavily medicated and anesthetized during the birth process.
The length of stay in the hospital began to shorten when patients of all kinds were
encouraged to ambulate early and get out of bed as soon as possible. The time spent in the
hospital became shorter and shorter until she recalls hearing about drive-through deliveries.


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Page 54 Hilliard recalls segregation of patients according to race in the 1960s at Shands: two
sets of bathrooms, two sets of drinking fountains and a small cafeteria in the basement for blacks.
She found amusement in the fact that the only place where patients were not segregated was in
the newborn nursery due to the cost of building an additional one. She remembers all of
Gainesville was segregated, including the doctors' offices with different waiting rooms and
different entrances. Although many of the employees of Shands were black, not many were
professionals. The first black faculty member was Faye Harris and eventually, some black
students were recruited to the College of Nursing. Hilliard told of a black nurse midwife who
worked for the state Board of Health supervising granny midwives around the state. She came as
a guest to a workshop at the College of Nursing and was stopped and nearly turned away in the
Shands cafeteria because of her race.

Page 58 In 1970, Dorothy Smith wrote a letter expressing her concerns about the lack of
support she was getting from the Health Center. Hilliard has a copy of the letter. In 1971, she
sent a letter to the Provost, Dr. Ackell, requesting to step down from the deanship and accepting
a teaching position. Hilliard remembers Dean Smith traveling and speaking around the country.
She was an active member of the National League for Nursing. She sensed that this era was a
great disappointment to Dorothy Smith, feeling that her ideas for the profession were not
supported.
In answer to what Dorothy Smith's major legacy was, Hilliard answered that there were
many people who had been influenced by her ideas, her charisma and strong belief in the
practice/education model. Her motivation was always honorable; the patient always was
considered the priority; and the integrity of all was her concern.

























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Page 60 Blanche Urey was the dean who came in to replace a beloved founding dean. This was
at a time when health care was moving out of the hospital, and nursing was looking at the
preparation of students for the primary care of the community. This also meant preparation at
the master's level. As Hilliard applied for a grant to prepare nurses for women and infants'
health, a representative of the Robert Wood Johnson Foundation suggested that she write the
grant for all specialties in the graduate program. Though this had not been what she wanted to
do, Dean Urey directed her to comply. As project director for this grant, Hilliard now had
responsibility for finding suitable preceptors for all thirty graduate students to satisfy the sixteen
hours of primary care practice. As she scrambled to find a qualified preceptor and clinical area
for pediatrics, she came across one of her students from Wyoming who worked at the
Jacksonville Naval Air Station and was willing to take some students.

Page 63 Hilliard resigned her position on the College of Nursing faculty in order to begin her
doctorate study at UF in the College of Education. She recalls a meeting with Blanche Urey a
week before she died. The dean had been in a meeting with administrators of the Health Center
and her faculty asked her how she was able to keep her cool during all the confrontational
activity. Dean Urey told Hilliard that she was not calm and that she was the type of person who
suppressed their feelings, and it had a consequence for her blood pressure.

Page 64 One of the assistant deans, Amanda Baker, was appointed interim dean while a search
committee was formed. This was in 1979, and she freed Hilliard from teaching responsibilities
to give her time to get the nurse midwifery program up and running. Lois Malasanos was
appointed as the new dean. Hilliard looks back at the individual strengths that each dean
brought to the college in a very different era with unique challenges in finances, technology or
professional practice models.
The Health Center vacillated in its support for nurse midwifery varying at sites in
Gainesville, Jacksonville and other locations, depending on changing medical and administrative
leadership.

Page 68 Hilliard concluded her remarks with her thoughts about how Dorothy Smith's ideas
were forward and right. She hopes that the ideals that made Dorothy Smith's College of Nursing
famous during the early years live on and flourish within the nursing community in the future.















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UFCN 1
Interviewee: Betty Hilliard
Interviewer: Ann Smith
Date: February 2, 2001


S: Today is February 2, 2001 and I am at the home of Betty Hilliard in the Villages
of West End of Gainesville, PO Box 215, Gainesville, Florida. My name is Ann
Smith and I am interviewing for the Samuel Proctor Oral History Program of the
University of Florida. Betty, why don't we start with where you were born?

H: Framingham, Massachusetts.

S: Massachusetts. And do you mind saying what year?

You don't have to. That is not a requirement.

H: No more. I just had my 76th birthday.

S: And so somebody else can do whatever math they want to.

H: This is Framingham. (handing the interviewer a book)

S: Oh, how wonderful. Framingham.

H: ... which has a lot of meaning to me because all of those old pictures and the
history of the town.

S: That would be wonderful. And I guess what I would like to start with is since we
are talking about nursing interviews and what they have to do with the University
of Florida, College of Nursing -- What was your educational background?

H: Do you want to go back to the Lincoln Primary school?

S: I was thinking of when you got out of high school, then ... ?

H: I went to the University Women's College, University of North Carolina, for a
year. But my Dad said, 'Well, you know, if you want to go back another year, you
need to work for a while to help pay for it.' And I really didn't want to do that. I
wanted to go to school, but I didn't want to go to work. So I went in-training.

S: And in-training, at that time meant ... ?

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H: It was 1943, so it was World War II, number one. But I saw our family doctor and
said, if you were going to suggest any place for somebody like me to go in-
training, where would you pick? And he said, well, the only place in the whole
country is the Massachusetts General Hospital in Boston, which was only twenty
miles from Framingham. So, I went in training there. I don't think most girls did
go in-training because they always wanted to be nurses. I think there were only
two or three options for young women. If you didn't go back to college or get
married, you either went in-training or went to normal school and became a
teacher. That was about it. So, that is why I picked nursing. I didn't want to be a
teacher. So look at what happened.

S: When you talk about going in-training in that time frame, that meant how long
before you became a nurse?

H: Well, it was three years, but it was three years, absolutely, counted to the day. In
other words, we had a formal graduation. I can show you some pictures because
I am going to put them in the book. The formal graduation was held in the winter
time but then they figured everybody's time and sick time. You had to make up
your sick time to come out to three years for you. And when you reached that
three-year period, whatever date that was, then you had what was called a
dining-room graduation. And it was just yours. That was when you were
finished.

S: And what constituted the dining room graduation?

H: Well, your friends all got together and they bought you a corsage for you and you
got to wear your white uniform for the first time. They had a part of the dining
room, the cafeteria, sectioned off so that we could have a party.

S: This was the dining room of the hospital?

H: The hospital. So, it was kind of fun.

S: And what was the student uniform, then?

H: Checks. Do you want to see what it looked like?

S: Yes. Do you have it?

H: I'll show you. They were short-sleeved. For every day. The long-sleeved one
was our formal student uniform.

S: And you had separate cuffs, separate collars, separate top ...


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H: Separate bibs.

S: That was very much like mine, too.
H: Separate blouses, separate skirts, separate bibs, separate aprons, everything
separate.

S: So you had more than seven pieces?

H: Yeah.

S: And you had studs and cuff-buttons, didn't you? Did you have black hose and
black shoes?

H: Yes.

S: That was for the student.

H: That was for students. And then, when you got to be a graduate, you could put
on white ones. I think that when I was these were (showing a picture) the
probie uniforms.

S: And "probie," for those people who aren't the "nursey" types are ... ?

H: ...well, the probationary period.

S: The probationary period is the first sixth months.

H: [Showing a picture.] There I am at the top in the checked uniform and then this is
my group of probie's when we first went in, my close friends. And we had a
bright blue uniform and that is what that looked like. I just had these out to get
fixed up so I could put them in my book, which is why I had them ...

S: Oh, these are wonderful, Betty. Are you in this picture?

H: I am at the end.

S: Oh, yes.

H: Did you find me?

S: I did. I did.


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H: I was lucky because when I went in, they passed the Bolton Act, so the Cadet
Nurse Corps came into being. And so I got tuition paid, and a monthly stipend,
which didn't amount to very much, and we all got uniforms.

S: The Bolton Act was to prepare nurses ...
H: ... to encourage more young women to go into nursing, because we needed
nurses then. So, that was so, we were semi-military. We had to say that we
would -- after graduation, work either in the military or in a strategic hospital,
somewhere. But do strategic nursing.

S: And so you had, because of your three year training program, what we now call
clinical experience by working in the hospital as well as having classes?

H: Yeah. We had half of our classes on duty time and half of our classes on our
own time. In other words, they divided it up. And we worked hard. I mean, long
hours and hard, but a lot of it was because it was World War II. And we worked
a lot of nights and a lot of p.m.'s but you see, the graduate nurses went off to join
the service. So there was an acute shortage and there might have been only one
or two graduates to supervise a whole building. And so students just had to fill
in. Sort of interesting. I have got a lot of that that is all in the book.

S: And who taught your courses?

H: We had clinical instructors and they were really very good. I wrote a chapter
about this, because people look back at diploma programs and think, well, you
know, that was just exploitation and hard work. It really wasn't, at least at the
General [Massachusetts General Hospital]. We worked hard, I don't mean that
we didn't, but I think our instructors were well-prepared, really with us, taught
what we needed to know. However, it was all procedure-oriented, in those days.
It didn't resemble anything academic. It was how many steps are there in doing
a shampoo and in what order that kind of stuff. How do you put a flaxseed
poultice together? Of course, when I trained, when we gave shots, we had an
alcohol lamp. Have you seen those? It is a little lamp and it was fueled by
alcohol. Sort of like a Bunsen burner, but it had a tablespoon attached to the top
of it that was right over the flame.

S: I think I have seen pictures of that.

H: You lit the flame and you put some water in the tablespoon and got it boiling.
And you had to boil that to sterilize your needle ...

S: Oh, I see.

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H: ... and then you drew up some water in the syringe, enough water to dissolve a
tablet of morphine or whatever it was.

S: That's right because morphine came in tablets, then.

H: All of the narcotics did, then, came in tablets.
S: And so you provided the sterile solution to draw it up. You carried the alcohol
lamp and lit it, to sterilize the water in the spoon. Is that right?

H: Right, because you had to boil your needle up. You see, the syringes were
glass. And the barrel and the plunger -- one barrel fit one plunger but no other
plunger.

S: They were not interchangeable.

H: That is right. So, we would boil up the syringes and every ward had a boiler, a
stainless-steel boiler. And then the needles, we boiled in the tablespoon. It was
something.

S: So, being procedure-oriented was just crucial.

H: It was. And they had to be sure that we all did things the right way and the same
way.

And so that was really what their teaching was all about. But they were good.
And I think that in a way we may have done better than college students did
because we didn't have as many classes, of course, and not as much time in the
library, but we certainly had a lot more contact with people. And could develop
communication skills and interactive skills and things that maybe, the college kids
didn't get.

S: I guess one of the things I was leading up to, was if your classes were taught by
physicians?

H: Well, we had physicians do some of the pathophysiology and you know, if there
was a disease that we needed to learn about, they could come in and that was
really watered-down medicine -- what we got from them. But... I think in the
very early years, in the turn of the century -- late 1800s, the physicians really had
to do the teaching, because there wasn't a backlog of prepared nurses to do it.
We were just beginning to get nurses prepared. So they did a lot more then, but


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then certainly at the General, we used them some, but we had our own staff of
clinical teachers.

S: And then, when you graduated from there, which was when?

H: 1946.

S: 1946, and then what did you do after you graduated?

H: Breathed a great sigh of relief.
S: And had a full night's sleep, maybe.

H: I stayed there for a year and it is interesting but I think we were sort of given the
impression that we had better. For all of the good things that they did to us, we
better stay and work for them.

S: You owed them some time and service.

H: And I didn't even think I could ask could ask what they would pay me. So, I
didn't. I said I would like to work on pediatrics and whoever it was who was
interviewing me said, oh, well, that is fine, but there is not going to be any room
on pediatrics for a long time, yet. And putting my foot in my mouth I said, well,
where should I work, then, in order to have the best background? And of course,
she said, OB [obstetrics]. Which was my least favorite subject in the whole world
... that and Communicable Disease or Isolation -- the two things I did not like.
But she said OB and so that was where I ended up, on OB, for a year.

S: And so what was that experience like?

H: Well, you should read my book, it is all in here. I worked on Baker Memorial,
which was ... There were three units to the Massachusetts General at that time:
the White Building (named for Dr. Paul D. White) where most of the poorer
patients were, Baker Memorial is where probably you and I would end up, and
then Phillips House was for the very ritzy people. So I was on Baker Memorial
and had been there about two weeks when they put me on nights there. And I
had to take care of the postpartum mothers and all of the labor patients, because
the mothers in labor came to that ward and were put into the room that they
would have after they had their baby. So I had to watch the labor patients and I
didn't know very much about doing that either at that. The delivery rooms were
two floors up, so when a mother was going to be ready to deliver, I had to be
sure I got the doctor. We didn't have any house officers on OB, then. So their
private doctors had to be kept informed and they, at least in my experience, they

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didn't come in and stay there. They just had you communicate over the phone
and tell them when they should be there. And boy! If that wasn't a guess.

S: I was going to say -- how could you assess that?

H: Well, I didn't know how to, because we were assessing we were doing rectals
[rectal examinations] at that time and that wasn't anything that we had learned to
do as students, certainly. And you either learned how to do it or learned
something ... You had to figure out how to tell, anyway, when somebody was
going to be ready and be sure you got the anesthesiologist there and the doctor
there on time. And there were a lot of things that were sort of nerve-racking. But
you had to learn how to problem-solve. And you couldn't make excuses. And
there wasn't anyone to help you, really. And so, you sank or swam.

S: Women in labor in that year -- did they require a lot of pain management?

H: It was just routinely ordered. They medicated patients very heavily.

S: And so that probably slowed labor down?

H: It probably did. I suppose it did to a certain extent, but they got Nembutal; they
got Seconal; they got Phenobarbital and later they got Demerol. We didn't use it
at first but when Demerol started being used a lot, then that was substituted for
the other things. And one thing the private physicians were doing in Boston at
that time (which was really adding insult to injury) but at the beginning of
transition, they were ordering Apomorphine for mothers and that is an emetic,
which makes you vomit. But they did it because they wanted to be sure that the
mother's stomach was empty when she was anesthetized because they used
drop-ether [A form of liquid ether dropped onto a gauze mask was commonly
used as a short acting anesthetic. This was before more refined anesthetic
agents were developed and was a danger because of the inability to control how
deeply the patient was anesthetized and the miserable side effects of vomiting as
the patient recovered.], was and so, talk about adding insult to injury! It was
really bad.

S: It makes you want not to have another baby.

H: ... or ever have one. But anyway, it was very bad, then. There were no
preparation classes for mothers, so they came in sort of not knowing anything
and scared to death. They couldn't have anyone with them. It was before we
could do those kinds of things.


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S: So they were alone and scared ...

H: So, I think that is probably why I stayed in OB. I saw so many things happen that
needed to be changed that ...

S: And so then, after that year, you decided to go someplace else?

H: I went to the Margaret Hague in Jersey City. That is a maternity hospital. At that
time, it had more deliveries than any other hospital in the country. It was a really
big maternity hospital.

S: How is the second name spelled?

H: H-a-g-u-e. He was a governor of New Jersey and he named the hospital after
his daughter, Margaret. But they had a PG [post-graduate] course and my
supervisors at the General said, you know, you really ought to do that, if you are
going to leave here and you want to stay in OB, you really ought to go to a good
PG course. You see, there were no baccalaureate programs. There wasn't any
college. That wasn't a part of the future. But anyway, I think they admitted -- the
PG course was three months and if you wanted to add teaching to that, you
stayed for four months, and when I went, they admitted seventy or more into the
group I was in. And we were all graduates. But when we got to the Margaret
Hague, we had to learn all of the procedures over again, to be sure that we were
all doing everything their way, which did not sit well with any of us, really. And I
ended up on nights and evenings most of the time, there, too. I decided I didn't
want to do the teaching month because all we did was to either teach about
toxemia [the clinical condition indicating toxins in the blood] or
retrolentalfibroplagia [a complication of the retina of premature infants who have
been on high oxygen] -- something that was watered-down medicine. And so, I
didn't think that was really going to do me much good.

S: So you went for the three months.

H: Well, I stayed a year. I worked in the nursery. So I stayed down there for a
while.

S: What made you decide to leave there?

H: I had enough. I had enough of it down there. I had some interesting things
happen down there and we had some fun. I made some good friends. But there
came a time ... So one day I said to one of my friends, I think I am going to join
the Navy. And she said, you are nuts! She said, here you have spent all of this

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time getting prepared in maternity nursing and you are going to join the Navy?
And I said, I am. Where else can I meet nice eligible young men? I can't meet
them here. So, I did. I joined the Navy.

S: And that was in what year?

H: 1949. I was in the Navy for five years.

S: And was that a good experience?

H: Yeah, it was maternity. They found out I was a maternity nurse and that is where
I got sent, of course. Most of it was wonderful, most of it. I had three
assignments. St. Albans on Long Island was one and that was just great. And in
1949, I was on OB there, the two lieutenants who were the charge nurses, they
had decided that they wanted to set up a rooming-in unit. So, they went up to
Grace, New Haven because, of course Yale had the first rooming-in program.
[The historically prominent Yale-New Haven Hospital, re-named Grace-New
Haven in 1945, was chartered in 1826 as the fifth hospital in the nation. In 1833,
it was moved from rental space to a newly constructed thirteen bed hospital.
The primary teaching hospital for Yale Medical School, it has led the way in many
fields including 1946, being the first US hospital to allow healthy newborns to
stay with mothers in the rooms and in 1949, the first US hospital to introduce
natural childbirth as a general service for all obstetrical patients.] They talked to
people up there and saw how it was set up and came back and they got
permission to set up a rooming-in unit similar to the one at Yale at St. Albans.

S: This is an official Navy photograph. It is labeled "Mother, baby, doctor, breadbox
and me."

H: The reason they asked me if I would be interested in helping with this project was
that I was doing some cartooning and stuff and they knew I drew pictures. So
they said, we have ordered all of these breadboxes to be built down in our
carpentry department, but we need to have something put on them -- you know,
little messages for the mothers, because we will keep these on the mothers'
bedside tables or the over-the-bed tables for the diapers and the cotton balls and
stuff for the baby. So I designed the breadboxes with pictures. So that is why
the breadbox. And that is me. And this is one of the doctors and one of the
mothers with her baby.

S: And so they would bring a crib in and the baby would stay in the room with the
mother, which was just totally different from what was being done anyplace else.


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H: That's right. And so that was 1949.

S: The nursery took care of the babies and brought them to the mothers for feeding
time?

H: No, the mother had the baby with her all day. Now, at night they went back to
the nursery. But all day, the mother had the baby with her and we took care of
the mother and the baby. And that is what they were doing at Yale, then, too.
But, this was the second rooming-in program in the country.

S: And did it just feel right as far as you were concerned?

H: Of course. Of course, I was all for it. It made absolutely good sense.

S: And the mothers were ...

H: ... thrilled. Yeah, they really were. But these were the kinds of things, I think,
that made me want to stay in. Things were so bad and we needed to be making
some changes like this. I wouldn't have wanted to hold my breath until I got the
next one.

S: So that was a good enough experience to keep you in obstetrics and make you
want to continue.

H: Actually, once I was in the Navy ... when I first reported to St. Albans, the Chief
Nurse said, oh, you know, we won't put you on OB, probably, not for a year or
more, because you need to have experience on the men's wards. But in about
six weeks, we ran into the Korean War around then, and in about six weeks, they
needed somebody on OB. So I didn't have very much time; I had some duty on
the men's wards and I just loved it. I have got a lot of pictures. One of the guys
on the ward was a photographer. He would lay in bed and snap all of these
pictures: pictures of me giving backrubs and pouring medicines, and I got them
all blown up. Then they transferred me over.

S: And then they needed you on obstetrics.

H: So, I missed that but I really did enjoy it. I was on nights. They were all guys
that had been in Africa and picked up hepatitis. And they shipped a whole bunch
of them back. So they were young and they were military, of course, and sick,
really sick. Another -- this is a backtrack, but my last night duty before I
graduated at the General, they assigned me to the isolation ward, which was at
the top on one of the buildings, the White Building. And I went there, one night,

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and was as unhappy as could be, because I didn't like isolation and I didn't want
to be all by myself up there. And you know, the next night when I went back, that
place was a beehive. They had moved all of those patients out, because a ship
had come into Boston Harbor with war-wives who had been overseas, and their
babies. And the babies had all gotten epidemic diarrhea. And so they admitted
twenty or thirty babies and put them all up on this ward. And so when I went up
that day, that night, here were all of these babies and they were sick. They were
so sick. So, you know what I was doing, keeping track of intravenous fluids and
changing diapers. But that was really something, too. That is a digression.

S: You were in the service for five years.

H: Yes, they transferred from St. Albans down to Camp Lejeune [in North Carolina].
And I loved that. Gosh, that was fun.

S: What did you do there?

H: Well, for a while actually, the Korean Crisis came then. Because when I first
got to Camp Lejeune, we could each have two rooms in the nurses home. It was
a peace-time Navy and there weren't very many of us there. But then, all of a
sudden, the Marines became active down there and a lot more were reporting for
duty and their families came and so it got really, really busy. And we not only lost
our second room, but we got a double-decker bed in the one room we had. And
my roommate -- now this is something else that is sort of interesting -- my
roommate, Gladys, when she came in, we were getting acquainted. She said,
you know my grandfather -- I think it was her grandfather -- was one of the
original Siamese twins. And I said, you have got to be kidding. And she said,
no, I am not kidding. And she pulled out her photograph album and there, of
course, was all of her family and all of these pictures of the Siamese twins when
they were small and when they were grown.

S: Isn't that interesting?

H: I think it is. It is not the kind of a story people are going to believe, but it did
happen.

S: Now, in Camp Lejeune, did you work in maternity, there?

H: Yes.

S: And was that a different experience?


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H: I had the clinic. And it was wonderful. I had two or three really good looking OB
men, one of whom I had a terrible crush on, and a couple good-looking
corpsmen, and me. We started off slow, but it got awfully busy when we had
this influx. But most of the time there, I was in the clinic and that was daytime,
which was really nice. And of course, we were out in nowhere, so if we wanted
to have any entertainment or parties, we had to think up our own. And we did.
We decorated up the Officers Club. We had wonderful parties. We had a good
time. I really didn't want to leave there. But I did. After a year, they sent me to
Bethesda, Maryland. And that was the one I didn't like, too well. Parts of that
were nice, too. I was, for a while, in charge of the nurseries at Bethesda. Shirley
Temple had her first baby there, to give you some sense of when that was.

S: Oh, really?

H: And so he was in the nursery. She has some complications and so he was in the
nursery longer than he ordinarily would stay. But that is the period of time,
anyway.

S: But that is interesting to be able to date those things. I think it gives people
perspective when you think about that.

H: I rode down in the elevator with her the day she was discharged. She was a little
bit of a thing, with dark hair -- by that time her hair was dark. But I ran afoul of
the chief nurse there.

S: Oh, not a good thing to do, Betty.

H: Well, they cut the staff in the nursery. We had room for fifty babies and they cut
the staff down to two nurses and two corpsmen on nights, when I was on nights
and had to make all of the formula for the nursery and for pediatrics and take
care of the babies. And the nursery was on the third floor and the mothers were
on the seventh floor. And so when you took them out, the mothers ... the
babies, you had to put them in these carts that had slots for babies and go up in
the elevator. And it wasn't safe. It wasn't safe to have that few people and that
many babies. And so I went to the chief nurse and told her I was very concerned
and she didn't seem to think that there was anything she could do. In the
meantime, somebody had told the chief of pediatrics that this was a concern that
I had. And so he went storming into her office and she got mad at me and
switched me to a ward of critically-ill surgical patients on nights. And that was
that. That was it.

S: Isn't that something?

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H: Well, you know, if I was going to do it again, I would do the same thing. I wasn't
going to ...

S: But, that kind of retaliation ...

H: But you got it in the Navy in those days. I think that the services have improved
a lot, now. But you could have people in administration that really didn't
understand much about what was going on in actual patient care or very much
about interpersonal relationships, either because they were in a position where
they could give orders and we were supposed to follow them. So, if you didn't
follow orders, that is what happened. You got transferred.

S: How long did you stay on the surgical floor, then?

H: I had a month of night duty, there. It was all right. I made out all right, me and
my aide who was seven months pregnant. The two of us lived from hour to hour
hoping that we weren't going to kill anybody. But I had some good friends; I had
a lot of good friends in Washington. And that city is really an interesting city.
One of my Navy friends lived in Washington and she took me home with her for
dinner and I met her family. And the ones that were living at home, then -- she
had two brothers that were a little bit older than she, maybe a year or two, and a
sister who was a little younger. But I began going with one of her brothers and
we had -- he was intellectual. We had a good time together. We did things that
people would turn their noses up, today. We would go to a church dance and
dance by a record player, you know, the music to the record player, and have the
best time. We would do the tango; we would be all over the floor, just having a
good time. And then get Cokes and potato chips out of the machine. That was
our date.

S: It sounds wonderful.

H: But they were a wonderful family and they made their house my house. Any time
I wanted to go down there ... I think it was just wonderful. I may have bothered
them without realizing it but I was very fond of them. And they were so cordial. I
ate a lot of meals there. We went to church every Sunday. That is about the
only time in my life I did go to church every Sunday. So, that part of being in
Washington was good. Then, when I got out of the Navy, I stayed there for a
while because I had the G.I. Bill [federal program that gave money for schooling
to World War II veterans] and Catholic University had one of the best of, one of
the few, nursing baccalaureate programs in the country at that time. They were
just beginning to get going. And so I enrolled and went to school while I worked

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part-time and got through on the G.I. Bill and picked up a roommate, one of my
friends who decided she was going to stay in Washington. They had just built
the National Institute of Health, right across the street from Bethesda. And she
went to work there. She became -- what did they call them in those days -- she
drew bloods, she went around and drew bloods ...

S: Did they call them phlebotomists, then?

H: No, I don't remember what they called them but phlebotomist is a new term. But
anyway, the two of us lived in Tacoma Park. And she was very frugal and had a
good sense of budgeting. And between us, and because she budgeted money
wisely, we were able to pool our money and live fairly comfortably there. So, we
had a good time. So that was Washington. But I would never want to live there,
again. It is too hot in the summer and too cold in the winter.

S: How was your experience with Catholic University?

H: Well, our program wasn't academic in the sense that we have academic
programs today. But, again, they were just beginning. I don't think that many
people on the nursing faculties had a good grasp of what nursing, at a
baccalaureate level should have been. We had one course, a required course, in
body mechanics -- Miss Bilmeier, and she made us learn the insertion and exiting
points of every muscle in the body, for one thing. And so we could recite them by
rote. That really isn't baccalaureate education.

S: You haven't called on that in your career many times?

H: I don't even remember them. But anyway, one of my teachers was Loretta
Hydegerkin and she wrote a book called the Principles and Practice of Teaching.
I think that was the name of it. It was nursing text, but it is on teaching. And so
she was really, the one who was most...most academic. And I didn't really get
very much out it, but she was approaching what we ought to be doing. But most
of the things I wanted were on campus: ethics and sociology and philosophy.
So, I got some of those, but they had too many courses. I wanted to take some
more of those courses instead of public health, for example. And they got mad at
me, because they said, indeed, you will not, you will take Public Health and we
have three courses, and furthermore, you are going to have two weeks of field-
work. So, I can't say that the program was terribly exciting, but it got me my
baccalaureate, anyway.

S: How long was it, Betty? Was it considered an entry-level program that took four
years or five years?

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H: No, they counted our diploma.

S: So, you got credit for your previous work?

H: I got credit for three years of diploma. They don't do that, anymore. But again, at
that point in time, they needed to get some people prepared and so that is what
they did.

S: And did you, at the time, think about what your goal was going to be after you got
a baccalaureate degree?

H: I don't think I did, really. When I was made to take those public health courses, I
really didn't like them. But, when I went home after, finally, I moved back home
to Framingham, I thought there may be something more to public health than I
got to this point. So I got a job twenty miles away in Worcester with the
Worcester District Nursing Society. And we did home-care, home-nursing. And I
have said quite a lot in my book about that. I did have an article published about
that, too, in AJN [American Journal of Nursing] because that was an eye opening
experience. It really was.

S: So, district or public health nursing taught you another facet that you didn't know
was out there.

H: ... a whole, different world of what made nursing different and special. It really
did.

S: And could you summarize that?

H: You can take the article home. I have got it in the other room. Well, it had to do
with quality time and if you don't make your time with your patient quality time,
then neither one of you are going to get what needs to be gotten out of the
experience. I had an old lady, well, she was in her eighties. And she had
diabetes; she had terrible diabetic ulcers on her legs and she had a huge
abdominal hernia. I mean that it had to have a binder. And she had a
colostomy. And you know, when I went up to take care of her -- she lived on the
third floor -- and her spare room had a big pile of coal in it, because she had to
heat her apartment through the coal stove. Her flat had two rooms, her bedroom
and then this front room with this stove and you know, that was her living area.
So I had to go and take care of her every day. And that could have been a
terrible experience but we really -- that is when I learned how to make something
work so that it was comfortable for both of us. So that is what I wrote about. She

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had been a businesswoman in Boston. She had quite a colorful career. But
then, when she got old and infirm, her family tried to keep her in a nursing home
and she wouldn't stay and so they just washed their hands of her. She really
didn't have anybody. So, anyway, I think that was my first published article, the
one I wrote about her.

S: You taught each other a lot.

H: Yes.

S: And so you stayed there and did public health nursing for how long?

H: Just about a year. And in between jobs, I would go back and work at the hospital
at Framingham -- the one where I was born, usually on OB. But that was kind of
fun. That was like going home. And I could go in and they would let me work for
a month or six months, six weeks or three months -- whatever I wanted, until I
figured out what I wanted to do next.

S: And they were glad to see you coming, no doubt.

H: I think. They always hired me, anyway. My family was well known in
Framington. My uncle and my great-uncle, both were highly-respected
physicians in town, in the early part of the part of the century. In fact, they were
influential in getting the hospital built. So, their names were well known. My Dad
was president of the hospital board.

S: Is that right?

H: They didn't say no to me. They had to take me whether they wanted me or not.

S: Yes, you could stomp around and drop names.

H: That's right.

S: So, then, were you recruited ... how did you get to Florida from that distance?

H: You have skipped about twenty years.

S: Really?

H: Well, not quite that long. I left Framingham. I did that public health in 1957. I
finished in 1957. No, it was 1956.

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S: So, having gotten your baccalaureate at Catholic University, you were starting a
Master's degree at Yale. Let's begin there.

H: They accepted me and they wrote and said you don't need to worry about tuition.
They had a grant in Connecticut, a commonwealth grant that covered tuition for a
certain -- I don't know what the requirements were to be covered, but apparently I
was because I didn't have to pay. So, this is the second place. The G.I. Bill for
the first one and then Yale took care of my payments for the time I was there.

S: Now, you are going to graduate school?

H: Yes, this was a master's program ... in maternal-newborn, when I started.
There were four of us who started in maternal-newborn at the same time. I
guess we started in August and sometime after Christmas, in one of my weekly
conferences with my professor, Ernestine Wiedenbach, she said, what would you
think about being a nurse midwife? And I said, who would want to do that? They
weren't very well-liked back then. They are not very well-liked, today, either. But
back then, the only nurse midwives that I knew anything about, really, were the
ones that were up in the Kentucky mountains and rode horseback. You know,
this is funny but I told my students -- probably told the whole classes of students
this -- about my wanting to go work where I could ride horseback, not necessarily
to deliver babies, but I thought it would be fun to be up in the mountains on a
horse. And so one of my classes gave me this. They said they couldn't get a
real one...

S: Oh, and so the students got a horse figurine for you because you told them that
story.
H: Really funny kids.

S: Well, that is my first thought. One thinks of midwives up in the hills.

H: That's right, because that is really where they came into notice, because they
were doing really good things. Their statistics were as good, and maybe in some
ways, better than some of the others in places where there was more to do with.
So that was very exciting. Anyway, I really didn't think I wanted to do it, but the
other three did and I couldn't be the only one to say no. So I went along with it.

S: Well, now they had a program like that? Or they were developing one?

H: They were developing one but what they actually were doing -- though they
called it maternal-newborn and didn't tell us -- were giving us nurse-midwifery

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from the beginning. And the only thing that we hadn't gotten to, yet, was the
actual delivery of a baby. We had done all of the rest. So they wanted to add on
they wanted us to use our elective period to do this intra-partal piece with
another month or two, perhaps added onto it, and then we could be certified as
nurse-midwives. And so we did this. The doctors didn't like it very well. They
weren't awfully kind some of the time. We didn't make out very well at Grace-
New Haven in the labor rooms, and so, Ernestine Wiedenbach was her name,
made arrangements for us to do most of our intra-partal we moved to New York
and did it at Sloane [Hospital for Women] which is part of Columbia Presbyterian
Medical Center. And they were somewhat nicer to us there. [Ernestine
Wiedenbach was an early nursing leader born to an affluent family German
family in 1900. To the dismay of her family, she enrolled in nursing school at a
time when "bobbing" one's hair was reason for dismissal. Over the course of her
career, she is credited with theory development in a practice discipline and, after
enrolling to become a midwife at age 45, practiced and taught maternal infant
nursing and midwifery at Maternity Center Association, Teachers College and
Yale University School of Nursing.]

S: How long was that program?

H: It was a year.

S: So it was a master's in midwifery?

H: Well, it ended up being midwifery. It started out maternal-newborn. And we had
some other courses. We had ethics and anthropology. Yale had done a little bit
better with the academics than Catholic University, by that time, but it was a little
later on. And every week, the faculty and the graduate students would just sit in
a circle to discuss issues, relevant to nursing, which was interesting to get that
mix of people. But it was highly clinical, clinically-oriented and well-supervised.
We were all experienced by that time but we were still supervised because they
didn't -- Ernestine didn't think we knew where we were coming from was from
the old OB nurse, the old labor nurse. And nurse midwifery has an entirely
different approach and philosophy and that is what she was trying to get into us
without alienating us. That is why she didn't tell us, I guess. So, anyway, we got
through -- by the next August, we were through and the American College of
Nurse Midwives had just organized, I think in 1956 and this was 1958, so they
didn't have accreditation and certification procedures, yet. So Yale University did
it for us. We were certified as nurse midwives through the university. That
meant a written exam and then we had to have an oral exam conducted by the
leading obstetricians at Yale University and I can see it, now. We would go, one
at a time into this room and here were these gentlemen wondering who in the

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world we were, anyway, what in the world they were going to ask us, and not at
all sure they wanted us to be part of their group. But, anyway, that was what you
had to do and then you got your certificate. Mine is in the garage. I'll show it to
you. So then I was a bona fide midwife with no place to practice and no place to
go because they didn't have any places for nurse midwives, back then. They
had the Maternity Center in New York. They did have that. But, there were
probably only three or four programs for nurse midwifery and very few services
outside of frontier nursing and Maternity Center. But I got a call when I finished
there from the Dean, College of Nursing, University of Wyoming. They were
looking for somebody to teach maternity. So, my classmate said, well, go ahead,
go; might as well see the West and get a free trip, even if you don't want to stay
out there. So I told the Dean I would be willing to look into it and she said, well,
good; are you going to be in New Haven this coming Monday? And I said, I am.
And she said, well we have a faculty member who lives in New Haven and she is
going to be there and she has agreed to interview you. And so we did this in
New Haven. I never got to Wyoming for the interview.

S: So they could look you over but you didn't have much chance to look them over.

H: But I went out there for -- I guess I was out in Wyoming for three years, about
three years.

S: Now, this was teaching in a baccalaureate program for them?

H: Yeah.

S: So, they had started a baccalaureate program and they were looking for
somebody with heavy qualifications in maternal-child.

H: Yeah. That was a whole other kind of experience out there.

S: How so? What do you mean?
H: You will have to read the book.

S: You are not the Westerner? Were you automatically a Westerner?

H: I wanted to be. We lived in Cheyenne. The University was in Laramie but the
students, when they got ready for medical surgical nursing, pediatrics and OB,
moved over to Cheyenne, because the hospital facilities were better there, but
they weren't very good. We weren't very well-liked. I think it was difficult for staff
nurses at that time to know how to deal with the faculty and students in a
baccalaureate program, because they were diploma graduates and I think that

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they felt like we would probably be -- oh, I don't know, above them, or let them do
the dirty work. So, it took a lot of doing to get myself friendly enough; have them
see that I was not going to threaten them, in order for them to be nice to the
students. And so that was a whole other kind of experience. But I went on call. I
worked nights. When they were busy, they would call me and I did mostly labor
room. I guess it worked out because at the end of the first year, they invited me
to go out to dinner. They were going to treat me, take me out to dinner. And it
was their way of saying . But, it was hard, at first, because, you know, I went
there with students and they would just ignore me, at first, only at first.

S: I think that was a very difficult time with different kinds of educational
backgrounds and programs. Everybody was busy sizing everybody else up.

H: That is right. That is right. And of course, they looked at me and they saw this
hoity-toity nurse-midwife from the East who probably knew that ...

S: Oh, yes, you probably carried all of the stereotypes ...

H: [They] probably knew that I would see all of these things that they were doing
wrong. This is Wyoming. That is also an official photograph, too. Here I am with
some of the students.

S: So, you stayed at Wyoming for ... ?

H: About three years. But, you know one day, one of the mothers that I had in labor
called up and she said, you know, what would you think about starting some
classes for mothers out here? We need so much information -- would you
consider doing that? Well, now, the only place, at that time, the only place -- two
places that I know of in the country that were doing classes were at Yale --
Ernestine had classes. She came up from Maternity Center, as a fellow, it was a
fellowship. And they were instrumental in getting the rooming-in set up there and
developing mothers' classes. There was some infant growth and development
components to that research, too. So we got to watch her teach a class. But,
she said, oh, no. You can't; you are not ready, anywhere near ready to do it, yet,
so, don't you do it. And another person, well, I was in New York, we went to visit
Louise Zabriskie in her storefront clinic. And Zabriskie wrote our OB textbooks.
She is probably way before your time.

S: I don't recognize the name.

H: But she is the only one. She teamed up with Dr. Eastman from Johns Hopkins
and they wrote the nursing text. She had this clinic -- and I told her when I visited

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her -- that I would like to start classes. And she, oh, no, no -- you are not
anywhere near ready, yet.

S: Is that right?

H: Not only were the doctors not very happy or used to having nurses teach their
patients anything .... You know, nurses didn't teach anybody anything. And
both of them knew that we needed to know a lot more about diplomacy and tact
and some of the niceties in order to make a go of it; in order not to do harm to a
growing movement -- something that was coming and would be good. But
anyway, I got to Cheyenne and this mother asked me and I said, well, let me see
if I can work out a way to do this. And so I called the president of the Laramie
County Medical group and asked if I could come to one of their meetings and
introduce this topic and talk about it. And he said, by no means; we can't have
you come to our meetings. He said, but if you want us to know something, get
one of the doctors you know to come and tell us what it is you want us to know.
So there was one obstetrician, I mean, real OB-GYN [obstetrics-gynecology] man
in Cheyenne and he and I were real good friends. And then there were about
twenty general practitioners that had maternity in their caseloads and these were
the others. But he was the only OB man. So I told him about it and he said, well,
I would do it for you but they don't like me, either. He was trying to get them to
stop having the nurses pour drop-ether for them and they were angry. So he
was doing spinals [spinal anesthesia which was more controlled and less
dangerous than using ether] and they didn't like his pressure. And so he said, I
don't think I am going to be a good one to do this, but maybe the health officer
down at the county health department would be good. We decided that he would
be a good one. And so we asked him and he said, oh, I'll be at the meeting and I
will be glad to do this; it sounds good. He said, you can have your classes in our
classroom at the health department and use some of our audio-visuals, it will be
great. So he went to the meeting and the next day he called me up. He said, it
is all set up, you can go ahead and get things going. So I put an ad in the paper.
And, you know, all hell broke loose. I am not quite sure what happened at that
meeting, but apparently, when he got up to say what he wanted to say, the
people who needed to hear it had gone or weren't listening. And so it came as a
surprise to them when they saw this ad of mine in the paper. And they were
furious. I want to tell you they were so angry at me for presuming that I could do
anything like this. So, anyway, and the Dean, when she ever heard about it, she
was over the mountain and in my office in Cheyenne in no time and she was
furious.

S: Now tell me what year this was. This was coming out of a time when a nurse
would take the patient's blood pressure, but would never, ever tell them what it

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was. This was an era with a mentality of keep-the-patient-in-the-dark-have-blind-
trust-in-the-physician. The nurses should not presume to tell the patient
anything.

H: Yes. That's right. It was 1959 or 1960. It was probably 1959. Right after I
finished at Yale. So, anyway, they were so mad you could almost see the steam
coming out of the nostrils, like a bull. They were something. So I talked to Bane
(my good friend and obstetrician) about it. And he said, well, go and see them;
go have some individual time with each one; make up an outline of what you
want to teach and maybe they will come around. Well, I had written the dean a
blow-by-blow description of all of this. She, I think, softened in time when she
realized that I really had tried. I had gone the right route, but it had backfired.
But what was interesting was that over those months, I had been working out at
the Catholic Hospital in town, because we needed more patients for the students
and so I needed to build some trust out there. I had been working with the
Sisters, mostly in the labor room out there, too. When they got wind of this, the
OB supervisor said to me, what they are doing to you is just awful. I will tell you
what I am going to do. Dr. Travis (who was the only obstetrician in town) has
more than 50% of the maternity patients, anyway. So, when any of the other
doctors want to bring their patients here for delivery, I am going to tell them that,
unless they will sign their mothers up for your classes, I will not let them have
their patients here. Dr. Travis had already told me he would send all of his
patients to my classes.

S: She was willing to go out on a limb.

H: She did. Furthermore, she said, you can use our classroom and all of our audio-
visuals. And if they don't want to let their mothers come to your classes, then
they can just deliver their babies somewhere else.

S: Wasn't that something? Talk about a supportive colleague.

H: Well, I tell you, some really adventurous times out there.

S: And when you think about that and what patients are expected to know and how
they participate in their care, now, and it wasn't too long ago when that was an
absolute no-no.

H: Those were fun days.

S: And I think it is interesting that, in fact, the request originally came from a patient:
we need to know things.

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H: And you know, those mothers -- I remember the first few classes I had -- the
mothers were, I had one that had ten babies and several that had five or six
babies. They were not primiparas [a woman who bears a child for the first time].
They were experienced mothers, but they did not know, even after having that
many babies. They, in every class, the mothers passed the hat and took up a
collection so that we could buy audio-visual and books and things to have, you
know to circulate, so that they would have materials that would help them.

S: ... pass on information. That must have been really something.

H: It was fun.

S: And didn't you feel, really, at the cutting-edge? This was just not being done
every place.

H: It wasn't. It was being done at Yale and Vera Keane had some classes at
Cornell in New York City. And one of her mothers wrote a book about it. And
Maternity Center had classes in New York. But that was about it.

S: But just about everyplace else, it would have been considered just as
controversial as ...

H: And anyone would run into the same problems. But when I left, we had a party,
because there were a couple of others that were leaving at the same time. And
one of the obstetricians came up and he said, you know, Betty, don't let it bother
you too much, we are just a bunch of prima donnas. He said, you have done a
lot of good out here; I hope you are not leaving because of this, because this
happened. So he was nice about it. But they were mad.

S: That was the feeling all over the country. That was certainly not unique.

H: No, and one of the reasons was Grantly Dick-Reed. Do you know about him? He
was British. He wrote Natural Childbirth?

S: Yes.

H: He came to Maternity Center at their invitation and he did some lectures and of
course he had done some writing. But he was very critical of the American
obstetricians, of what they were doing. Because he was seeing that his mothers
were supported in labor; they didn't need much medication in labor, if any; they
had easier childbirths. And he was just very critical of the way things were going

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here. And so any time anybody mentioned natural childbirth or preparation or
anything like that, it was just like waving a red flag. That was the spirit of the
times. That was what it was like. They were all hurt. The doctors were all hurt,
because they were trying to do their best. They were trying to do their best, but
they were running into all of this controversy. And of course, I was right in the
middle of it. And looking back, I wouldn't have wanted it any other way, but at
the time, it was a little hard.

S: It was hard to get perspective, at the time.

H: It really was. But while we were in Wyoming, we went -- the Dean invited me to
go to a nursing conference in Phoenix, Arizona. Actually, she invited three of us,
to drive down with her. So I guess she had forgiven me by this time because this
happened. And in going to Phoenix from Cheyenne, it was quite easy to go
through Sante Fe, New Mexico. And Sante Fe had the Catholic Maternity
Institute, which was a birth center, and the nurse midwives there: they had a
nurse-midwifery program and they took students from the master's program at
Catholic University, there. But they had a birth center and I wanted to see what a
birth center was like. And so I asked the Dean if we could stop so that I could, at
least, make a contact there. And she thought that would be a good idea. They
could go that way. And so we stopped in Sante Fe and they went out
sightseeing in the afternoon and I went and knocked on the door at the Birth
Center at Catholic Maternity Institute and was cordially received. The sister who
was on duty, we had tea and cookies and she said, you know, I am on call,
tonight and if you think you could, and we have anyone come in, I'll call you and
you can come back and help. And so I thought that was great. I said, I hope you
have a baby; I would love to come. So we went that night, to dinner at the Pink
Adobe. I have the cook book in there. The Pink Adobe, and I had gotten I
guess I had just been served my piece of steak and a baked potato when I got a
call and it was Sister Michael. And she said, you need to come now, because
this is not going to wait. But if you come, you will be in time. So I went out and
we had this mother. The room was subdued; there was light so that Sister could
see what she was doing, but it was quiet and dignified nothing like the hospital.
And it was a beautiful baby and a beautiful birth and I was so impressed with it.
You know, it was the way it needed to be for mothers, everywhere, if they were
normal and didn't need to be in a hospital. This is what they needed to have.
So, the next morning, before we left to go to Phoenix, I went back out there and I
gave the mother her bath while Sister Michael bathed the baby and taught. She
was teaching the mother. She said, you know, even though here is a mother
who had another baby, I still like to go over the care of the cord and these things
and be sure she understands. And so while we were doing this, there was a
knock on the screen door to the outside of this room they used for deliveries.

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And here was the Daddy and this little girl. The little girl was all dressed up in a
pink dress and black Mary Jane shoes. And they had come to see the new little
boy, the new little brother. And that was wonderful. You see, that was
something that was not .. So, I tell you, I was hooked.

S: That is the kind of experience that just turns you around in your tracks.

H: So that was a lot of fun. So we went to Phoenix and I don't think that impressed
me very much. So, anyway, I left Wyoming.

S: ... and went where?

H: Where did I go? ... I came here.

S: How did you get to Gainesville?

H: Well, that was interesting, too. I told you this part of it, I think.

S: I know, but it is not on the tape and I want every tidbit.

H: Well, my brother was staying with me. That was interesting, too. He came out
and this is how he got going in the space program, because they were doing
some stuff with missiles out there. But I only had a single bed in the bedroom
and I had this couch. And so we had this arrangement that we would change
every week. One week he would have the bed and I would have the couch and
the next week, switch. So that is how we did it for the time he was out there. But
then, one night, we were getting ready for supper and I said I was getting ready
to leave. Well, he said, I have heard you talk about it; now, why don't you do
something about it? Where would you like to go? And I said, Florida, I think,
because my Mother and Dad and I came to Florida for winter vacations during
the fifties. I just thought I would like to live down here. So, he said, well, okay,
write to somebody down there. And I said, I don't know anybody to write to.
Now, by this time Dorothy Smith had started the program and started the kinds of
things that made it so innovative. I didn't really know anything about her. I knew
through the AJN [American Journal of Nursing] that there was a program, a new
program, here, but I had no idea of what it was like at all. So, he said, well, why
don't you write to her? And when I did, she wrote back -- I sent her my CV
[curriculum vitae] -- and she wrote back and said, I am not going tell you about
other positions because we would like to see you here, first. And so I flew to
Gainesville and had an interview with her. That is how I got here.

S: What did she say? Do you remember anything of the interview?

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H: She really didn't ... she asked me a lot of questions, all the things you would
ask. What my work experience and educational experience had been. Then,
she said, we don't actually have any places in maternity. I wouldn't have been
very good in Med-Surg nursing. But she said, maybe we could find something
else for you to do until the service grows with enough students and we can justify
three instructors in maternity. So, that first interview, I accepted. She offered me
a position for $6,000 a year.

S: And that was what year?

H: 1961. I think it was $6,000 or $6,500. Anyway, she offered me a position and so
I packed things up and left Wyoming, went home and then my mother drove
down with me from Framingham and helped me find a place to stay and settle in.

S: And the position was in pediatrics?

H: No. It was .. they said I could teach classes, because they had classes down
here for mothers by that time, they were just starting. They were Red Cross
classes and all of the mothers had to salute the flag at the beginning of each
class. You know, the Red Cross had their own outline of classes so you couldn't
vary from that. So, they weren't the kind of classes that I have been talking
about. They were more like how the baby grows and then you skip right over
labor and delivery and talk about nutrition.

S: That was the requirement.

H: Those were the beginning courses and that was what the Red Cross had. That
wasn't what I wanted but I did teach some and I did it a little different from that.
And I worked up on the OB floor, you know, to get to know everybody and stuff.
And then, you know, what we really want you to do is to teach communicable
disease control -- my second most hated subject in the whole world. Except that
when I got going, I loved it. I have a bunch of books that relate to communicable
disease and epidemics and stuff in there because if you do it from a historical
point of view, it can be fascinating.

S: That's right.

H: And so that is the way I taught that class. I had a good time teaching that, too.

S: What do you think Dorothy Smith said in her interview that made you want to
leave Wyoming?

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H: Well, I had already made up my mind, I wanted to leave. I had no idea that I
would fall right into another teaching position, so there wasn't any question that
when she offered me a position, I didn't want to look anywhere else, really. But I
didn't know, until I had those interviews down here, about all of the things that
she was doing. You know, it was the other faculty that came with her that talked
about what they were doing: unit manager system and faculty privileges, you
know all of those things.

S: Now, who were your faculty colleagues at that time and what were they ...

H: They are all going in the book. Except that these pictures -- I want to take back
down. They are too small. Some of them are too small. I want to take them
back down and get them bigger, made bigger. This was the faculty when I came.

S: Oh, this is a wonderful picture. I even recognize some of these.

H: Yeah, you would. But see how small it was. That is Lucille Mercadante.

S: I recognize her.

H: And that is Audrey Urquahart. So, the Nurse Ill's were part of the leadership; this
was the faculty and the people in nursing service.

S: Virgie Pafford, Carol Hayes...

H: Jen [Jennet Wilson] Dottie [Dorothy Luther], Lois Knowles, Edna Jones, Madge
Sledge, (she didn't stay very long), June Remillet, Carol Taylor, Jean Lore (she
was a charge nurse on fourth floor, a medical floor),

S: So, that was the faculty when you came. And Shands had been built?

H: Shands was built in 1958, yeah. 1956? 1956, I think.

S: ...and you started teaching communicable disease. Now, at this time, when
students entered the College of Nursing, were they admitted to the College of
Nursing when they were freshmen or was it considered an upper-division
college?

H: It was upper-division.

S: So, they were juniors and they had their prerequisites?

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H: They had the first two years ...

S: ... in the liberal arts?

H: Right.

S: ... and then they were admitted as juniors. And you taught communicable
disease and caught the bug about liking it.

H: I did.

S: That is a bad pun, isn't it? Now, what was your recollection, when you first joined
the faculty, from either what your colleagues told you about Dorothy Smith or
what her philosophies and teachings were? What were you just getting a
glimmer of when you joined there?

H: How neat it was compared to what I had in Wyoming. You know, the ease with
which service and education had come together and the fact that I didn't have to
work for a year to get somebody to let me ...

S: ... to trust you.

H: We were part of the service. We were part of it.

S: Just for the tape's benefit, just explain what that was. Nursing service and
education were jointly ...

H: We had joint responsibilities. For example, we had a Maternal-Infant Section
which had weekly meetings to discuss the students' progress and how things
were going on the unit. The maternal-infant nursing faculty and the Nurse III on
the maternity unit were members. We all shared responsibility for the students'
clinical experiences and also for the quality of patient care.

S: ... and Nurse II's were kind of like the equivalent of a head nurse on the floor.

H: They were the head nurses. The faculty had responsibility for patient care, for
upgrading the quality of care. So, to do this, we had faculty privileges and they
carried some responsibilities, but what she wanted to do was to set up nursing
more like medicine. You know, where you have your faculty and you have your
residents and interns and the medical students and they are both practice and
education. It was that kind of thing.

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S: That model.

H: Then, of course the Unit Manager System, putting administrative people on each
unit to take care of phones and copying and all of the non-nursing things that we
used to have to do, so that literally we were freed up to pay attention to nursing.

S: Now, the Unit Manager System was innovative. That was not something that
was done in every hospital in the country.

H: No, I think only here until, now, Loretta Ford came down from the University of
Rochester. She was interested in doing that, doing something like that there.
She and Dorothy were very good friends and she ended up being a very good
friend of mine, too. But that is another story. Anyway, so Rochester was doing it
and then Luther Christman out in Chicago was also working at this, doing this. I
resigned from here when I went to school. I had positions offered to me in both
places, Rochester and out with Luther Christman at Rush. So I visited out there.
I had a summer at Rochester, which is another story. So, anyway, it was fun to
talk to both of them about how they viewed what we were doing here and how
excited they were about how innovative how needed it was in nursing for us to
do these kings of things.

S: And Dorothy's position, Dorothy was not only Dean of the College of Nursing but
she was ...

H: She was in charge of nursing service.

S: Now, the administrator at that time was Harrell?

H: Well, George Harrell was Dean of the School of Medicine. Russell Poor ...

S: Sam Martin ... ?

H: Sam Martin was one. Russell Poor was the Provost of the Health Center at that
time.

S: Did you know him?

H: Yep. Knew them all. There weren't that many people here. We all knew each
other. Go have coffee together. That was another thing that so nice about it in
those years. And the key people, Sam and Russell Poor and George and


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Dorothy, all were in agreement that what was happening, should happen. And
so they were all supporting it and making it happen at that time.

S: ... like the support of the Unit Manager System, the joint practice of teaching
and service. What other kinds of things were supported? Patient education?

H: I think they had to run interference, too. There were a lot of doctors -- a lot of
people, but particularly, the doctors -- were vocal. They used to say that we were
training psychological nurses. You know, the ones we trained wouldn't be able to
do anything. Because what they wanted to do was, they didn't want any change.
They wanted their handmaidens back; that was all they needed. So they just
didn't go along with all of this. I know when we first started putting nursing
histories in the charts, they would take them out and tear them up.

S: For the listener, tell what a nursing history was and why that was different from
anything that had been done before.

H: Well, I think the old kind of nursing was to obey the doctors' orders, not teach the
patient anything, which is what they really wanted to have, but Dorothy's idea
was that we needed to have our own information about patients and what they
knew, what they needed to know, what kinds of things they were concerned
about, what we could do to help them, what plans of care we needed to develop
for each patient, how to evaluate that plan, how to know whether it worked or not.
So, it was just kind of a parallel history to the medical one, but it wasn't disease-
oriented; it was patient-oriented.

S: And initially, not only was it that the physicians didn't want it on the chart, but I
think, initially, it wasn't part of the permanent medical record.

H: It wasn't. And they didn't want to see it be part of it.

S: So there were a lot of obstacles in getting that to be part of the permanent
record. Because, I think at one time on our floor, we would routinely (as the
patient went home) take that nursing history out of the chart and put it in a
separate file on the nursing unit so that if that patient were to return, you had a
baseline that you could update but you couldn't send it with the regular medical
record down to medical records.

H: That's right. Well, there was a lot of excitement in the early sixties, but, of
course, the key people left. You know, when they did and other people came in
that were not so supportive, you had to have that supportive framework for


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something this innovative. And when it was lost, then that is when things
changed for the worse.

S: Now, going back to the Unit Manager System for a minute, now, what... if the
Unit Manager was doing what they were supposed to do on the floor, what were
their responsibilities that had previously just fallen to nursing?

H: They ordered drugs and supplies. Took care of getting them and putting them
away, housekeeping came under their responsibility, copying doctors' orders and
the other kinds of desk work, phones and ...

S: Phones and clerical stuff. Previously, that was all nursing.

H: That was all nursing.

S: Emptied the linen cart and stacked it in the closet ...

H: ... and if there was time left, then you took care of patients.

S: Do you remember -- we were talking before about some of the non-nursing
faculty that Dorothy Smith had brought on board. Now, was that common around
the country, to have faculty members in a College of Nursing that were not
nurses?

S: It is now after lunch and we have gotten Betty as far as Florida and having joined
Dorothy Smith's faculty. And we talked a little bit about some of her
philosophies: the joint practice of education and service and the Unit Manager
System, in an attempt to relieve nurses of what were considered non-nursing
activities. We talked some about your faculty colleagues. Were there sections,
specialties, then? Were they divided into obstetrics and others?

H: We had sections, then. We had a maternal-infant section.

S: How were decisions made, Betty, as far as the faculty was concerned?

H: Usually, Audrey who was our Nurse II -- I think she was a Nurse III, anyway,

S: That is Audrey Urquahart?

H: Yes. She was a supervisor of our maternity unit. She came to our meetings
because a lot of the things we talked about had to do with patients and students.


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S: That is right.

H: That was another nice thing. Now we could go to their meetings and she could
come up to ours, so that we were communicating. We all had the same goals,
but probably some different ways of getting there, being service and education.
But you wanted to know about some of the other non-faculty.

S: Yes.

H: One of the first ones was Sid Jourard. He was a psychologist.

S: And what was Dorothy's objective in having someone like that on the faculty?

H: ...to help us. Really. He had group discussions for the faculty where we could
talk about where we were frustrated or needed an outlet to talk about what
differences the change was making in our lives. He did a lot of individual
counseling, too. The group ones and the individual ones. But I think she
deliberately brought him in just so we would have a person to go to that could
support us and help us through a time of change, because most of us were
diploma graduates. And we had some academic education, but it wasn't
anything like it is today. It didn't do that much for us, really. And so I think she
knew that she was going to have to educate us right along with the students, but
she had to be very subtle about it, which she was. She was very gentle about it.
But she did bring us right along. We got educated.

S: She really was advanced, wasn't she?

H: Yes, she really was. Quite a lady.

S: And who else was on the faculty?

H: let's see, were you here when Willamae came?

S: Yes.

H: OK, well, she was one.

S: Willamae Whitner was one of my professors.

H: OK.

S: Now, her background was what?

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H: Research. And she went down on maternity and did a study with Peg Thompson
who was in charge of the nurseries, which -- and that was way ahead of
anybody's time, too.

S: But this was nursing research ...

H: This was nursing research and it had to do with the staff nurse, doing it, not some
professor up in the ivory tower ...

S: ... and that was another philosophy of Dorothy's, that the person who was --

H: ... taking care of ...

S: closest to the patient ...

H: ... yeah, needed to be doing this. And Peg was a good person. She was very
able in her own right, but she needed the avenue and so Willamae provided that.
That study was published.

S: Where did Dorothy find people like Sid Jourard and Willamae Whitner?

H: I don't know. Some of them were local people. Carol, I know, was local.

S: Carol Taylor.

H: And Sid, I think Sid was, too. Well, Sid wrote a book called The Transparent Self
and she may have read that and thought that he had the right kind of thinking --
to be a person that could come in and function in that role of supportive person
for faculty. And let's see, Howard Wooden. Howard was an art historian. Did
you know him?

S: I didn't know him but...

H: He and his wife were delights. They lived down in the old Primrose Hotel for a
while. Then when I decided I wanted to build a house, he thought he did, too.
So we looked at the same neighborhoods and had a good time with planning
houses. He never stayed long enough to do it but we did. And see that statue
over there? He and Virginia gave that to me when they left. I had my
housewarming when I finally got my house built and that is an African good-luck
piece.


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S: Howard Wooden, who was a curator of a museum and was he a sociologist?

H: No, he was an art historian. Well, he may have had some sociology in his
background.

S: And so, why did Dorothy bring him on board? ...for the College of Nursing?

H: Well, he turned out to be one of the most valuable non-nurse members we have
had. It may have had something to do with the fact that before he came -just
before he came down here, he was project director for a program at St. Mary's
Hospital in Evansville, Indiana. And this was one of the first family-centered
maternity-care programs in a hospital where they had rooming-in and they had
ongoing teaching for the mothers and they had unlimited visiting. And so he was
project director for this before he came down here. And so, that probably had
something to do with it, but he was a godsend to us, because we wanted to try all
of those things down here. And when he came, he was certainly a resource
person. But the things that he did that I liked, when he did a class and we had
him often, he would bring slides that illustrated what he was talking about, but
they were all paintings from the old masters. But when he put one up, then he
could talk maybe it would be a woman and a child, a famous painting but
then he would talk about the year that was painted and what the conditions were
like, then for women and children and families and health care at that point in
time when that picture was painted.

S: How valuable for those students!

H: Wasn't that wonderful? And so, that was one of his techniques and he
introduced me to so many old masters and wonderful paintings. And so, then,
when I had to teach physiology for the Dean, I had to do something and so I have
a lot of old masters in slides that showed a lot of things that fitted in with
physiology.

S: What a resource!

H: Yes, he was. He was great and a very good friend.

S: Sounds like it. A special person. Did you know Sol Kramer?

H: I knew him very well.

S: And he was on the faculty? Did he have a joint appointment?


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H: No, he was in the department of psychiatry. And he was the first ethologist [a
zoologist who studies the behavior of animals in their natural habitats] I had ever
known. I didn't even know what it meant until I met him. He was very interested
in mothers and babies. See, in the sixties, he came in the early sixties, there
was a lot of work going on with bonding and the need for mothers and babies to
be together, the need for touching. A baby's smile is not because the baby has
gas. It is a conditioned reflex; it is a neuromuscular reflex that is in response to
something in the partner, which would be the mother. That is an example of the
kinds of things that he was looking at. But he invited us down he had a lab in
the basement. I think I have told you this, haven't I?

S: I think so. But, I want to hear it again.

H: Well, we went down and watched him with his fishes and his insects, because he
could tell us all about mother/parenting/baby behavior in these different species,
because the behaviors are species-specific, but all species have them. And we
do, too, but at that point in time, it was very difficult to get anyone to accept that
fact, that we did. So, he was very valuable. He came to class a lot and really
opened the students' eyes to some of this stuff. And I think that it is a shame that
we have lost a lot of this.
S: I remember thinking how innovative it was to have a College of Nursing faculty
with anyone who wasn't just a nurse. Now, did you know Sam Shulman?

H: Yes.

S: And what was his background?

H: He was a sociologist. And he did a research seminar for our faculty. It was
around supper-time, you know, to kind of bring us gently up.

S: And Mary McCaully?

H: And Mary is a friend. She is still here in town. I still see her now and then. And
she was a psychologist who was, I think, employed/hired by the department of
OB. She did a lot of work with the psychology of women and children. Why little
boys grow up to have the characteristics they do, and little girls have different
characteristics and how they are socially programmed this way. So she came to
class.

S: Now, Sam Shulman...

H: He up and married one of our students.

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S: Sam did?

H: Sam did.

S: Oh, inside stories.

H: Right.

S: I have another one on my list, a person by the name of Mr. Hinkley. Did you
know a Mr. Hinkley? Where did I get that name ... he was in charge of
construction of building Shands.

H: That's right. And he was down in the basement in the engineering department.

S: And stayed as chief of engineering.

H: I think he was; I think that was his title.

S: He didn't necessarily have anything to do with the college?

H: No, but we all knew each other in those early years ...
S: ... because it was a small handful ...

H: ... small enough. See, another person that came to our Orange Mafia Parties
was Annie Vestle who was the executive housekeeper for the hospital.

S: Now, let's just stop here a minute because you mentioned the Orange Mafia.
You want to tell us what that was?

H: I think we just needed a reason to get together so we could have martinis and
pizza. This just happened to be the group that was interested in doing it. There
was Lucille Mercadante, me -- I think Jen came to some of them.

S: Jen Wilson.

H: Probably Audrey. It has been so long ago that I can't really remember all the
people who came. But there was a nucleus group.

S: And you met at people's homes?



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H: Yes. But we were interdisciplinary, you know. There were a couple of nurses
from the College of Nursing, a couple from service and then a couple of others
who had other kinds of positions. So that was really fun, but it was just a good
excuse. But when we did get together, we talked about what we were doing and
how we saw what was going on there from our perspective and that was very
helpful.

S: It was an interdisciplinary meeting.

H: Yeah. It really was. We didn't write that out as one of the goals, but it turned out
to be that.

S: When I was thinking about this Mr. Hinkley in charge of construction, one of the
things that I thought about was that, since that was such a small handful of
people who were driven by the image of what they wanted for patient care and
student learning, did he have anything to do with -- wasn't there an apartment
built for a maternity patient to live in before they went home or something like
that? Now that had to be done in conjunction with his planning, didn't it?

H: Well, it was already there when I came so I don't know. But the idea -- it was sort
of like a little efficiency. There was a bedroom and in the corridor, there was a
refrigerator and a sink. And there was a bathroom. So it was like a tiny halfway
apartment. And the idea was that there were some mothers who were really not
ready to go home when they were discharged with their babies. They really
needed some more help, mainly nursing. Either with the way they were handling
their babies or help with breast-feeding and needed another day or so, but
weren't patients in that sense anymore. So that is why they had that apartment.
But the medical residents came by one day and saw it and decided it would be a
lot better if they had it and they took it away from us.

S: Just like that?

H: They did that. That did that in the clinic, too. Everything is for doctors. You
know that. We only get what they don't want. Don't put that in.

S: We shall do some editing, shall we?

H: But they did. They turned it into a resident's call room. And I suppose that is all
right but it wasn't the original plan. Because what we had planned was very
exciting. It was another something that was new, again.



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S: Now one of the things that I read in some of the papers that you gave me talked
about nursing internships and nursing residencies. Now, traditionally, those are
words that you hear in terms of medicine, but that was a Dorothy idea that she
incorporated into nursing.

H: Yeah. I guess it must have been. I am trying to figure out how all of that got
started. I know that we had some maternal-infant interns. A couple of them are
right here in town, still. They needed primary care. They needed how to take a
history and identify common, ordinary problems and deal with some of them.
Teach classes. And so that internship was developed so that they could work
some with the doctors to learn the medical pieces of this. There must have been
money for that. Jim would be able to give you some of that information, I think.

S: Who?

H: Jim Guth. But I know we had a couple of them at Carver Clinic when we had our
first pre-natal clinic. They came there to do some of their supervised clinical
experience.

S: Now, as I recall, the internship was to be up to twelve months, supervised
practice post baccalaureate and residency was to be supervised practice after
the Master's degree?

H: I think so.

S: Now, tell me what was Carver Clinic?

H: Well, that is another interesting story. We were trying to get appropriate pre-natal
nursing experience for students in the big Shands clinic. And that was just
nothing but an assembly line. And the nurses did the blood pressures and
weights and urines and then the mother went into a room to wait for the doctor
and then he saw her and then she went home. The mothers all came at nine in
the morning, no matter where they lived or how hard it might be for them to get
there. There was this assembly line. I wrote an article about this, too, that was
published. Well, anyway, we wanted the students to do some different kinds of
things in the clinic besides doing the weights and blood pressures and sort of
disjointed thing. We wanted them to have some mothers that were theirs. That
they could see, each visit and maybe go up when they were in labor and delivery
-- really follow them through. And part of this was for them -- we wanted them to
take their patients and take a little piece of the waiting room and maybe have a
small class or something or a question-and-answer period. And that is in the
book, too, another chapter. Anyway, they had the Birth Atlas up on an easel one

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day, one morning in the big waiting room in the clinic. And it showed -- the
picture they had there showed a baby and a placenta and then there was a
picture of a philodendron plant in water to illustrate the similarity in the way
growing things live. And some old lady that was sitting there with her husband
turned around and looked at that picture and she hit the ceiling to think that we
would have anything that indecent out in the main public waiting room. She
complained to somebody and, I don't know who it was, but whoever it was said
we couldn't do that anymore.

S: So, this was an indecent picture ...

H: It wasn't indecent at all, but she thought it was.

S: She said, take it down. It is offensive.

H: So, anyway, Harriet, who was in charge of the clinic, said ...

S: Harriet?

H: Harriet, what was her last name?

S: Daniels?

H: Harriet Daniels worked up on the third floor, though. Harriet ... I'll think of it. But
anyway, she said, you know, that is a shame that you can't do that anymore, but
I have got a place that you might be able to turn into a little teaching room.

S: You always had a savior somewhere around, didn't you?

H: Well, it seems that way. Anyway, she had a little room in the back corridor of the
clinic. They were just using it to store things. So, the students Jen and I and
the students got it all cleaned out and fixed it all up as a little teaching room. We
put in the right kind of visual aides and chairs. And we had wonderful classes
there and the chairs spilled out into the hall. There were mothers sitting out there
wanted to hear what was going on. And it was just great. It was tiny but it
worked out well.

S: But no one was offended.

H: Well, until the residents found it and decided that they could use it much better
where they could wait and study. And so one day we went in and they had taken
all of our stuff out and taken it over. So that is when we decided that Shands

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would have to go. And by that time let's see Dr. Daley was on OB faculty and
he was very pro the kinds of things that we were doing. And so he helped Jen. I
guess I must have been in school, then, because I wasn't around too much of the
time. But he helped Jen draw up a proposal for an independent prenatal nursing
clinic downtown. He would be responsible. He would be our referral physician or
if we had problems or anything, but we could see patients down there. These
were MIC [maternal infant care] patients. So after they had their initial physical
and everything was okay, we could see them as often as we wanted. However,
we would always do their prenatal care until the thirty-sixth week and then they
would have to go for one evaluation visit. Then we could have them again. But
anyway, the thing was that it was one of the first nurse clinics in the country, I
think. That must have been 1969. So the nurse practitioners weren't doing
much of anything at that point. But we had this clinic and we had the blessing of
the OB department but they were ours. They were our patients and you know,
they wanted to come back. They would come, you know, it wasn't like every
month but whenever they wanted to come. But they didn't miss appointments.
They came. We really need to look at that data, because I'll bet you the
outcomes were really quite good because it was a laid-back clinic. We had a
student from the college of education come and take one corner of the room. We
had it down in the old Carver Library, down in the black section of town. So this
was a big gymnasium, actually. We got some examining tables from the health
department and the students -- because we needed some privacy in that big
gym, we hung rope off of something and the students took sheets and tie-dyed
them, because that was tie-dying time in the sixties ...

S: ... they knew how to do that.

H: They knew how to do that. So, we had tie-dyed drapes for the mothers and so
they had some privacy. And then the education took the kids in the corner and
kept them entertained.

S: Oh, the toddlers that came.

H: The little kids that came with the mothers. That was great. We had one a week
for a while and then two a week. The second one we had was for teenagers.
That is when we began having interns come down there, because the interns
then could have the kind of opportunity to do the care that we thought that nurses
ought to be doing, then. So that went fine for a while and then one day we came
in and somebody had broken in and vandalized the place. They had taken the
telephone and every medicine -- opened up our storage cabinet and stolen about
everything that they thought they could sell for drug money or whatever. And so,


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by this time Dr. Mahan was on board, too, and he was another really good
person.

S: He was a supportive person.

H: So, they said, well, don't worry; don't cry; you can come down to the Health
Department and keep on doing just what you are doing.

S: And so it could continue?

H: So, we just moved and went down and they had, well, it was an MIC clinic, is
what it was. Local and it was down near Waldo Road but on Fourth Street. So
we just had it down there for a while when they finally moved that into the new
Health Department. That didn't work out too well, because there was too much of
a mix of medical people and nursing people. So that is when I started some
other kinds of clinics. But that Carver Clinic and the MIC one, they were just
great.

S: That sounds just like what they are trying to do, today, if they really want to be
independent practice, serving the public that is already under-served.

H: There was no way we could do it at the Shands Clinic because that was a
medical model.

S: It was really being dominated, then, by medicine?

H: It was all right, but we needed to have our own place, too. So we had it.

S: It sounds like the Camelot years.

H: I don't know but you know, when Mattie Snider was in charge MIC, the
nursing .. Did you know Mattie?

S: No, I didn't. But I have heard the name, but I didn't know Mattie.
H: She was a love, a real love. And she was so good to us. She figured out ways
for us to do all kinds of things through the MIC project that we needed to have a
way to get in. And so, one day, she invited Jen and me to go to dinner with her
down at the Arredondo Room. And she said, I am just going to be down there
and if you are around, come on down and we will have dinner together. And so
we went down and we walked into the Arredondo Room, and do you know, it was
full of people, all dressed in evening gowns and all dressed up -- a lot of our
faculty, the Dean and the Assistant Dean and a lot of the OB faculty and a lot of

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the MIC people and they had a dinner for us. And then they gave us each a
plaque of appreciation for Carver Clinic. And Dr. Daley and Dr. Mahan, both had
their funny little speeches to make.

S: No kidding.

H: Mine is out in the garage. I'll show it to you.

S: And you never knew that was ...

H: No. I had no idea that they were doing anything like that.

S: She said, just come on down.

H: I would have dressed up ... if I had known.

S: If you had known you were going to be the guest of honor. Isn't that something?

H: But wasn't that nice? to think that they would do that?

S: Isn't that incredible? Well, one of the things that I read in the material that you let
me have was talking about Dorothy -- and I don't know whether she instituted this
or whether she asked the Provost and said that at that time, when Shands
opened, it was kind of an archaic belief that running a hospital with "X" number of
lines, budgeted for nurses, and then if you have somebody who leaves or
somebody who is on sick leave or you have no way to overlap that person's
duties for when they are gone or how long it takes to recruit somebody else to
come in, to say nothing of time to orient a new person to that job and then
additional staff for education of the staff, inservice education. I thought I was
born with that but I must have gotten that from her in graduate school. It was just
ludicrous. What happens when one nurse who works forty hours a week says,
OK, I am giving my two weeks notice? What happens to the patients in the time
it takes you to get someone else hired and trained? Maybe that is a good
question for Lucille Mercadante, isn't it?

H: I think it might be.
S: But I read that in some of the material that Dorothy had said in her position
paper.

H: It might have been in her letter to Dr. Ackell.

S: I think it was.

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H: Because she was getting very discouraged with some of the ways that nursing
wasn't being supported.

S: Well, I must have just integrated that as part of my bone marrow, I guess. One of
the questions in there had to do with, I think, in her letter, she talked about the
recognition that the College of Nursing had received from outside visitors and
being mentioned in outside publications, to say nothing of the publications that
must have come out of the College of Nursing. I am sure the OB department had
visitors that came down to see what you were doing. Do you remember some of
those?

H: I know we had so many visitors at one time that she asked us, in one of the
faculty meetings, she said, you know, there are so many coming that we can't do
our work, so, what can we do? And we decided that they should all write
behavioral objectives and submit those to us. Tell us exactly what they wanted if
they were going to come. And we did. That is what we did. So, any visitor that
came after that had to think out what it was she wanted to come for. And I think
that did help a little bit. Help cut down ones that really weren't all that serious,
just curious. But we had to do something because it had reached that point
around the mid-sixties, it had reached that point. Than in the mid-sixties, she did
have she had research money for faculty development. Do you remember
that?

S: Yes. Yes. I remember some of that.

H: We were all asked who we would like to have come. We could have somebody
come and teach for a semester, or trimester, we had then. Or we could have
somebody come and just doing an evening program. Medicine was doing this
kind of thing. They had some wonderful people come. They had been doing it
for a long time. So we submitted names to her of people in our fields who were
the leaders. And she would get them down here. And we had wonderful
programs because here were all of these -- the nursing leaders in the country.
Small of us from all of the specialties gave her the names from our specialty.

S: I remember that.

H: That was very exciting.
S: Whom do you remember coming from your field?

H: Ernestine came from Yale. Vera Keane came. She succeeded Ernestine, I
think, after Ernestine retired, she was director of the midwifery Program at Yale.

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She came. Both of them came for a summer and took over the students for a
summer. And Betty Bear came, of course she had been on our faculty before.
So we invited her to come back, which was really nice. And Gene Cranch was
the other one who came. She had come up from Miami but was working at
Maternity Center in New York and is a nurse midwife and so she was a good
person to have come. Those are the ones who came and did trimesters and
taught a course.

S: I don't know the names in OB. I am all right with the ones in med-surg but I can't
compete with you. That sounds so esoteric, top-flight ...

H: It was wonderful and you see, it was part of our education, too, a wonderful part
of it. It was a wonderful experience to be a part of all of this and have all of
this.

S: All of those leaders.

H: Well, all of the things that Dorothy did, you know, that was one piece of it. The
way Willamae worked with us in terms of research. All the other non-nurse
faculty; things she did herself. She had us writing papers.

S: Tell me about that. I remember you mentioned that you would get an
assignment.

H: Yes, she assigned us to write a paper about our course ... to tell her exactly why
it should be in the curriculum. Why, what we were doing, was so important.

S: She wanted you to justify to your Dean what -- It made you think twice, didn't it?

H: I had to write one for communicable disease control. But she liked it. She wrote
me a nice note and told me how much she liked it so ...

S: But that is a good assignment. That is not idle work.

H: It isn't. It was one of the most challenging papers I have ever written and I loved
doing it.

S: And I'll bet she didn't hesitate making comments in the margin, did she?

H: She didn't make any. She just told me she thought I had done a really nice job
with it. That was another good thing about her. If you did something she liked,
she told you.

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S: Yes. She was very generous.

H: Very generous. And if she didn't like what you did, she told you.

S: She told you, too. We talked a little bit about some of these activities and some
of the things that the College of Nursing was doing and how the College of
Medicine felt about it. Did you get reactions from other parts of the Health
Center? Was health-related professions in operation? Did you do very much
with them?

H:We had a joint workshop with the physical therapy department. Early.
Because I had met a woman when I was in Wyoming by the name of Mabel
Fitzhugh. Mrs. Fitzhugh did a lot of work with Michael and Niles Newton at the
University of Mississippi in their Department of OB/GYN, developing exercises
based on Reed and his physiotherapists but she developed -- she was a physical
therapist -- some prenatal and postpartum exercises and also a lot of exercises
and breathing techniques that mothers could do with infants and small babies
and toddlers. And when I was in Wyoming, I got a call from her one day, asking
if she could come. She said, I am just going around to different schools of
nursing if they are interested because I think what I have would be interesting to
you in maternity, your maternity nurses. So she came to Wyoming and it was so
good that when I got down here, I called and asked if she would come here. And
I said, this time, we will pay you. And so she did. She came down and because
it was physical therapy as well as nursing, we did it in their department and their
big exercise room and they were a part of it, too. It was an all-day workshop. We
had local nurses from the community, students, some mothers. It was just great.

S: So, you felt like, at least where it was appropriate, that other disciplines like
physical therapy were willing to work in a team partnership with nursing?

H: I don't think that we ever gave it any thought that they wouldn't, because it was
that kind of a feeling in the Health Center. And the doctors, they will be doctors
but we had a lot of good friends in the OB department. A lot of good friends.
Even the ones who didn't understand what we were doing.

S: And I think medicine in many instances, will initially resist and I guess all
disciplines do this, but then later as they would get to know you, or get to see one
of their patients benefit from something that nurses contribute, will either soften
or incorporate that.



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H: That does help. Now, with the intern program, we must have had money, and
again, I was in school during this time, so I am vague about it, but we must have
had because we could we had an obstetrician from the faculty to do the
medical part for the internship students and I am sure that they just didn't send
him over for free. So I think we must have had some money. It was more than
just a friendly relationship. But we did have him and he also helped us when
we finally got a rooming-in unit set up at Shands, he could finally help us a little
bit, sway the others to our way of thinking.

S: When you were talking about how Dorothy Smith was influencing and educating
the nursing faculty, you talked about these wonderful guests and experts from
around the country and your assignments to write a paper, but you also told me
about discussions at her home. You said that she would open her house and
discuss an issue. Did the entire faculty attend?

H: I think they did. I think we sort of felt like we needed to.

S: It was all a close family, by then.

H: And there weren't all that many of us. But those were very good discussions and
yet, she didn't do it. She would let one or another of us be responsible for the
particular topic. And this was always with the idea that we were going to show
how what application it had to what we were doing or what we ought to be doing.
She also had very good Christmas parties for faculty.

S: Tell me about the topics that she had. Did she assign the topic to you?

H: She assigned "memory" to me. And I had to go to the library and find our about
memory in depth, you know, much more depth than I knew. How it works and
why it is so important and why we should have some understanding of it in
nursing, and the difference it makes.

S: Do you remember any of the other topics that other people presented?

H: I don't.

S: Do you remember when nursing grand rounds began?

H: It was early sixties, because I was on the program for one of those. I didn't do it.
I had a group in town -- the nursing mothers of Gainesville. And this came out of
a couple of my graduates from prenatal class called and asked if we could do
something. Mothers who were breast-feeding in town had no resource. You

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know, the doctors would put them on bottles if they had a problem. They just
needed a resource of mothers who knew something about nursing their babies
and could help. So we had this group and we called the Nursing Mothers of
Gainesville. I guess we met every couple of weeks for a while and then every
month. Carol Taylor came. I think Mary McCaulley came to some of them. And
I was there for all of them but some of the other faculty sometimes came. We
had wonderful meetings. We had a library so we had resource materials. We got
lists of all the nursing mothers who were discharged from the hospitals in town so
that we could contact them and be resources for them over the weeks that they
needed help. When their babies after a while, that became the toddlers group,
because they had outgrown the need for breast-feeding information, so then
there was another breast-feeding group. And our group became the toddler's
group. And on, there became a preschool group. Then Carol and Mary and I (I
forget who else), we sort of bowed out of that. It seemed to be going pretty well
without us. We became the environmental-resources seminar. We met every
couple of weeks to study group behavior, not so much clinical maternity nursing,
but social issues and group behavior and ways to make groups work better. That
was one of the things we talked about. I think we had a lot of subjects but they
were more scholarly. You know, it wasn't ...

S: And this was who, now?

H: Carol Taylor, Mary McCaulley and me. They were some others but...

S: I would have loved to have been in that group.

H: It was. It was a great group. Some really great people, thinking people but we
had a good time together. Sometimes bring in a guest. But, anyway, why did I
start talking about that?

S: We were talking about the nursing mothers.

H: But you asked me a question that got me to that and the nursing mothers. I have
forgotten what it was ... oh, grand rounds. So, Dorothy asked me to present this
-- what we were doing with the nursing mothers of Gainesville at a grand rounds.
And the day that I was supposed to do it, I got a yellow-fly bite. There were a lot
of yellow flies here and I was allergic to them and so I had a leg that was all ... I
couldn't go, so Sandy Linebarger, who had been a student but was on our
faculty, said she would go and she would take my paper and she would read it .


S: And did community nurses come to Grand Rounds?

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H: We had to have it in H-611, you know the big auditorium, because we had
enough people so that it was justified to have it.

S: Well, that is where I remember nursing grand rounds being presented, because
we wanted to encourage the nursing service people to come and it was handy for
the nursing educators to come. So it was open to everyone. [Grand Rounds is
the in-depth presentation of one or a few patients to a multi-disciplinary group for
discussion and suggestions for further care and treatment. It serves a teaching
function as well as a detailed analysis of a case by expert practitioners and
beginners, alike.]

H: Well, there was an awful lot going on in the sixties. We did our part, but the
college of medicine was doing so much more. But we were able to go to all of
theirs. They had some wonderful people come and speak, really world-
renowned people. It was just a very exciting time.

S: It was. The whole Health Center was perking with activity, I would think. Well, I
remember nursing grand rounds, doing a number of them, as a matter of fact --
some of them more successful than others.

H: Well, that happens, you know.

S: One of the things I was going to ask about the delivery of care on the patient
floors, when you first came to the College, did they have ancillary people that the
nurses supervised? Did they have aides and did they have LPNs [Licensed
Practical Nurses, who are prepared with one year education of bedside nursing
care]?

H: Both.

S: It seems to me that those job duties have changed over the years. I remember
that we initially had to "teach" baccalaureate nurses how to supervise somebody
else, because prior to that, it had been total care. There was the nurse. And the
nurse did everything for the patient. And so, when there were other people on
the team, particularly if they were not a RN, we had special emphasis on how-do-
you-know-the-quality-and-quantity-of-what-your-aide-is-doing for the patient.
How do you check behind or how do you evaluate their level of care? Was that
integrated into part of their education?

H: I don't know, except by example, if we did anything specific in teaching our
students. But we had aides and LPN's on maternity and in the nursery and they

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were very good. They were good friends and when we had a party, they all
came. It was another close-knit group. And so I think if the student saw the
friends' relationship and the working relationship on that floor, then they would
have gotten what they needed to know about that. They were wonderful people.
And I am sure that Audrey [Urquarhart, the Nurse II was responsible for the
twenty-four-hour care of the patient on the floor] did a lot of work with them. You
know, when that floor was set up and she employed people, I am sure that she
had to do some of that, and Lucille would help, maybe with that kind of a
question.

S: That is right. This is more of a nursing service kind of thing.

H: But I remember the devils food cake that Bessie Banks made every time we had
a party.

S: Oh, do you?

H: ... and things like that. I don't know, one time, I was a patient at Alachua
General Hospital for some surgery, years ago. But they came, they split up their
time and would come over and stay with me for maybe four hours at a time ...

S: Is that right?

H: Both the nurses and the aides and the LPN's all the staff. They all took their
turn but they all came over to see that I had what I needed.

S: Isn't that wonderful? That tells you more than words ever could. Well, one of the
things I had heard was that there was such a feeling of camaraderie and kinship
in Shands. While there was a level of distinction emerging in the country,
particularly between the diploma nurse and the associate degree nurse (who was
just beginning to emerge), and then the baccalaureate nurse. While there were
levels of education differentiating practice of nursing, the teamwork at Shands in
the sixties included the team of the LPN's and the aides and other disciplines, all
in the service of what the patient needed. I guess it depends on whether you
look at that as an inclusive team of caregivers or whether you are into the
exclusive attitude of 'my-degree-is-higher-than-yours'. [Traditionally, nurses had
been educated in schools of nursing under the auspices of hospitals. There were
very good ones and others who used students for free labor to staff the hospital.
In the beginning the students were taught by physicians who, understandably,
taught them a simplistic version of the physician's education and what they
thought would assist patients and themselves. As nurses began to control their
own destiny, they realized that the care of patients that nurses perform was

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separate content, many times unknown to the physicians. An example would be
to place a patient on the bedpan comfortably or to change the sheets of the
patient in skeletal traction without hurting them. Nurses began to identify this
content as their own and teach it in the nursing programs. In the fifties and
sixties, there was a movement to establish nursing as a profession, by moving it
into an academic setting, establishing a body of knowledge of its own, beginning
research on nursing practice (as begun by Florence Nightengale), and granting
college degree status. This also required a differentiation of how this nurse
would practice, using this education differently and what Dorothy Smith was
instrumental in doing. The job description for a baccalaureate nurse would
include patient problem-solving, gathering data, establishing a care plan,
leadership etc. while the hospital diploma nurse (and later the associate degree,
two year educated nurse of the Junior College Programs) would be more
"technically" trained to carry out procedures, follow the established care plan, and
carry out physician orders for the patient. The licensed practical nurse (LPN) or
the licenced vocational nurse (LVN) is a ten to twelve month program
concentrating on bedside care and activities of daily living such as bathing,
feeding, etc.]

H: I don't think that was I think Dorothy was trying on the fourth floor, she
and Marion McKenna [doctoral nursing candidate at the time and part-time
faculty] had a research project going and I think they were trying to spell out
differences. And of course, she saw down the road, if we had been able to do it,
that we would have some different there would be different orientations and
objectives for the different programs and different job descriptions in the hospital
for these people. We didn't get there. And I think that was a severe
disappointment to Dorothy.

S: We were talking about Marion McKenna and Dorothy studying the levels of
differentiation ...

H: I can't give you very much information about that but Jim [Guth] may have
something written or he may be able to put his hand on .... And in some of the
material, I think some of the material that I shared with you, I think that she had
something about that.

S: Yes. But, basically, it was to say that the person with the associate degree ...

H: ... was the technician.

S: They would have one job description whereas the professional nurse who has a
baccalaureate degree, has other duties.

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H: That is right. But it was a difficult concept, for me.

S: It was.

H: ... for me, anyway.

S: It was for me, too.

H: Because I tried to explain it to people and even thought I thought I knew what it
was, I tried to explain it to an OB resident one time. He said, you know, you just
sound like that is more social worker stuff that you are doing. So I wasn't doing it
very well. But I think that some of us really did get we weren't quite ready for
that, maybe. And the program -- see, the junior college programs were just
starting and we didn't have all that many baccalaureate programs and the
faculties of those programs have diploma backgrounds, most of them. And so it
did make it difficult.

S: It got very blended.

H: It was kind of a hard time.

S: Well, switching gears just a little bit, one of the questions that I had thought about
was how did Medicare or Medicaid change the care of patients in OB that you
knew of. Do you think the institution of those programs made any difference as
far as the delivery of care?

H: I think the MIC Project did a lot to help. And those were poor patients, of course.
But I think that project, because it covered thirteen counties, and we took teams
out from Shands to the clinics in all of these counties. I think that did an awful lot
to bring prenatal care to those patients who otherwise would not have gotten it.

S: Who probably wouldn't have gotten any care or very little.

H: Probably it wouldn't have until they appeared in the Emergency Room.

S: Yes.

H: I had to laugh. Dr. Prystowski was the OB Chairman when I first came. They
wrote a proposal see, in order to get funding for the MIC Project the College of
OB had to write a proposal to say exactly what they were going to do and how.
And he had me come down one day to read the proposal and he said, you know,

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we put your name in here, and he put it in because I am a nurse midwife ... he
could have cared less. But he wanted the word in there because he thought that
if they thought that we were using nurse midwives down here, it would help his
cause. And I don't think he thought I would understand that.

S: But it was pretty transparent?

H: It really was. So I said, sure.

S: One of the things that I think has changed in all specialties is the length of time
that patients stay in the hospital for certain conditions. How have you seen that
change over your career as far as maternity patients and how long they stay?

H: When I was at Boston Lying In [Hospital] as a student, the primips [primiparas or
mothers having their first baby] could go home in ten days, and the multips
[having their second or more delivery] had to stay for two weeks, because when
they got home, they had other children and would have a harder time. So it was
ten days to two weeks and that was in 1945, around 1945. And then it gradually
got down to five days and then ...

S: Do you remember them talking about the rationale for one way or another? Was
the rationale for staying in for ten days that they needed to rest after they had
been through this ... ?

H: I think that they really did, because they had been heavily medicated; they had
been anesthetized; they had been and their babies had been.

S: Did they have to stay on bedrest?

H: How long did they stay on bedrest? I think they did. I could get my old
procedure book from the Margaret Haig and tell you exactly how long.

S: I'll bet because that is in the procedure manual, I am sure. I can remember
Mother saying how weak she was and when I told her that was from laying in bed
and not being able to do anything except to get up to the bathroom and not
shower and wash for three days or something.

H: I think that is probably why they began shortening the time when they began to
realize that early ambulation was important -- for that and also to prevent venous
clots and stuff. So it did. It did go down. And then, of course, it went way down
to what they were doing last year or the year before with the drive-through
deliveries. You know, this is interesting. Do you watch Good Morning, America?

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S: I do.

H: Did you watch it this morning?

S: Yes.

H: And hear about the epidurals, [epidural anesthesia] the obstetricians and the
epidurals and they are going to have some births on Tuesday.

S: I am certainly going to be watching.
H: Me, too. And how natural childbirth isn't the thing, anymore. And that is going to
change. That is going to be my next project.

S: Well, to think that 70% of the people who come in now have epidurals.

H: And you know, I don't think epidurals are without some complications.

S: I promise you, they are not.

H: ... and I think it needs to be studied. So, when I get through with some of this
stuff, I am going to do that. But I think we need to get back to preparation
and...

S: ... The patients who come back ... if you just counted the ones who returned
for spinal headaches, if that is all you studied ...

H: ...if that is all you did, that would be ...

S: .. .be a big number ... who had to come in for a spinal patch.

H: It just seems that is now the vogue. It is what everybody does, so everybody
wants it. And it is wrong. It has got to change.

S: It is the pendulum just going the other way, again.

H: You cannot win. Just try to move ahead a little at a time -- little baby steps. Two
steps ahead, because you know you are going to go back one.

S: That is right.

H: I don't know, but I wondered if you knew that.

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S: I watch that rather regularly and every once in a while they on ABC network, will
have something that has to do with medicine and nursing.

H: This is a giant step for them. To go into a delivery room and not know what the
TV camera is going get into.

S: ... and they are in three institutions. You have said that Shands started as this
small, cohesive group of staff, and over the years, it has become this monster of
a maze.

H: ... bureaucracy...

S: How do you think that affects patient care? I have seen wandering patients and
they don't even know what clinic they are supposed to be directed to. Before
they go to the clinic, they have to go to Radiology and Lab, first ...

H: Well, it has just become very impersonal. I think any bureaucracy that grows -
gets big does. I am not sure that there is a way to help it except to decentralize
and try and do something cohesive in smaller units. I think we have always tried
to do that on OB. And probably the other units have, too, because you can deal
with a piece of the health care system but not the whole thing, anymore.

S: Do you remember when, maybe the beginning female physicians started trickling
into their work force? Did you have female physicians in OB? Did they start
coming into practice or was that not a rarity in OB?

H: I think we always had them -- more, now, of course. There are a lot more, now.

S: Was there resistance in the early years, to any of the ... ?

H: I wouldn't have been too aware of it. There was so much resistance against us.
That was all I could cope with. I am sure they felt it because they were doing the
same thing. They were treading into territory that the male physicians, I am sure,
had always thought was going to be theirs. But I think gradually, people get used
to I am sure that they are used to it, now, and don't give it another thought. But
we had some delightful female residents and they went on. There are several of
them around here in private practice and they are all doing fine.

S: There was something on television where they referred to how many female
obstetricians there were on that show. And they talked about -- I think it was at
Beth Israel Hospital in New York City ...

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H: ... more than half were females. And I think that is life. I think that is how it
should be. I have had some awfully good friends who were obstetricians but I
have always wondered why they chose that. Don't put that in.

S: Nope. The other things that I was looking at had to do with some of the racial
things and I was wondering if patients were ever segregated since Shands
opened or if that opened as an integrated ...

H: No. It was segregated.

S: Was it segregated at first?

H: I have a chapter in my book about that, too. If you wander through the old
hospital, there are two sets of bathrooms on every corridor, two sets of drinking
fountains, because in the beginning there were some for blacks and some for
whites. It was definitely segregated. Cafeteria, on the first floor was white and
there was a little cafeteria in the basement for the blacks. The only place in the
whole hospital that wasn't segregated was the newborn nursery and that was
funny because of course, money came into play. They didn't have enough
babies of either color to justify two nurseries and two staffs so they had to put
them together. So, I thought, (put it in my book) that I wondered when the
differences began to show.

S: At what age do you ...

H: Yeah, but that is funny because that is the only reason that wasn't segregated,
as well, because everything else was, rigidly segregated. The whole town was.

S: Well, I knew that Alachua General Hospital was, because I have talked to people
who worked and told me what areas were segregated in AGH.

H: And downtown, the doctors' offices were. They had little waiting rooms for the
black mothers and black patients and nicer waiting room for the whites .. and
different doors. It was terrible. And coming from New England where the
president of our high-school class was black ...

S: You must have been in culture shock.

H: I was.

S: Welcome to the South.

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H: I really was. I had a lot of problems with that.

S: Well, now, on a segregated unit with black patients, what was the staff?

H: We had a black wing and a white wing. Mothers had rooms that we didn't put
black and white mothers in the same room, but we had black and white staff and
they took care of all of the patients, black and white. And heaven forbid, the
black aides in the nursery took care of white babies. It was crazy.

S: Were there a lot of black employees at Shands?

H: Yeah.

S: But I think that there were probably very few black students until maybe even the
late sixties and the seventies.

H: That is about right. And the first one, Faye Harris -- was she a student or did she
come as faculty? I think maybe she came as faculty. But she was the first black
faculty that we had. And we finally had some black students but I would have to
give that some thought. I am not quite sure.

S: I remember having to -- we had at one point in medical surgical nursing, we had
maybe three or four sections, and when we divided the students up, I remember
we used to fight over having a minority of any kind. If there was a male
student .... One year, we had five male students and we fought over having
them in our sections because it increased the conversation. It gave so much
more perspective to whatever the topic was and I can remember fighting over
who would have the black student in their section so that we could have a
different cultural perspective. But I know that they were definitely in the minority
by a bunch.

H: And I think it must have been the late sixties before it was even possible. They
had to work out the whole civil rights thing.

S: They are still working it out.

H: Well, I know, but I mean what was going on in the sixties had to ... before we
could even consider it. It wasn't right. None of that was right, but it happened.
But I laugh over the nursery.



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S: I think that is a wonderful story. And you think how people lived. Were you on
the faculty during the time of all of the Johns Committee [Florida legislative
committee formed to see out communists and homosexuals in the 1950s]
business in Tallahassee?

H: No. That was a little before my time.

S: ... before you got there. But you heard about it, no doubt.

H: Oh, yeah. I heard about it. Bad goings-on. Sixties were very tumultuous time,
but [they were] very exciting for me, because of all of the things that were
happening in maternity with mothers and babies. A lot of things that were
happening, then, that were exciting at that time.

S: I can remember Dorothy Smith saying, it was such a time of change and she said
that when there are times of change and things are going on, those are your
opportunities. Those are your openings for moving ahead.

H: Yeah, she is right.

S: You look for those opportunities.

[Tape interrupted.]

S: We were talking about some of the diversity that was going on in the sixties.
Now, do you remember when Dorothy retired? Do you remember what was
going on in the College?

H: Let me tell you one other story, first. Ethel Kirkland is a black nurse midwife and
she worked in the Board of Health while it was in Jacksonville. And she traveled
the state supervising the granny midwives, actually. But we had her come to
class a number of times to talk to the students about her role and how it was as a
black nurse midwife. She was a marvelous person, a marvelous woman. She
came to be a part of a workshop that we were doing one time. We took her to
the cafeteria at lunchtime and they stopped us. The cashier stopped us because
she said she can't come in here. And I said, well, she is our guest. So the
cashier thought about it for a little bit and then she said, well, maybe if one of you
gets in front of her and the other ones gets behind her, really close so that
everybody looking at her knows that you are with her, it will be all right; you could
try that. Now, can you imagine? And Ethyl was okay. She kept her cool. I don't
know how.


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S: And she heard this whole conversation?

H: She was standing right there with us. Yes. But that gives you some kind of a
feel for the flavor, how bigoted people were, how awful they were to each other.

S: How hurtful to each other.

H: Anyway, I just thought that ...

S: You know, when we were talking about anybody who was a black caregiver or
some of the first black nurses, did you know Vivian Filer?

H: No.

S: Well, Vivian was one of the people -- I am not even sure how I first knew her, but
when I first came to Florida, she was -- to put it in her words, just an aide and she
rocked babies in the pediatric nursery.

H: That is right.

S: And then there were people like her mentors, like Judy Moore and some of the
others that said, why don't you become an LPN; why don't you go back to
school? And to look at someone like her who subsequently became the Acting
Director of Santa Fe Nursing Program, and you think ...

H: We had one on OB like that who was an aide and went back and got her LPN,
and then her RN and ended up as the Nurse III. So they were so unfairly treated.

S: They sure were and had to go the long route, many times.

H: And they needed help. It was good that there were some people who were able
to bolster them and tell them that it was OK or protect them.

S: Do you remember when Dorothy ... did she tell the faculty that she was thinking
of retiring?

H: I remember what she first did, was [to] step down. And come out of that office
and come up to the -- we were on the fifth floor -- and she had a little office, one
of our little offices up there. And so, the faculty decided to welcome her by
buying her special furniture for that little office and I know she had a bright blue
file cabinet. Whoever it was went out...


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S: What she did was to say I retire from the deanship and I want to teach? Is that
what she did first?

H: Yeah. She just stepped down from the deanship but was teaching.

S: ... but was going to stay on the faculty?

H: But she didn't stay very long. She ended up you know you could see the
handwriting on the wall in that letter to Dr. Ackell that she wrote in 1970. And I
think she retired in 1971, didn't she? It had gotten to the point where there was
no support in the Health Center for what she was trying to do. It was getting so
big.

S: And all of the people who had originally been there and been supportive ...

H: They were all gone. And so, that was really sad when she did that. But, you
know, we all continued to be very good friends, even after she retired. We saw a
lot of her. We had parties together. And she was busy because she had
achieved a great deal well, people in nursing knew her, of course. She was
active in the National League for Nursing. She traveled and did speeches. So
she was doing some things. But it must have been a sense a great
disappointment that other people didn't see how important it was and to help her
with what she was doing.

S: If you were to look back and say what was her most important contribution to
either the College, here or nursing, at large ...

H: I think it would have to be the way she instilled her philosophy what she saw for
nursing and nursing practice -- to everyone she met: faculty, students. You
know, she put out a lot of people who had their eyes opened and are doing,
hopefully, a lot of the things that she would be pleased to have them doing, now.

S: Well, and she was very charismatic about it, too. I mean, as a teacher, she was
not someone you could ignore.

H: [Laughing.] No, that is true.

S: Have I said that correctly?

H: She wasn't.



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S: I think you are right. I think she influenced a lot of people and sometime
influenced people when they didn't even know that they were absorbing.

H: Well, that is what she did with us, you know. I mentioned that subtle education.
We didn't realize, exactly.

S: Subliminally...

H: ... but we were.

S: You were changed forever.

H: I can't talk for the others but I sure was. I sure was.

S: You are just at a higher level, because you admit it.

H: Well, I am sure she did.

S: I think she ...

H: But I know all of the original faculty, there isn't anybody who didn't love her to
death. Not anybody, who didn't think the world of her.

S: Well, her motivation was always at the right place. Her heart was always ... if
she said this is for the betterment of patient care, what nurse is against that? I
mean, her motivation was just unquestionable. Do you remember when Blanche
Urey came?
H: Sure do.

S: What do you recall of her leadership?

H: A lot.

S: Your answers are getting shorter.

H: No, I have got some long stories to tell here, too. You may be getting tired.

S: Not yet.

H: We have just barely gotten started.

S: We may have to make another appointment.

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H: Anyway, to move back a little bit after Dorothy left, I guess Judy Moore took over,
first.

S: She was an interim dean. I remember that.

H: Before Blanche. And I need to tell you what was going on with maternity. Well, it
really wasn't maternity. You see, we now had, by the mid-seventies, we had
physicians' assistants, we even had a program. There were a few nurse-
practitioner programs; now on maternity, we had family-planning nurse
practitioners. They usually had three or four month long programs to teach
family-planning concepts. And I guess the other specialties had mostly short
term courses but we needed to get the nurse practitioner preparation into a
graduate program because it was the coming thing. Primary care and the use of
nurse practitioners, but they needed to be masters level. And so I wrote a grant
to Robert Wood Johnson in 1975 and I asked for some money and told them
what we wanted to do was to prepare nurse practitioners in women's and infants'
health rather than the traditional old maternal-newborn hospital oriented. We
wanted this to be primary care and they thought that was a good idea. And so
they sent somebody down to talk to us and when they came down, they thought
if you are going to do this for maternity, why don't you do it for the whole
program, the whole graduate program? So, they suggested that I rewrite the
proposal so that I could show how primary care could be built in as a base for all
of the specialties in the graduate program instead of just the maternity. Which
was a bit more than ...

S: What an assignment!

H: I didn't really want to do all of that because the curriculum meant that every
master's student, and we had about thirty at the time, they all had to have sixteen
hours of supervised primary care practice with a preceptor every week, for that
first, I guess they were semesters by this time. But that meant thirty and with all
of those preceptors, then, Blanche said to me, you have got to do it. I was
project director with co-director with Dick Reynolds over in Community Health
where the P.A.s [physicians' assistants] were. And that was the other piece of
this. Robert Wood Johnson's people said, don't duplicate efforts, but if they are
doing some things and you need the same kinds of skills and you do them, then
you work together. And that was all right. I didn't have any problem with it, but
some of our faculty did, because that wasn't even a baccalaureate program,
then. They couldn't see the masters people should be working with these P.A.s.
Anyway, that is a piece of the story. But Blanche said, you have got to find
places for all of these people. I tried to tell her that five was enough to start with

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and Dick Reynolds thought so, too. He was really upset because he and I
wanted to start slow. But she insisted with no ifs, ands or buts. She said, you do
it. And so there I was and it was, maybe, I don't know, mid- summer. We had
a few months before the students would be ready for this but all of those
preceptors. And I was all over the place. I found some preceptors, one or two,
really good GPs [general practitioners] here in Gainesville that agreed to take the
students. My MIC, maternity students were OK anyway, because I had places
for them. I had a former student down at Lowell Prison who is a nurse
practitioner and she took one. Did I tell you about the Naval Air Station?

S: No.

H: Well, I am getting ahead of myself. Anyway, I had gone to Rochester [University
in New York] and done a primary care course that was set up for faculty. When I
came back from there, I couldn't get a pediatric preceptor here in Gainesville.
The pediatricians said, no, no way. So, I got the chief of pediatrics at the Naval
Air Station in Jacksonville to do it. So I went over and spent a year with him
because we had to round out our primary care with supervised practice for the
next year. So I did it over there and got to know those people. So, then, when
Blanche was giving me this fit about students, I went over to the Naval Station to
make some arrangements for a couple over there and I was talking to, I guess
somebody in pediatrics over there. She said, you know, we have a family
practice unit over here and there is a nurse practitioner in there, so let us go
meet her; maybe she can help you. And so we went over to family practice and
the nurse practitioner said, well, hi, Miss Hilliard; it has been along time. And it
turned out she was one of my students in Wyoming. And here she was, married
to a minister in Jacksonville and a nurse practitioner at the Naval Air Station.
And so, of course, she took a couple students. So I had some pretty good luck
getting students placed, but it was a terribly anxious period, because I didn't
know if I was going to find enough places for all of them good places. Really
good places. So that was funny. And I forgot all about Rochester, but that
summer up there was interesting, too. We did that course. That was Robert
Wood Johnson. They said that if you are going do this course, if you are going to
change the program, you have got to have some nurse practitioner skills. She
said, we have set up programs .... I think they had four across the country at
that time where faculty could go and get prepared so that they could go back
home and prepare their faculty. So I went up there and had quite a good time up
there. I learned a lot and had a lot of adventures. And then, Blanche after I
came back from there, Blanche and I flew out to California because there was a
nurse practitioner there that was very good and quite well known. We went out
to visit with them and find out what we needed to be doing with our program. Of
course, all of this is in the book.

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S: We need to cite that, liberally, don't we?

H: Well, no, but whoever picks up the book is going to be a little repetitious, I think.
But, anyway, we visited at Davis [Davis campus of University of California] with
the program and then they took us up to Santa Rosa where there was a nurse
practitioner, P.A., physician group that was in actual practice. And flying all over
the state, too. So they thought we ought to talk to them, too, about what kinds of
things they were doing. And on the way back, we got lost. We left the nurse
practitioner that went with us from Davis up there, because she drove us up in a
state car but she said, you won't mind driving this back, will you, because I need
to go home and I live way over on the other side. So we got in this state car and
started back and it was fine until it began to get dark and we had to go over some
mountains in order to get back to Sacramento. And Blanche said, how much gas
have you got? And I looked at the gauge and it was empty. It was black; it was
dark. She was fit to be tied. You did ask about her leadership style. I liked her
and I don't want you to come down too heavy on her, but she did do these things.
And so, anyway, I got to the point where I was crawling up a hill and then
coasting down so I wouldn't use any gas. I thought which one of us is going to
take the back seat tonight and, in a state car. This was a California state car; it
wasn't even ours.

S: A long way from home.

H: Anyway, we coasted down this one last hill and do you know that at the bottom of
it, there were some lights and there was this gas station and the guy said, it is a
good thing you came right now, because I was getting ready to close, you know,
ma doesn't like me to be out in the dark, way out here when there is nothing
around. And so, he filled our tank and told us how to get home, back to
Sacramento. So Blanche and I had some interesting times together.

S: I guess so. And then, do you remember anything about when Judy Moore was
the interim Dean?

H: I just knew she was. But I think, during that time I was not there.

S: It wasn't a long time.

H: See, I got my doctorate in 1973. And so, about 1970, I resigned because I
couldn't study at the University of Florida and be on the faculty. And so I
resigned.


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S: And so where did you get your doctorate?

H: Here, in the College of Education.

S: I see. Then, you started going to school ...

H: That one was free, too. All of them were. It was really kind of nice. I didn't pay
anything for any of my education.

S: It was just meant to be.

H: But, so I wasn't in the college when Judy was Dean.

S: And then, were you there when Blanche died?

H: Yes. And that was very sad.

S: It sure was. Do you know if she had any awareness that she had any health
problems?

H: Yes, she did. We had talked about this a week before. We had a meeting, it
seemed like it was sort of an anxiety-provoking meeting and afterwards I said,
you know, you really keep your cool. How do you keep so calm when things like
this are going on? She said, Believe me, Betty, I am not calm. I think we were
using Type "A," "B," and "C" personality, at that time. Whatever it was, she said, I
am the worst type and, you know for high blood pressure and ... so, she knew.

S: She was upset.

H: It was really sad. I liked her. There were a lot of good things about Blanche. But
the ones that stand out in my mind are not really the best ones.

S: And then, they had another search committee to find Lois Malasanos, then.
H: But they had Amanda, between.

S: That is right. Amanda Baker was ...

H: And she was interim dean in 1979 but she said to me, you can have the year off
to get your program underway; go to Jacksonville and work with them over there
and use the time. You won't have to teach anything over there; just use the time
and see if you can get things underway for the Nurse Midwifery Program. See,
by this time, the nurse practitioner, the curriculum was already integrated by this

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time. And so that grant was finished and we were preparing nurse practitioners.
So that was done and so it was time to move on and do this other thing. So she
gave me that year.

S: Not only was she interim or acting dean, but she was also a candidate, wasn't
she?

H: Yes, she was and didn't get it. I have always been sorry.

S: Well, I think that must have hurt her, too.

H: It hurt her a lot.

S: I think she either expected it or ...

H: That is when she left.

S: She left and went to Alabama.

H: I have seen her since. I saw her in an airport, somewhere. She was very happy
up there.

S: Yes, it turned out to be a good move for her.

H: So, it was good but I am sure she felt ...

S: I think it was hurtful at the time.

H: ... really let down that happened. And she was a good dean when we had her.
Anybody who would give me a year off to do the things I wanted to do ...

S: We were talking about Amanda and after Amanda did not get the deanship, then
she left and then Lois Malasanos was recruited.

H: And she, again, had a very different style. I like Lois. She is a good friend.
S: And they all came at very points in time as far as healthcare in general or what
was going on in just the Health Center, the developments in medicine, the
financial milieu of what was going on in health-care and what their individual
talents were to bring to the College. Very different eras, if you really look at it.

H: Time doesn't stay still. That is for sure.


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S: It really doesn't. And your perspective looking forward and what you think you
need in a leadership person and then you look back and say what you had or
what grew from it, are very different views.

H: Starting out, you never would have believed all of the things that happened at the
Health Center, would have happened the way they did.

S: That is right.

H: They didn't really want midwifery, at all. But, over in Jacksonville, at that time,
the OB/GYN Chair at University Hospital was really supportive.

S: Is that right? And who was that?

H: Bob Thompson. And he was responsible for getting the nurse midwifery service
over there which later on, he got demoted, and the service got discontinued.

S: Really?

H: Yes. And the atmosphere toward nurse midwives has changed over there to be
not so very good. But at that point in time, it was very good and that is why she
said to go to Jacksonville. That would be the place to see what could be worked
out with that service, those people because Shands would have no part of it.
They wouldn't even listen. That was way out. We could have had see both Dr.
Daley and Dr. Mahon interviewed for chair of the OB Department and if either
one of them and Notelovitz did, too. If any one of the three had gotten to be
chair, we would have had the best nurse midwifery here, possible because they
were all in support. But, they hired GYN men in that position and all of them and
they could have cared less. So we went to Jacksonville. And over there, they
didn't -- the head of the midwifery service could have cared less, too. She really
didn't want us and the students. We were friends but she just didn't want us. So,
they weren't all that helpful over there. So, when we finally got our grant money
for a program, I had to look somewhere else for places for our students. I could
do all right for prenatal; I had clinics in Reddick and in Trenton and Green Cove
Springs and a bunch of other places, oh, Cecil Field.

S: Really?
H: Well, yeah, because I did part of my year ...

S: ... your practicum.



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H: ... over there. Some of it was at the big hospital and some of it was the
pediatric nurse practitioner of Cecil Field.

S: So, you had contacts.

H: So, I could ... so that was helpful to see what I could do with the midwives in the
Navy. But, anyway, I had prenatal, postpartum family planning. Okay, it was just
the delivery piece that was missing. Fortunately, I had BJ Chiota, down in Ocala,
and she had started a service. There was a service in Palatka and they were
willing to take students. And the best place was down at Morton Plant Hospital
down in Clearwater, because one of my former students was nursing director
down there.

S: Who was that?

H: Katy ...

S: Sacchrison. I got a Christmas card from her. She and I stay in touch.

H: I wish you would tell her... the next card you write to let me know.

S: I w ill. I w ill.

H: Because she was a marvelous help. I couldn't have done it down there without
her.

S: I was in Florida Organization of Nurse Executives with her for a long time and
she was my student as a junior when she was a RN to BSN student.

H: Mine, too.

S: That is the same era. I will certainly do that.

H: So, be sure because I have sort of lost touch, now, that I am not going down
there. They had a very good nurse-midwifery service at Morton Plant and so she
got me all set with that group.

S: Isn't that nice?

H: ... and I was able to get, with those places to precept my students, I was able to
do it. So, I burned up the road.


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S: I was going to say, it sounds like you spent a lot of time on the road.

H: Well, one of the problems was that when nurse midwives really began to settle
into Florida and practice, they mostly came from the University of Mississippi,
which was a certificate program. They were not degree. They did not come
from degree programs. And you know how the National League for Nursing
feels about that. And the American College of Midwives, too. You know, if you
don't have a masters, instructor for masters students, forget it. So I had to be
that person. You know, they were wonderful preceptors but I had to be the
image in each place so that I could say that there was a master's person ...

S: ... supervising at some level.

H: Yeah. Doing something. I didn't do anything, but I was there.

S: Yeah. It had to be on the piece of paper.

H: I was there. So that was a little bit of a problem. And that has sort of been
hurtful for the nurse midwives in the state, too.

S: Another way of dividing ourselves, isn't it?

H: Because they are so skilled and so good at what they do and then to have it is
sort of like, "you are better than I am because you have that piece of paper."

S: Well, I am kind of toward the wrap-up time.

H: I don't wonder. We have been talking ...

S: I know. I never would have dreamed ... you know, to say please block out an
entire day.

H: Well, you haven't got it all, yet.

S: I know. I know. I keep thinking that I am making notes in the margin if we ever
go back. If you had to look back on what the legacies of the College of Nursing
might be since Dorothy was there and laid all of that foundation, and we have
talked a lot about some of us running around imbued with some of those basic
philosophies that we didn't come with what do you think the early days of the
College of Nursing what impact, or the early days of Shands, I should say,
since it was also joint practice, what do you think the major legacy to nursing or
to health care is?

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H: I think that we will see her ideas be put in practice, someday when people wake
up and fly right. It will come. It is just, she was way ahead of her time -- just way
ahead of her time. And there were only a few people like Lee Ford who saw that;
who saw what she was doing and how necessary it was and how right.
Absolutely, right it was. And I hope we wake up and see that nursing has got to
do this, more now than ever, because I think nursing is in such a demoralized
state right now, that if we don't do something to put the excitement and the
meaning back into it, we are going to just drop out of the picture. Aides and other
people will just take over. I just don't think there will be nursing, if we don't do
something and do pretty quickly.

S: I think so. Some of the excitement and some of the stories that we remember
about the sixties, you know when you thought you were on the right track and
Dorothy could just redirect you with one comment. You would think, oh, I didn't
think of that. And you spent the weekend scratching your head and thinking.

H: I am just sorry she didn't get the recognition that she should have had when she
was alive. But I think she will get it.

S: I think she will, too.

H: It is too bad that she missed out on some of that.

S: And her ideas, not only just her writing but her ideas, were so prolific. I mean
she just had such an impact on so many of us. Well, if we were to wrap-up, at
least this day's interviews (I am qualifying my question), are there things that I
haven't completely finished talking about or that things that should be in here,
topics that we didn't say that should at least, make this interview, complete? Are
there other things that you would like to add?

H: I think we have covered quite a lot.

S: For Chapter One, this ought to do it?

H: I really think we have. We got up to the 1980s.

S: I think so, too. We have covered a lot of ground. Well, officially, Betty, thank you
so much for your time.

H: You are very welcome.


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S: I think what I will do is put as a bibliography, "See the book." Do you have
a name for the book?

H: Yeah.

S: Labor of Love.

H: Yes! A Labor of Love











































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