Interview with Lucille Mercadante, March 28, 2001

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Interview with Lucille Mercadante, March 28, 2001
Mercadante, Lucille ( Interviewee )
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University of Florida College of Nursing Oral History Collection ( local )
University of Florida -- History


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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Interviewee: Lucille Mercandante
Interviewer: Ann Smith
Date of Interview: March 28, 2001





Interviewee: Lucille Mercadante
Interviewer: Ann Smith
March 28, 2001

Pages 1-5 Mercadante, born in 1925, went to Mt. Vernon Hospital School of Nursing, in Mount
Vernon, New York, and graduated from this three-year program in 1946. She entered the Navy
Cadet Corps to return her obligation for their payment of her education but was not asked to
serve since the war was at an end. She worked at Mt. Vernon Hospital of 350 beds, first in
OB/GYN and later in the outpatient department. In 1948, she and a friend began attending
Teachers College, Columbia University in New York city part time for their Bachelor's Degree
(acquired in 1953), while working full time at Mt. Vernon. Two years later, she went on for her
Masters Degree on scholarship funds enacted by President Eisenhower.

Page 5- Mercadante's advisors recommended that she change her in major in public health
because of a back injury which was thought to be a potential hindrance in climbing steps to
apartments in the New York public health districts. Counseled by one of her instructors from her
BS program, Eleanor Lambertson advised that she major in Nursing Administration. During the
year's study for her Masters Degree, she took courses with Fran Reiter which emphasized the
education of nurses aides, retraining RNs and orientation.

Page 6 She was still working at Mt. Vernon when she received a letter from Nancy Rood, who
was the first nurse hired to be responsible for the nursing care of patients at Shands in
Gainesville and responsible to Dorothy Smith. Rood asked Mercadante if she would be
interested in heading the Inservice Education Program at J. Hillis Miller Health Center in
Gainesville. Mercadante came down for an interview and to learn what was being planned as a
unification model of nursing practice -- having nursing education and nursing service responsible
to Dean Smith.

Page 8 Mercadante is a small person and she describes her first meeting with Dean Smith as
"incredible," as she watches this six-foot, New Englander stand up from behind her desk to greet
her. In July 1958, she arrived in Gainesville that had a population of about 30,000 people
including 11,000 students from University of Florida. She describes her adjustment from being a
New Yorker and having to acclimate to the weather in Gainesville in July. They started planning
for the Unit Manager System and what staff had to be educated through her department.

Page 10 Mercadante had been in her role of Inservice Education Director for a year when


Nancy Rood moved to Jacksonville. The dean wished to replace Rood with someone from
within the system considering all the preliminary teaching and indoctrination that had transpired.
Mercadante moved into the office close to Rush Jordon, Director of Shands Hospital. She
indicated that hospital administrators were going through an adjustment in their roles because in
other settings, nursing had been a major part of what they oversaw. Mercadante tried to
accommodate by keeping Rush Jordon and his assistant, Duane Houtz, informed while reporting
to Dorothy Smith. In fact, she formed a close relationship with Duane since they were often
asked to travel together on consulting visits and to speaking engagements as the Unit Manager
System became known around the country. They jointly published a number of articles in
hospital and nursing journals. As the assistant dean for Nursing Practice from 1959 to 1967, the
College of Nursing grew in stature. Thelma Ingles, a consultant from the Rockefeller
Foundation and a friend of Dorothy Smith, approached the college about an exchange program
with the university in Bogota, Colombia.

Page 15 In 1967, Mercadante went to Bogota as visiting professor and consultant with the
Rockefeller Foundation. She enjoyed the freedom of being a consultant and not carrying out
staffing and operations responsibilities. The 1960s was a time of nursing shortages in Florida
and recruitment of nurses to Gainesville was difficult. This was compounded by the competitive
salaries that were being offered in Miami. Shands was part of the state system at the time and
salaries were tied to that category.

Page 16 Mercadante recalls some of the innovations instituted at the opening of the J. Hillis
Miller Health Center in late 1950s. One change was that it should be called a "health center"
and the philosophy should reflect that title. This included the collaboration of the disciplines,
learning and working together whenever possible, the belief being that if the students knew more
of the other disciplines' contributions, they would have more respect as professional colleagues.
Nursing and medical rounds had joint participation. Nursing faculty were blended into the mix
to the extent that several joint appointments were faculty members who also were
administratively responsible for a patient unit. Mercadante mentions examples on Psych/Mental
Health and Pediatrics. Other joint appointments did not work as successfully, such as in some of
the medical surgical units. Power struggles began growing between those learning a different
hierarchy and between those with varying educational preparation. The traditional head nurse
was accustomed to making the decisions about her budget allocations, and now the unit manager
(accountable to hospital administration) made those monetary decisions. Philosophically, the
unit manager system was to allow the professional nurses the freedom from clerical chores to
return more time to bedside nursing care. If the unit manger was a clerical person without a
degree, a lack of understanding might result in a power struggle if nurses were not getting the
supplies or other support they felt they needed for patient care.

Page 22 Mercadante had not experienced segregation until she came to the South. She had
worked with black nurses on her staff in New York. At Shands, LPNs and aides were black but
very few RNs were black.
Page 24 Mercadante tells of the struggles that Dean Smith had with some of the medical chiefs
of service, primarily surgery. There was a power struggle over the control of the Operating


Room and, with the help of a consultant's recommendation, the Operating Room was taken from
the Nursing Department and placed under the control of Dr. Edward Woodward, chief of the
Department of Surgery. Apparently Dorothy Smith had mixed feelings about this since most of
the activities in this setting took place while the patient was unconscious. She therefore
questioned if this was professional nursing. Woodward had also introduced the concept of
operating room technicians who were taught to pass instruments and follow the directions of the
surgeon. Compounding this was the strong influence of the unit manager and Mercadante
believes that Woodward was against the Unification Model.
Mercadante describes some positive collaborative relationships with the College of
Pharmacy and with Physical Therapy.

Page 26 The care plan, describing the status and plan for care for the patient, brought
apprehension to other departments such as medical records. Because this was a new introduction
to the permanent record, the Medical Records Department initially removed it. Mercadante
allows that some of the charting by nurses was not particularly valuable "sleeping, no problems."
There were some territorial issues since physicians had previously seen the patient as "theirs"
and now others on the team were thinking in terms of "ours."

Page 27 Mercadante was granted graduate faculty status when Joan O'Brian, assistant dean for
the Graduate Program, continued to get requests from students for course work on
administration. Dean Smith opposed this, believing that only clinical majors should be offered
as graduate options. Mercadante began by holding a seminar with about a dozen interested
students. She enjoyed it since the seminar had discussion and content with none of the burdens
of grading.

Page 32 Mercadante speaks fondly of Carol Taylor who helped the staff understand the concept
of the Unit Manager System and published several articles. Mercadante tells of her great respect
for Annie Vestle, the first executive housekeeper of Shands. Vestle understood the concept of the
College of Nursing and she reinforced it by diligently taking on any and all tasks that could be
done by the Housekeeping Department.

Page 35 Mercadante explains that she had come from a background in which a nurse always
continues to take care of patients and she saw no conflict, regardless of her title. She talks of
knowing cases where faculty members resisted bringing students to clinical areas in the evenings
or nights because of the inconvenience. She notes that this was not the case at UF. She took
Dorothy Smith's message of primary nursing -- following the one patient throughout the course
of their care -- everywhere she went.

Page 38 The role of the Nurse II position (formerly Head Nurse) was twenty-four hour
responsibility. It worked at Shands because the health center was located in a safe community to
come out in the middle of the night if needed. In the late 1960s, after Mercadante left to consult
in Colombia, there was some unrest among the nursing staff at Shands. There was friction
between diploma-trained nurses and their college-educated counterparts. Smith often spoke
negatively of the "diploma school mentality."


Page 40 After Mercadante left, many of Smith's supporters in the Health Center's leadership
also were gone. Smith resigned. The forward-thinking philosophies that had been instituted
began to erode. The leadership who had envisioned the original Health Center were almost all
Mercadante spoke of the first few male RNs who came into the field, but she could not
recall any female physicians.

Page 44 Patients were segregated by racial background while Mercadante was at the Health
Center. She recalled some black personnel, primarily as aides, orderlies or LPNs. She
remembered the Johns Committee originating in Tallahassee in 1956 and the fear it engendered
in colleagues and who might report names to the committee. McCarthy hearings were in the
early 1950s. Mercadante had Hildegard Peplau as a professor at Columbia. Peplau was
considered the "mother of psychiatric nursing" with programs across the country using her book
Interpersonal Relations in Nursing. She was called before Senator Joseph McCarthy and under
this cloud, she was asked to leave her position at Columbia. Mercadante spoke of the fear, the
tension, and suspicion in the air.

Page 48 Mercadante speaks of the closeness of the staff in the early days of Shands in the
middle 1950s and how it created a sense of team and camaraderie that extended to patient care.
In response to the questions of effects on the care, she said that she felt that the size of the
institution in 2001 had a negative effect on the care. By virtue of the size, it was impossible to
feel much closeness.

Page 49 After returning from a leave of absence to consult in Colombia, Mercadante resigned
to consult full time. At this same time, Joan O'Brien left as dean of the Nursing Graduate
Program to marry and subsequently take a position as dean of the College of Nursing of
Downstate Medical Center, State University of New York. She coaxed Mercadante into joining
her as her associate dean on a temporary basis as consultant for six months. They were trying to
replicate the University of Florida philosophy of Dorothy Smith. The six months turned into
seven years, at which time Joan O'Brien resigned.


Page 53 In 1975, Mercadante accepted a position in Nursing Administration at Mt. Sinai in
Miami, Florida. In 1980, she was associate director of a small international hospital in Miami
and in 1983, she took a position at Barry University in Miami. It was her intention to teach
administration but this was a time in nursing when this content was in great demand. She was
the associate dean for the Graduate Program as well as heading up the nursing administration
major in nursing and teaching three courses. Barry University later also added the nurse
practitioner major. Mercadante states how much she enjoyed her eleven years there and decided
to leave the Miami area only when Hurricane Andrew came through in 1992 causing so much
devastation. A combination of the hurricane damage to her house and the desire to retire caused
her to leave Barry in 1994 and Miami in 1996. She returned to the Gainesville area to be near

Page 57 In recalling events over the course of her career, Mercadante remembers the first open-
heart procedures performed at Shands and the excitement over the advancements of
craniotomies. She talks about the scandalous decision for the College of Nursing to make the
nursing cap an optional item. It was thought that the cap no longer represented the professional
nurse. She recalls the first time she wore a white lab coat over street clothes and the reactions
she got from physicians who felt that sort of attire belonged to them.


Interviewee: Lucille Mercandante
Interviewer: Ann Smith
Date: March 28, 2001

S: Today is March 28, 2001, and I am at the home of Lucille Mercadante in
Gainesville, Florida. My name is Ann Smith. I am a volunteer for the University
of Florida Oral History Program, [and] I am interviewing Lucille [for] the second in
a series of University of Florida College of Nursing alumni interviews. And Merc,
you are not a Floridian. Where were you born?

M: Mount Vernon, New York, [which] has changed quite a bit now, but it was the first
town as you come up from the Bronx Bronx, New York the first city and the
beginning of Westchester County.

S: And are you willing to say what year, or don't we do that?

M: Oh, I would be happy to, 1925.

S: 1925. And so you spent your childhood, there?

M: Yes. As a matter of fact, I graduated from Mt. Vernon Hospital School of Nursing.

S: Now, that was a three-year program?

M: A three-year program, that is right.

S: I remember those.

M: Hm-mm!

S: And then what did you do? Now, you graduated in what year?

M: I graduated in 1946. I was a cadet nurse. I was in the Cadet Nurse Corps and...

S: ...and that meant funding?

M: It meant funding. That is right. As a matter of fact, my mother violently opposed
because my brother [had] volunteered he went into the Navy and she just
saw me going off once I graduated. She had already paid my tuition, and I said,
well, I am going to give it back to you or you can give it to me to start my bank
account, but I am going to be a cadet. I think it was during our probationary first-
year period, we got $15 a month. By the time we became seniors, we got $30 a


month. Man, we were ...
S: That was big stuff.

M: Yes. Fortunately or unfortunately, because I was really looking forward to going
into the service, but the war ended before I had [a chance], so that was it. So,
then, I just worked at Mount Vernon Hospital.

S: And the agreement for the reimbursement was a commitment of two years or
something like that?

M: That is right, but they did not hold us to it because the war ended.

S: They did not need the nurses then. So, you started there. Was that a large

M: Mount Vernon Hospital, at that time, was fairly large. It was a 350-bed [hospital]
and had all of the services, [an] outpatient department, which I eventually
became supervisor of. My clinical area, to begin with, was OB [obstetrics],
OB/GYN [obstetrics/gynecology].

S: Was it? I didn't know that.

M: Yes. Oh, I loved it. I really did. I wanted to go on and get my Master's in
Maternal/Child but, unfortunately, I had a back problem. We were taking a
patient up to the delivery room [up in the elevator to an upper floor of the
building]. In those days, you went up from the labor room.

S: I remember, yes.

M: Getting on the elevator, the wheel stuck and I picked it up [the end of the
stretcher], and my helper helped pick it up, and the following morning I was
working nights I could hardly walk. [By] the afternoon, I could hardly get out of
bed. It was a two-year kind of thing with, I mean, they had me in a cow-horn
brace for a while. They had me in this and all sorts of things and, finally, they did
do a laminectomy. Since then, I had problems on and off, on and off, but, thank
God, you know, I was able...

S: It held pretty well.

M: Yeah.

S: Talk about starting out your career.

M: Hm-mm. As a matter of fact, I remember when I went to Teachers College,
Columbia University, because I did go and get my bachelor's. I went down to


Page 3

Teachers College and got my bachelor's with one of my classmates. We went
down together. It took us five years, but we got it. [At this time in history, nursing
was trying to establish itself as a valid profession and was moving from an
apprenticeship training in the hospital setting to an education in an academic
setting. Nurses were gradually and grudgingly given some college credit for any
course work that might apply toward a degree.]

S: A baccalaureate?

M: Yes.

S: You had to start over from scratch, huh?

M: Just about. Well, you got all the chemistry [courses]. They did give us credit for
something like fifty credits forty-eight or fifty credits, something like that -
toward the degree.

S: And what year was that?

M: That was in 1948. Well, I got my bachelors in 1953, and then ... I might have to
go in and look at the diploma. I think it was 1953. Anyway, so I went back. It
was 1948, [and] it took about five years. But we went part time, too. We did not
go full time.

S: Yes, I remember.

M: I remember taking the subway from Mount Vernon. Well, we would have to take
a bus to 241st Street in the Bronx and then the subway down to Teachers
College, 125th Street or whatever it was. I did that with my friend Ruth Edling.

S: Now, did you work part time or full time?

M: No, I worked full time.

S: Those were the days.

M: That is right. I worked full time, except for the last two years which is when I had
the problem with the back. Then, I was on workman's compensation, as a matter
of fact. My mother, bless her heart, gave me the rest of the tuition to complete
my program, and I finally graduated. When I decided to go back for the Master's,
which was about two years later... Ah! And that was when [President Dwight
D.] Eisenhower [1953-1961] signed in this bill for the scholarships.


Page 4

S: I remember that, yes.
M: Well, I was one of the first. I had already enrolled, part time, for the Master's,
and I went down, and I wanted to get into Public Health. Maternal/Child was out,
so I thought Public Health might be a good field. Well, the gal who was in charge
of Public Health, Louise Smith, I think her name was, said that, because of the
back problem, I would be a liability because of the steps ...

[Tape interrupted.]

M: She said it would be unfair to me, as well, because we would be in districts in
New York City climbing steps and doing this and that and the other thing, and
she didn't think it would be very wise for me to go into Public Health. And so,
one of my instructors, when I was getting my bachelor's was Eleanor
Lambertson. Dejected as I was, I just walked in to see Eleanor Lambertson
because she was also an advisor. I said, I need your advice, and I told her the
sordid details. She said, Lucille, don't worry about it. I will put you in a program
that you will be very happy with. And it was Nursing Administration, of course -
she was the major advisor for Nursing Administration majors at the Master's

S: She knew what she was doing.

M: Well, I don't know about that. But at any rate, that woman we were pretty good
friends while I was still in New York. She really was something else.

S: What a mentor!

M: Yes, just wonderful. Just wonderful. So, that is how I got my Master's with the
scholarship. I applied, and I got the recommendations, and I got the scholarship
and got my Master's in one year.

S: So, now you have a Master's degree in Nursing Administration...

M: Well, it is a Master of Arts. See, they did not have Nursing Administration, per se,
[but] your major focus was on Nursing Administration. It was a Master of Arts,
and I had, as not really a sub-specialty, but one of the things I became very
interested in was...

[Tape interrupted.]

M: ... Fran Reiter was one of the leading people at that time, at least at TC


Page 5

[Teachers College], with this program of Inservice Education training program -
training nurse aides and retraining nurses and a real heavy focus on orientation
and all of that. I took her two courses, and lo and behold, I was working as
supervisor in the Outpatient Department at Mount Vernon Hospital when I
received a letter. The letter came from an individual by the name of Nancy Rood,
and she was from the University of Florida, College of Nursing, in Gainesville,
Florida. I had a friend of mine who was working at a travel agency in Manhattan,
so I called her up and said, where is Gainesville, Florida?

S: That's right. Who has ever heard of it?

M: Yeah, and she laughed. At any rate, I received the letter, and it talked about
coming down possibly, if I was interested. They were looking for someone to
head up the Inservice Education Program at the new hospital that was going to
be built at the J. Hillis Miller Health Center in Gainesville, Florida. The letter went
on to say that the position they were interested in filling was for someone to head
up the Inservice Education Program. So, I went down to Columbia and made an
appointment to see Fran Reiter. Lo and behold, it so happened that Nancy Rood
had gone up to TC [Teachers College] for a summer program, and while she was
there, she talked to several faculty about her pursuit of someone. She
mentioned what it was for, and Fran Reiter gave her my name. So, that is how
she got in touch with me. So, I thought, well, I have my Master's [and] I do not
know that I want to continue being supervisor of the Outpatient Department,
although I ran the place and it was wonderful. I enjoyed it tremendously. I
worked with all of the physicians and all of the different clinical areas and what
not. But I thought maybe I should kind of think about this. My brother had since
married and he had his family, and there was the concern about having to leave
my mother alone. I knew she would not uproot. She had to stay in Mount
Vernon. But at any rate, I was invited to come down to have an interview. I
packed my bags and came on down and met with Nancy Rood, first and
foremost, and we hit it off very nicely. She said, now, of course you are going to
have to meet with the dean, Dorothy Smith, because this is a unification program.

S: What did that mean to you?

M: At the time, I was not too sure because we had heard a little bit about it at TC but
I was not too sure exactly what it meant completely. Having been at this small
community hospital, Mount Vernon Hospital, supervisor of the Outpatient
Department, I actually reported directly to the Director of the Hospital and not the
Nursing Service Director. So, there was a little bit of a dichotomy there, a little
difference or whatever. I thought, well, let me hear what it is about. Nancy
explained that it would mean that we would be responsible, all of Nursing would


Page 6

be responsible, to the Dean of [Nursing] Service and [Nursing] Education. That is
the unification.

S: Was that going on anywhere else in the country?

M: I do not think so. Somebody said something at the time about Rush
Presbyterian, but I do not think they started until after Dorothy Smith and until
after a group of us went on the road to tell about the program. At any rate, we
talked, and I went to be interviewed by Dorothy Smith.

S: What was your first impression?

M: [Laughs.] Bless her heart. First of all, you know, I am not a big person, and there
Dorothy stands up. First, she is behind her desk, and then she gets up, of
course, to shake hands. Here is this six-foot-whatever Maine-New Englander.
What a presence!

S: Very imposing.

M: Oh, yes. I mean, incredible! She began to talk about the program and the
expectations with regard to nursing, and I was thoroughly intrigued. I really was.
I said, I need to go home and think about it. Before I left, they more or less
pretty much gave me the impression that if I wanted it, it was mine.

S: Now, they were interviewing you for an Inservice position?

M: Inservice, right.

S: And this is what year you are talking about?

M: This is 1958. I have forgotten the date that I went for the interview, but July of
1958 was when I came down to Gainesville lock, stock, and barrel. It was hot. It
was empty. At the time, I think the total population of Gainesville was about
30,000, and that included 11,000 students from the University of Florida.

S: Is that right?

M: Incredible. And having come from New York City ...

S: You must have felt like you made a wrong turn.

M: Absolutely. As a matter of fact, Jen Wilson [founding Chairman of the


Page 7

Department of the Maternal Child Nursing Department] met [me] at a certain
place, and she was to show me where we were going to stay. I mean, oh my
God, I almost died. It was down in a gully, so to speak; it was damp; it was
absolutely I don't even remember what part of town it was in. The following
morning was a Sunday morning, and my friend and her mother [and I] went out
immediately to find newspapers to look for a place to move to because it was just
impossible to stay where we were at. Jen Wilson, I guess, or whoever put this
thing together to find us a place to stay. We finally wound up at Millhopper Road,
old Millhopper Road, an old place but it was really very nice. The hospital was
not even finished yet.

S: I was going to ask you about that. Did you have meetings, and were there other
people on the faculty? Were you in planning sessions?

M: Oh, yes. We were in planning sessions. We started to put together a whole
orientation program. We also put together the Unit Manager Program what
was to be taught to the unit managers and what was to be taught to the nurse
II's. Now, nurse II was the title of what [had been called] the head nurse. But
one of the things that Dorothy and Nancy -- because it was joint effort -- tried to
get away from [was] the stereotype of nursing service titles so you did not have
"supervisor" and "head nurse" and that sort of thing. We had nurse I's and nurse
II's, and that was it, really. Then there was Nancy, who was the assistant dean
for Clinical Practice, I was director of Inservice Education, and Lois Knowles was
the Assistant Dean for Academic Affairs or Academic Programs. I think Lois was
already an Assistant Dean at the time. I was there a year as Director of Inservice
Education when Nancy fell in love, got married and went off to Jacksonville to
live. So, there was the position, and at the time, one of the gals who was the
Nurse II for Medical Surgical Service (was a nice Italian lady named) Vickie
Canetta Victoria, I guess, and Canetta could end in "a" or "o". Anyway, the
dean was looking for someone to take Nancy's place, Nancy's position. She
wanted to do it internally. You know, we were still so young and new and

S: But you were open for patients by this time?

M: Yes. My brother found this booklet among his papers and he said I am sure it
belongs to you. This is the J. Hillis Miller Health Center Booklet. And I said, oh
my God, just look at that. There is old J. Wayne Reitz, and there is the first
patient it was a pediatric patient that we had, and there was the panoramic
scene of what it looked like.

S: This is wonderful, Merc.


Page 8

M: There is J. Hillis Miller and there is Rush Jordan, the hospital Adminstrator. [Tape
interrupted.] So, Dorothy was looking for a replacement for Nancy, and we went
to visit with her we, meaning Vickie Canetta. Because she said well, I do not
know, maybe I might be interested in it. She had her Master's, too. But Vickie
had a beautiful orange grove down in Crescent City, and she would go away on
weekends and whatnot, and she decided that she really did not think that she
would want to tie herself down that much. She had had a lot of administration
experience. I had had some as supervisor of the Outpatient Department [and
when] I was head nurse of OB at Mount Vernon Hospital, but, you know, I was
not too sure. I went in to talk to Dorothy, and she said, well, Merc, do you want it
or don't you?

S: Sounds just like her.

M: I looked at her, and I said, yes, I do. And she said, well, it is yours. So, I became
the assistant dean for Clinical Services. I moved into the office which was not
too far from Rush Jordan's office, who was the director of the Teaching Hospital
and Clinics. Rush was quite the hospital administrator type. (If hospital
administration did not have nursing, what, really, would they have?
Understand?) So, he was always busy, kind of finding out what was what about
the budget and about the staffing and about one thing or another, and we
continued on our same relationship I reporting to Dorothy, but Dorothy
encouraging that I keep Rush informed, which, of course, I did. I attended his
hospital administration meetings. He had an assistant, Duane Houtz. A very
nice guy. Just wonderful. You would hardly think of him as a hospital
administration type. He was married, and he had a couple of kids and [was]
really just a nice, likeable fellow. As a matter of fact, we collaborated on a lot of
things. We became the traveling duo, you might say. We would be invited to
different places around the country to talk about the Unit Manager System.

S: Both [speaking at] meetings as well as [visiting specific] institutions who wanted
to know what the University of Florida was doing?

M: Yes. We wrote articles. Here are some of them. "Organizational Plan for
Nursing Services" and "Utilization of Nursing Personnel".

S: Nursing Outlook [well-known professional publication] the real McCoy.
Definitely my era.

M: Yeah. People were very interested in what we were doing and how did we do it
and the Unit Manager System. There was a joint article written, "The Unit


Page 9

Manager System Works for Us" or something of that nature, and it was also
published. I do not think I have a copy of it here. I think both Duane and I were
co-authors on that one. But anyway, it was a wonderful kind of relationship that
he and I had. Rush was a little bit uptight because of the fact that he did not
have complete control of nursing.

S: Well, that was a new thing for hospital administrators to relinquish that kind of
control over a big percentage of the employees.

M: Oh, yes. I have forgotten exactly what year he left. He went up to Birmingham,
Alabama, to become the administrator of that big complex. He was a very
brilliant man. He knew his hospital administration. But he held a tight rein on
things. The person who came and took his place -- I do not know if it was Charlie
Sweat. Charlie Sweat was there at some level because Duane left, too, and
Charlie Sweat may have been in Duane's position and I have forgotten who took
Rush's place. But I was there. I was the assistant dean then, from 1959, I think it
was, until 1967 and, again, we were notorious in the College of Nursing and what
it was doing, the Unification Program, the whole nine yards. One of Dorothy
Smith's friends [was] Thelma Ingles. Thelma was a nurse consultant with the
Rockefeller Foundation, and she was talking to Dorothy. I think they were at
Duke together when Dorothy was at Duke University. She would come to visit
periodically, and was intrigued by the program. She said, you know, I am
working with a group down in Colombia, South America. It is with the
Universidad del Valle in Cali, Colombia. She said, I have the dean of the School
of Nursing down there, Inez Durana is her name. I think she is still living in
Bogota. She said, I would like to see if we could maybe do something about
setting up a similar kind of arrangement. The Rockefeller Foundation

brought down Carmela Cavaro, who had the Nurse Midwifery Program up in New
York and then, also, she was at South Carolina. But she went down, as I did I
am getting ahead of myself. She went down under the Rockefeller Program to
set up the Master's program in Nurse Midwifery and Maternal Child, and I was
approached by Dorothy, through her talking to Thelma, about possibly going
down to work with the dean at the School of Nursing and their director to see if
they could get this Unification System going down there. But before we even
started that, Thelma had arranged for us to have what we called an exchange
program. The exchange program was whereby we would select, up here, let us
say, the nurse II of OB and they would have their OB head nurse, supervisor or
whatever because they didn't have that many levels. We would send our
people down there to work with their people for a month, and then their people
would come up and work with our people up here for a month.


Page 10

S: Now, I remember some of that because [of] Mary West, do you remember her?
She was on Pediatrics ...

M: Yeah.

S: ...and I believe she was the nurse II, and she and I were friends at the time that
she went to Bogota for a month. I think she participated in that program.

M: Yes, we did Pediatrics. We did OB. We did Surgery. OR [operating room]. It
really worked out to be a very successful program in terms of getting to know the
people and their getting to know us. Then, that is when Thelma reached the
point where she talked to Dorothy about this exchange was fine, but she
wanted a longer period of time for me or for a person, an administrator, to go
down and work with them down there to see if we could incorporate the program
down there.

S: I see. Is that when you left here?

M: That is when I left. I left in 1967. I was the Assistant Dean until 1967 and I went
down and while I was down there because I went as a visiting professor,
consultant, with the Rockefeller Foundation I kind of enjoyed the idea of
consulting. I really did. No heavy burdens about administrations and staffing
and, of course, we were going through the cycles of shortages, you know. We
were also going through a period where I would try to recruit nurses from Miami.
Of course, Miami at that time, and even now I suppose, their salaries were
beyond what we were offering at Gainesville. So, if you wanted to recruit people
from Miami to come to Gainesville, or from anywhere else, our salaries were
terrible because, at that time, we were still part of the University [system] and the
Regents and all that sort of thing. If you gave a raise to the nurses at Shands or
at J. Hillis Miller Health Center, you would have to give raises to the other nurses
in other parts of the state system, and so our hands were tied. You could not
recruit. It was getting to be very frustrating. So, I liked the idea of consulting.

S: Can we go back a little bit, because some of the things we have touched on are
some of the things I would like you to embellish a little bit for the non-nursing or
the non-health care person? When you talked about Dorothy Smith and the
founding of the College of Nursing, what kind of visions did she have for the
College of Nursing or did she and the other leadership people have for the Health
Center? What kinds of things would you identify as avant garde or ahead of
things as far as the rest of the health care in the country?

M: Well, one thing really, the whole concept in one word "health" "health center"


Page 11

rather than "medical center". This was, I think, mainly due to George Harrell, the
first dean of the College of Medicine, along with Dorothy, because of a concept
that they had that people who learn and train together will work more
collaboratively together. So that if you have nursing students and medical
students learning and training together, then their relationships are going to be
more collegial than the other way, and that as you get nurses who are
academically equivalent or at a level with the physicians, then all the more
reason you should have ...

S: Mutual respect.

M: Exactly.

S: And the patient benefits.

M: Exactly. So, we would have nursing rounds where medical students participated,
and our nursing students participated in some of the medical rounds. [Rounds, in
a teaching setting, are presentations of particular patients by a student, who
gives general information about the patient's condition as well as the individual
patient, followed by questions or discussion, either in a conference room setting
or at the bedside involving the patient.] It was really a very exciting period to see
this, at least at the student level. Whether it went on afterward in their own
practice physician-wise or nurses pursuing that kind of continuing education, we
know that some of it went and some of it did not.

S: The solidification of practice, nursing service, and nursing education -- that was
brand new. That was a whole different structure. There were places around the
country where if a faculty person wanted to bring their students into a clinical
area, they might be received and they might not.

M: That is right, and that was something that, again, we tried to work it out so that
the faculty felt as much a part of a nursing unit, a patient care unit, as did the
nursing service people. As a matter of fact, Dorothy went to the extent of putting
faculty actually in charge of nursing units.

S: Yes, there were dual positions.

M: Dual positions. Barbara Buchanan, who was Psych/Mental Health, and Lee
Davidson. Lee Davidson, who was a nurse II. Lee and Barbara worked
beautifully together, beautifully. I can not say the same for some of the other
clinical areas. Polly Barton and Carol Bradshaw. Carol Bradshaw started out as
a Nurse II in Pediatrics.


Page 12

S: I remember that.

M: Polly Barton and Carol Bradshaw worked beautifully together. I think to a certain
extent we had it in OB with Jen Wilson and Audrey Urquart. At the time, Audrey
was OB. She was the OB nurse II. Med/Surg, for some reason, did not quite
click it off as well. There was Lil Garrity; she was the nurse II for a period of time,
Lilian Garrity. I am not sure if it was Dottie Luther or Jane Kordana who were the
faculty people. Those were the kinds of collaborative efforts to bring together the
whole concept of the unification model. It was not so much a question of who
was the last word.

S: Not a power struggle?

M: There was a lot of power struggle.

S: Well, when you think of a lot of those people coming from the traditional
background, and you have to unlearn all of those this-is-my-hierarchy kinds of

M: Yes. Also, at the time, there were not that many nurse II's that had Master's
[degrees]. Now, they all had bachelor's [degrees] there might have been one
or two exceptions. But there were very few nurses, just generally speaking, that
had Master's degrees, and most of them were faculty. So, you had that kind of
power struggle, too, in terms of who is better qualified, [or] who is better
educated to make these decisions. So, yes, there was some push and pull.

S: When you refer to the Unit Manager System, explain briefly how that changed a
nursing unit.

M: Again, this was a struggle in terms of "he who controls the purse strings controls
everything." Now, you have a head nurse in the traditional model, and that head
nurse is the one who pretty much calls the shots with regard to what you order,
how much you order, this and that and the other thing, and [she is] held
accountable if you go over your budget for your particular unit. Well, now it is the
unit manager who does that, you see. So, if the unit manager is so inclined to
put restrictions on certain things to keep the budget down, then there are

S: And the unit manager was accountable to administration?

M: Yes.


Page 13

S: And the nurse II was accountable to you?

M: And me to Dorothy Smith. Exactly. So, there was that real difficult period. And
some of these people, they were not bachelor's-prepared people, [and] they were
not hospital-administrative types. They were more clerical. You tried to teach
them about some of these things but...

S: Now, the purpose of the Unit Manager System, as I understood it, was to support
the clinical activities: order the linen, make sure the supply levels were where
they needed to be, the dietary responsibilities .. Is that correct?

M: Yes.

S: And then, I know that the clerks took off [transcribed to appropriate requisitions]
the medical orders and they could do the routine requisitions to x-ray or make out
the diet sheet with the current order and that kind of thing, so that the nurse was
not tied up with what, obviously, a clerk can copy from one piece of paper to
another, answer the phone and take messages. And was supposed to, as I said,
support for the clinical activities.
M: [Yes,] to give the nurse II and the rest of the nursing staff more time to be with
patients, which makes sense.

S: Yes. Philosophically sound.

M: Exactly. And sometimes it worked, and sometimes it did not, and sometimes we
would have problems.

S: It certainly would depend on the individual.

M: Yes.

S: Now, one of my questions that I was thinking about was what other kinds of care
givers were on the team in the early days of Shands? Were there LPNs?

M: Yes.

S: And aides?

M: Yes.

S: Now, the aide, would he or she be someone who would come with any


Page 14

experience, or would that fall under orientation or a training program or an in-
service program?

M: Orientation.

S: To train them about what they would need to do to help with the care of the

M: Right. That was part of the in-service education program, where you did recruit
and we had some really very fine nursing assistants or aides. They had
orientation and on-the-job training, OJT as we would call it, and some of them did
very well.

S: When you came to Shands the very first time, had you worked in any place
before where it had been segregated?

M: No.

S: Did that come as a surprise?

M: It came as a surprise. It really did. Now, I am not saying we did not have our
flukes in New York. I mean, we did. But I had blacks who were on my staff when
I was head nurse on OB in Mount Vernon Hospital.

S: Well, and I think that was the feeling if people of that generation did not have
occasion to work with blacks as we did or had never spoken to one.

M: Oh, yes. But it was incredible, honestly. The one RN who worked with me, she
was not black [in her mind]. She was a British subject, absolutely. But this was
an experience, coming down here.

S: How many of the staff throughout the hospital [Shands] were African Americans?

M: Almost all of the aides and orderlies were black. We began to get a few from out
of the area coming into Gainesville, [and] we began to get some LPNs, black.
Very few RNs this one was one of them but very few RNs who were black.

S: I had been told that the hospital was built in the time where you had
[segregation], and if you go into the old part of Shands today, you find the two
sets of bathrooms. It was segregated like everything else in Gainesville was [at
that time].


Page 15

M: Absolutely. You could not fight it. It was one of those things. A lot of rednecks
whom you really did not know were around.

S: Yes. Now, did you come down and join Dorothy when Shands was still being

M: Yes.

S: Did you have any input into the building or any say-so into the structure for
patient care, or was that already decided?

M: It was kind of already in the hopper, you know, already decided. I think we may
have had some input, Nancy Rood and some of us, as far as nursing stations
and how they might be configured, but it was very, very limited. It is too bad
because we could have made some [suggestions].

S: We touched on this a little bit ago, but we were talking about the relationships
between the other disciplines in the Health Center and what they thought of
nursing, what they thought of what Dorothy was trying to accomplish. What do
you remember of that?

M: I remember at the time I was there, I do not know, I was shocked to find out that I
had left in 1968 and that Dorothy had left in 1972, and for some reason or
another I had thought it was that she had retired. I found out some time later that
she retired, but she resigned, more or less. But one of her staunchest supporters
was Sam Martin. Dr. Sam Martin was a very, very strong supporter of what she
was doing. Now, some of the others, some of the chiefs of different Services,
gave a lot of lip service. About a year or two into my assistant deanship, there
was some hassle over the Surgical Services operating room. Ed Woodward, [M.
D.], brought in a consultant or somebody, a nurse. He wanted to have input. Of
course, we had a unit manager in the operating room. Our thoughts regarding
how the OR should be run and his thoughts about how it should be run were
diametrically opposed. So, before you knew it, the operating room was taken out
from under us, from Nursing [Department] and put completely in Dr. Woodward's
hands. I do not know whether it is still that way. It may have gone back; I have
no idea. But, again, it was one of those power struggles. It had nothing to do
with Unification Model or anything of that nature, although Dorothy was of the
opinion that -- and there were some other people that felt the same way -- that
OR nursing was really not ...

S: I remember hearing that it was certainly more in the technical range than the
professionals she was trying to prepare at the baccalaureate level.


Page 16

M: Exactly. At the time, there was even a little kind of snide joking going on that you
could teach a chimpanzee to pass instruments. Why have an RN waste her time
to do that? So, you had OR techs (technicians), and Unit Manager System
helped to perpetuate that. [Dr. Woodward] was the one who brought them in, OR
techs. I remember.

S: He was a very powerful political influence in Shands.

M: Yes. I do not think he was that much for this whole Unification Model, at all.

S: Was there a relationship with the College of Dentistry? That was way later. The
College of Pharmacy, was that developed when you were there?

M: Yes, it was being developed. As a matter of fact, it was developed. Dr.
McConnell was one on the faculty from the College of Pharmacy staff. His wife
was an RN and worked at Shands for a while. As a matter of fact, they lived right
across from where I was living, 1786 SW 35th Avenue. They lived right across
the way from us. Warren McConnell. We collaborated. We had some very good
ideas with respect to Pharmacy and how orders could be better delivered and
making rounds with nurses with regard to making sure that medications were
given on time and that sort of thing. We had a good relationship, Pharmacy and

S: Do you remember anything with the Allied Health College. Was there any
collaboration with Physical Therapy or Occupational Therapy that you recall?
M: I think we had a better relationship with Physical Therapy than we did with
Occupational Therapy, and I do not remember now, I am not quite sure why. I
think the person who was in charge, the faculty person, director of the Physical
Therapy component of the college was more open to nursing input than the
Occupational Therapy director. That is my recollection right now. And I do not
really remember their names. All I visualize is that one person was much more in
favor of joint programs.

S: One of the things I know Dorothy is remembered for is the initiation of what was
referred to as the Nursing History. [This was the process] to take data in an
organized, systematic way to get a baseline of what the patient's strengths were.
We were talking in another interview about [the nursing history and] how that was
received by the rest of the Health Center community and what a struggle that
was to get as a part of the permanent medical record and that kind of thing.

M: Oh, yes. The nursing care plan.


Page 17

S: Yes, the care plan. [The plan designed by an RN from the data in the medical
chart, including the Nursing History than included measures for the prevention of
complications, education that the patient and family should receive, and much

M: Yes, the care plan, which in many, many ways really told the story about the
patient and the patient care program. We struggled. We struggled to keep the
Medical Records [Department] from removing nursing care plans to the point
where I felt the accrediting bureau should do something about [their removal]. Of
course, we were at the point where we were charting "2 a.m.: sleeping, no
problems; 4 a.m.: sleeping, no problems," that kind of garbage, which I can
appreciate was ridiculous, and if you want to keep that kind, no. But the Nursing
History and the Nursing Care Plan that Dorothy, the College and the Nursing
Service people were trying to develop was really beginning to develop into
something very meaningful. Now, we did have a problem, however, in that some
physicians were kind of jealous about, you know, this is my patient, where we
liked to think of it in terms of our patient. There were some physicians who were
very jealous about that.

S: Can you recall who were members of the faculty with you when you first joined

M: Nursing faculty?

S: Yes.

M: OK. Well, there was Lois Knowles, Jen [Jennette] Wilson, Dottie [Dorothy]
Luther, Jane Kordana, Barbara Buchanan, Polly Barton. Later on, well, we
developed Psych/Mental Health as a major a little bit later on. That is when
Bobbie Dykes and Joan O'Brian-Hartigan came.

S: Now, did you make a change from assistant dean in charge of Nursing Service -
then did you add the graduate program?

M: I was involved in the graduate program to the extent that I was granted graduate
faculty status. I was assistant dean for Clinical Services when they brought the
graduate program into being, [and] then Joan O'Brian was the Assistant Dean for
the graduate program. Dorothy was very much opposed to a Nursing
Administration major. All she wanted was clinical majors. Nursing education and
nursing administration majors were out [of favor] at that time. Joan was getting a
number of nurses interested in the graduate program people like Betty


Page 18


S: I remember Betty. She was a classmate of mine.

M: At the time, she was the director of the School of Nursing at Jackson Memorial in

S: No small matter.

M: No small potatoes you are not kidding. Betty was interested in Medical
Surgical Nursing. Okay, fine. But she wanted administration, as well. She
wanted to know more about administration. She was administering a big school
of nursing.

S: Lot of money.

M: Yeah, and there were a number like that. Joan approached me one day and she
said, Merc, I know that Dorothy will not go for an actual course in Nursing
Administration, but if there are enough students, how would you like to hold
seminars and have a seminar once or twice a week with these graduate
students? I said, I would love it. So, Betty Severyn was one of them. I think I
must have had about ten or twelve who attended the seminars when we had
these seminars.

S: How wonderful.

M: Oh, I had a ball. It was just wonderful. It really was. No course -- nothing of that
nature. That is how I got graduate faculty status.

S: Perfect. Just perfect.I was leading to the question about the non-nursing faculty
that Dorothy hired and whether you were involved with some of them. Did you
know Sid Jourard?

M: Oh, yes. Carol Taylor.

S: Carol Taylor. Sam Shulman?

M: Sam Shulman, no. Sid Jourard and Carol Taylor were two. Maybe Sam was
after I had gone.

S: Maybe. Mary McCaulley?


Page 19

M: Mary McCaulley. That name is familiar, yes.

S: She was a psychologist, and I think she is the one that has the personality type
indicators now.

M: Oh, yes.

S: And I think she worked with Obstetrics, the Obstetrics staff, but that may have
been later. Saul Kramer?

M: No.

S: Did you know Howard Wooden?

M: No.

S: Mr. Hinkley?

M: Oh, Hinkley, yeah.

S: I was told he was in charge of construction at Shands but then later stayed on as
the Chief Engineer, maybe. Does that ring a bell?

M: I believe so. Yes, I remember Mr. Hinkley.

S: Because I remembered the name right away and thought I knew him. And then,
Willamae Whitner?

M: Oh, yes, Willamae. My goodness.

S: I think she was so integrated into my head as part of the faculty that it would not
have occurred to me to list her as non-nursing, because she helped with any of
the research that any of us ...

M: Yes, I believe that her degree, her Ph. D., was in research, if I am not mistaken.
Oh, yes, Willamae. And Sid Jourard, my goodness. I do not know if I was here
at the time when he passed away, died. That was such a tragedy, a tragic thing.
That was terrible.

S: Now, all of that was before I came, or since I did not know him, I did not know
anything about it.


Page 20

M: And Carol Taylor. Carol Taylor did a lot with the whole Unit Manager Program.
She wrote an article or two, as well, on the Unit Manager System.

S: Now, when you were at Shands, how did you see someone like Carol Taylor as a
faculty person? Because Dorothy was certainly was the first one I ever heard of
who would take a precious budgeted faculty line and hire someone, even part
time, who was not a full fledged "nursey"' person. Did you see that as innovative
or suspicious?

M: No. I do not know that I even thought about it. Maybe it was because when I was
at TC [Teacher's College, Columbia] in the Nursing Program that I was in I do
not remember if it was the bachelor's level or the Master's level I had someone
who taught a course, a woman who was not a nurse but she was teaching in the
Nursing Program. It may be [with] that in the background there, I did not think
anything much about it. Of course, later on, I became more of an academician, if
you will. I was more academe later in my career than earlier, so that I was not
one of those full-time faculty people who might take umbrage with the fact that
my dean would hire a non-nurse, using the nursing faculty line. I do not think that
I had that much concern about it. Particularly Carol and I had a lot of respect for
Sid. You know, I enjoyed so much his classes, and we would sit in on his talks
and what not. And Carol was so funny.

S: She was such a joy. What a storyteller.

M: Absolutely. Just incredible, really. So, I just thought she was a welcome addition
to the faculty.

S: She explained herself to me. She said, an anthropologist can go to some far off
Samoan Island and study a tribe now, why would I go to that trouble when I can
study the tribe of Nursing? Well, I sat straighter in my chair and was about to be
offended until she described the criteria: that a tribe has customs, its own
language, a symbolic dress. Of course, we were in to caps and stripes and long
sleeves and short sleeves and cuffs and studs and all of that, and I thought, I
guess I am guilty as charged, I guess I will just back off. But she was so helpful,
I think, in letting some of us blow off steam so that we could have a little cool time
to think about more positive ways to problem-solve when we felt frustrated in one
respect or another. She was just wonderful for giving you a little breath and
saying, let us regroup here. Was Annie Vestle the first housekeeping person?

M: Oh, Annie Vestle was the first housekeeping person. She made so many
contributions, really, to the development of Shands. She used to go around and
talk about herself as "Queen of the Mops."


Page 21

S: I did not hear that.

M: Queen of the Mops. She referred to herself as the Florence Nightingale of the
Housekeeping Service. Queen of the Mops, Ann Vestle. As a matter of fact, she
is such a delight, [and] Zulema remembers her, too, because I brought her down
to Colombia.

S: Did you?

M: I surely did. I brought her down and, oh, she had a ball. But I wanted them also,
the people in Colombia, to get a feel of Housekeeping. You know, that was one
of the things.

S: Yes, I would imagine it was.

M: And she was just wonderful. She was one of my dearest friends here in
Gainesville. She really was, and she called herself Queen of the Mops. You
know, you think of Housekeeping, and you think, eh. She was a brilliant woman,
and she published she wrote extensively and published in their own
Housekeeping journal. [She was] very well known in Hospital Administration
circles because of her knowledge.

S: And what a wonderful person to have at Shands when, in fact, you are trying to
have nursing take care of patient care and not be concerned about dusting the
corners or whatever.

M: Exactly. She was very supportive of nursing. You know, in many situations, I
have been in other hospitals where Housekeeping personnel, as well as Dietary
personnel, do the least they can. And it leaves it up to the nurse to do, empty the
basket or take the tray or whatever. Not with Annie. Not with Anne Vestle. She
was after her staff and would go around and she would "white glove" stuff I am
not kidding to make sure that bedside tables were clean.

S: Sounds like an executive housekeeper to me.

M: Oh, she really was. She really was an executive housekeeper. Absolutely.

S: She calls them as she sees them.

M: That is right. Anne Vestle was great. She really was.


Page 22

S: That is wonderful. When we were talking about joining practice and education,
one of the things that Betty Hilliard had said was that when she came to Florida,
this was the very first time when she did not feel like she had to negotiate as a
faculty person going to take care of patients, that she was educated and the love
of bedside nursing was hers and that she was so surprised that, in fact, it was
one and the same. You did not have to ask the nurse II, may I please have
permission to go in and talk to one of your patients? Was that a new concept for

M: Again, maybe it was because of my own particular background in nursing
service. I was head nurse of OB for five years, and I took the labor room and
delivery, and I was practicing. Now, I would have to make out time schedules
and do whatever evaluations periodically and so forth. But anyone who worked
with me at the time knew that I would rather be up there doing it. I was right
there. So, Head Nurse, to me, was [just] a title. It was the money, perhaps,
[though it was] not that much in those days. But I loved it.

S: Well, and that kind of respect can only be earned. When physicians knew that
you knew what you were doing and they could trust your assessments, you could
not do much better than that.

M: And when I was supervisor, again the title but I was supervisor, of the Outpatient
Department, I ran those clinics. I was in there. Dr. Settimbrini, who was the
ophthalmologist, when he would come, I would help him with the removal of the
chalazions [inflammatory tissue in the eye] with this, and so forth and so on. Not
other nurses in the clinic, me. I would go, because that was my joy. That was
what I really wanted to do. So, coming here, maybe that was one of the things I
found so attractive, the whole concept of this unification, because although I was
not academe at the time, I was involved in patient care and practice. To me, it
just seemed kind of logical.

S: That is right.

M: At the time, you always talked about nursing faculty who really did not want
students to do 3-11 or 11-7 [shifts] because they [the faculty who would have to
be there to supervise] did not want to be up at that hour, and things of that
nature. But here, this was going to be different, and it was going to be a
collaborative and joined effort. To me, Betty [Hilliard] going in and being able to
take care of a patient was great.

S: It felt right or natural.


Page 23

M: Exactly. The whole concept of primary nursing, you know, the primary nurse
practitioner that sort of thing, it was Dorothy Smith [Dorothy Smith's vision]. And
I said that as many times as I could wherever I was, that it was Dorothy Smith
from the College of Nursing who really laid the foundation for that whole concept.

S: I think that is true.

M: Moving from Team Nursing to Primary Nursing.

S: Call it what you will, whatever its latest name is.

M: I am your nurse. You are my patient.

S: The accountability and responsibility where it needs to be.

M: Exactly.

S: When you were at Shands, what was the hierarchy like? There were aides and
some LPNs, the nurse Ils...

M: There were some nurse Is. They were what you would call staff nurses. You
had your aides, you had your LPNs (not that many LPNs), and you had your staff
nurses and the nurse II and then me. That was the hierarchy.

S: Now, the nurse Ils had twenty-four-hour responsibility?

M: Twenty-four-hour responsibility, that is right.

S: Did that work well?

M: I think to a certain extent it did, possibly because of the size of the community.
[Having to do with safety.] If you were called out in the middle of the night, say,
in the Bronx, and you had to go uptown, that might not work so well. But, here, I
would say at least during the time that I remember with my group that, yes, they

S: It was a little Camelot time, was it not?

M: Yes, it really was. It began to change, I would say, as we were getting into the
later1960s. When I went off to Colombia, I began to feel a change. There
seemed to be a little bit of unrest with the nursing staff. It depended upon the
faculty person, in terms of power struggle. Do you know what I mean?


Page 24

S: Yes.

M: And I think that, possibly, there were some nurses who were beginning to kind of
get a little bit testy about this sort of thing. When I told Dorothy that I would be
going into consulting full time and not coming back, I know that there were
several people who chose to leave, and it may have been because of that.
Maybe they were feeling overwhelmed by the faculty.

S: Was there ever friction or antagonism between nurses who were prepared at
different educational levels? You know, the diploma nurse versus these new
baccalaureate nurses that would be maybe working as nurse Is.

M: Oh, I think so.

S: Friction was pretty common at that era.

M: Particularly if you had, let us say, a diploma nurse. Dorothy used to call it the
"diploma school mentality".

S: Yes, I remember the phrase. It was not a compliment.

M: No, it was not. It really was not. She would say, I came from a diploma program.
To heck with diploma school mentality. Anyway, you would get graduates from
the diploma schools who would have had ten, twelve, fifteen years experience,
practicing, taking care of patients, if you will. And along comes a faculty person
with a Master's degree, maybe one year of experience. There was this feeling
of, you are going to tell me what to do? This is my patient; I have the experience.
I think that sort of thing was what began to take hold. Now, we tried to hire (and
we did our best) to get our own graduates. As soon as they were out, man, we
tried to get them because we wanted to get more baccalaureate people on staff.
That was the only way we felt...

S: It was going to build that strength.

M: Exactly. And more and more nurse II's with masters, as well, so that there would
not be this feeling of second-class citizen business. But that was hard, too,
because you did not have the budget. You could not pay enough.

S: Always other places [with higher salaries] calling them.

M: Exactly. As I recall, things were beginning to change. You could feel it in the


Page 25

environment. And then, once I left and then Dorothy, I do not know how it
progressed. You were there, so you can say what the environment was like.

S: I have heard other people, both having to do with the College of Nursing and with
Shands but also with the College of Medicine, as other people who came from,
say, more traditional backgrounds, then the original vision of Shands became
more watered down and there was less strong influence for that.

M: Yes. I think when George Harrell left, [his] philosophy of people who learn
together work well together sort of went down. Also, family practice was the big

M: Dorothy began to lose some of her staunch supporters. Sam Martin, who was
chief of Medicine and then became provost, and some others. I have forgotten if
the dean from CHRP, College of Health Related Professions, if he left too. He,
too, was a strong ally with Dorothy. So, those winds began to shift.

S: Betty shared a letter that I think Dorothy had written to Ed Ackell about her
discouragement, the lack of support. I think this was very shortly before she
decided it was an uphill battle and she was tired of fighting.

M: Fighting. That is right. Because she was not getting the same kind of support
from the other deans that she had been used to, and the chiefs [Chiefs of
Medical Services such as Medicine and Surgery]. Was it Ackell who took Sam
Martin's place?

S: I think there was someone else in between.

M: I think so. Oh, I can almost visualize him and I cannot think of his name offhand.
But I do not think he was the same kind of support.

S: And when it began to fray around the edges, I think that is when it kind of
disintegrated a little bit.

M: Yes.

S: We were talking about Inservice Education and Orientation for the nursing staff,
[but] was there was a plan for maintaining clinical competence once they were on
board? For the nurse who has just graduated from a program, was there
continuing education in that same kind of. .. ?

M: Yes, I believe we did have a program. Also, to get not only the nursing students


Page 26

and faculty with the nursing staff involved, we started Nursing Grand Rounds,
which we felt would bring all of the groups closer together. That developed
through our Inservice Education Program. When I left Inservice to go into the
assistant dean position, we did bring in Vivian Ross. She left UF, I have forgotten
when, but she is now at the University of South Florida. She is there as a
Geriatric Nurse Practitioner, if I am not mistaken. But she came in as Inservice
Education Director and did a lot in terms of clinical activities. She was very
strong clinically, as well. Well, Geriatric Nurse Practitioner, she is a Professor
down at the University of South Florida. As a matter of fact, we co-authored the
article on Nursing Grand Rounds, which was published in Nursing Outlook.

S: Was it in Nursing Outlook? I was going to ask you. I will try to look it up.

M: Yes. So, there was continuing effort to keep the nurse Is, the staff, up to snuff
with clinical nursing practice.

S: Things were happening fast in health care at the time. There were a lot of
developments for nursing as well as the other disciplines. When you came and
were in charge of the Nursing Service, was it your idea that a budgeted line for a
nurse or an employee should also count the vacation that they were out or the
sick leave that you could anticipate? Was that built into the system? Do you
remember anything about that?

M: I am trying to think of, specifically, how we went about vacation time, sick time. It
was really part of the state system. Let us say you wanted to give your nurses,
say your nurse Ils, a four-week vacation, well, you could not unless all of the
other nurse II -- type people in the state system got the same thing.

S: You were bound by that.

M: You were bound by that. You were bound by salaries the equivalent. It was
almost like a civil service kind of thing, not too unlike the VA system where if you
have a nurse here in Gainesville VA and you have a nurse in the Bay Pines VA
or wherever, then you have to stay within those guidelines. That is what we were
pretty much bound to, and the faculty was pretty much the same, if I am not

S: Do you recall when you began to see female physicians coming through, or the
reverse I guess male RN's or see a sprinkling of the non-dominant gender
coming into those fields?

M: Well, one of the successors to the position which then, I think, became director of


Page 27

Nursing Services at Shands rather than assistant dean, or it may have been
assistant dean and director, but the person reporting directly to the director of the
hospital was a male.

S: Was that Julian?

M: That was Julian. Julian Ciccatello, sure, from Mercy Hospital down in Miami.
Prior to that, [and] I am trying to think now if he was an LPN at the time and then
became an RN but there was a black fellow. [Neil Butler was an African
American who was well thought of as a manager in nursing. He later went into
city politics and was Mayor of Gainesville.]

S: What floor or what specialty?

M: I do not remember what floor or specialty. But we had a male, Lee Davidson.
Lee Davidson was Psych/Mental Health. He was one of our first nurse II's.

S: And I think Psych had some. They were kind of out in front. You wonder how
much influence a male would have in a field like that where part of it might have
been for brawn on a bad day.

M: Yes. But female medical students, I do not remember any at the time.

S: I think that might have been later on that we started seeing that.

M: Yeah. Of course, now, my gosh. Many of my [own] physicians are females.

S: It is amazing, is it not?

M: Absolutely, I love it.

S: Just amazing. We talked a little bit about this, [but] I was thinking about outside
events, outside of nursing and outside of the Health Center, social implications.
We talked about the segregation at Shands and some of those cultural things
that impacted us. Now, patients were segregated, as well is that correct?

M: [Yes.]

S: Did you have different floors? Do you recall about that? Maybe just separate

M: Separate rooms, not separate floors. You know, we had the traditional


Page 28

Med/Surg, Pediatrics, that sort of thing, and I know there were separate rooms.

S: So, you could not have a semi-private or a four-bed ward with any racial mixture?

M: Not that I recall.

S: What about the caregivers? Now, the nurses, did they have any compunction
about who to take care of?

M: No. That was something [for which] you have got to give credit to nursing. There
was never even ...

S: Any real blink?

M: No. Not at all. A patient was a patient, regardless.

S: And percentage of staff, you said there were a lot of African American aides.

M: And orderlies.

S: And orderlies, right. Do you remember when the first minority was hired for the
College of Nursing, or maybe that was after you left?

M: It must have been after I left.

S: There were not any black ... ?

M: No, not that I recall. It must have been afterwards.

S: Now, were you on the faculty when all of the Johns Committee activity was going

M: Johns Committee?

S: Johns Committee it started in Tallahassee, where they were looking at the
whole state in terms of blacks, anybody who might be suspected of
homosexuality. At the time in Gainesville, I know that there was a lot of fear [with]
faculty all over the campus because committees were calling them in. But maybe
you had already left.

M: No, I was here. Oh, yes. That was in, I think, the early 1960s. It was frightening.
You did not know who you could trust. You did not know if this person working


Page 29

by your side might not be one of the informers of this committee. I do not
remember anyone in particular who was actually called to meet before the
committee, but I know it was going on. It was incredible.

S: It must have been a scary time.

M: It was, yes. That was the Johns committee, but who was it who was up there, the
senator in Washington who was after not only Reds and Pinko's but also

S: McCarthy?

M: McCarthyism. That was it. And it was incredible, just incredible. I remember,
my goodness, I had Hildegard Peplau as one of my faculty when I was in my
Bachelor's program and during the time that she was at TC [Teachers College at
Columbia University] she was called before some group, "Pinko." [Peplau is
considered to be the "mother of psychiatric nursing" and her classic publication
Interpersonal Relations in Nursing has been integrated into every field of

S: There was such an atmosphere of fear.

M: Just incredible. Oh, yeah.

S: Now, Medicare and Medicaid, what year did that come about because that had to
have some major change of influence in patients. but that may have been after,
as well.

M: I think it was.

S: Do you recall patients at Shands who were indigent and how that was taken care

M: I know that we had a number of indigent patients come to Shands, and I don't
recall exactly how they were paid for. Or they were "freebies." I am not too sure
about this, but I think as part of that Hill-Burton Act, a certain percentage. ...
[Hill Burton Hospital Survey and Construction Act of 1946 administered funds for
the construction of hospitals on the stipulation they care for a percentage of
uninsured patients.]

S: Oh, was that for patient care?


Page 30

M: I think so. I would not swear to it, now, and somebody would have to do some
research on it. I was on the Board of Trustees at Mercy Hospital, and during our
meetings, we would have where they would report on the amount of indigent care
that had been provided, and that they were able to reduce the amount of tax or
whatever they would have to pay. But it depended on that, and I think there was
some semblance of that here at that time. Medicare -- I do not think that came
into being until maybe 1972, 1971, something like that.

S: When you look back on nursing and the effects of patient care, particularly in
acute care, what do you see managed care having done to the delivery of care?
M: I think what managed care has done, to a certain extent, has been a benefit. It
has reduced the amount of unnecessary clinical, laboratory, whatever tests. Now,
after I left Shands and went to not so much a teaching hospital but a not-for-profit
type hospital, well, I am here to tell you, man, they skinned Medicare and they
skinned Medicaid. I think that managed care has helped to reduce that to a
certain extent. I really do. And I think that hospital administrators and
physicians think twice now before they go ahead and prescribe unnecessary type
things. Because I remember sitting in on some of the audits that were done.
And these were nurses who would come in to do the audits.

S: I remember.

M: I mean, it was incredible. And also, the double billings and the triple billings.

S: The duplications.

M: The duplications, all of that sort of thing. To that extent, managed care has
helped to reduce that. I think where they are in trouble is when they are taking
the prerogative of clinical practice and clinical diagnoses away from the
physician. That is where I think they are in trouble.

S: The pendulum has gone too far.

M: Exactly. To that extent, they have not saved health care that much money.

S: That is true.

M: They really have not. But I think it is probably going to be here to stay. I do think
that we need more patient care rights, patients' rights. I simply do not
understand the position taken by some of the folks in Washington where they
have denied patients the right to sue their HMO [Health Maintenance
Organization] if they feel they have not been [treated fairly]. I mean, that is


Page 31

terrible. So, we have our government to thank for that, too. But I think that
patients' Bill of Rights has to have some passage one of these days. I really do.

S: I do, too. One other question about that. The size that Shands has grown [to] -
so often you hear of people who cannot find their way to the clinic they need to
go to or to the department where their next diagnostic test is. When you were
there, it was small with a handful of people, and you knew each other. Do you
think the size of an institution like that impacts care?

M: I do. I really do. I think that, not only does the size affect the people working
there, in terms of the camaraderie that you find in smaller institutions there was
so much camaraderie...
S: I have heard other people say that with just warmth in their voice.

M: Yes, so much camaraderie. But you get beyond a certain point, and you lose
that. You also lose the concern you have for patients or for patient care because
you have got so many now that, you know, your plate is full. That is the kind of
thing that happens when you get to be a 1000 bed hospital. You lose some of
that individuality, the camaraderie, the closeness.

S: Well, and there is a sense of ownership when you have this small cohesive

M: Yes.

S: Everybody is a part of it and wants it to work.

M: Right.

S: Now, when you came back from the year's leave absence and told Dorothy, I like
this consulting stuff, then what did you do? Were you based in Gainesville?

M: No.

S: Tell me what you did, then.

M: That is a very interesting story, too, because Joan O'Brien got married and left at
about the same time. She married Frank Hartigan, and Frank was a school
teacher for the deaf.

S: I think I do remember that.


Page 32

M: He was a school teacher for the deaf in New York, and when they married, she
relocated to New York. Supposedly, she was going to retire from nursing, but
she had this offer that she could not possibly refuse to be dean of the College of
Nursing at Downstate Medical Center, State University of New York, the SUNY
System. Joan had interviewed for the position, and they wanted her and she
wanted it, and they wanted to do the unification program. That is why she was
so attractive to them, [because] they wanted to start this unification program.
The College of Nursing Program there was only about a year or two years old,

S: It was a good time.

M: Right. Before I knew it, Joan flew down because I was still in Cali and met
with me and told me about this position she was taking and, Merc, would you
come up and be my associate dean? I said, Joan, gee, I just met with Dorothy
not too long ago and I love consulting; I am tired of administration; I want to stay
as a consultant. She hemmed and hawed and fussed and whatnot, and she
said, well, then come as a consultant. I said, come on now, Joan. I am not going
to come as a consultant, forever; there has to be a time limit because that is
what consultants do, they have a time limit. Okay, she said, so come for six
months as a consultant. No, first, she said, come for a year as a consultant. And
I said, no, let us do it for six months; if it works out okay, then maybe I will extend
it to another six months. In the meantime, she got Gertrude Cheraschovic, who
was with the VA for a number of years. When Joan was looking for an Associate
Dean, she interviewed Cherry, and sure enough, Cherry took the job. I had met
Cherry on and off because she had been in the VA and I had been visiting VAs
and so forth. So, we got to work. I was in charge of developing the Floor
Manager Program (not the Unit Manager Program) for the University Hospital
and also to have programs for the nursing staff with regard to Unit Manager
System and clinical practice and nurses and supervisors and head nurses and
the whole nine yards. Cherry and I worked together on those models, and Joan
started with the College of Nursing with her faculty. Six months passed and
things went okay, and we were in the midst of something, and I said okay, and so
we extended the consultant contract. Toward the end of that year, something
happened; Cherry and Joan had some kind of a falling-out. Cherry went into the
office one day and threw her keys -- a big bundle of keys on the desk and said
to Joan, I am finished, I am through, that is it, no more. And out she walked. I am
in the office down the hall, and so I saw Cherry walking by, and I thought, what in
the world? They had their discussions before. The next thing I know, Joan's
head is popping around the door into my office and I looked up and I said, what
happened? Oh, Merc, she said, come into my office. She said, you have got to
help me. What do you mean I have to help you? And she said, Cherry quit. I


Page 33

said, you have got to be kidding; she will sleep on it [and] she will be back
tomorrow. She will not, she said. Sure enough, she was not. And she said, now,
Merc, you have got to help me, you have got to, at least until I can find
somebody. She said, you can move right into it because you know everybody,
you have been working with everybody, you know this you know that. And I said,
Joan, you know I really do not want administration. I know, she said, and I mean
it, I am going to be looking for somebody, and it is only until I find somebody.
Seven years later ...

S: Oh, no, Merc, no.

M: Seven years later. It was at the time that Joan finally left because Frank retired
and they decided to move back to Florida. She is down in St. Petersburg now.
One day, I received a phone call from the director at Mt. Sinai in Miami Beach.
He had talked to me a couple of times previously, and he said, well, Lucille, are
you tired of academe? Are you ready to come back into administration and
whatnot? So, I thought, well, I had seven winters and I was beginning to get tired
of it, and I had been hospitalized at the hospital for ten days with pneumonia. I
thought, well, maybe it is about time. They had a search committee, so they flew
me down to Mt. Sinai in Miami. I met with the search committee, and it was love
at first sight, you might say. Oh, they loved me, I loved them, and the whole nine
yards. So, they made an offer. It was not more than I was getting, but when I
figured it out, no city tax, no state tax, I came out ahead. I was ahead, not much,
but ahead.

S: And you did not shovel snow.

M: And I did not shovel snow. That is how I wound up in Miami one year of
consulting after Cali, thanks to Joan O'Brien-Hartigan. But anyway, it was a
good experience. Down State, they were published a couple of years ago talking
about their unification model. I do not know where it is now because many of the
main players have since gone. They apparently were doing okay.

S: Still trying to ...

M: ... still trying to bring it together. The doctors were not as cooperative as ours
were here, initially at any rate. So, I do not know that it has continued to any
great extent. When I go up to a unit, said this one doctor one day at Down State,
when I go to a nursing station, I do not want to have to talk to a floor manager; I
want to talk to the head nurse. And that was pretty much the feeling. I do not
know if it continued or not, but that was where it was at.


Page 34

S: What year did you go to Miami and go to Mt. Sinai?

M: 1975. And I went to Barry University in 1983. I was at Mt. Sinai until 1980, and
then, I was the associate director [of] hospital administration at this small
international hospital. I was there for three years, and then I went to Barry. It was
there that I went to meet with Judy [Balcerski, Dean of the School of Nursing at
Barry University in Miami]. I really went because I thought, well, I will apply for a
faculty position, teach administration, because they were going to be starting this
graduate program and the idea was to have a nursing education and nursing
administration major. I got to talking to Judy and a small search committee,
some of the faculty I think there were two, three, four people and the next
thing I know, Judy said, Lucille, would you be interested in being associate dean/
director of the graduate program? At first, it was director of the Graduate
Program. It was not until we got into it, a year later, that the titles were changing
at Barry and all the other schools had associate deans, so instead of director
then I was the associate dean for the graduate program and she had an
associate dean for the undergraduate program. That is when we took off with a
nursing administration major. At one point, I had 100 enrollees in the nursing
administration major because I not only was the associate dean for the graduate
program, but I also headed up the nursing administration major and taught three
of the classes.

S: Wow, what a lot of work.

M: It was, but it was so enjoyable.

S: And a perfect market for it with all of those people in Miami that needed the
qualifications and the expertise.

M: Oh, yes. And the nursing education major. Then, we were about three of four
years into the program when we decided to go ahead and put in the nurse
practitioner major.

S: No small task.

M: No. But we had Claudia Hauri who was already on the faculty. Claudia was with
the accelerated program, you know, where they took them from the Bachelor's to
whatever. She was about ready for a change by then, and she was a nurse
practitioner herself and was getting her doctorate from UF in Education. So, we
started the program and now, today, the nurse practitioner program has over 100
enrollees. Nursing administration and nursing education is down.


Page 35

S: Times change.

M: Sure do. But I enjoyed my stay at Barry. It was a wonderful experience. I was
there eleven years, and then I decided that and I think that Hurricane Andrew
was the deciding factor...

S: Really?

M: Yes. We went through Hurricane Andrew in 1992, and it was terrible. I mean,
really. Over $80,000 to repair the house, roof and whatnot. And it was getting to
the point where, here you start the program, it is going well, and you think, well.
Gee, I guess I must have been bordering on sixty-seven, sixty-eight. Now, I
could have gone on, of course, but I wanted to retire. So, I went and I talked to
Judy and I said, you know, I thought maybe I might do some work at home, like
two days a week and three days come into the office, because things were really
going well. Oh, she said, well, administrators have to be here full time. So, I said,
well, okay. I said, then I think it is time for me to leave. She said, oh, do not
So, I stayed one more year while we got a replacement for me, and by
1994, I wrote her a letter and I said, it is time for me to now just take my time to
smell the roses. And we remain good friends. We exchange letters and cards
and all that sort of thing.

S: And did you stay down there, or did you come up here?

M: We stayed down there. Let us see, I retired in 1994, and we came up here in
1996. 1994 is when we decided to go ahead and see about putting the house up
for sale and came up here because we just felt that once you have retired and
you are out of the loop, so to speak, then, you know, you want to be closer to
family and that sort of thing.

S: That is right.

M: And so, that is where it is at now.

S: Did you do any consulting or anything after you left Barry?

M: Not consulting, but I was appointed to Mercy Hospital's board of trustees. I was
the first nurse that they had on the board and I served for three years.

S: More hospitals would do well ...

M: Yep.


Page 36

S: They frequently, I do not think, have a balanced view of what is going on without
the nursing perspective.

M: That is right.

S: Good for you.

M: Anyway, no, I have not done any consulting or anything of that nature. Some
people say, don't you miss it, and wouldn't you like to keep your finger in the
pot? I say, you know, it is almost like being half pregnant you either are or you
are not. You are either retired, or you are not. If I wanted to, I could have stayed
on, but I did not want to because I want more free time.

S: If you have made an obligation over here, then you are not [free].

M: Exactly. So, like next week, we have a trip up to Branson, Missouri.

S: Oh, fun!

M: Yes. It is a six-day, and then we have some other trips that we have already
scheduled. That, and with our little ones here [referring to the two little dogs], and
working out in the yard.

S: Don't you feel like you earned it? I mean, think of all of those hours and
meetings and days.

M: Yes. As a matter of fact, one of my colleagues at Barry, Melba same age as a
matter of fact, she was with the University of South Carolina, and she came to
interview for Nursing Education, because that was her background, nursing
education. She came to interview for the position, director of the Nursing
Education Major, and I am interviewing her, and she said, do you think that at
sixty-five... ? I said, what do you mean? She said, well, my age? I looked at
her and I said, Melba, what do you think I am, a chicken? Same age. But Melba
always talked about [the fact that] she was going to go on and go on, and even
after seventy, she was just going to keep working. Well, Melba died a year
before I left. It was terrible. Hey, take those moments when you can because
you never know.

S: That is right. You know, when I look back over my career and how many years
and how many changes I have seen in nursing -- the medications, the
techniques, the delivery systems -just think how many changes there have been


Page 37

in that amount of years over a career's time. Are there ones that stand out in
your mind that you remember [for example] as a student, we did not have this or
when that was brand new or...

M: Oh, gosh. The first open heart surgery that was done here. I mean, incredible.
Myron Wheat [cardiovascular surgeon]. I remember Dr. Roberts who did those,
God, those craniotomies and those tongs and things and whatnot. Those were
the beginnings. We thought open-heart [surgery] was something. Now, you have
got heart transplants; you have got the kidney transplants; you have got liver
transplants. I mean, open-heart, that was the thing.

S: Betty [Hilliard] and I, when were talking about student days, she said something
about being a probe. For the tape, I said, please explain that is your
probationary period. So, we talked about our student uniforms and how they had
collars and cuffs and aprons and belts and, you know, enough starch to kill a

M: That is right.

S: Remember that?

M: Oh, yes. I remember when we first started here, you know, we were this school,
the College of Nursing, without a cap.

S: Scandalous!

M: Scandalous! It was terrible.

S: Outrageous.

M: I mean, doctors just didn't. I mean, no cap? You are a nurse?

S: Cannot be done.

M: Cannot be done.

S: Oh, the things we got all embroiled in and all upset about.

M: And I remember the first time that I wore a white coat over a dress or a suit or
something. The doctors looked -- that was their uniform.

S: Oh, it was.


Page 38

M: Of course.

S: You were pushy, weren't you?

M: Oh, I was. I was. No cap, lab coat.

S: Cannot be nursing.

M: No.

S: Well, I have come down to the end of my questions. The only question I have left
is are there items or issues that I have not asked, where I skipped a gap or did
not do my homework enough?

M: No, I do not think so. Now, if you are going to give me a copy of that for my
review ...

S: Oh, yes. Absolutely.

M: ... and I think of something, we might want to get together on it.

S: Super.

M: Lois Knowles and I, we would meet with Dorothy -- we didn't mention anything
about that. But we would have our meetings with Dorothy, I think it was once a
week. We had faculty meetings. But those are the kinds of things that maybe do
not really pertain to what it is that you are looking for, anyway.

S: Well, they might. Why don't you, as you think back about what we talked about

[End of the interview].