Diploma Nursing at Salt Lake City Religious Based Hospitals

Diploma Nursing at Salt Lake City Religious Based Hospitals

By JESSIE EMBRY

When Anna Elizabeth Coulson graduated from Juab High School in the early 1930s, she had few real employment opportunities in her home town of Nephi. Deep into the Great Depression, she like many others lacked the financial means to attend college.As a young girl she later recalled someone told her that she had the hands of a nurse and that set her course. Her first experience was working as a home nurse for a year before deciding she wanted more training. The nearest hospitals that offered nurses’ training were the LDS, Holy Cross, and St. Mark’s in Salt Lake City. Since she belonged to the Mormon church, her first choice was the LDS Hospital then owned by The Church of Jesus Christ of Latter-day Saints. There she met with a supervisor who told her that more than half of the admitted students would fail the program. She also visited the Holy Cross Hospital where a Catholic Sister explained that if they admitted a young woman they expected her to graduate.1 Coulson successfully completed the Holy Cross Hospital’s nurses’ diploma training program. Hospital nursing diploma training programs were the primary method by which nurses were trained during much of the twentieth century.

Nurses at the W.H. Groves Latter-day Saints Hospital in Salt Lake City.

UTAH STATE HISTORICAL SOCIETY

This article will focus on women student nursing training experiences at the three religious based hospitals in Salt Lake City—St. Mark’s, Holy Cross, and LDS—their work at the hospitals, and their relationships with instructors and their classmates. This paper draws on histories compiled by the training school alumni organizations. and oral histories gathered by the Charles Redd Center for Western Studies, Brigham Young University. 2

Churches established the first hospitals and the first nurses’ training programs in Salt Lake City. In 1872 the Episcopal Church opened St. Mark’s Hospital at 500 East and 600 South. Seven years later, the hospital moved to a fifteen-bed facility at 272 South 500 East and then to its location between 700 and 800 North on 200 West (today’s 300 West) in 1893. Many of the small hospital’s earliest patients were victims of mining accidents and typhoid fever. To help meet the shortage of nurses, the hospital opened a training school in 1893 and during its best years graduated from twenty to thirty students each year. St. Mark’s hospital nurses’ training school operated continuously until 1970, graduating a total of 980 students from the program. 3

In 1875 the Sisters of the Holy Cross opened Holy Cross Hospital in Salt Lake City and expanded into a new building six years later. Catholic Bishop Lawrence Scanlan had asked Sisters of the Holy Cross to come Utah to provide medical care to a growing number of Catholics, many of whom worked in the dangerous hard rock and coal mines in the territory. In 1901 the Sisters opened a school of nursing in connection with the hospital for the same reason that St. Mark’s did—there were not enough nurses to staff the hospital. Holy Cross Hospital continued to offer a training program until 1973. 4

Between 1901 and 1973 Holy Cross graduated 1,056 nurses. The beginning classes were very small, ranging from one to sixteen students and by the 1920s and 1930s the average graduating class of nurses was twenty although only fourteen students graduated in 1935 and eleven in 1936. Enrollment increased in the 1940s; the largest graduating classes were fifty in 1944, fifty-seven in 1946, and fifty-eight in two classes in 1947. During the 1950s, enrollment began a general decline until 1973 when the final class of twenty graduated. 5

The Church of Jesus Christ of Latter-day Saints also established several hospitals in the state to provide medical care. The first was the Relief Society, the women’s auxiliary of the church, which started the Deseret Hospital in 1882, but closed in 1896 for financial reasons. Nine years later the LDS church opened the W. H. Grover LDS Hospital along with a school of nursing with money donated by W. H. Grover, a Salt Lake City dentist. LDS Hospital offered nurses’ training until Brigham Young University created a School of Nursing in 1955. During those years LDS graduated 1,343 students. Like St. Mark’s and Holy Cross, class size varied, a typical year between twenty and thirty nursing students graduating from the training programs. 6

The three Salt Lake City religious hospitals followed a national trend at religious and secular hospitals by offering nurses’ training classes. Nurse historian Barbra Mann Wall explained Catholic hospital training programs grew in the late nineteenth century as the church-owned hospitals could no longer rely solely on the assistance of sister-nurses and a few paid employees. “By the turn of the 20th century, nuns felt compelled to open their hospitals for training of both sisters and secular women.”7 In 1880 there were only fifteen hospital-based training programs in the United States; thirteen years later there were 225 programs. In 1900 the number increased to 432, and three decades later there were more than two thousand programs. 8

With so many hospitals offering training, hospital administrators, nurses, teachers, and students realized the need to standardize education and training. In 1913 the University of the State of New York offered accreditation for hospital teaching programs. To receive accreditation, a hospital nurses teaching program had to provide at least fifty beds, serve thirty patients a day, students had to have received a high school education or equivalent, and the nursing programs had to provide training in medical, surgical, obstetrical, pediatrics, diet, and contagious disease nursing. 9

Over the years nursing organizations also accredited hospital programs. But the process was not automatic; programs had to meet established standards. St Mark’s nursing program first tried for accreditation in 1938 but was denied because the nurses’ home was overcrowded, there was only one poorly lighted class room, and the university course work was not satisfactory. To become an accredited nursing program St. Mark’s Hospital needed to provide the nursing students with better housing, improved classroom facilities, a vacation, and reduced work hours.10 These improvements required additional money and hospital administrators appealed to church members for financial assistance. “If we could get more support for a modern school, comparable to the regular help given by the St Mark’s Charity Association to the hospital service, we might be sure of maintaining our reputation for graduating nurses who can compete with the best in any state,” was the appeal.11 St. Mark’s was not accredited until the 1960s.

Accreditation helped hospitals to attract students but it was not essential. For a number of years, the three Salt Lake City religious supported nurse training hospitals were highly regarded.A national study in 1949 rated 1,156 nursing schools and the LDS, St Mark’s and Salt Lake County Hospitals ranked in the top 25 percentile and the Holy Cross and the newly organized University of Utah nursing programs in the middle 50 percentile. 12

Nurses’ training programs at all three of the Salt Lake City church based hospitals helped local girls receive hands-on training. They were similar to the apprentice programs where other young men and women gained their training working with skilled craftsmen. The hospitals kept the nursing programs small providing individual attention to the trainees and the hospitals lacked sufficient financial resources to provide large dorms for their student nurses. While students worked closely with trained nurses, the students provided essential inexpensive staffing services for the hospitals.

By mid-century a fundamental question was raised by the nursing profession: should nursing students be “trained” or “educated”? LDS Hospital student Evelyn Jorgensen believed that the term “training” was demeaning. “You train animals; you educate people .We were trained,” she recalled. In her assessment, the students were taught skills but lacked the book learning. During her training she and other student nurses were required to manage floors of patients and provide services that, according to Jorgensen, were beyond their knowledge. When there was an acute shortage of nurses during World War II, Jorgensen concluded that as a student nurse, “I hate to use the word exploited, but because of the situation, we were given an inordinate amount of work.” 13

Most nurses’ organizations agreed with The Bishop Abel Leonard Nurses Jorgensen’s assessment that student nurses Home near St. Mark’s Hospital needed a liberal arts education and more housed nursing students trained classes rather than training through work. As at the Hospital. a result, nurses’ programs began moving from hospitals to colleges and universities. However, the switch came slowly. The Teachers College in New York led out in this direction hiring its first nursing professor in 1907;Yale opened its school of nursing in 1924.14 At first hospitals offered a combined nursing diploma and college degree program. In 1931, for example, Holy Cross Hospital students could take a five year nursing program by working with St. Mary’s of the Wasatch, a Salt Lake City Catholic college.15 The diploma students took some of their science classes at the college. The five-year program included more liberal arts classes and allowed the students to earn a bachelor’s degree. The University of Utah opened a nursing program in the School of Education in 1942. LDS, St. Mark’s, and Salt Lake County Hospital arranged to send their students to the university’s nursing program shortly after it was created. Six years later in 1948 the University of Utah established a College of Nursing. 16 After St. Mary’s of the Wasatch closed in 1959, Holy Cross students also took general education classes at the University of Utah. 17

With the increased availability of university programs, hospital administrators began to question the diploma training and considered going to a four year bachelor’s program. In the 1940s Episcopal Bishop Arthur W. Moulton said St. Mark’s should wait to see what administrators of other nurse training hospitals decided. One reason for the possible change was that the University of Utah wanted to have the hospitals work with its new College of Nursing. However, when university administrators offered to create the “St. Mark’s Division of University of Utah College of Nursing,” hospital administrators refused fearing a “loss of autonomy.” Instead they decided to work with Presbyterian owned Westminster College in Salt Lake City to offer a three year registered nurse program with an associate degree and a five year program for a bachelor’s degree. In 1949 St. Mark’s administrators reported that the new program at Westminster “seems to be very satisfactory.” 18

A 1951 Utah Nurse article about the University of Utah’s College of Nursing praised St. Mark’s and Holy Cross “for continuing to produce in as large numbers as possible good three year graduates to meet community needs.” At the same time the author of the article thanked LDS and Salt Lake County hospitals for having “faith in the long range benefits of better nursing education [to make] sacrifices to spearhead the efforts to bring professionals to truly professional status.”19 With this assessment, however, the joint University of Utah and LDS program was discontinued a short time later. At the LDS church’s Brigham Young University a School of Nursing was instituted in 1955, and three years later the LDS Hospital Training Program became a part of that nursing school’s program. 20

The St. Mark’s School of Nursing was accredited in June 1967. However, recruiting students for its diploma programs continued to be a struggle. Most nursing students wanted a college degree, and the diploma programs now competed with those offering college credit and an associate degree. Graduating students from the two different programs generally received the same pay. On August 15, 1968, the directors of St. Mark’s nursing program voted to end the diploma program with the last class to graduate in 1970. 21

The Holy Cross Hospital closed its diploma school three years later. 22 Father David C. Goddard reflected on the Holy Cross School of Nursing: “[While] we close the book and place it now upon the shelf,” the nurses who graduated “spread out in ever-widening influence over the years like rings from a pebble....Through your lives, dear graduates, in your service to the sick, as in the lives and service of all Holy Cross graduates of every past year, the love and dedication of the Sisters of Holy Cross and the love of Christ . . . will never . . . end.” 23

The closing of the Salt Lake City nursing diploma programs followed a national trend. In 1960 there were about eight hundred diploma programs, two decades later there were only three hundred diploma programs and by 1997 there were only one hundred remaining.24 This type of programs declined as increasing numbers of schools of nursing were established in colleges and universities across the country. Hospital programs could no longer afford to pay for training, were no longer or easily accredited, which made it difficult to attract students, and more complex treatment methods required more education. 25

Who were the women who came to the Salt Lake City hospitals to be trained as nurses and what do they recall about their experience?26 One common characteristic was that most came from Utah. For example, the 1947 graduating class at LDS had thirty-four students with twenty-two from Utah, eight from Idaho, and the rest from a scattering of states. The 1953 class had twenty-two students with twelve from Utah, and the 1954 class had twenty graduates with sixteen from Utah. In 1956, twenty-seven students graduated from St. Mark’s, and twenty-three were from Utah. But each year was unique. The 1957 graduating class also had twenty-seven students, but only sixteen were from Utah. 27

Students at all three schools also came from similar economic backgrounds. Some Utah students were from Salt Lake City, but more were from Carbon County and areas in Salt Lake County outside of the city. Marilyn Howe who attended in the 1950s explained that “a good portion” of her Holy Cross class came “from probably middle class or lower class farming rural people.” 28 But religion did not determine where students went. Until 1966 hospitals could request religious affiliation on the application forms, but it was not a determining factor for whether the person was admitted. Nearly two-thirds of the students at Holy Cross were not Catholic. 29

In selecting a hospital program to attend, young women considered the school’s reputation, graduates’ and others’ reports, location, religion, and personal impressions. Many students from Carbon County, for example, came to Holy Cross because they were Catholic. Others from the county who were not Catholic also went to Holy Cross because most nurses at the local hospital had trained there.

Clara Brennan, a Catholic who grew up in the suburbs of Salt Lake City, went to Holy Cross for religion, but was “surprised at the number of LDS students that came to Holy Cross Hospital for nursing.”30 My “impression was that they knew Holy Cross had a good school of nursing.” In the 1930s Mormon Helen Stevens said, “I surveyed all the schools in Utah and found out that Holy Cross was the best school.”31 In 1939 Shirley Paxman, a Mormon, decided to leave BYU and train as a nurse. An uncle told her that Holy Cross was the best place to go.32 In the late 1960s Teri Weidman, also a Mormon, recalled that the doctors in Cache Valley told her friend that the best nursing degree was at Holy Cross. 33

For Mormon Janice Evans who as an orphan was raised by relatives in Glenwood in Sevier County, Holy Cross was her best option following graduating from high school in the 1950s. A local family doctor in the county helped her complete “papers so I could get a scholarship. My dream was to go to BYU and go to LDS Hospital, but that didn’t work out. [The doctor] knew people at Holy Cross Hospital. He was instrumental in getting a scholarship that paid for my entire nursing training.” 34

Bessie Witt’s selection of Holy Cross’s nursing program was most unusual. She had recently became engaged to a missionary and feared that if she went to Brigham Young University, which had just established its nursing program with the LDS Hospital, she would find herself dating other men. She chose Holy Cross because she would be in a situation surrounded by women and because a hospital administrator in Nephi was Catholic and had high praise for Holy Cross. Witt recalled having a good experience when she went to visit Moreau Hall, the nurses’ home at Holy Cross.“My first introduction there was totally warm. The head nun came forward and talked to my mother and me....[She] welcomed us in.” 35

Religious affiliation was important in choosing the several different nurses’ training programs. Edith Gerrard, for one, wanted to be around other Mormon students. And, she later recalled, the “Ensign Ward which was catty-corner to the LDS Hospital,” which was very convenient. She further explained the LDS Hospital nursing director “impressed me.” Like many others who trained during World War II, she joined the government’s Cadet program which paid and helped eliminate her financial concerns. 36

In the mid-twentieth century, St. Mark’s and Holy Cross advertised for nursing students. A 1967-1968 St. Mark’s pamphlet explained, “Since its beginning many students have received a professional education in the care of the sick, and graduates of St. Mark’s Hospital School of Nursing are practicing in all fields of nursing.” It also stressed, “Salt Lake City is a center of great scenic beauty and historic interest.” 37

UTAH STATE HISTORICAL SOCIETY

These nurses’ schools applications asked questions about the applicants’ health, schooling, and religion. St. Mark’s students also required a report from a doctor and one from a clergyman. 38 Interviews were an important part of the application process to make sure that the young women were serious about nursing and had the qualities that would make a good nurse. When Joyce Taylor applied at LDS Hospital in the 1940s she had to also be admitted to the University of Utah. Both Lona Booth (class of 1957), and Terri Weidman (class of 1969) had interviews at Holy Cross. 39

The sisters at Holy Cross interviewed applicant Shirlynn Campbell, a Mormon, and her mother. “The nun interviewed me. The nuns were a little new to me, but they were very nice.” The sister asked Campbell’s mother about her personality, and her mother replied, “Whatever she decides to do, she’s so determined to she’ll do it.” Four other American Fork High School students applied at Holy Cross, and only Campbell and one other were accepted. “The one who really wanted to go wasn’t accepted. They just told her they didn’t think she’d be a good nurse.” Campbell added that “the one that wanted to be a nurse really bad went to Weber State and became a nurse. She worked for awhile and then quit nursing. The nun was really right when she said she wouldn’t be good in nursing.” 40

Once admitted nearly all the interviewees agreed with Edith Gerrard that they were “pretty scared and frightened.” She continued, “We were all apprehensive. The standards were very high. The rules were high. The academic standards were high. We knew that we had to meet all of those or we were washed out.” Gerrard, a Mormon, decided to enroll at the LDS nurses’ school where she was comfortable with the religion. For Marilyn Howe, a Mormon who went to Holy Cross in 1951, there was the added concern of associating with the Catholic faith. “My folks left me on the front door of the dorm and drove away. That scared me half to death. There were nuns, and I didn’t know anything about nuns.” 41

The nurses’ schools dealt with such fears by assigning a mentor to each new nursing student. Faye Burns, a Lutheran from Cedar City, went to Holy Cross in 1951. Her big sister from the second year class “wrote me a letter before I came....She said she was looking forward to meeting me.” Marsha Pack who came to Holy Cross in 1965 had a second year student and a senior assigned to her. I “had a big sister and a grandmother....The first few days we got to meet them and ask them questions.” 42

At first students at all three hospitals lived in homes near the hospitals or in the hospitals. In 1906 St. Mark’s built a nurses’ home in memory of Episcopal Bishop Abel Leonard who had worked hard to improve the living conditions for the student nurses. The new home had room for thirty-five nurses and a gym. In 1945 the hospital completed a new wing on the nurses’ home in hopes of receiving accreditation and attracting more students. 43

Because the living conditions in the LDS Hospital were not adequate, a nurses home was built in 1906. In the new home, most rooms had two beds. There was a dining room and a classroom in the basement. However, the home was not large enough for all the students and cottages were constructed to house those in the senior class. Other students lived some distance from the hospital. Audrey McBride, who attended LDS in the 1940s, spent her first six months at the Beehive Annex downtown. She rode a bus to the hospital. 44

The Holy Cross students lived in houses near the hospital. Marjorie McQuillan, a student during the 1940s, lived in the dorms at St. Mary’s of the Wasatch for six months. Then she moved to the two dormitories in the hospital. For the first nine months, the students were on probation. At the end of that period they were formally accepted into the training program during the capping ceremony. As official students, they were now allowed to wear nurses’ caps. After receiving her cap, McQuillan moved into nurses’ homes. Holy Cross “had four homes that the nurses lived in. Our class lived in two different homes. Ours was 1206 South First. We called it ‘twelve-oh-hole.’” 45

Holy Cross administrators wanted a place where all the students and the sisters could live rather than having them scattered into houses near the hospital or in crowded accommodations in the hospital. In the late 1940s the hospital raised money and constructed a nurses’ home, Moreau Hall, on First South across from the hospital.46 Holy Cross student Ruby Hayes started in 1951 and recalled, “Moreau Hall had just been completed. We were the first class to spend the entire three years there.” The nurses lived there until the school closed in 1973.The four-story building was modern, and the students enjoyed their experiences there. Each floor housed a class. The Holy Cross Sisters lived on the fourth floor. Usually the women had a separate room which included a sink. There was one large bathroom between two wings on each floor. 47

For student nurses living at Moreau Hall there were strict rules they had to follow. Lights had to be out at ten p.m., and a nun walked the halls to make sure everyone obeyed. Janice Evans said they sometimes put a rug by the door so the sister could not see the lights. If they were visiting in other rooms, they could hear the sister’s wood beads and that was a signal to whisper. The nuns inspected the rooms every week and left a card showing if the sink was clean, room picked up, and bed made. Everyone had to eat in the cafeteria and no food was allowed in the rooms. 48

Since the students lived together, they grew very close. Like most students in dorms, they played pranks. Marilyn J. Howe remembered the teachers were very strict. “Once in a while somebody would try to play games ...but most of us ...just took out our hostilities later on each other by pulling dirty tricks in the dorms.” One prank was knocking on a door and throwing a wet rag at the person who answered. Once the director came up, knocked, and got hit with the rag. “It undid her flute [on her headdress] which cost her hours of re-starching. She was not happy, and so we were grounded for awhile.”49 Others were typical college dorm tricks such as short sheeting beds, putting plastic under the toilet seat, or sugar in the bed.

According to nurse historian Kay Kittrell Chitty, the principal method of teaching classes at the diploma programs was the “modified apprenticeship model.” According to an LDS Hospital history, that meant that the classes had a “minimum of class work and a great deal of practical experience.”50 Doctors gave lectures; nursing instructors supervised clinical training. The courses matched the hospital units that the students worked in. This was expected since the hospitals started the programs not only to train nurses but to help staff their floors.

Over the years the hospitals developed their own curricula. At Holy Cross, for instance, students took religion classes their first and second years, two quarters of psychology the first year, anatomy-physiology, chemistry and microbiology, nursing principles, and nutrition and ethics all during the first year. Medical-surgical nursing classes were two years long, psychiatric nursing was the second year, and third year nursing classes were devoted to children, obstetrics and tuberculosis. 51

Holy Cross nuns taught the classes at St. Mary’s, while Sister nurses, lay nurses, and doctors taught the classes at the hospital. Ruby Hayes recalled the Sisters at St. Mary’s “were wonderful teachers. We had a Sister, Ann Josephine, who was a cute little nun with a great swooping limp. She was a very brilliant woman who taught us anatomy and physiology. We had another nun, Sister Emily Anne, who taught us English. She was from back east. She was a very regal looking person. She was straight forward and a little rigid. Sister Clara Assasi taught chemistry. I think she put the holy fear into all of us.” Carol Imhoff also recalled a chemistry teacher who “had something against Dial soap.” When a student left some on her desk, the nun “came in and started teaching the lesson. She picked up the soap, went over, raised a window, and tossed it like a football out the window, never saying a thing.” 52

After St. Mary’s closed, the Holy Cross students attended classes in Moreau Hall. The first class was “nursing arts.” Fay Burns remembered, “That was the introduction to nursing . . . and all the good stuff that you have to learn first before you touch a patient.” In the second and third years Mary Jo Cannarella explained, “Many of the lectures were given by medical doctors. Our curriculum was on a medical model.” After the freshman year “where we learned the art and science of nursing,” the students took “medsurg, pediatrics, or any of that,” and “we were taught by doctors who were in that specialty. ... We went through disease by disease, the medical and the surgical conditions and interventions for those conditions and diseases. We also learned the drugs that were associated with treating those conditions.” 53

Ruby Hayes remembered not all the classes at Moreau Hall were nursing. One sister wanted the students to be “well rounded.” Besides bringing in cultural groups, she brought in an Arthur Murray instructor. “Here was this school of nursing that was all girls. We were dancing with each other and learning the tango, waltz and the rumba. I have to admit, never in my timid little life had I ever sluffed a class. But dancing was beyond my two left feet.” Hayes signed in at the front door, danced to the back door, and then slipped out and up the stairs to her room. “Consequently I have never learned to dance.” 54

Carol Imhoff took a charm class her senior year because “Sister Raphael ... wanted us to learn how to decently apply make-up and be polite. ... Her thesis always was, ‘You’re the first person that a patient sees in the morning. You can make or break his day depending on how you look and how you act when you walk into that room. If you . . . look decent and if you smile, he will have a far better day than if you come in a disheveled mess and act grumpy.’” 55

In the 1940s LDS, St. Mark’s, and Salt Lake County Hospital sent their students to the University of Utah for the first six months. Edith Gerrard had attended the university for a year,“so I had some experience. But some of the new nursing students hadn’t ever been to the university. For them it was very difficult.” They took “very academic classes, anatomy, physiology, chemistry, and all the basic, very difficult classes. Two-thirds of the girls ‘washed out’ academically or by choice because it was very difficult.” 56

After completing the university courses, LDS students took classes at the hospital. Maxine Cope recalled that initially graduates who had done well “did most of the teaching. [Later] the doctors just galore came in. Every time we had any kind of a lecture, which was practically all the time, there were more doctors lecturing than anything else.”57 Betty Jo Reiser also recalled University of Utah professors teaching classes. “At the Hospital we were taught nursing practices, the history of nursing and medicine, and medical and surgical practices.” They worked on a “mannequin dummy called “Mrs. Chase.” 58

If classes were important, hands-on work by the students was an essential part of their training. As 1970s Holy Cross student Teri Weidman explained, “We started right out doing some nursing skills. They told us, ‘You’re here to be a nurse so we will get on with the job.’” Some responsibilities did not seem much like nursing. Many interviewees recalled waking patients up, getting them ready for the day, and giving backrubs at night. According to Holy Cross student Mary Jo Cannarella, it was a lot of “Certified Nurses Aide type of work which included catherization, changing dressings, and caring for various kinds of tubes.”59 LDS student Betty Jo Reiser recalled, “Sometimes we felt we were maids, not nurses. We had to dust the rooms and take out dead flowers.” 60

One of the first things the students learned was how to make a bed— and the beds had to be perfect. With no fitted sheets, the bottom sheet was tucked in all around with square corners. The top sheet also required square corners at the bottom. Janice Evans remembered, “We actually had to make the bottom sheet fit tight enough so the instructor could flip a coin on the bed and it had to flip off.” Edith Gerrard at LDS also recalled that “beds had to be made exactly to perfection. As we did our square corners, we thought we had accomplished a lot.” One student did not get her bed made correctly because “one of the roller wheels on the bed was askew.... She was not ‘kicked out’ but reprimanded.”61

After the first year, the students took on more responsibility. They went directly from their classes to the hospital where they practiced what they had just learned. Betty Jo Reiser recalled that they did not do anything on a patient though until they had demonstrated proficiency in specific procedures. One doctor asked a student to do a procedure, and when she told him she had not passed it off, he said, ‘For Heaven’s Sake, what do those instructors do? Teach you how to close doors?’” 62

The students had many duties. They worked regular shifts, often from 11:00 p.m. to 7:00 a.m., or 3:00 a.m. to 11:00 a.m. Mary Jo Cannarella explained night shift was hard. After working all night, they still had to go to class. “I can remember trying to take notes in lecture and the handwriting slanting down the page and going off the page because I was actually falling asleep while I was taking notes.” Sometimes she had to decide if she wanted to eat or sleep. The answer “depended on if we needed the calories or the sleep.” 63

The students rotated to each area of the hospital. Helen Bland explained, “We worked on pediatrics with the children and on the medical and surgical nursing floors.” They worked on a men’s floor and the women’s medical floor. “For our nutrition training we worked in the hospital kitchen.” These rotations were the same when Mildred Wood Nyland trained at LDS Hospital in the 1930s. She especially remembered her time in the kitchen. She tried to make cherry pies starting “right after breakfast.” She tried to make a “good pie” but “it was an insufferable pace.” Finally the pies went out for dinner. “When the trays came back, every one of them had cherry pie with one bite out of it.” 64

These Salt Lake City hospitals were unable to provide training in some areas needed to obtain a license. Consequently, students at Holy Cross went to Pueblo, Colorado, to the state mental hospital for training in mental health procedures and to the Glockner Penrose Hospital in Colorado Springs for communicable diseases. At other times they went to the hospital in Gooding, Idaho, and the Salt Lake City Shriner’s Hospital. Experience in working with mental health patients was difficult. Ruby Hayes recalled: “We were allowed to work in some of the different treatment areas. They still did cold wet sheet and insulin therapy. It sounds so terrible in this day and age since medications have taken over. I can remember wrapping these poor patients in cold wet sheets and just having them shiver.” 65

In the 1920s LDS students went to Primary Children’s Hospital for children care and only went on a field trip to the Utah State Mental Hospital in Provo. 66 In the 1960s St Mark’s students did rotations for psychiatric nursing at the University of Utah and for children’s care at Neighborhood House, Rotary Center, and at Primary Children’s Hospital.

Those who trained at hospitals frequently commented about how much nursing duties and procedures have changed over the years. They had to sharpen and sterilize needles. Bed pans were reused and had to be sterilized. There were no throw away items and so syringes, gloves, and all the instruments in surgery also had to be cleaned and sterilized. Marjorie McQuillan explained that during World War II they had to be very careful with linen and other items. “Everything was scarce. We really had to pull together.” Edith Gerrard added that not all instructions were followed during the war because there was such a shortage of nurses. “We did the best we could.” For example, it was impossible to give forty-five minute baths and get to everyone. 67

Night shifts were hard but sometimes fun because there was more free time. Sometimes, nursing students made fudge when things were slow. Marjorie McQuillan recalled that they used the cocoa and Karo in the units and sometimes stole sugar from the doctors’ dining room. One time they left the fudge cooking in a double boiler and forgot about it. “By the time we got back it was just charred.” They gave the pan to the janitor who “deep-sixed it in the garbage.” However, the nun in charge noticed. According to McQuillan, she was “a pain,” and threatened that “Case reports will not be signed until the top of the double boiler is returned.” So the students bought a new one out of the fifteen dollar a month allowance they received. 68

Holy Cross student Lona Booth echoed the sentiments of many students about the long hours and hard work. “We felt like slave labor because we were staffing the hospital. As a senior I would be a charge nurse and a team leader.” But like most other diploma nurse graduates, she continued, “Looking back on it, we got invaluable experience, experience that the students don’t get nowadays.”69 The students appreciated the hands-on training where they learned a principle in the classroom in the morning and practiced on patients in the afternoon.

Religion was important at the three church operated hospitals in Salt Lake City as it was elsewhere across the United States. Nurse historian Barbra Wall explained that at Catholic hospitals,“What made sisters’ classes different was their emphasis on Catholic religious traditions. This included teaching the necessity of baptism and the sanctity of life in every developmental stage.” As one Holy Cross graduate explained, “There was a close tie . . . between the sisters and the nurses, which tended to put our nursing standards on a high plane.” 70

Several of the nurses interviewed explained that the religious aspects helped them focus more on the individual patients rather than money. Carol Imhoff concluded, “It’s probably why the Catholic hospital went broke, but the patient was the most important thing.” Evelyn Jorgensen agreed and said that at LDS Hospital, “Patients came first!”71 In contrast to this emphasis, Janice Evans, a retired nurse, felt that in recent years the emphasis on patient care had changed. “My husband and my daughter have been in the hospital a lot in the last few years. I just shudder because the room was messy.” She complained that the nurses just checked the equipment. “They did not ever try to make the patient comfortable.” 72

St. Mark’s demanded more religious attendance from Episcopalian members. In 1943 the hospital’s supervisor notes explained, “There will be communion next Sunday. Try to have all Episcopalian girls on duty in the morning so they can attend the communion services.” But all students were required to attend some religious service. The same supervisor asked everyone at the hospital to be at chapel on Tuesday if they were home. 73

Anna Elizabeth Coulson, the author’s mother, graduated from the Holy Cross Nursing program in 1937.

While most students at the LDS Hospital were Mormons those who were not, in the words of Mildred Wood Nyland, “managed to live through it.” Nyland attended school in the 1930s and remembered having Saturday and Sunday off. “Saturday was the day we washed our undies and got ready for the coming week. Sunday we went to church because it was a church institution.” 74

Evelyn Jorgensen, who trained at the LDS Hospital during World War II, remembered that she had one day off. “It was supposed to be Sunday, but we were usually working on Sunday.” If they did get Sunday off, the students went to the Ensign Ward for meetings. But she added,“We had devotional every morning. The superintendent of nurses was always in charge of that. It would just be a spiritual thought that would be taught by somebody, a song and a prayer, and then off we’d go. It was just a half hour thing long, but it was daily.” 75

Holy Cross students also participated in religious services. LDS student Alice Smith Aylett entered the school in 1923 and graduated in 1926. Her roommates were Catholic, so they “had to get up a half hour before I did to go to Mass.” But that was not the only religious responsibility. Aylett recalled, “We would march into the chapel every morning after breakfast with Sister Elena and say prayers, which was nice and good for us.” All the student nurses were required to attend midnight Mass on Christmas eve or work for a Catholic so she could go. Aylett recalled, “I went to Mass the first year, but after that I relieved.” 76

While it was awkward and uncomfortable for some Mormon nursing students to be educated at Holy Cross Hospital, there were others who appreciated the exposure to new religious traditions. Shirley Paxman described the positive impact of her experience at Holy Cross. “Going to Holy Cross and St. Mary’s made me very ecumenical, and I spent my life being ecumenical because I learned so much about other religions. That opened up dimensions to religion and spirituality to me that I’ve never had in my Mormon upbring.” She enjoyed learning about the role of Mary, the Mother of Jesus. She “learned what reverence in a sacred place means.” She continued, “I was introduced to the Christian calendar. Mormons don’t observe the Christian calendar. I learned what Ash Wednesday was, I learned what Lent was, and I learned what Advent was. I learned all those magnificent religious holidays that are observed by the Christian community all over the world.” She especially enjoyed the Holy Cross Hospital chapel and worked to establish one in the Intermountain Healthcare Hospital in Provo. 77

Graduation had a strong religious focus. The Holy Cross students and graduates walked from the hospital to the Cathedral of the Madeleine where following a mass for graduating nurses, the students received their diploma and were invited to kiss the bishop’s ring. For those nursing graduates who were not Catholics this was an awkward moment. LDS Hospital held graduation at Kingsbury Hall or the Union Building at the University of Utah where the Presiding Bishop of the LDS church, the general authority in charge of the hospital, spoke at graduation. 78

Today none of the three hospitals are owned or operated by religious institutions. Holy Cross Hospital (now Salt Lake Regional Hospital) and St. Mark’s Hospital are owned by nation-wide megahospital chains. The LDS Hospital is part of the Intermountain Healthcare system, which was created by the LDS church that divested its ownership and operation of all of its medical facilities. None of the three former religious supported hospitals have their own nurse training programs. As a result, they like other hospitals face a shortage of nurses. Although hospitals have not reintroduced student training, they do work closely with colleges and universities to increase the number of graduates.

Today, much of the work once assigned to student nurses at hospitals is now done by Certified Nursing Assistants (CNAs), trained in nursing homes or technical schools. Utah universities and two-year colleges offer a Licensed Practical Nurse (LPN) degree that can be completed in two years or a Registered Nurse (RN) degree that can be completed in three. The University of Utah, Brigham Young University,Weber State University, and Utah State University (in connection with Weber State), and Southern Utah University offer bachelor degree programs in nursing.

During the eighty years between 1893 and 1973 that church-owned hospitals operated programs in Salt Lake City, more than three thousand women secured valuable training while earning diplomas in nursing. They went on to become the nurses in urban and rural hospitals, care facilities, and homes. Anna Elizabeth Coulson’s experience is just one example. After graduating from Holy Cross in 1937, she worked as a head surgery nurse at the Budge Hospital in Logan where she met Bertis L. Embry and they were married in 1941. During World War II, she traveled with Embry as he received naval training. She worked in hospitals across the country. After her children were raised, she resumed working as a nurse, ending her career as a public health nurse. Others, like her who trained at LDS, Holy Cross, and St. Mark’s Hospitals were a vital part of the history of health care in Utah during the twentieth century.

NOTES

Jessie Embry is Associate Director of the Charles Redd Center for Western Studies at Brigham Young University.

1 Anna Elizabeth Coulson Embry is my mother.Anna Embry,interviewed by Jessie Embry,March 2, 1982,13,LDS Family Oral History Program collection,Charles Redd Center for Western Studies,L.Tom Perry Special Collections,Harold B.Lee Library,Brigham Young University,Provo,Utah.

2 The histories include Lottie Felkner, The St.Mark’s Hospital School of Nursing Story (1970); History of Holy Cross Hospital School of Nursing (1973); History of Dr.W.H.Groves LDS Hospital School of Nursing, 1905-1955,and Evelyn Plewe Jorgensen, Dr.W.H.Groves Latter Day Saints Hospital School of Nursing:A History 1905-1955 (1991).Copies of these books and other archival records are at the Utah State Historical Society,Special Collections,Westminster College;L.Tom Perry Special Collections,Harold B. Lee Library,Brigham Young University;and Special Collections,Marriott Library,University of Utah.

3 Felkner, St Mark’s

4 Marilyn C.Howe, The Early Holy Cross Hospital and Salt Lake Valley (Salt Lake City:np,1975),19.

5 History of Holy Cross.There were exceptions to the general decline in enrollment.For example,fortytwo students graduated in 1964.

6 Jorgensen, Dr.W.H.Groves

7 Barbra Mann Wall,“’Definite Lines of Influence:’Catholic Sisters and Nurses Training Schools,18001920,” Nursing Research 59 (September/October 2001):315.

8 Sandra Hawkes Noall,“A History of Nursing Education in Utah”(PhD diss.,University of Utah, 1969),29;Kay Kittrell Chitty, Professional Nursing:Concepts & Challenges,3rd ed.(Philadelphia:W B. Saunders Co.,2001),37.

9 Felkner, St.Mark’s,26-28.

10 1938 Accreditation Letter,St.Mark’s Papers,Box 1,Folder 2,Archives,Govale Library,Westminster College,Salt Lake City,Utah.(Hereinafter referred to as Westminster College Archives.)

11 Ibid.

12 St.Mark’s,Box 1,Folder 2,Westminster College Archives.

13 Evelyn Jorgensen oral history,interviewed by Ashley Sanders,Nurses Training Oral History Project, Charles Redd Center for Western Studies,L.Tom Perry Special Collections,Harold B.Lee Library, Brigham Young University,Provo,Utah,September 19,2006,3.(All other oral histories cited are part of this collection.)

14 Chitty, Professional Nursing,36.

15 History of Holy Cross,14;Tomiye Ishimatsu,“A Study of the Baccalaureate and Diploma Curricula in Nursing”(MS Thesis,University of Utah,1964),4.

16 Ishimatsu,“Diploma Curricula in Nursing,”4-5.

17 Ibid.,4-5;Noall,“A History of Nursing Education,,”68.

18 Felkner, St.Mark’s, 91-92,94-95;St Mark’s Papers,Westminster College Archives.

19 “University of Utah College of Nursing,” Utah Nurse,June-July 1951:19.

20 Noall,“A History of Nursing Education,”29;Chitty, Professional Nursing, 37.

21 Felkner, St.Mark’s,140-42.

22 Barbara Springer,“Last of Area’s Diploma Schools,Holy Cross Nursing Facility Graduates Final Class June 3,” Salt Lake Tribune,May 26,1973.

23 Address by Father David C.Goddard,Holy Cross Scrapbook,Utah State Historical Society.

24 Noall,“A History of Nursing Education ,”29;Chitty, Professional Nursing, 37.

25 Chitty, Professional Nursing,38.

26 The Charles Redd Center for Western Studies at Brigham Young University conducted oral history interviews with thirty-three women who were trained at Holy Cross and six at LDS.In addition,St. Mark’s hospital archives at Westminster College provided valuable information.

27 These numbers come from the Salt Lake Tribune accounts of the training school graduations July 8, 1947;August 23,1953;August 22,1954;September 2,1956;and June 18,1957.

28 Marilyn Howe oral history,interviewed by Angela Swenson,January 27,2006,3.

29 Holy Cross Records,Salt Lake City Diocese Catholic Archives,Salt Lake City,Utah.

30 Clara Brennan oral history,interviewed by Ryan Riberia,February 2,2006,5.

31 Helen Stevens oral history,interviewed by Angela Swenson,February 7,2006,1.

32 Shirley Paxman oral history,interviewed by Angela Swenson,September 3,2006,2.

33 Teri Weidman oral history,interviewed by Ryan Riberia,September 29,2005,2.

34 Janice Evans oral history,interviewed by Angela Swenson,February 20,2006,1.

35 Bessie Witt oral history,interviewed by Ryan Ribeira,February 2,2006,2.

36 Edith Gerrard oral history,interviewed by Ashley Sanders,October 10,2005,2.

37 St Mark’s Pamphlet,Utah State Historical Society,21-22.

38 “St.Mark’s Hospital training school for nurses:rules,”PAM 8980,Utah State Historical Society Library.

39 Joyce Taylor oral history,interviewed by Ashley Sanders,September 19,2005,1 and Joyce Taylor Scrapbook,used by permission;Lona Booth oral history,interviewed by James Dalrymple,July 14,2005,1; Weidman interview,1-2.

40 Shirlynn Campbell oral history,interviewed by Ryan Riberia,February 2,2006,1-2,5.

41 Gerrard interview,1;Howe interview,1

42 Faye Burns oral history,interviewed by Angela Swenson,January 9,2006,8-9;Marsha Pack oral history,interviewed by Ryan Ribeira,October 11,2005,2.LDS Hospital also had a big sister program that started in 1927.Jorgensen, Dr.W.H.Groves, 102.

43 St.Mark’s Records,Box 1,Folder 2,Westminster College Archives.

44 Audrey McBride oral history,interviewed by Ashley Sander,November 25,2005,2;Joyce Taylor, scrapbook,copies in possession of author;Gerrard interview,2-3.

45 Marjorie McQuillan oral history,interviewed by Angela Swenson,January 27,2006,4.

46 Felkner, St.Mark’s, 21-22;Evelyn Jorgensen,comp., Pictorial History of the Latter Day Saints Hospital School of Nursing,1905-1955 (Salt Lake City:Latter Day Saint Hospital Nurses Alumni Association,2002); “When,As,and If,Utah,”Pamphlet 18718,Utah State Historical Society.

47 Ruby Hayes oral history,interviewed by Angela Swenson,November 3,2005,2.Most other interviews give the same information about the student dorms.

48 Janice Evans’comments reflect what nearly all the Holy Cross students said.Evans interview,3.

49 Howe interview,3.

50 Chitty, Professional Nursing,37-38;Jorgensen, Dr.W.H.Groves, 45.

51 Holy Cross School of Nursing brochure,Box 3,Folder 9,Utah State Historical Society.

52 Carol Imhoff oral history,interviewed by Ryan Ribeira,October 22,2005,3;Hayes interview,3; Evans interview,4.

53 Burns oral history,2;Mary Jo Cannarella oral history,interviewed by Angela Swenson,November 2, 2005,4.

57 Maxine Cope oral history,interviewed by Lisa Christensen Gee,June 22,2005,2.

58 Betty Jo Reiser oral history,interviewed by Ashley Sanders,October 19,2005,6.

59 Helen Bland oral history,interviewed by Angela Swenson,February 26,2006,2-3;Cannarella interview,3.

60 Reiser interview,6.

61 Evans interview,7;Gerrard interview,3.

62 Reiser interview,6.

63 Cannarella interview,5.

64 Bland interview,3;Mildred Wood Nyland oral history,interviewed by Angela Swenson,October 8, 2005,2.

65 Ruby Hayes interview,5.

66 Jorgensen, Dr.W.H.Groves ,49.

67 McQuillan interview,6;Gerrard interview,3.

68 McQuillan interview,6.

69 Booth interview,2-3.

70 Wall,“Catholic Sisters and Nurses Training Schools,”317-18.

71 Imhoff interview,16;Jorgensen interview,6.

72 Evans interview,4.

73 St Mark’s Minutes,April 1943,Westminster College Archives.

74 Nyland interview,1,4.

75 Jorgensen interview,6.

76 History of Holy Cross,55.

77 Paxman interview,3-4.

78 Jorgensen interview,4;all the oral histories with Holy Cross students discussed graduation.