1. Becky Adams Gwen Kibler

2. Professionalization

3.  Recognize nursing as a separate profession  Independence from physicians  Have their own organizations  Monitor the education system  Register graduates of nursing programs

4. Why was organization needed?

5.  Standardize and raise the educational requirements  limit the number in nursing  Seek professional recognition  Power for nursing

6. Sacrifice and ServiceCan we have both? 1) Exalt womanly character 2) Emphasize the service ethic of nursing 3) Ability of act in own self-interest 4) Womanly art of nursing a) Yet, not to appear unladylike

7. Best interest of nurses Best interest of physicians and hospitals  Demand higher wages for their skills  Denounce the misuse of nursing students  Professional autonomy  But not to appear commercial  Try to forge alliances with physicians and administrators who staff the hospitals with students

8.  Physicians  Hospital administrators  Public  Nurses

9. TTraditionalists-working in private duty Emphasize character and spirituality as core of nursing WWorker nurses-also working in private duty Focus on direct work-related reforms RRationalizers-nurses working in hospital management positions Focused on staffing without focusing on the trained nurse’s position PProfessionalizers-members of nursing associations Wanted to define the future of nursing

10. What was the beginning of reform?

11. 1890, a national organization was purposed to be called the “American Nurses’ Association” 1893, Isabel Hampton was instrumental in starting the National League of Nursing 1897,The society of superintendents created the Nurses 'Associated Alumnae(NAA) and the official journal was the American Journal of Nursing The association was primarily concerned with raising nursing educational standards and a code of ethics

12.  Membership was limited to superintendents of larger training schools who gave two full years of training in general hospitals of 100 or more beds  1911, NAA name changed to American Nurses 'Association (ANA)  Organizational leaders differed from membership in class background and education

13. How are changes made?

14.  Control who entered training  Require a high school graduation  Eliminate allowances  To have standard nursing training  Limit hours for nursing students  Graduate from approved nursing schools  Have state-mandated examining boards for all who “nursed for hire”

15.  Women's right to vote  Nursing differentiated from mothering  Separate nursing from physicians control  Change public opinion about nurses and the need for reform

16.  Differentiated nurses more by education than practice  Physicians argued that the market would determine a good nurse not legislation  It forced training schools to expand their programs to meet requirements  Lack of resources caused inspectors to pass schools they had not visited

17. “Where there is one nurse with a missionary spirit…there are 49 others who are obligated to make the humiliating confession: ‘I am a nurse because I must earn a living for myself and those dependent on me, because my nursing is well-paid, honorable, and to me interesting.’” –Trained Nurse

18. English hospital leader Editor of “The Hospital” Founder of the Royal National Pension Fund of England Foe of nurse registration Proposed a national pension fund for healthcare workers in the US (part scheme/ part charity)

19.  Chief organizer: Celia R. Heller  New York nurses’ group  Began in 1897  Goal: to seek a law in the state of New York that would give licensure to small hospital and short course graduates

20.  Magazine that supported private-duty nurses and small institution trained nurses  Editors believed character of nurses mattered above everything else  Editorials and letters were written to this magazine late 1800’s and early 1900’s by all forms of nursing “in the selection of the nurse the supreme test should be character… not titles or degrees, not educational attainment, but a high grade of character.”

21. Annette Fiske (1873-1953)  Upper-middle class Episcopalian  A.B. and Master’s in the Classics from Radcliffe  Challenged professional views of the “bosses”  Student and then instructor at Waltham Training School of Nurses  Recording secretary of Massachusett’s Private Duty League (later Massachusett Nurses’ Association)  Nursing “traditionalist” view Charlotte Aikens  Canadian born  College Educated  Ontario hospital trained  Ward administration trained in New York  Articles in Trained Nurse and National Hospital Record  Believed in improving nursing with hospital needs by raising standards  Vice-president of American Hospital Association

22.  WHO: Nursing superintendents with a small group of nurses vs. working nurses  WHAT: Fight for/against professional nurse  WHEN: Early 1890’s  WHY: The group believed it was time to make standards for nursing and claim professionalism while others (the working nurse) worried about their jobs