When the early nursing graduates received their diplomas and looked for work, there were few hospital nursing positions since, at that time, student nurses provided patient care. Senior nursing students also acted as Head Nurse in charge of the ward and as clinical teacher/supervisor of students. Graduates did find work within a hospital as a supervisor or superintendent of the hospital nursing school.
Reverby contends that “ the training school attended frequently determined the kind of institutional position offered.”[i] Positions ranged from superintendent of a nursing school to head nurse and supervisor. According to Reverby, in 1898 “one administrator calculated that 60% of the nursing superintendents in 327 schools trained in only 24 schools.[ii]
Graduates did find work as a staff nurse, mainly in larger public hospitals and those hospitals too small to sustain a training school. Graduates of specialty hospitals, knowledgeable in the specific practice requirements of physicians and care of their patients, found employment. According to Reverby, hospitals were reluctant to hire graduate nurses for two reasons: 1) they were harder to control - where a student 'did what they were told and worked long hours' and 2) they were 'wage earners' insisted on time off and were more expensive.[iii] Nurses also found work in physician offices, schools and industry.
With the advent of anesthesia and more complex surgery, surgeons found that having well trained nurses to administer anesthesia and assist during surgery and care for patients post operatively assisted in healing. Nurses were hired as anesthetists and operating room nurses.
Careers of two early graduates: Linda Richards and Isabel Hampton (m. Robb)
Linda Richards, America's first trained nurse, first position was as night supervisor at Bellevue Hospital in New York City. There she met Sister Helen, a nun of the All Saints Order, who had trained in the Nightingale System in London and mentored her in the Nightingale System.. In 1873, Bellevue, as all hospitals at that time, nursing reports to physicians regarding patients were all verbal as were orders that the physician provided the nurses for patient treatments .Linda Richards, realizing the possibility for confusion and error, started to provide written reports which were appreciated by physicians. She created a system for charting and maintaining individual medical records for each patient. This was the first written reporting system for nurses which were widely adopted - even by the famous Nightingale System.
Miss Richards career included superintendent of several nurse training schools including s Mass General Hospital and Boston City Hospital. She traveled to Japan and organized the First Training School for Nurses in Japan.
Isabel Hampton (m. Robb)- 1860 -1810. Isabel Hampton was born and raised in Canada. After moving to America, she enrolled in Bellevue Hospital Training School for Nurses in 1881 and graduated in 1883. She was the first Superintendent of Nurses at the Johns Hopkins School of Nursing Described as having a " commanding presence: her manner exacting, appearance striking, credentials impeccable, and impact unquestioned. Isabel Hampton Robb, the first superintendent of nurses at the Johns Hopkins Hospital and principal of its brand-new nurse training school, set in stone a path for generations of nurses even yet to come."[i]
Among her accomplishments, Miss Hampton helped to found the organizations that became known as the National League for Nursing, the International Council of Nurses, and the American Nurses Association. Hampton also played large role in advancing the social status of nursing through her work in developing a curriculum of more advanced training during her time at the Johns Hopkins School of Nursing.[i] She was the author several books Nursing: Its Principles and Practices (1894), Nursing Ethics (1900) and Educational Standards for Nurses (1907)[ii].
[ii] https://www.aahn.org/robb downloaded 9/21/2018.
[i] Johns Hopkins Nursing online magazine. https://magazine.nursing.jhu.edu/2013/12/this-way-forward-isabel-hampton-robb-1889-94/
i] Reverby, Susan,1987, Ordered to care: The dilemma of American Nursing 1985 – 1945.Cambridge University Press. p. 105
[ii] Ibid p. 105
[iii] Ibid p. 108