Lavinia Lloyd Dock Nursing Pioneer

Where have we come from? Who are we? Where are we going?

Early Years

• Born on February 26, 1858 in the town of Harrisburg, Pennsylvania.

• One of six children (4 sisters and 1 brother) into a quite wealthy family.

• The parents insisted that the children, especially the girls, received a proper Victorian education in art, music, literature and language.

• (The son became a prominent physician.)

Early years

• Lavinia cared for her 44 year old mother during her terminal illness.

• Was influenced by article about “new profession” for women-- in the Century Magazine in 1882.

• Her father’s finances took a down-turn; she decided at the age of 26 to enter the Bellevue Hospital nurses’ training school in New York (1864) a year before the Civil War ended in 1865.

Societal Reactions

• Why exchange traditional role as wife, mother, and manager of the home to work for money?

• Why study and work in a strange hospital in New York?

• “One friend went to nursing school for 2 weeks and learned all she needed to know!”

• It is a disgraceful decision for a lady.

Nurse Training School

• Was based on Nightingale’s principles that had a great influence on improving the care of the sick and wounded.

• This was a time when women with influence had reformed several hospitals, and initiated the student apprenticeships.

• Bellevue was joined later by the Connecticut Training School at New Haven, and the Boston Training School that welcomed their first students in 1873.

Hospital School

• Student nurses received room and board in a nurses’ home near the hospital.

• Students wore the blue and white striped seersucker uniform covered with a white apron.

• (One never served food to a patient with the same apron worn while bathing patients.)

• The uniform was short enough not to touch the floor, but long enough to be modest and not show the legs.

Hospital school

• Nursing was considered a “calling”.• Study and work were very serious endeavors.• No diversions after work except an occasional

concert or opera.• An evening might be used for making

chocolate over a gas jet. • No smoking allowed! Makeup, lipstick, red

nails were unheard of.

Hospital School

• The libraries contained few books.• Courses were elementary with lectures by

physicians, mostly.• Daily conversations were focused on work and

study. • Followed a military atmosphere and discipline

and careful attention to ethics.• Students learned by imitation and trial and

error.

Hospital School

• The age of 26 for admission was appropriate since the women were “more settled,” had previous life experiences, and knew how to follow instructions!

• Probationers looked forward to receiving the “cap”.

• Upon graduation they received a diploma and a nurse’s badge.

“Trained nurses and students did improve hospital conditions”.

• Number of hospitals and nursing schools in the U.S. increased to 549 by 1900.

• In 1874, a visiting committee at Bellevue reported the high death rate of maternity patients due to puerperal fever after being examined by the physicians in surgical wards.

• The training school took charge of the wards and finally removed these patients from Bellevue.

Post-Graduation

• Lavinia’s first job was as night supervisor.• She also helped develop a visiting nurse

service for a church mission.• Recommended for the first visiting nurse

position in Connecticut.• Here, the nurse practiced autonomously by

deciding “the frequency of home visits and when to make referrals”.

Post-Graduation

• Volunteered in Jacksonville, Florida in 1888 during the Yellow Fever epidemic.

• Volunteered during the devastation of the Johnstown, Pennsylvania floods in 1889.

• It was the first major disaster relief effort handled by the new American Red Cross, led by Clara Barton.

Societal Changes

• U.S. transitioned to Industrial Nation after Civil War.

• People moved from rural areas to work in factories.

• Blacks and Native Americans were joined by immigrants from other countries.

• All lived in segregated tenement areas—deprived from education, employment & health care.

Lillian Wald

Henry Street House

• Lavinia’s beliefs in freedom & justice led her to join Lillian Wald, Mary Brewster, and other pioneer nurses at the Henry Street House Settlement to provide care for people living in tenements.

• This was the forerunner of the Public Health Nurse role.

• As reformers, the “new woman” was educated, committed to a career, and usually unmarried.

Materia Medica

• Authored the first pharmacology text for nurses in 1890.

• The purpose was to aid the nurses in knowing what medications they were giving and the observations to make about the effectiveness or side-affects.

• “Physicians, often, gave large doses of dreadful poisons and expected nurses to watch the results and not allow any untoward effects”.

Materia Medica

• She collected “every recipe she could find to make the nasty, oral liquid drugs of the day easier to take.”

• Text proved to be beneficial for medical students as well.

• The text went through 7 copyright editions (from 1890 to 1926.)

Materia Medica Contents

• Introduction to Metric System• Glossary of terms• Classification of organic & inorganic drugs;

drugs from animal and vegetable kingdoms according to their physiological effects, and a table of poisons and antidotes.

• Instructions were provided so that nurses could make some of the mixtures.

Medications

• Mixtures of gold, silver, copper, antimony (from stibium) and zinc were mentioned.

• Strychnine and atropine were used together for Lupus and tubercular diseases.

• Aconite from the Monks Hood plant (Wolfsbane) was used as a depressive, a sedative, diuretic, diaphoretic, and to decrease temperature.

Medications

• Mustard seed and Flaxseed (Linseed) oils were used in poultices. Mustard in small amounts orally aided digestion.

• Pomegranate rind was given to eliminate tapeworm, but was not safe for children. It had an unpleasant taste, caused severe cramping.

• The person fasted 12-18 hours before taking a decoction of 2 ounces to 1 pint water in divided doses over one hour. A cathartic was given afterward and no food was allowed until the treatment was over.

Medications

• Ground ordinary pumpkin seeds mixed with sugar and water could also be used for tapeworm.

• Oil of Cloves was used as an anesthetic in the cavity of an aching tooth.

New Drugs 1902 Edition

• Antiseptol—replaced Iodoform• Diphtheria Antitoxin: • Methylene Blue: (primarily for rheumatic &

neurological diseases)• Migranin: (contained caffeine and citric acid for

migraine and influenza. • Terpin Hydrate (expectorant for bronchitis & whooping

cough)• Tuberculin: • Urotropin: (to dissolve uric acid calculi)

Significant Contributions

• Lavinia felt that experiences at Henry Street House were the most influential factors on her thinking and actions.

• Involvement with other suffragettes in support of the equal rights amendment led to badgering by politicians and arrests—yet every woman in this room has the right to vote!

Significant Contributions

• She worked with many of the pioneer nurses in educating nursing students and insisting on raising the educational standards.

• She thought nurses had a responsibility to society and were the patient advocate for all people.

• She helped create the American Society of Superintendents of Training Schools for Nurses which is now the NLN.

Significant Contributions

• Collaborated with Isabel Stewart in writing a history of nursing from primitive times to 1920 that was used as a nursing text.

• Worked with Ethel Bedford Fenwick to develop the International Council of Nursing, and served as the first secretary of the organization; an office she held for 22 years.

Significant Contributions

• She was involved in initiating the American Journal of Nursing and served as the editor of the journal for 23 years, the opportunity to publish several articles on freedom and justice.

• She was inducted into the American Nurses Association Hall of Fame in 1976.

Significant Contributions

• Lavinia’s career in nursing and advocacy for freedom and justice issues lasted for 70 years.

• She returned home to live with three of her sisters. She fell and broke her hip and died April 17, 1956 at the age of 98.

Nursing Heroines

• Lavinia and the other pioneer nurses: Isabel Hampton Robb (Johns Hopkins) Jane Delano, Isabel Stewart, Adelaide Nutting, and so many others provided a great foundation for us.

• Should we be conducting more research on the contributions of nurse heroines since then? Now, what do we plan to do for the future of nursing and health care?

By viewing the old we learn the new.

References

American Association for the History of Nursing. www.aahn.orgBurnam, M.A.B. (1998). Lavinia Lloyd Dock: An activist in nursing and social reform. Ph.D. dissertation, The Ohio State University.Dock, L.L. & Stewart, I.M. (1938). A short history of nursing. (4th ed.) New York: G.P. Putnam’s Sons. Dock, L.L. (1902). Text-book of materia medica for nurses. (3rd. ed.) New York: G.P. Putnam’s Sons. Wald, L. (1915). The house on Henry Street. New York: Henry Holt & Co. (reprint edition)