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Profiles in Nursing
Mary Eleanor McGarvah, Pioneer for Nurse Attorneys
Protector of nurses, purveyor of justice
Nurses who are lawyers now have their own organization, The American Association of Nurse Attorneys (TAANA). They work both to enhance patient care and to protect and advance the profession of nursing. There was a time, however, when the words nurse and attorney simply did not go together.
Not that there haven’t always been legal issues in nursing, and many involved the relationship between nurse and patient. Did the nurse give adequate care? Should a nurse witness legal documents for a patient? Other issues involve nurses as a force for positive change. Does nursing research lead to better legislation, for instance? Without legal definition and direction, it would in fact be hard to recognize nursing as a profession distinct from, say, medicine, or social work or counseling.
Mary Eleanor McGarvah was not the first nurse to recognize that the law could bring lasting change, but she was the first to take the next step: She became an attorney. Her field was public health, an area rife, even today, with issues of compliance, political influence and conflicting interests. We need to remember, too, that at the start of the 20th century, care to the vulnerable, whether very young, very old or very poor, was unregulated.
McGarvah actually completed nursing school, graduating from the Farrand Training School for Nurses at Detroit’s Harper Hospital in 1911 before she finished high school. In one of her early jobs at the Detroit Department of Health, McGarvah began to tackle several problems that plagued the city. She first worked to bring midwives under supervision. At the time, most of Detroit’s many immigrants used midwives, but these attendants often did not even register births. Morbidity and mortality statistics were high though inaccurate. Soon enough, McGarvah became a supervisor in the special investigation division.
Day nurseries and orphanages were next, and many cases featured conflicting public and private rights. Having decided that progress depended on legal sway, McGarvah secured a high school diploma and entered law school. She graduated from the University of Detroit in 1929.
Eventually convalescent homes, communicable diseases — especially tuberculosis — and even massage parlors came under health department regulation, thanks to McGarvah. As a nurse she understood public health requirements; as an attorney she tackled enforcement. By 1946, she was head of the Department of Special Investigations; she continued in that post until her retirement in 1955 after 41 years of service.
All the while, she maintained a private practice, often coming to the aid of nurses who sought her services. She also co-edited the second and third editions of Jurisprudence for Nurses, along with Carl Scheffel, M.D. Critics of the first edition — the first book on nurses and the law and written solely by Dr. Scheffel — complained that it presented outlandish examples that were useless to real-life nurses. McGarvah worked with Scheffel to develop more credible material. Beyond that, updates were necessary because, as she said, “Neither nursing nor law stands still.”
Today, in the era of nurse paralegals, forensic nurses and legal nurse consultants, it seems strange that McGarvah’s accomplishments were so singular. We take for granted the distinct role of nurse attorneys who protect the profession and work for change in public policy.
Their organization, TAANA, now grants the Mary Eleanor McGarvah Humanitarian Award to individuals who manifest public service in health law and awareness. The first recipient was Tipper Gore, wife former Vice President Al Gore, and more recently California Congresswoman Lois Capps.
Elizabeth Hanink RN, BSN, PHN is a freelance writer with extensive hospital and community-based nursing experience.