Profiles in Nursing
Dagmar Nelson and a Spellbinding 1930s Legal Case
A case during the 1930s challenged anesthesia as a nursing specialty.
Reading about Dagmar Nelson, RN reminds me of Chinatown. You know, the '70s movie about corruption and skullduggery in paradise, a.k.a. Los Angeles. In the movie, it was water rights. In the landmark case of Chalmers-Francis, et al. vs. Nelson, et al., practice rights were at stake. Nursing won, and it is a good thing. Otherwise, according to Ronald Van Nest, CRNA, MA, anesthesia as a nursing specialty would probably not exist.
It is not that Nelson set out to change the profession. She was from St. Paul, Minn., and a graduate of Rochester’s St. Mary’s School of Nursing. For 10 years she worked at the Mayo Clinic giving anesthesia, a common practice for nurses in those years.
In 1932, Verne C. Hunt, a Los Angeles surgeon on staff at St. Vincent’s Hospital, asked her to come to California and work for him. He warned her of the longstanding local antagonism towards nurse anesthetists, but Nelson was game and came anyway. She became an employee of the hospital, and though she worked for all the doctors, Dr. Hunt’s cases were given preference.
In the '30s, Los Angeles suffered from the Depression just like the rest of the nation. High unemployment and scarce dollars made the area a minefield of competing interests. The hiring of a nurse anesthetist by a prominent hospital attracted immediate attention, and within months Dr. William Vare Chalmers-Francis charged Nelson with practicing medicine without a license.
Working through the anesthesia section of the Los Angeles County Medical Association, he and others sought an injunction against the hospital to bar Nelson from administering inhalation anesthesia. On March 24, 1934, Judge Roth of the Superior Court turned down the request, and on July 12 the case went to trial.
And what a trial it was. There was no jury, just an endless parade of witnesses. The plaintiffs argued on procedural grounds and claimed that administering anesthesia was practicing medicine. Not only did they charge criminality in practicing without a medical license, they also contended that such activity unjustly deprived those who did hold licenses — doctors — of property rights and income. Defense attorneys countered that administering anesthesia fell within nursing, as it was taught in nursing schools and mandated by state curriculum standards.
On July 31, 1934, Judge Alan B. Campbell ruled that Nelson and the hospital were not in violation of the California Medical Practice Act, because nurse anesthetists never acted independently. They remained, at all times, under the supervision of the physician.
Not dissuaded, Dr. Chalmers-Francis filed first for a mistrial, and when that maneuver failed he appealed to the California Supreme Court in 1936, where he also met denial. Only a lack of financial support prevented an appeal to the U.S. Supreme Court.
Nurse Nelson continued to work with Dr. Hunt, who remained a staunch defender. With his tragic murder in 1943, she left St. Vincent’s and worked at the Los Angeles General Hospital and Children’s Hospital. She died on July 4, 1958, of acute leukemia.
In 1983, the American Association of Nurse Anesthetists established the Dagmar Nelson Fund to provide money to certified registered nurse anesthetists who face legal challenges to their right to practice.
Elizabeth Hanink, RN, PHN, BSN, is a freelance writer with extensive hospital and community-based nursing experience.
This article is from workingnurse.com.