Linda Richards (1841-1930) and Nursing Education

Profiles in Nursing

Linda Richards (1841-1930) and Nursing Education

Charting a new course for the nursing profession

By Elizabeth Hanink, RN, BSN, PHN
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Linda Richards was a true pioneer of the modern nursing profession in not one but two nations. Not only was she the first American nurse to graduate from a formal nursing program, she trained the first Japanese nurses and established many innovations we now take for granted, including the use of written patient charts.  

Richards was born in an era of informal nursing. As she recounted in her 1911 memoir, nursing duties beyond those provided by family members typically fell to what were popularly called “born nurses”: women in the local community gifted with sympathetic natures and an appropriate combination of indefatigability and patience.

Although Richards recognized those characteristics as central to nursing, she also saw the value of formal training. Her own training began when she was a teenager, learning to assist the local physician who had treated Richards’ tubercular mother. Richards also cared for her own fiancée, who was severely wounded during the Civil War and died four years after the war’s end.

Hoping for a more formal nursing education, Richards joined Boston City Hospital, but was so discouraged by the experience that she left after only three months. In 1872, she enrolled in the new nurse training program established by Susan Dimock, M.D., at the New England Hospital for Women and Children and in 1873 became the program’s first graduate.

Nursing work in those days was extremely grueling. Nurses worked 16-hour shifts, were on call 24 hours a day and were expected to clean and do laundry as well as caring for patients. Most nurses knew almost nothing about medicines or symptoms and Richards was dismayed to see that physicians often regarded nurses as little more than maids.

Another problem Richards noted was that physician orders and nurses’ reports were entirely verbal, which created many opportunities for confusion. In her first post-graduation job at New York’s Bellevue Hospital Training School, she decided to present her reports in writing. One of the hospital’s physicians so appreciated having written records that he pushed for it to become standard practice. Such written charts were later adopted throughout the U.S. and England.

In 1874, Richards had the opportunity to apply that and other ideas as the superintendent of the training school at Boston’s Massachusetts General Hospital. The nurse training program had gotten off to a rough start and was staunchly opposed by the hospital’s conservative physicians, even ones who were frustrated at their nurses’ lack of training and skills.

Richards quickly made the program a great success, inviting outside lecturers, reorganizing the nursing staff and finally delegating custodial duties to scrubwomen. She also assigned specially designated night-duty nurses so that the hospital’s nurses would no longer have 24-hour-a-day responsibilities.

In 1877, Richards was invited to pursue further training in Great Britain. There, she had the opportunity to meet Florence Nightingale, who recommended her to other programs at King’s College Hospital and the Edinburgh Royal Infirmary. At the Royal Infirmary, Richards met and studied with Joseph Bell, J.P., D.L., FRCS, best known today as the teacher of Sir Arthur Conan Doyle and the inspiration for Sherlock Holmes.

After returning to the U.S. and establishing a training school at Boston City Hospital, Richards traveled to Kyoto, Japan, at the behest of the American Board of Foreign Missions. She spent four years in Japan, working as a missionary and establishing that nation’s first nurse training school. The Japanese later remembered her as the nurse who stayed up all night to wash the eyes of a young child afflicted with opthalmia neonatorum.

Richards came back to the U.S. in 1891 and went on to establish and run nurse training programs in Pennsylvania, Massachusetts and Michigan. From 1899 to 1909, she turned her attention to training psychiatric nurses. Ill health prompted her to retire in 1911 and write her autobiography, Reminiscences of Linda Richards.

The programs and practices Richards established continued long after her retirement and death. Just as importantly, she was able to convince skeptical hospital administrators and physicians that trained nurses could provide better care than those without formal nursing education.

For her achievements, she was inducted into the American Nurses Association Hall of Fame in 1976 and the National Women’s Hall of Fame in 1994.  

Elizabeth Hanink, RN, BSN, PHN, is a Working Nurse staff writer with extensive hospital and community-based nursing experience.

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