Profiles in Nursing

Mary Annice Miller and In-Service Nursing Education

“I represent nurses who are finally getting a voice in the planning and equipping of hospitals.”

By Elizabeth Hanink, RN, PHN, BSN
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In-service education usually elicits a big yawn, right? I mean, you are already a nurse, and what could you learn from people who don’t even do patient care themselves? Surely the charge nurse from the unit upstairs couldn’t be an expert. After all, she’s from here! Experts are people from other places.

Mary Annice Miller, if she were here, would beg to differ. In fact, she wrote a book about why, called In-service Education for Hospital Nursing Personnel (1958). It became, when published by the National League for Nursing and the American Hospital Association, the recognized work on the subject and a true classic of nursing literature.

The book and later articles established Miller as a leader in a particular type of nursing education: on-the-job staff development. “Such on-the-job learning does not mean acquiring information about unusual treatments and diseases. Its purpose is to improve daily habits of working, thinking and behaving.”

Miller graduated from Good Samaritan Hospital School of Nursing in Portland, Ore., in 1934. She worked for the hospital as a staff nurse before advancing to assistant supervisor at Harborview Hospital in Seattle. Later, she earned a BSN and certification in public health and nursing administration from the University of Washington. During World War II she served in England as a member of the Army Nurse Corps.

After the war, in the early 1950s, Miller began work as a hospital consultant for the Washington State Department of Health, producing several professional articles for the American Journal of Nursing and the Washington State Journal of Nursing. In 1954, she joined the National League for Nursing staff in New York. Her efforts there included the Nursing Aide Training Project, an attempt to teach nurses to become effective instructors of ancillary staff. As part of her job, she wrote a series of monthly columns for Nursing Outlook.

When consulting, Miller saw herself as an objective outsider who could help beleaguered directors of nursing and supervisors step back from the daily fray to assess policies and procedures for effectiveness and currency. She donned her cap, white shoes, uniform, pin and all, and worked with the staff nurses. This way she discovered what was actually being done, not what administrators thought was being done. But she can speak for herself!

“By working along with them I soon get an opportunity to explain who I am and what I am really trying to do: that I represent nurses who are finally getting a voice in the planning and equipping of hospitals and that I am interested in any idea they may have to improve nursing service, not only in their own hospital but in other hospitals as well. I represent nurses who are finally getting a voice in the planning and equipping of hospitals.”

Mary Annice Miller died at age 52 in 1962. She left a strong legacy of helping hospitals meet the education needs of their staffs by formalizing what, until her time, had been a helter-skelter hodgepodge of ad hoc teaching.

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

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