Profiles In Nursing

Florence McQuillen (1903–1981), “Benevolent Dictator” of Nurse Anesthetists

A scholar and CRNA pioneer, she learned chloroform delivery under pressure at a small hospital in Montana

Florence McQuillen on the left is signing a document, and on the right is smiling towards the camera

Florence “Mack” McQuillen, fondly remembered as the “benevolent dictator” of the American Association of Nurse Anesthetists (AANA) from 1948 to 1970, was an influential leader in nurse anesthesia practice.

A Crash Course in Chloroform

Born in Minnesota in 1903, McQuillen began her nursing career in 1925 as a student of the Central School of Nursing at the University of Minnesota. Her leadership career started almost immediately; before she had even graduated, she was offered a position as superintendent of nurses at Frances Mahon Memorial Hospital in Glasgow, Mont.

One of the prerequisites of this new job was a skill not included in her nursing school curriculum: administering surgical anesthetic. Training programs at two local hospitals introduced her to the use of ether and nitrous oxide, but McQuillen had to learn to administer chloroform on the job in Montana, where she immediately became the small hospital’s sole anesthetist. “I look back now and think the good Lord took a liking to me when I survived several hundred experiences with chloroform,” she later wrote.

In 1927, McQuillen was offered a new job as a staff anesthetist at Mayo Clinic in Rochester, Minn. There, she worked directly with the Mayo Brothers and with the clinic’s leading anesthesiologist, John S. Lundy, M.D., expanding her expertise in the evolving science of surgical anesthesia. McQuillen eventually became Mayo Clinic’s chief nurse anesthetist and a clinical instructor.

Recognizing CRNAs

After two decades at Mayo Clinic, McQuillen’s career began a new chapter when a friend from nursing school, fellow nurse anesthetist Hazel Currier, urged her to get involved with the AANA. After delivering several notable and memorable presentations at AANA events, McQuillen was invited to become the organization’s first executive director in 1948.

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In this role, McQuillen began paving the way for the future of nurse anesthesia practice through a series of ambitious initiatives, including the establishment of a national certification exam for nurse anesthetists.

Thanks in large part to McQuillen’s efforts, the AANA received formal recognition from the American Hospital Association in 1949. In 1952, the U.S. Department of Health, Education and Welfare granted the AANA the authority to accredit nurse anesthesia programs and certify nurse anesthetists. The now widely recognized term “certified registered nurse anesthetist” (CRNA) was formally recognized in 1956.

Studying Addiction as a Workplace Hazard

In 1962, McQuillen and John Lundy wrote an important article in the AANA Journal on the risk of workplace addiction for anesthetists. This was a problem she had witnessed firsthand during her early career in Montana, where she had been hard-pressed to prevent diversion of her little hospital’s stockpile of alcohol and narcotics.

Her and Lundy’s paper, “Narcotics and the Anesthetist: Professional Hazards,” was one of the earliest examinations of chemical dependence as an occupational risk for anesthesia providers, and is still often cited in scholarly papers.

A “Most Unpopular” Journal Club

Throughout her career, McQuillen had always urged her fellow nurse anesthetists to stay current on anesthesia literature.

Nursing Education

In the ‘30s, she established a “Journal Club” to encourage her Mayo Clinic colleagues to read and share the latest scientific research related to their practice. She later recalled that the club was “a most unpopular event,” but the experience led to the creation of a new scholarly journal, Anesthesia Abstracts, which McQuillen and Lundy founded in 1935 and coedited for many years.

More than 30 years later, McQuillen helped to make the AANA the first professional nursing organization in the United States to establish a continuing education policy. Today, of course, this is a professional standard for most nurses.

Visionary Autocrat

Despite her many achievements, “Mack” (as McQuillen was commonly known) was not universally popular within the AANA. Some of her fellow officers resented her autocratic leadership style, complaining that she expected them to do what they were told rather than offer their own ideas and input.

The board of directors usually took McQuillen’s side, but these clashes eventually weakened her support within the organization. McQuillen stepped down as executive director in 1970, receiving the AANA Award of Appreciation in gratitude for her years of service. Shortly before her death in December 1981, she was honored with the Agatha Hodgins Award for Outstanding Accomplishment.

“The Careful Charting of Our Course”

Under McQuillen’s leadership, AANA membership more than quadrupled between 1948 and 1970, and the specialty’s credibility and prestige increased exponentially. Much of the standing CRNAs enjoy today can be credited to her efforts.

Marie Bader, CRNA, who was AANA president towards the end of McQuillen’s tenure, called McQuillen “the right person at a time when we needed someone to take over the pressing needs of the Association” and credited the AANA’s success to “the careful charting of our course by this lady.”

JESSICA DZUBAK, RN, MSN, is the director of nursing practice for the Ohio Nurses Association and a freelance writer specializing in the healthcare industry.

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