Profiles In Nursing

Linda Richards (1841–1930), The First Graduate of America’s First Nursing School

Linda Richards young and old

After graduating from the inaugural class of America’s first professional nurse training program, Linda Richards made remarkable reforms to nursing education and practice: improving hospital lighting, creating the first charting system, and establishing nurse training programs across the United States.

A Born Nurse

Malinda Ann Judson Richards was born in Potsdam, N.Y., on July 27, 1841. She lost both parents at a young age — her father to tuberculosis when she was just 4 years old, her mother to the same disease several years later.

Richards spent much of her childhood as a nurse at her mother’s bedside. Seeing the skill Richards demonstrated in caring for her mother, a local physician often took her along on house calls, answering her questions and instructing her in medicine. By the time she was a teenager, she was known as the local “born nurse.”

At 15, Richards enrolled in a one-year teaching program at St. Johnsbury Academy. After graduation, she met her fiancé, George Poole. Before they could marry, Poole enlisted to fight in the Civil War and was severely wounded. He and Richards never actually married, but she cared for him until his death a few years later.

Inspiration From Germany

Caring for Poole and hearing of the great need for nurses during the war renewed Richards’ heart for nursing, so she moved to Boston to work as an assistant nurse at Boston City Hospital. However, she soon learned that “assistant nurse” was just a fancy title for “ward maid.” Worse, the wards were poorly managed, and the nurses cared little for their patients.

After a period of illness, Richards set out to find a nurse training program where she could be formally instructed in nursing like her peers in Europe.

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Serendipitously, Susan Dimock, a young American physician just returned from completing her medical studies in Germany, wanted to reform nursing in America after observing the work of the nurses and deaconesses at Kaiserswerth Deaconess Institute in Düsseldorf.

Dimock brought her idea of a formal one-year nurse training program to Boston’s New England Hospital for Women and Children, where nurses had been receiving informal training since 1863. Richards was the new program’s very first enrollee.

No Exams, No Textbooks

Compared to nursing programs today, this first nurse training program was crude. There were no entrance or exit examinations and no textbooks. Nurses were not even permitted to know what medications they were administering to patients.

The students worked long hours and had only three hours off every two weeks. They received 12 lectures over the course of the year, and trained for three months on nights and three months each in the medical, surgical, and maternity nursing wards.

Richards was the first to graduate, in 1873. She received several job offers before accepting a position as night supervisor at Bellevue Hospital in New York City.

Turning the Lights on at Bellevue

Richards’ first shift at Bellevue gave her a glimpse into a hospital system that desperately needed reform. Administrators insisted on turning off gas and steam overnight, creating unsafe, inhospitable conditions for nurses and patients. Nursing duties had to be performed by candlelight, and each ward was allotted only two candles per week.

At the end of her first month, Richards pleaded with the warden to be allowed to use gaslight in the wards, insisting that she couldn’t be held responsible for patients she couldn’t see. Her request was granted, although the nurses took care to use the smallest amount of gas possible, turning it off promptly at dawn.

Nursing Education

Richards made an even larger contribution to nursing later in her time at Bellevue. One evening, she left a written note about a patient case for a less senior nurse who needed to draft a report. In the morning, the doctor saw the note and thought it was for him.

Pleased with this new form of communication, he requested written reports on all serious patient cases — the beginning of our modern charting system.

Recommendation from Nightingale

After a year at Bellevue, Richards departed to become superintendent of Massachusetts General Hospital’s fledgling Boston Training School. During her tenure, the school became known as one of the finest nursing programs in the country. It was a pattern Richards would repeat many times.

In 1877, Richards finally had the opportunity to fulfill her dream of training in Europe. She spent several months in the UK at St. Thomas’ Hospital, King’s College Hospital, and the Royal Infirmary of Edinburgh before traveling to France to tour Parisian hospitals.

In the course of her travels, she met Florence Nightingale, who recommended her for studies at the Edinburgh Royal Infirmary with this note of introduction:

“I have seen her, and have seldom seen anyone who struck me as so admirable. I think we have as much to learn from her as she from us.”

Richards later spent five years in Japan helping to establish that country’s first nurse training program.

Back in the U.S., Richards continued to work for another 20 years, founding nurse training programs across the country. Much of what we recognize as standard practice today is the result of her early efforts to improve nurse training, enhance patient care, and elevate the profession.

After Richards retired in 1911, she published her autobiography, Reminiscences of America’s First Trained Nurse. On April 16, 1930, she passed away, leaving behind a remarkable legacy.

MERRITT HENSON, RN, BSN, OCN, SANE, is a registered nurse, freelance medical writer, and Lyme disease advocate.

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