Profiles In Nursing

Mary Marvin Wayland (?-1946), Pioneer of Evidence-Based Nursing Practice

Standards of care once depended on where a nurse worked

The Columbia building in Los Angeles - an old beige building with columns

Photo above: Columbia hospital on Wilshire Boulevard in downtown Los Angeles, where Mary Marvin began her career as a nurse in the 1920s.

Evidence-based practice is such a fundamental part of today’s nursing vocabulary that it’s hard to believe there was a time when that wasn’t so. In fact, we can trace our modern approach to nursing research to the pioneering work of Mary Marvin Wayland, RN, M.A.

Following Orders

The epigraph of Mary Marvin’s landmark article “Research in Nursing,” first published in the May 1927 issue of the American Journal of Nursing (AJN), is a well-known quote from Louis Pasteur:

Without theory, practice is but routine born of habit. Theory alone can bring forth and develop the spirit of invention.

When Marvin first earned her nursing diploma from the University of Minnesota School of Nursing in 1912, a spirit of invention was not something nurses were encouraged to develop. Nurses were expected to follow the orders of their physicians and hospital matrons without question.

One consequence was that standards of care depended greatly on local custom. As Marvin later noted, there were dozens of methods for preparing hypodermics. Handwashing techniques varied widely. Approaches to catheterization were equally diverse, with some institutions advocating a mere sterile finger cot. Everything depended on where you worked.

This also meant that techniques like safe, inexpensive methods for handling thermometers were wanting. What brushes should be used for hand scrubs? What were the safest ways to lift and transport patients? What were the appropriate procedures for colostomies or nutritive enemas? No one was really asking such questions.

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A Role for Scientific Research

Marvin believed, as she wrote in 1927, that through scientific research, “the art of nursing the patient would be more nearly perfected in a shorter time than it could possibly be by slow accumulation of knowledge gained through casual experience.” She also felt that nurses were ideally placed to make systematic observations and speed the development of nursing knowledge through their “eternal vigilance and faithful record keeping.”

However, she understood that to do that, nurses first needed a good, solid understanding of anatomy, physiology, diseases and surgical processes. She also strongly advocated the integration of practice and theory, recognizing that neither was sufficient in itself.

She even noted the importance of varying assignments to suit the individual strengths of different types of students and to ensure that boredom doesn’t dampen students’ enthusiasm.

A Brilliant Teacher

Marvin devoted much of her career to putting those sentiments into practice. After spending her early years practicing at Columbia Hospital in Los Angeles and Seaside Hospital in Long Beach, she moved to the East Coast and became a nursing instructor.

She earned her bachelor’s degree and teaching certificate in 1919 from Teachers College, Columbia University. She then taught at Lakeside School of Nursing in Cleveland and Simmons College in Boston while completing her master’s degree.

Hiring Now

When she wrote “Research in Nursing,” Marvin was director of supervision at New York’s famous Bellevue Hospital, a position she held until 1928. However, she continued to teach on at least a part-time basis for the rest of her life.

A biographical item in AJN in 1930 called her “without doubt one of the most brilliant teachers of nurses in our country” and wondered “how many patients have received more intelligent care and how many student nurses have a truer comprehension of what nursing really is, because their teachers, supervisors or head nurses have been in direct or indirect contact with the philosophy which Miss Marvin exemplifies.”

Educating Nurse Leaders

Marvin believed that a nurse’s education should not end with graduation from nursing school. “The right kind of ward teachers are just as important if not more important than a good classroom teacher,” she wrote.

To that end, she authored an important textbook for head nurses: The Hospital Head Nurse: Her Function and Her Preparation, first published in 1938 by MacMillan, with an expanded second edition in 1945. That text was widely used throughout the U.S. and abroad.

After her marriage in 1930 to Charles Wayland, Marvin moved back to California, living in San Jose, Sierra Madre and later in Long Beach. Although she retired from hospital practice, she continued to spend her summers teaching at Columbia University, the University of Chicago and several California institutions.

Before her death in March 1946, she was chairman of the California State Nurses Committee and a member of the Florence Nightingale International Foundation. Before her death in March 1946, she was chairman of the California State Nurses Committee and a member of the Florence Nightingale International Foundation.  She left a brilliant legacy of “helping a student to be a nurse, and teaching the patient to get well and keep well.”

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

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