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I consider it a great honor to have been asked to bid you welcome to the city in which the first training-school for nurses was started, now nearly thirty years ago. It has often been remarked that events which have relation to each other are apt to happen about the same time; for instance, discoveries in science have frequently been made almost simultaneously by different investigators working independently. Thus in the year 1873 training-schools were opened at Bellevue Hospital, New York; at the Connecticut State Hospital, New Haven, and at the Massachusetts General Hospital, Boston.


"Probably few of you remember a time when trained nursing did not exist, but as I can, I may be allowed to say a few words about the condition of things which made the need of it so urgent. When I was a girl, nursing was either considered a gift, like a good voice, or an occupation, like cooking. Every family had some member or friend who was always known as a 'born nurse' and whose help was called for in any emergency. In many cases she certainly deserved her name, and the care she gave was much better than none at all, but it was anything but scientific.


"The 'born nurse' flourished especially in country districts, and was called in often without reference to the doctor, thus becoming his colleague, so to speak, if she approved his treatment, and not if she happened to disagree with him. I can remember several cases where these 'born nurses' directly disobeyed the physician's orders; if the patient got well, the credit was theirs; if he died, the fault was the doctor's. That was one class.


"The other was to be found in all cities where it was necessary that physicians should have some women of experience on whom to rely in acute cases and those of an obstetric nature. If a case of pneumonia or typhoid threatened to be serious and the household was becoming exhausted, the attending physician usually provided some woman whom he had employed in like circumstances before, and often she had learned to be a good nurse by obeying the doctors to whom she owed her living.


"For obstetric nurses there were elderly married women or widows, very respectable, and with a good deal of experience. Sairey Gamp might have been and no doubt often was, found in the hospitals, but I have never in this country known or heard of such a creature in private practice.


"As to the hospitals, when I first came to live here in 1871, Bellevue was probably about as good as most general hospitals throughout the United States, and the condition of things there was certainly bad enough. The nurses were of two kinds,-either elderly stupid creatures who had not sense enough to be house servants, and who had usually more than a taste for drink, or else they were young women of rather lively tendencies who were always ready for a flirtation with the house staff.


"In those days it was a risky thing for a doctor to order liquor for a case, as he was very likely to find the nurse the worse for it and the patient none the better. If, on the other hand, he strictly forbade any stimulant whatever, the sympathetic attendant was ready, for a consideration, to smuggle some in for the patient when she brought her own supply.


"Of downright brutality and cruelty there was, perhaps, not much, but there was a great deal of ignorance, carelessness, and mismanagement. You, who went into and graduated from training-schools already thoroughly organized, can have but little idea of what the first pupils in our schools went through. They were the pioneers who cleared the ground and sowed the seed by which we all profit now.


"At the present time there are three hundred and eighty-eight training-schools registered in Washington, and the number altogether is probably over four hundred, while from two hundred and fifty to two hundred and seventy-five pupils graduate each year from the fifteen schools of Greater New York.


"At your commencements you were probably told that you were going to follow a very beneficent calling, and that you were rather seraphic to have chosen it. I don't think I have ever been at any nurses' commencement at which at least one of the speakers did not say how blessed it would be to smooth the sufferer's pillow, and although I am a great admirer of Sir Walter Scott, I have come to wish that he had never written that line about the 'ministering angel,' because I have heard it so often. I do not mean to be flippant about a profession which I profoundly respect, for I am convinced that no woman can be really a good nurse who does not love nursing and to whom each patient is not more or less like her own child for the time; but besides doing an immense amount of good, like physicians,-indeed, a surgeon said to me only last summer, 'Without trained nursing surgery could not stand where it does now,'-you are, like the doctors, members of a regular profession, entitled to its honors, and at the same time bound by its responsibilities, and those responsibilities are not only personal to each of you, but they touch you as members of a general body.


"Now, it has been found, over and over again, that it is one of the hardest things in the world to make us women work together effectively. As somebody who wanted to start a woman's club once said, 'Women will join, and they'll pay their dues, but they won't come and they won't work.'


"If we will only think a little, it is usually not hard to find a reason for any trait of human character which is not abnormal, and I think we can account for this one. From the earliest times men have been in the habit of congregating together, either for offence or defence in war, or for council in peace, and while they were still living in caves they had practically learned the lesson which we have all heard in so many forms, about there being safety in numbers, that 'united we stand, divided we fall,' etc. But the women, on the other hand, were left behind, each one in her own cave with her babies, or later, as life grew more civilized, in her castle, or in her house in the town, or in her hut in the fields, but always shut into the little circle of interests which began and ended with her home. For many women that always has been, and always will be, the fullest and happiest life, but it is not to be followed by all of us, and if we once step outside that charmed circle we must be prepared to meet other obligations. They do not come easy to us, and I believe it is for the reason I have just given, but it is cowardly to shirk them, and also bad policy. Just now there is a great outcry against trusts. Wherever two or three people are gathered together we are told that they are forming a trust about something or other, which is therefore to be condemned. I do not, of course, mean to stand up for any organization which strives to make too much profit or to grind the working-people, but nobody can watch the tendency of our day without seeing that the big fish are gradually swallowing the little ones....


"But the great object must be to draw all members together. Women are by nature-or long habit-rather suspicious of each other, and, as I have said before, it is hard to make us work together loyally and unselfishly; and yet you must, if you wish to keep up the standard of the schools. There should be a journal devoted to the interests of the alumnae throughout the country, and it should be taken by every member, and so well supported that it may be really useful. Every profession or trade which amounts to anything has at least one of these technical journals, and some of them are excellent. I do not mean a scrappy little paper, made up of cuttings from medical magazines and articles by young persons who have the terrible talent of writing easily, but a well-edited and responsible 'organ,' to use the newspaper word. Every school in this country should report its commencements in it and the number of its graduates; every nurse who has a case requiring peculiar care should report it, carefully concealing the identity of the patient; good articles by competent writers on subjects of interest to the profession should be published, and news given of nurses who may be working in other parts of the world. To give you an idea of how much such a publication is needed, I have found it impossible to ascertain how many graduate nurses there are now in the United States or even the number of training-schools, nor can I find out where to apply for English or American trained nurses in case I should be taken ill in any European city where they have an agency.


"To conduct such a journal properly will cost at least two thousand five hundred dollars a year, and if that should be too small a sum, a sufficient one can easily be raised, and you should see that it is forthcoming, and not for one year only, but as a steady subscription. A man is supposed to attain years of discretion, if he is ever to have any, when he is five-and-twenty, and your profession is already older than that in this country. It is high time that you should all work together as a whole, forgetting any little rivalries which may have existed between one school and another, and making one body united for the common good. That is the only way in which you can keep your calling on the high plane to which you have raised it.