HUP Nursing Students, 1898 HUP's School of Nursing grew from need. As noted in The First Fifty Years (a chronicle of the school's early years), at the time it opened, "nursing was being performed by untrained men and women, many of whom were not fitted for their duties. . . . There were no standard of qualifications to be met for eligibility to nurse the sick."

In 1878, four years after HUP was founded, the medical staff – and the Board of Lady Visitors (now the Board of Women Visitors) -- petitioned the hospital’s Board of Managers to create a training school for nurses. But  it would be nearly a decade before the school was founded and a curriculum created.

When the school opened in 1886, the woman chosen to lead its fledgling program was Charlotte Marie Hugo, who had received her training in the Nightingale School, considered the best training organization. Initially, the school offered a one-year certificate program and a two-year course for a diploma.

From the start, the school was ahead of its time. The comprehensive scope of lectures included classes in OB/GYN, orthopaedics, nutrition, application of electricity, care of children, hygiene, and diseases of the eye, ear, skin and kidneys. Dr. William Pepper, one of the School’s founders, delivered the introductory lecture while other members of the medical staff were selected to lecture on subjects considered essential for a nurse’s training.

The Life of a HUP Nursing Student

Hup-nursing-first-class The first graduating class of the HUP Nursing school's two-year program, in 1888.

Student nurses had little free time to themselves. According to the ‘Rules for Pupil Nurses,’ they were expected to be on their wards “promptly at 7 am” and remain on duty until 9 pm, with two hours off each afternoon. Breakfast was at 6:30 am, ‘dinner’ at 11:30 am, tea at 4 pm and supper at 9 pm. According to the school’s chronicles, “Their meals never consumed more than 15 minutes of the time allotted for this purpose.”

In addition to hearing lectures and learning basic nursing skills, they were also required to do a certain amount of cleaning. Duties included sweeping the ward, dusting furniture, and washing the beds, tables, and window sills. However, they “did not then nor ever scrub floors as was reputed to be the custom in some hospitals.” 

Probationers (as nursing students were called during the first month of training) started in dietary work and cleaning. They were taught to make empty beds (and of course miter the corners) in under five minutes, as well as make beds which were occupied. “Procedures were demonstrated but once and after that, woe to the pupil who forgot any detail of the routine.”

The required uniforms consisted of a dark blue dress with bib, cuffs, and apron, and a round cap of organdy.

Nursing students were required to be in uniform when on duty at the hospital. Miss Hugo designed the uniforms, based on those worn by English nurses. It consisted of a dark blue dress with bib, cuffs, and apron, and a round cap of organdy.

In spite of the long hours and strict training, the students were apparently grateful for the valuable experiences.  Said one graduate years after receiving her degree, “I would not say our superiors were hard and unfeeling, but our training was along military lines … but it did us no harm, it fitted us well to meet the problems we have had to face.”

Growing to Meet HUP’s Needs

The first class of two-year nursing students graduated in 1888. Most remained on staff at HUP. Indeed, by the end of the year, every department in the hospital but one was filled with the hospital’s own graduates.

As HUP’s services expanded, so did the nurses’ training to meet its increasingly demanding needs. The establishment of a maternity ward in 1888, an orthopaedic ward in 1890, radiology in 1896 and other significant advances all called for a greater, more concentrated nursing knowledge and skill. By 1889, the School no longer offered a one-year certificate. Four years later, the course was expanded to three years.

Spanish-american-warUniversity Hospital Train during the Spanish American War

Helping in Wartime

The School’s dedication to service and commitment to caring were reflected during the Spanish-American War, when many HUP nursing students and graduates cared for American soldiers who were wounded or made ill by typhoid fever. Mary Swindells Schneller wrote of being on the first hospital train sent by Penn to Camp Meade in August 1898 to bring back those suffering from typhoid fever. “The doctors and nurses were kept busy giving treatments until arriving at Thirty-first and Chestnut Streets the following day where ambulances and patrols awaited to convey these patients to the hospital...” The students’ tradition of helping continued through both World Wars as well.

Distinction in the Profession

Theresa-lynch-1945 Theresa I. Lynch, with a student nurse, in 1945

From the beginning, the School’s graduates earned distinction in the profession. In 1891, Mary Clymer, an 1889 graduate, became the first OR nurse in Philadelphia. She is also the nurse who appears the Thomas Eakins portrait of the D. Hayes Agnew clinic.* A 1905 graduate became the first nurse anesthetist in Philadelphia and yet another received the Carnegie and O’Neill medals for heroism after saving two patients from a burning building. Closer to home, Theresa I. Lynch, a 1920 graduate – and later HUP’s director of Nurses -- founded the Penn School of Nursing in 1950 and served as its first dean. HUP’s school itself became one of the first to receive accreditation from the National League for Nursing, in 1945.

* The original now hangs in the Philadelphia Museum of Art. A reproduction created by the Museum hangs in the John Morgan Building in the School of Medicine.

Transitions in Nursing Education

With the passing years, the move toward baccalaureate degrees for nurses was growing.  As noted in Passing the Legacy, a history of the last 50 years of the School, “Nursing courses were based on a stronger science base than previously.… The predominance of learning by doing was replaced with closely supervised clinical experiences.”

When it closed its doors in 1978, HUP’s School of Nursing had graduated over 5,000 men and women. It not only provided the cornerstone for nursing education at Penn but left behind a rich tradition of nursing leadership and excellence.

“The HUP program was the intellectual foundation of today’s nursing school. It is no mere coincidence that many of the HUP graduates became the movers and shakers nationally in nursing,” said Afaf Meleis, PhD, dean of Penn’s School of Nursing. “Our HUP alumni are our legacy and an important part of our future going forward.”

The historical photos featured in this article are used with permission of the Nurses Alumni Association of the School of Nursing – Hospital of the University of Pennsylvania, and the Barbara Bates center for the Study of The History of Nursing, School of Nursing, University of Pennsylvania.

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