1898 - 1913
Berea’s first hospital was established in 1898. It existed primarily to care for the students attending Berea College. Soon after its foundation the Nurses Training School was opened for young women. It was a highly competitive program with a criteria set for incoming students. Young women hoping to participate in this program were required to be at least 18 years old, present a letter from a minister of the gospel testifying of their good moral character, present a letter from a physician testifying that they were in good health and an above average strength and vitality, and demonstrate a sufficient ability to read, write, and perform fundamental operations of arithmetic.
Those who were deemed worthy then underwent a three month probation period in which they were employed for the most part at the hospital, observing more experienced nurses and learning the general conditions for the care of the sick. If they proved themselves to have the natural qualifications and disposition necessary for a career as a nurse during this time period, they were accepted full time into the program and became student nurses.
Once new student nurses were accepted, Berea College agreed to provide them with board and lodging, a uniform, text books, and instruction in the art of nursing and the theory of hygiene for a period of twenty-one months. It was understood that at times more practical work would be practiced and at other times more text book instruction would be enforced depending on the number of patients in the hospital. At the close of two years from the time these student nurses were first received on probation, they graduated as an apprentice nurses and received their diplomas. The graduates from this program were competent in their field and had no trouble finding steady employment. President Frost praised the program saying, “Our trained nurses are going out as angels of mercy, and every student goes to his home with new ideas of hygiene because of this little fraction of a hospital!”
1916 – 1921
In 1916 the Kentucky State Law required one year of high school work of students beginning a nurse training course and three years of resident work for young nurses before they could be certified as registered nurses (RNs). William Goodell Frost strongly disagreed with the new policy. He said, “We feel that it would not be useful for the mountain region for us to prepare nurses so highly trained as this. They would insist upon high pay and be lost for mountain service. Moreover we cannot expect to have the number of variety of cases in our Hospital which would make a three year residence here profitable.”
President Frost’s aim was to encourage the Berea student nurses to go out and become nurses for homes in the mountains that could not afford highly trained experts, and he believed through doing so he was in accordance with the mission of Berea College. He was concerned that a three-year course would spoil the girls for this purpose so he gave up the idea of a practical nursing course entirely. Instead the nursing program was condensed into an 18 month course within the Vocational School.
The 18 month course, also called the Practical Nursing Course, was specifically devised to meet the needs of the Appalachian mountain people who were unable to pay the fees demanded by registered nurses. At the completion of this course student nurses received a Berea diploma certifying their ability to perform the duties of a practical nurse, but they did not meet the requirements to become registered nurses.
Many from the nursing department heartily disagreed with this new program. Nursing students were dissatisfied because it did not support their ambitions to become RNs. Consequently they decided to go elsewhere for the training. There was a highly significant decrease in the participation of student nurses. What once had been a class of twelve became a class of four.
Dr. Robert H. Cowley, college physician and professor of hygiene and physiology, repeatedly protested against the short course program. He insisted, “The only argument I have ever heard in justification of the 18 months nursing course is that it fits the graduates quickly to go into the mountains where they could do a great deal of good.” Then pointing out the flaw in this logic said, “As a matter of fact none of our graduates has ever gone to the mountains to practice.” After allowing the 18 month course to be offered three times he wrote to President Frost expressing that he was convinced they must abandon the short class and offer the full three year course, enabling Berea’s graduate nurses to become state registered. He believed that dropping the 18 month course would be of even greater worth than people realized, for it would bring in a better class of girls, and by their senior year they would be almost as helpful as graduate nurses.
In 1920 Mary Longacre reported that six nurses completed their course, but were desirous to complete a three year course so they could make the State Board examination and become registered nurses. She explained that the girls had been barred from the Red Cross membership and Public Health work. She observed, “The girls are too poor to support themselves and go to the mountains to nurse, but if registered in State, the state or counties would help support them […] I recommend unreservedly a three year course as the present course is not true to the nursing profession.”
Despite the many valid arguments and protests against the short course program, President Frost held firm to his convictions throughout the rest of his administration. It was not until William J. Hutchins came in to office that the short course program was closed and the three year training program was put in motion, fulfilling Kentucky’s minimum requirements for nurses.
1921 - 1953
The new Berea Catalog of 1921 announced there would be a “three year course initiated in the nursing program preparing future nurses for the state examination, which when successfully passed gave them the title of Registered Nurse and all the legal and professional privileges along with that title.” This program also permitted them to practice in other states and made them eligible for Red Cross and Government Service.
This course included a nine month experience in the Louisville City Hospital, set up by Dr. Cowley. This was done because although Berea Hospital was able to prepare its student nurses for many basic health issues, it was so small that it failed to provide a variety cases that larger hospitals such as Lexington and Louisville were able to provide. Spending nine months in Louisville exposed Berea student nurses to diseases and cases that they never would have encountered during their training at Berea. Dr. Cowley, pleased with the effects of the affiliation with Louisville City Hospital said, “I feel that now we can graduate our girls splendidly equipped.” The Berea student nurses benefited greatly from the Louisville experience and enjoyed it thoroughly. Mrs. Lewis, Berea Superintendent observed that of the nine Berea student nurses training in the Louisville, only two had returned to their Berea program willingly. The others would have changed programs and stayed in Louisville if they would have been allowed.
In 1926 the contract with the Louisville Hospital was discontinued and a new contract was devised with the Cincinnati General Hospital providing the girls with a similar big city hospital experience. This relationship lasted for over thirty years. The training provided by the Cincinnati Hospital for Berea student nurses was challenging and forced each to step out of their comfort zones. They learned a great deal from the Tuberculosis Sanitarium and received many lectures on medical, orthopedic, obstetrical, and dispensary lectures and ward work.
The positive results for the new three year program were immediate. Dr. Cowley stated, “Our fear of not being able to get enough girls for the 3-year nursing course was under grounded. We have had to turn away applicants.” Entrance requirements into the program rose from one to four years of high school, and the quality of work provided by the student nurses improved proportionately. Changes were also made in the housing arrangements for the student nurses. Previously they had roomed with the Vocational students in the Kentucky Hall dormitory, but this created problems for the night nurses who were unable to get enough sleep with the chattering of the young students all day long keeping them awake. The night time nurses were not the only ones negatively impacted by staying in Kentucky Hall. It affected all the student nurses’ social lives. As Miss Longacre puts it, “Their life is restricted because their free hours do not correspond to those of the general student body. The Edwards House, a small building near the hospital was enlarged to accompany the needs of the student nurses and was given to them a “nurses’ home.”
In 1924 the Nurses Training Department was separated from the Vocational School. In 1925 it was renamed the “School of Nursing,” a name that stuck for the next 31 years. Miss Lena Hafer became the first head of this nearly independent School of Nursing as superintendent. She once wrote, “Now my time is almost wholly taken up with doing secretarial and registrar’s work for the School of Nursing, business manager for the hospital, and supervising student labor in the hospital from daylight to 8 p.m.”
The Berea College School of Nursing progressed rapidly during this time. It was listed by the National Committee for the Improvement of Nursing Service among the top 25 percent of schools in the United States. A number of graduates from Berea’s nursing program served in the armed forces during World War II. One of these graduates, Rose DeSimone, served over seas in North Africa. In a letter to her friends back in Berea she said,
"We no longer wear make-up because we are eternally covered with a thick, sticky layer of mud colored dust…I have all my GI equipment stuffed, or rather, carefully placed in layers for a mattress cover to help build up my bed. My jeep suit and GI sweater folded in my fuzzy woolen scarf make a nice pillow – much better than my musette bag full of cans, I assure you. I’ve seen cripples of every description, peroxide French blondes…an Arab man walking in front of a string of shrouded women. There are beggars of every description and uniforms of armies of forty nations. I’ve met and walked with many of our own boys. I’ve visited the graveyards of our boys who made up the North African invasion, and in the middle were buried four nurses."
Dr. Armstrong, a physician at Berea College, wrote that in wartime Berea nurses everywhere seemed to be given special respect and recognition. He recalled someone telling how the surgeons at one camp, when faced with a severe emergency, would request for what they called, their “hill-billy nursing team.”
After World War II the United States standards for nursing began to change and it became necessary for the School of Nursing to change. Although the three year program School of Nursing had produced many fine outstanding graduates, the times required a more substantial education for their nursing students. Even before World War II Miss Ruth McCollum, Nurse Superintendent during 1933, expressed that a mere high school education and three years of training at the School of Nursing was not adequate training for the student nurses. She asserted that a college education was necessary for the expected growth and development of the student nurses. She said, “When we expect a nurse to be able to do public health nursing, to understand the use of mental hygiene in the care of patients, and to see the patients as a part of her environment, we are demanding much more background than a high school graduate has, and what we can possibly give her in three years.”
The three-year diploma program continued until 1956 when it was finally transformed into a four year degree program through the college. This was accomplished through six long years of debate, study, and improvising to make the degree program possible. The major reasons for this change were that there was a national recognition of the need for nurses with the increased competence which a collegiate college affords, and that nurses, like other citizens in a democracy, should have a broader educational experience than merely those studies which are professionally relevant.
In a letter, Miss Rosnagle, Dean of the College of Nursing and Health in Cincinnati, wrote to Berea, “We shall miss Berea students…We are glad to have had a part in helping to bring to fruition the program of the Berea College Department of Nursing…We rejoice in the independence which Berea can now assume, which will allow it to make its own original and creative contribution to the field of Nursing education and Nursing service.”