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8 Addressing the Times: NUNS AND THE STANDARDIZATION MOVEMENT We cannot help asking where now are the faithful nuns, those “angels of the battlefield” who taught the world how to nurse. . . . So much maligned, yes, even by some of our nursing journals. . . . 1 A Sister of St. Francis February 1907 In this letter to the editor of a secular nursing journal, a sister protested the disrespect many felt in the early decades of the twentieth century. Rather than relying solely on their own autonomy to set up and manage their hospitals, nuns had to deal with external factors such as the professionalization of nursing, the Flexner Report, and the American College of Surgeons. Sisters carried an additional burden. They were religious women who were unfamiliar to many people when they first arrived on the American scene. Their gender traditions differed from Protestants: nuns had voluntarily taken the religious vow of chastity, and they wore habits that were distinctive to a woman’s religious order. One layman voiced a common view that they lived “more or less secluded lives, quite apart from the world and under conditions quite peculiar to themselves— lives of service given almost solely to the care and comfort of the sick and ailing.”2 Sisters also were part of a Catholic tradition still trying to earn respectability. Added to perceptions about them was the growing antiCatholicism that had resurfaced in the 1890s. Though their nursing dur166 Wall_CH8_2nd.qxd 4/11/2005 2:59 PM Page 166 ing the Civil War helped lessen prejudice against them, hostility toward Catholicism had increased when immigrants from southern and eastern Europe poured into the country. Many Americans saw sisters as representatives of the immigrants’ church. These images, along with the widespread idea that Catholics were a threat to democratic institutions, set nuns apart as “outsiders.”3 This “outsider” status influenced their adaptation to changes in nursing and medicine. The Catholic Hospital Association: A Sisters’ Organization The most important influence, however, was the hospital standardization movement.The American College of Surgeons (ACS) organized in 1913, and by 1917 it had adopted minimum standards for hospital approval. Hospitals had to have an organized medical staff with monthly meetings to discuss cases, a sufficient laboratory for proper diagnosis, and a sophisticated system for record keeping. It was at this point that physicians obtained more authority in hospital decision making, particularly those involving staffing. To keep pace with the hospital reform movement, fourteen Sisters of St. Joseph of Carondelet met with Father Charles B. Moulinier, regent at Marquette University Medical School, in Minneapolis in 1914 to discuss plans for a Catholic organization that would ensure the highest hospital standards. The Catholic Hospital Association (CHA) was formed the following year, with Father Moulinier as president. At the first CHA convention in June 1915, two hundred sisters, physicians, and lay nurses representing forty-three hospitals attended.4 The CHA was a powerful constituency in supporting the ACS’s efforts at standardization,5 and in 1918 it approved the ACS’s plan for Catholic hospitals. The ACS began inspecting hospitals that year, and by the early 1920s it had approved most of the institutions represented in this book. Some hospitals, such as St. Mary’s, Cairo, and St. Joseph’s, Fort Worth, did not receive approval until the sisters constructed new buildings. New standards determined by a secular agency threatened nuns’ control over their hospitals.6 Neither they nor other Catholic leaders had helped formulate the ACS plan. On the other hand, because Father Moulinier was a member of the ACS standardization committee, which involved actual hospital inspections, Catholic hospitals could be protected from any strong secular control and generally were.7 Father Moulinier favored a sister for president of the CHA, but conservative bishops and priests opposed him and prohibited nuns’ 167 Addressing the Times Wall_CH8_2nd.qxd 4/11/2005 2:59 PM Page 167 appointments as full-time officers. Priests held the highest leadership positions until the 1960s. Sisters, however, served on the executive board, headed committees, participated in conventions, and set standards for Catholic nursing education.8 Two members of the Sisters of St. Joseph of Carondelet especially were active. Sister Esperance Finn, superior at St. Mary’s Hospital, Minneapolis, was one of the founding members of the CHA and served as second vice-president from 1916 to 1919. Sister Madeleine Lyons was a member of the national executive board from 1921 to 1924 and became the first president of the CHA’s Minnesota-North...


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