Olden Days of Nursing: A Pioneer of the Past Spurs Others Forward

Olden Days of Nursing: A Pioneer of the Past Spurs Others Forward

by Guest Blogger: Cynthia Freund

I talked with Marianna the other day about the book I’m writing (more about that later). She referred me to a post on her blog from a couple of months ago, a post describing the olden days of nursing. She added that she had some very positive responses to that post—and then she put the question to me, “Would you be interested in writing something about the olden days for my Blog?” I obviously fit the age criterion.

I read the post of August 4, 2020, Olden Days of Nursing: Dialysis, about a nurse working in the days when kidney dialysis first became available, the beginning of the 1960s. I know Marianna was asking me to write something about my own early experiences in nursing, and I may do that yet. But this particular post made me think of a dear friend who died a year ago, one-month shy of her 95th birthday. She, too, started one of the early kidney dialysis units, but this time at the Veteran’s Administration Hospital in Durham, North Carolina. 

In this millennial year of the nurse, I want to pay tribute to Audrey Booth, both a typical and unusual nurse—a pioneer in many ways.

From the dust bowl of Nebraska, Audrey, a curly-haired blonde, climbed on a horse twice her height to ride to-and-from a one-room country schoolhouse and onto become the Associate Dean at the University of North Carolina (UNC) at Chapel Hill. 

The interval between that Nebraska farm and UNC took her to Case Western Reserve in Cleveland, Ohio, where she earned a master’s degree in nursing. She became an expert in the care of polio patients during the height of the epidemic in the 50s, including caring for kids in iron lungs. That expertise brought her to Hawaii and Guam, and also transported her back to the mainland and the University of North Carolina (UNC). After the polio epidemic, she focused on kidney disease and, in the 60s became a leader in opening the new hemodialysis unit at the VA hospital in Durham—one of the very early dialysis units in the US.

Looking for new hurdles to jump, she joined a small select group planning the nurse practitioner program at UNC. And then, when the North Carolina Area Health Education Center Program started in the mid-70s, Audrey became the Director of Statewide Nursing Activities. (AHECs, as they are called, were designed to be centers of education and innovation, serving as magnets to attract health professionals to rural and underserved areas.) She became an Associate Dean in the School of Nursing in 1984—while continuing with all of her duties as AHEC Director. 

Throughout her career, the essence of Audrey was as a leader, a role model and a mentor. She led and taught many nurses, usually just by example. She was not well-known nationally, but she was known by hundreds of nurses—and other health professionals—in North Carolina. Many of us attribute our professional success to her leadership and guidance. 

And, as a matter of fact, it was Audrey who suggested to me that we interview the founders and influential promoters of the nurse practitioner movement in N.C. UNC started one of the very early family nurse practitioner programs. It was quite unique in its alliance with those starting a statewide AHEC Program and a Rural Health Program—a collaborative effort involving many. Audrey, and I, were involved in that pioneering effort. So, we conducted the interviews, but Audrey left the book-writing to me. 

I am about to finish that book, titled: Nurse Practitioners in North Carolina: Their Beginnings in Story and Memoir. It will be in print in the spring of 2021—and will feature many other nursing stars of the olden days of nursing.   

Audrey’s spurring me on to write this book is a perfect example of how Audrey led others—encouraging them to greater endeavors. Plain and simple: Audrey was an influencer, on a grand scale and with each individual. She was a mentor in the truest sense of that word. She was a strong voice for nursing and a strong model for women when women were still fighting for their due recognition. We indeed should celebrate all such nurses, just as the World Health Organization has done, declaring 2020 as the International Year of the Nurse and the Midwife.

Dean Emerita Cynthia Freund, MSN ’73, and Associate Dean Emerita Audrey Booth, MSN ’57, were awarded the highest honor of the North Carolina Nurses Association (NCNA) when they were inducted into the NCNA Hall of Fame on Thursday October 9, 2014. Nurses chosen for the Hall of Fame are recognized for their extensive history of nursing leadership and achievements in North Carolina.

Cynthia “Cindy” Freund, RN, PhD, worked for eight years with the newly developed Family Nurse Practitioner Program at the University of North Carolina at Chapel Hill in the early 70s. She then went to the University of Pennsylvania to start a joint program (MBA/PhD) between the School of Nursing and The Wharton School. She returned to UNC-CH and retired after serving 10 years as Dean of the School of Nursing. To her, retirement means “working without pay.” In her retirement, she worked on her book: Nurse Practitioners in North Carolina: Their Beginnings in Story and Memoir, to be published in Spring 2021.

Three Trailblazing Nurses

Lorraine Starsky writes in the Pittsburgh Post-Gazette about three “extraordinary” Pittsburgh women who happened to be nurses. Each woman had provided services beyond the boundaries of the nursing role. 

My hope is that in the World Health Organization’s 2020 International Year of the Nurse and Midwife more “extraordinary” nurses will be the subject of media attention. 

I hope you enjoy these stories as much as I have. 

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Three extraordinary Pittsburgh women

In this International Year of the Nurse and Midwife, Lorraine Starsky tells the story of three women who were trailblazers 

LORRAINE STARSKY OCT 25, 2020 9:00 AM

In May 2019, long before COVID-19 became a worldwide pandemic, the World Health Assembly designated 2020 as the International Year of the Nurse and the Midwife.

The designation was, in part, to pay tribute to Florence Nightingale. Considered the founder of modern nursing, Nightingale was born on May 12, 1820, making 2020 the 200th year anniversary of her birth.

Nurses and midwives have had a long, rich history of safeguarding the health of people. Primarily they work without recognition and pass into history with their names unknown and their stories untold. In honor of the International Year of the Nurse and the Midwife, here are the remarkable stories of one midwife and two nurses who worked in the Pittsburgh area.

Hannah Sandusky

Hannah Sandusky was born in 1827 to a Jewish family in Kovno, Lithuania. With no doctor in the village, Hannah was taught important skills by accompanying her midwife mother as she assisted with local births. She married Louis Sandusky, a window glazer, who came to Pittsburgh in 1860. Hannah and their son joined him 1861. She began working as a midwife, as well as providing care to the many impoverished residents of the Hill District — newly arriving Eastern European immigrants and Blacks from the South.

Her reputation drew the attention of a local doctor who called on her intermittently to assist him with difficult deliveries. He was very impressed by her skill and in appreciation for her help, he sent Sandusky and her son, who had an eye problem, to Germany to see an eye specialist. During the time that her son received treatment for his eye, Hannah attended a recognized school of midwifery.

With her son’s eye treatments completed and her midwifery education finished, Hannah returned to Pittsburgh with formal certification as a midwife, making her one of only a few women in the U.S. with that credential. She delivered 3,571 registered births, but there were, no doubt, many more births that went undocumented. Her passion for providing care did not always carry over to paperwork and The Birth Registration Act didn’t go into effect until 1870. Regardless of the exact number of deliveries; it is an impressive feat since she accomplished this while she raised her seven children.

Sandusky was very kind-hearted and was known for providing her services for free. In situations where a family was facing hardship, she also gave food, baby clothes, and blankets after a birth. She was affectionately known as Bubbe (Yiddish for grandmother) Hannah throughout the Hill District. She was 82 when she delivered her last baby and died at age 86 on November 15, 1913.

Her legacy lives on through the Bubbe Hannah Fund at The Midwife Center for Birth and Women’s Health at 2831 Penn Ave. Donations to the fund underwrite services for individuals experiencing barriers to quality health care. The Midwife Center overcame attempts to drive it out of existence, flourished with grassroots support, and expanded to become the nation’s largest free-standing birth center operated by midwives.

An exquisite, art quilt portrait of Bubbe Hannah hangs on the waiting room wall sweetly looking on the families awaiting the midwives’ services.

Anna Heldman

Anna Heldman

Like midwife Hannah Sandusky, public health nurse Anna Heldman spent the bulk of her nursing career in the Hill District.

Anna Barbara Heldman was born in Castle Shannon on January 15, 1873. Early on, she felt the call of nursing and found work as a practical nurse at Allegheny Hospital in 1893 despite the fact that she had no training or experience. When South Side Hospital established a Hospital Training School for Nurses, Heldman enrolled and was given a year’s worth of credit for her two years of practical nursing at Allegheny Hospital.

She was among the first graduating class of the South Side Hospital Training School for Nurses, receiving her diploma on April 8, 1897. About a year later, she volunteered to serve as a nurse in the Medical Department of the United States Army during the Spanish-American War. She served in Florida, Georgia, and Cuba. When she returned from her tour of duty, she worked briefly as a private duty nurse.

Heldman didn’t find private duty nursing challenging. In 1902 she learned about a new type of nursing referred to as community visiting nursing, the genesis of public health nursing. She was hired at the Columbian School and Settlement in the Hill District modeled after the Hull House in Chicago.

It evolved into the Irene Kaufmann Settlement. At this time Pittsburgh had very high rates of tuberculosis and typhoid, with the Hill District being a hot spot since it was crowded with the poorest of the poor — Blacks escaping the South and new immigrants.

Initially Heldman was discouraged, but she persisted. She already was fluent in German and that helped her master Yiddish, which was useful for nursing Jewish immigrants. She also learned Syrian, Lithuanian, Polish, and Italian, which gained her the trust and affection of the community. She became a recurring sight in the Hill District’s streets and alleys carrying her black nurse’s satchel. Soon people began referring to Anna as “Heldi.”

Her commitment included fighting for better housing conditions, stricter labor laws in the Hill’s cigar factories, better schools, workers’ compensation and the first legal aid service. She and her staff nursed well over 1,000 flu and pneumonia victims during the 1918 flu epidemic.

In addition, she initiated numerous public health programs that ultimately became city services, including a visiting nurses service, a prenatal nursing service, baby clinics and regular medical inspection of students in Pittsburgh’s schools.

The Hill District became Heldman’s family as she never married or had children. Because her dedication touched the lives of so many men, women and children in her 38 years of service as a public health nurse, she became known as the “Angel of the Hill District.”

As an expression of gratitude for her devotion to the Hill District, the city in 1939 renamed Overhill Street, Heldman Street, which still exists. When she died in March 1940 at 67, her body was brought to the Irene Kaufmann Settlement House. Thousands filed past her coffin to pay their respects to the indomitable woman they called the “Angel of the Hill District.”

Evelyn Paige Parke

Evelyn Page Parker was born January 8, 1921 in Pittsburgh. While she was a student at Westinghouse High School, she knew she wanted to become a nurse. However, in 1940 no schools of nursing in Pittsburgh would admit Black students to become Registered Nurses, so she left for Philadelphia. She enrolled at Mercy Douglass Hospital School for Nurses, which was the first nursing school in Philadelphia for Blacks.

While at Mercy Douglass she took a course at Philadelphia General Hospital, where she learned that Blacks were not permitted to eat in their cafeteria. She was not deterred and continued to go to the cafeteria. Eventually the cafeteria cooks let her eat.

Later in life she related the story, “Everyone started looking at me, thinking ‘What’s she doing here?’ But then, they started letting African American students eat there.”

Parker graduated in 1943 from Mercy-Douglas. She persisted in her efforts to promote equality for Blacks. Philadelphia General Hospital finally opened its nursing school and internship programs to Black students in 1945.

In the meantime, she pursued her nursing career in Philadelphia. She focused on public health nursing and was instrumental in helping to found the Community Nursing Services of Philadelphia in 1959. During this time, she married, had a son, and worked on her bachelors in Nursing from the University of Pennsylvania, which was awarded in 1961.

In the late 60s Parker returned to Pittsburgh and enrolled at the Graduate School of Public Health at Pitt. She finished her Master’s degree in Public Health in 1969 and became a faculty member at the University of Pittsburgh’s School of Nursing until 1981.

She then taught at Duquesne University’s School of Nursing until 1984 when she retired. She mentored students at both universities throughout her career. Even in retirement, her passion for nursing and social justice burned bright as she continued to help young Blacks pursue their dreams of a career in nursing.

Parker volunteered for many causes, from the local NAACP chapter, the AARP health committee, American Heart Association’s Sister to Sister Program and many cancer survivors’ groups. Probably closest to her heart was the Pittsburgh chapter of the National Black Nurses Association, which is called Pittsburgh Black Nurses in Action.

Evelyn remained a devoted member until her death in 2008. In her obituary, her son Tom Parker said “I think the challenges she faced just motivated her more.”

Today the Pittsburgh Black Nurses in Action carries on her legacy by offering support to prospective Black nursing students and addressing health disparities in the community. The Evelyn Paige Parker Scholarship is awarded annually.

Lorraine Starsky BSN, RN, retired in 2019 as a Public Health Nurse with the Allegheny County Health Department. She is working part time currently as a community health nurse consultant for Project Destiny. She can be reached at lorrainestarsky@gmail.com

First Published October 25, 2020, 9:00am