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(An extract from Science of Caring - the magazine of UCSF School of Nursing.
To view the original format of this article, see ourwrk.pdf.)
Four decades of prehistory made possible the
research beginnings in the 1960s and 1970s,
and the subsequent flowering of research
from the 1980s onward.
by Marilyn Flood, RN, PhD
Associate Dean Emerita
The story of research development in the School of Nursing at UCSF usually begins with Dean Helen Nahm's recruitment of nursing and sociology faculty in the very early 1960s.
But there is a prehistory that stretches back much further. This made possible the research beginnings in the 1960s and 1970s, and the subsequent flowering of research from the 1980s onward.
The earliest chapter of the story dates to the appointment of Edith S. Bryan as assistant professor of public health nursing in 1918. She steadily built both summer and academic year offerings until she took a leave for two years, from 1925 to 1927, to earn master's and PhD degrees in psychology and counseling at Johns Hopkins University. She thereby became the first nurse in the United States with an earned doctoral degree.
She returned to Berkeley, continued teaching public health nursing and engaged in descriptive research on newborns, seeking correlations between labor and birthing events and subsequent newborn behavior. /1/
Dr. Bryan presented a paper, "Methods of Research and Study," at the 1932 National League of Nursing Education (NLNE) convention in San Antonio, Texas. In this, she noted that nursing research has pure, applied and social science research within its purview, and that all three must be taken into account for complete and undistorted results. She advocated attracting to nursing those who already had scientific training, as well as providing this preparation to those who were already nurses. She noted that "the research worker in the field of the pure science of nursing must at times be free from the restraint of service" and that "the research worker cannot be poured into a mold"; i.e., directed to study particular questions. "If we are to develop the science of nursing to its greatest achievement, we must accord the scientific research worker in nursing a position of increasing dignity, honor, and power in the profession."
She ended her paper with the observation that, if we attend to the research methods set up in our profession and understand those who do research, we will progress toward "finding for ourselves a place among the recognized scientists and . . . .proclaiming our work a science."
These were not the synthesized, recycled ideas that regularly recurred in speeches at NLNE meetings. She pointed to a dimension of nursing that few even conceived at the time. She did not achieve structural change to give longevity to her vision, but she sketched the outlines of an expanded view of nursing.
The second chapter of the prehistory is set in the years just after World War II, when the University was moving off war-emergency footing. It was moving on to possibilities generated by the flood of new students supported by the GI Bill and by expanded work with governmental funding on projects of national interest.
The US declaration of war in December 1941, and all of the changes flowing from that, interrupted establishment of the School as an academic unit. It is true that the Regents, on March 17, 1939, established the School as a unit of the University. The solely administrative aspects of this action were completed within the next year. But Academic Senate advice and, in some areas, action were needed to finish the process.
Given the nature of the five-year-long deliberations leading up to the 1939 Regents' decision, some influential members of the Berkeley Academic Senate thought that they had been outmaneuvered, and proceeded to obstruct the intent of the Regents' and the president's decision.
The first issue, appointment of someone to head the School and department, was originally conceived as two positions, but then consolidated to one. At least two Academic Senate committees advised President Sproul on this, and in the protracted conflict that ensued, a number of nurses became hopeful of being named.
Margaret Tracy, who had championed the idea of the School, had accumulated some detractors in the process. But underlying the resistance to her appointment were issues of gender and the perception of nursing, as well. C.B. Lipman, dean of the Graduate Division, advised President Sproul confidentially that a man should head the School, but if for some reason the appointee had to be a woman, she should be a physician, not a nurse, and certainly not "a person who is trained merely in nursing, and under the old plan of training nurses at that."
This betrayed ignorance of Margaret Tracy's preparation, but perhaps reflected a widely held misconception. Margaret Tracy was appointed director of the School and chairperson of the department by May of 1940.
A second issue was the administrative placement of the public health nursing courses and, more to the point, of the public health nursing faculty and students. The entire San Francisco Nursing faculty submitted their resignations in a showdown over the issue, saying they did not want to be part of a school without public health, which they saw as integral to nursing. This moved toward resolution in April 1941.
Finally, in December 1941, after a two-year delay and considerable conflict, the Academic Senate established the composition of the faculty of the School of Nursing, technically meeting the requirement, but in a backhanded way. That faculty comprised representatives of 10 fields other than nursing – a total of 46 members, only three of whom were from Nursing, but with a later possible total of 12.
The budget committee of the Academic Senate, which controlled the appointment process, subject only to President Sproul's veto, denied promotion or took no action on academic appointment of the instructors in San Francisco. It was at this impasse that the matter sat throughout World War II. Were "faculty meetings" ever to be convened, which seems to have happened only once, the Nursing faculty had to rely on the mostly supportive 15 Medicine faculty members, along with some of the Berkeley members, to protect Nursing's interests.
Margaret Tracy was able to negotiate for salaries and instructor positions necessary to teach the large numbers of Cadet Nurse Corps students. And in President Sproul's move to standardize titles on the Berkeley campus, Margaret Tracy was titled dean in 1944.
In response to President Sproul's postwar request, Dean Tracy in January 1946 identified the School's five-year goals:
The first and third of these goals were measurably met. The second goal was a precursor to the later idea that the San Francisco campus would have upper-division undergraduate students outside the professional schools, a school of human ecology, a "fifth school" and all the various iterations of similar ideas that never materialized over three decades. But goal number four was to be postponed in the service of finishing the work of establishing the School. Faculty members spent energy, which might have been directed toward research in the late 1940s and early 1950s, to get advanced degrees. This, they believed, was a necessary prerequisite to the School's having a faculty with research as an integral component of its work.
Once the initial flurry of postwar change subsided, the budget committee of the Academic Senate again addressed the issue of academic appointment of the School of Nursing faculty. Given that this was the committee that had, in both 1942 and 1944, proposed the cancellation of Miss Tracy's assistant professor title altogether in response to submission of papers for promotion to associate professor, the ensuing recommendations were not surprising.
Between 1946 and 1948, the budget committee – and President Sproul himself – tried to find a way out of the impasse. As Provost Deutsch said in mid-1946 about the issue, "We have gotten to the place that the irresistible force meets the immovable body." The clinical professor series, sweetened with assurances that advancement in salary and security of employment would be included, was urged in 1946. The faculty unanimously rejected this and explained that, although this would meet the interests of faculty individually, it would not serve the School well in terms of future faculty recruitment, representation in the Academic Senate or inclusion of research as a part of the work of the faculty. The specialist series was another rejected proposal for these same reasons and more. /2/
In early 1948, Miss Tracy gathered the whole faculty, still small enough to meet in her office on the fifth floor of the Clinics Building, to deliberate. She laid out the pros and cons, as she saw them, of a faculty appointed as clinical professors, as compared with the regular professor series, and then asked faculty members one by one to comment. It was a solemn-faced group that resolved to do what was necessary to gain full University academic recognition. /3/ These women were for the most part at midcareer or later. They were making no small commitment of time, energy and money to earn the necessary degrees. In a March 1948 memo, Dean Tracy proposed to President Sproul that a moratorium on faculty appointments be in effect until 1950-51, except for individuals who earned promotions. During that time, the faculty, each identified individually by name, would pursue graduate work. /4/ He accepted the proposal with alacrity!
Thus began commutes for some and leaves of absence for others. One person recalled 20 years later that it seemed as if everyone was in school, and that the table conversation took a sudden turn in new directions. Interests in clinical research questions were shelved. Less than a decade before, Miss Tracy had been known to take a dim view of doctoral education for nurses. Her assertion now to President Sproul that this faculty was being held to a standard expected in no other university, but that the School would be the stronger for it eventually, suggests she had changed her view.
Finally, in 1951, the Academic Senate extended academic recognition to the faculties of both the UCLA and the UC Berkeley-San Francisco Schools of Nursing. Throughout most of the 1950s, faculty promotions continued to be caught in the crossfire of battles that were about larger issues. But the fundamental principle that Nursing faculty could be promoted to tenured appointments in the regular professorial series was established. Without this, the later research story could not have unfolded.
This condensed version of necessity omits many complexities in the story, as well as the perspectives of other participants in this saga. The huge controversy over the proposed relocation of the schools and hospital from San Francisco to Berkeley in 1946-1947 was part of the backdrop for this story, as was the development of the School of Nursing at UCLA.
Without the skillful political maneuvering of Lulu Wolf to get the support of the Southern Division of the Academic Senate, academic recognition probably would not have happened as soon as it did. The Robert Gordon Sproul papers at the Bancroft Library at University of California, the University of California School of Nursing and Margaret Tracy correspondence with Annie Goodrich folders in Manuscripts and Archives of Yale University, and the School of Nursing Archives in the UCSF Library are among the sources for this account.
Dr. Flood served as Associate Dean for Academic Programs from 1985 through 2001 at UCSF School of Nursing.
/1/. Edith Bryan also became quite active in California nursing professional organizations, holding offices simultaneously in the California State Nurses Association (CSNA), the California League for Nursing Education and the California Organization for Public Health Nursing. Her University affiliation ended in 1934, but she served as president of CSNA from 1935 to 1937 and remained professionally active until at least 1940.
/2/. During these two years, the faculty recognized that their responsibilities for nursing in the hospital were not compatible with the expectations for creative work, including research. A parallel process, primarily administrative and budgetary, addressed this issue. Mr. F. Stanley Durie, the hospital administrator, played a key supportive role in this. Faculty members, with the exception of Mary Harms, ceased to have direct administrative responsibility for nursing in the hospital in 1949.
/3/. The account of this meeting is on Tape OH9C, Pearl Castile Interview, Reel 3, UCSF Archives and Special Collections, made June 6, 1969. Participants in the taped conversation were Pearl Castile, Winifred Incerti, Mary Harms and Miriam Laycook.
/4/. Persons named in the March 4, 1948, memo from Margaret Tracy to Robert Gordon Sproul were Pearl Castile, Mildred Newton, Amy MacOwen and Alice Ingmire, who would earn doctorates. Mary Harms, Hannah Binhammer, Dorothy Loveland, Ruth Lotspeich and Miriam Laycook would earn master's degrees. In an updating memo of August 3, 1949, Miss Tracy additionally named Kathryn Smith as enrolled for master's study, Jeanette Hiller as enrolled for doctoral study and Ann Hill to be on leave in 1950 for master's study. All completed the identified degrees. Mary Harms completed doctoral work, as well.
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