[Reprinted from The Modern Hospital, September, 1914, Vol. Ill, No. 3.] 
 
 CULTURE COURSES” IN TRAINING SCHOOLS 
 FOR NURSES. 
 
 BY EDITH KATHLEEN JONES, 
 
 Librarian at McLean Hospital, Waverley, Mass. 
 
 Ever “the old order changeth, giving place to new.” If 
 Sairey Gamp has disappeared completely below the nurs- 
 ing horizon, no less certainly is there rising a new ideal 
 for the profession, a nurse who shall be not only the right 
 hand of the physician and the surgeon and the mainstay 
 of the disordered household, but also a congenial com- 
 panion for the patient. In convalescent and mental cases, 
 especially, the successful nurse is one who can arouse in- 
 terest and attention and induce the patient to enter again 
 into normal relations with the world. 
 
 That convalescent and mental nursing require more 
 tact and sympathy and patience than any other sort, no 
 one knows better than the nurse; but of the fact that 
 often the whole long medical battle is finally won or lost 
 through the personality of the nurse during this trying 
 time the physician is desparingly aware. While the doc- 
 tors can get plenty of nurses efficient in an emergency, 
 capable and deft in the more mechanical aspects of their 
 profession, they complain that it is very difficult to secure 
 attendants with the education and resources which would 
 render them companionable and congenial to their more 
 highly educated and cultivated patients. Tact, sympathy, 
 skill, and patience — these qualities are indispensable; but 
 if to them a nurse can add a knowledge of books, an ap- 
 preciation of pictures, an interest in current events, she 
 will have at her command resources which will give her 
 tremendous advantages in the way of entertainment and 
 companionship; and, incidentally, she will come pretty 
 near to being the perfect woman, whose price, according 
 to Solomon, is above rubies. 
 
 Since the demand is for this ideal, what are the train- 
 ing schools to do toward supplying such nurses? In the 
 general hospitals there has been much serious discussion 
 of the subject, and two plans have been proposed: one, 
 that a higher grade of education be required for entrance 
 into the training schools; the other, that these schools add 
 to their curriculum lectures in current events, literature, 
 and general culture. The first plan would shut out, from 
 
both general and mental hospitals, many of our best nurses 
 — girls who are intelligent and ambitious and eager to 
 learn, but who have had few advantages — and it is impracs 
 ticable, for the present at least, because the supply would 
 not equal the demand. As a rule, college educated men and 
 women do not take up nursing as a profession. There re- 
 mains, then, the second scheme, that of introducing so- 
 called “culture courses” into the training schools. 
 
 In a way, this is not a new idea. For years past more 
 or less tentative efforts have been made in many hospi- 
 tals to give their pupil nurses lectures on current events 
 and topics of the day, but in few, if any, cases have these 
 lectures been such an unqualified success that they have 
 been included permanently in their curriculum. Perhaps 
 one reason for their failure is the fact that they were 
 usually merely desultory lectures, and not a part of the 
 required course, for unless one has an inborn love of 
 study, or his interest is very thoroughly aroused, he is 
 not apt to do any more studying than is obligatory. 
 Another cause for the nonsuccess of these lectures may be 
 the lack of teachers within the hospital to keep the stu- 
 dents interested, and the absence of an adequate library. 
 Teachers may be imported — at a cost; books may be bor- 
 rowed from the nearest public library, but at a certain 
 inconvenience and much responsibility for someone, and 
 few hospitals care to surmount these obstacles. 
 
 Taking into consideration these attempts by other train- 
 ing schools, when McLean Hospital contemplated giving 
 some such courses to its pupil nurses, it counted as its 
 greatest asset a well-selected library of more than seven 
 thousand volumes. It had always been a matter of re- 
 gret that the nurses did not make better use of the ma- 
 terial at hand, and for ten years it had been the dream of 
 the librarian that “somewhere, somehow, somewhen,” time 
 should be found to give instruction to the nurses in books 
 and reading, with the view of securing to a greater ex- 
 tent their cooperation in the efforts of the library to get 
 books to the patients. In the fall of 1913 it was decided 
 to try something of the sort as an experiment, and, if it 
 seemed successful and was appreciated by the nurses, to 
 add it permanently to the curriculum. 
 
 As a beginning, six lectures on the development of the 
 English novel were given in October to the women of the 
 senior class. They were made compulsory to the women, 
 but, because it was not thought the men would care for 
 them and it was difficult to spare them from the wards, 
 
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 the men were not at first included. Although an experi- 
 ment, and given by one who had had no previous experi- 
 ence in teaching, yet, if success is measured by awakened 
 ▼ enthusiasm for books worth while, eagerness to do the re- 
 
 quired work, and, upon the whole, fairly satisfactory re- 
 sults in the examinations, this course was a success, and 
 certainly it was appreciated. So many graduate nurses 
 still in the hospital service and men of the senior class 
 expressed their regret that they were unable to attend 
 the afternoon lectures, that at their request the course 
 was repeated in evening classes, at which attendance was 
 entirely voluntary. It means an eagerness to seize op- 
 portunity when men and women who have been hard at 
 work all day on the wards are not only willing, but de- 
 sirous, to give up an hour of freedom after 8 o’clock at 
 night to attend lectures which are not compulsory. 
 
 At the end of the course the nurses, like Oliver, de- 
 manded more. As the library was particularly rich in its 
 fine arts department, this subject was chosen for a second 
 course, given in the spring term to the entire senior class. 
 This, too, was fully appreciated by most of the members, 
 and with few exceptions they did remarkably good work; 
 in fact, the hospital felt that both courses were enough of 
 a success to warrant giving them another year. 
 
 It is no part of the plan of this paper to give a synopsis 
 of these two subjects as taught at McLean Hospital, or 
 to go into details, except as they may serve as suggestions 
 to other hospitals planning something of the sort. The 
 courses were made compulsory because it was felt it might 
 not be possible to hold the attention and interest of the 
 students in any other way, once the novelty had worn off, 
 and examinations were given because they tend to fix a 
 subject in the mind. There was no attempt at a complete 
 course in English literature because of the shortness of 
 the time at the disposal of the class, but, as fiction repre- 
 sents by far the greatest amount of reading matter of 
 the present day, a very brief summary of the English 
 novel was given, from the old ballads and romances to 
 the very latest “best seller.” The required reading con- 
 sisted of a few of the great books — at least one of Jane 
 Austen, Scott, Dickens, George Eliot; either “Vanity Fair” 
 or “Henry Esmond;” “Westward Ho!;” “Huckleberry 
 Finn” or “Tom Sawyer;” “The Scarlet Letter” or “The 
 Marble Faun;” “Treasure Island” or “Kidnapped;” several 
 of Kipling’s short stories; a choice of several other nov- 
 els. The idea was not only to show how the novel grew 
 
and changed from century to century, but also to intro- 
 duce the class to the very best writers, so that they might 
 have an ideal by which to measure the stories of the 
 present day. They were asked to write a short paper on 
 their favorite author or book, and some of these essays 
 were excellent in point of view and analysis. 
 
 The course in the history of art presented more diffi- 
 culties and took much more time. Roughly speaking, it 
 was based on Reinach’s ‘‘Apollo,” which many of the class 
 purchased; but, realizing that most of the ground cov- 
 ered would be entirely new to many of the students, and 
 that they would have little time for outside reading, the 
 lectures were very carefully prepared to give all the infor- 
 mation possible in the class; the outline of each lecture, as 
 well as new names and terms, were written on the black- 
 board, and rough sketches were drawn to illustrate some 
 points. But, most important of all, large photographs 
 and (when it was possible to get good ones) colored pic- 
 tures were displayed on the platform and passed among 
 the students. Pictures are indispensable in a course of 
 this sort, and, if the hospital does not own them, the pub- 
 lic libraries and art museums will be found willing to lend 
 their collections, or, indeed, to help in any way possible. 
 While on the subject of pictures, it may be said in passing 
 that the very best colored reproductions known to the 
 writer are published in “Die Galerien Europas,” 1 and sep- 
 arate pictures may be purchased at 25 cents each. To 
 those who have never seen any paintings by the great mas- 
 ters, a photograph conveys a very inadequate idea, and 
 cheap colored prints are worse than nothing; but in these 
 pictures the individual tones and colors are wonderfully 
 well reproduced, and a good idea of the peculiar style of 
 each artist can be obtained. 
 
 Speaking from one year’s experience, it would seem 
 worth while to devote one lecture to Greek and Roman 
 mythology, and it certainly adds greatly to the intelligence 
 of the students if a brief outline is given of the physical 
 geography, history, and characteristics of each nation and 
 their effect on their art. Since this course is meant for 
 “general culture” rather than an exhaustive study of art, 
 the broader and more fundamental one can make it the 
 more the nurses will get out of it. 
 
 In a pioneer work like this, with an inexperienced 
 teacher, it was inevitable that there should be mistakes. 
 
 tDie Galerien Europas ; Leipzig, Seemann. The volumes are pub- 
 lished by subscription, but they, or separate pictures, may be secured 
 through any foreign bookseller. 
 
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Perhaps the greatest of these lay in trying to give too 
 many names and facts, too much detail, and in taking for 
 granted more previous knowledge than many of the stu- 
 ? dents had. Another year only the most important items 
 
 will be given, but these will be hammered home. More 
 frequent reviews and examinations will be given. The art 
 course will immediately follow the literature and be ex- 
 tended throughout the school year, making it much less 
 hurried. 
 
 The greatest difficulty encountered was in finding a 
 point of contact from which to start, for, while some mem- 
 bers of the class were well educated and had read widely 
 and intelligently, many of them had had few opportunities. 
 When Dickens is only a name and Jane Austen not even 
 that; when Florence is merely a dot on the map and Rome 
 a city in Italy where vague things once happened; when 
 Homer is thought to have written the Arthurian romances, 
 and Mars and Eros, Zeus, Venus and Hermes, whether 
 under Greek or Roman names, mean absolutely nothing; 
 when Raphael and Rembrandt are known simply as “ar- 
 tists” and convey no distinctive impression — where is one 
 to begin ? Yet, if the outlook is at first a little appalling, 
 so much the greater is the need for a start. With a good 
 library at hand, a judicious selection of books can be made 
 and put for two or three months in the nurses’ sitting 
 rooms, where they may be taken up at odd moments, read 
 aloud and talked over. In this way something of history 
 and mythology may be imbibed almost without knowing it, 
 and one may become acquainted with the names at least 
 of the great places and writers and artists before the 
 courses are begun. During the course the necessary 
 books might well be reserved in some place accessible to 
 the entire class, so that no one person can monopolize 
 them. It might again be emphasized that if a hospital 
 has no library of its own, the public libraries will be 
 glad to lend their books. 
 
 It is yet too early to speak of results from this ex- 
 periment at McLean Hospital, but it is true that the nurses 
 themselves appreciated what was being done for them 
 and cooperated heartily. Over and over again they 
 voiced their feeling that a new world of books and pictures 
 had been opened to them, and that, although they were 
 unable to remember all the details, they had acquired a 
 certain foundation on which to build in the future. At 
 least they became acquainted with the great names in 
 ^ literature and art, and knew a little of what they stood 
 
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for. Moreover, interested themselves in what was to many 
 of them a new-found world, they took their notebooks to 
 the wards, talked over the lectures with the patients, got 
 them interested, helped and were helped in turn by them 
 toward a wider outlook and a larger range of interest. 
 Nurses and patients alike went over the lectures, read the 
 books, criticised, compared impressions, had more topics 
 in common. More than once certain patients took excep- 
 tion to opinions expressed by the lecturer and quoted by 
 a nurse, and called the former to account. This interest 
 was good for the patient and not at all bad for the lec- 
 turer. Although it was a little difficult to arrange mat- 
 ters so that the whole senior class could be spared from 
 the wards for one hour a week in addition to the time 
 needed for the other classes, yet, from this one year’s ex- 
 perience, it would appear that the nurses give more to the 
 patients in awakened interest and stimulus than they 
 take from the wards in time. If such courses make them 
 better companions, and therefore more efficient nurses, it 
 would seem to be for the interest of the hospital, espe- 
 cially for the hospital for mental diseases, to give them 
 at least one “culture course” with their more technical 
 studies; while there is no doubt that better education will 
 make them more valuable in private nursing, whether in 
 mental or convalescent cases. 
 
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