When Linda Richards began her first nursing job at Boston City Hospital, she was little more than a maid, cleaning up the ward and its patients.
Nearly a century and a half later, nurses are highly trained in medicine and technology, often playing integral roles in complex medical teams, helping plan, execute, and evaluate treatments.
Richards, the first trained nurse in the United States and a pioneer of nursing education, helped sow the seeds of that transformation.
For decades after her death in 1930, Richards’ accomplishments, which included the introduction of bedside charts to track patients’ progress, were widely acknowledged, but over time she was nearly forgotten.
Massachusetts General Hospital, where Richards led one of the nation’s first nursing schools in the mid-1870s, is hoping to restore her place in history with an exhibit highlighting her accomplishments and a new portrait that will hang among those of other medical pioneers.
“She encountered a lot of resistance early on when she promoted the idea of training nurses, and she really fought through that,” said Georgia W. Peirce, the hospital’s special projects manager and co-chair of its Nursing History Committee. “She just quietly went about changing the face of nursing.”
Peirce said the plan to honor Richards grew out of research done for the hospital’s bicentennial in 2010 and the opening of its Museum of Medical History and Innovation.
The portrait of Richards was painted by Warren Prosperi, a 21st-century artist with a 19th-century aesthetic, who studied photos of Richards and read her memoir to get a sense of her personality. Prosperi, who works closely with his wife, Lucia, in executing his paintings, said he was taken with Richards’ forthrightness and lack of self-consciousness in photos, but also with her apparent strength.
“You wouldn’t want to get in this woman’s way,” said Prosperi, 65, of Southborough. “She’s like a soldier of sympathy.”
Lucia Prosperi, 62, said the painting came together as soon as her husband began sketching Richards’s face on a bare canvas.
“The eyes were just there . . . and she was present, and I thought, this is miraculous,” she said. “She’s here with us.”
In Richards’s memoir, published in 1911, she wrote that at Boston City Hospital in 1870, even her ward’s head nurse had no training in monitoring patients’ symptoms and knew neither the names nor the effects of the medicines she dispensed.
The hospital’s nurses had no training, received little respect or supervision, and seemed barely engaged. “[T]he majority were thoughtless, careless, and often heartless,” Richards wrote. She left City Hospital after three months.
Three years later, Richards became the first graduate of a nurse training school organized by Dr. Susan Dimock at the New England Hospital for Women and Children, now known as the Dimock Center, and the first nurse in the US to complete a training program.
The exhausting regimen required student nurses to wake at 5:30 a.m. and work until 9 p.m., after which they were on call all night as they attempted, with frequent interruptions, to sleep in small rooms between the hospital’s wards. There were no nights off, and only one free afternoon every two weeks.
Upon graduation, Richards spent a year as night superintendent at New York’s Bellevue Hospital, then returned to Boston to head a faltering year-old nurse training program at Mass. General.
The nurses there were on a rotation that gave them different menial duties each day, and the medical and surgical staff had no desire to see the women educated. Richards quickly began recruiting outside lecturers and changing the nurses’ routines.
It was a dramatic transformation from earlier practices. In a 1936 interview, former nurse Mary Elizabeth Norris described her seven years at Mass. General in the 1860s:
“The nurses swept, dusted, made the beds, and gave baths. The Head Nurse gave medicines and was responsible for the diets,” Norris told Ruth Sleeper, a graduate of Mass. General’s nursing school who would go on to be its director. “There were no classes; one nurse taught another what she knew.”
Mass. General’s nursing school was the first of several Richards reorganized or founded across a 40-year career that took her to New York, Pennsylvania, Connecticut, Michigan, and Japan, where she spent five years establishing and running that country’s first nursing school.
Richards often faced opposition from doctors and hospital trustees. In a remembrance following her death, Dr. Alfred Worcester wrote in the New England Journal of Medicine: “Only those who remember the surgeons and physicians of the Massachusetts General staff, and their hostility to nursing schools, can appreciate the victory Linda Richards won in that ultraconservative institution.”
Richards described in her memoir the chilly reception doctors gave her when she began to organize a nursing school at Boston City Hospital, eight years after leaving in frustration as an untrained nurse.
“Looks of bare tolerance rather than of pleasure greeted me on my rounds, and plainly expressed the feeling that my suggestions were an interference,” she wrote.
Linda Richards Fields, a Vermont native whose great-grandfather was a first cousin of the nursing pioneer, said elements of that chauvinism lingered when Fields became a nurse in the early 1960s.
“It’s taken a long time for doctors to trust . . . nursing. It took them a long time to see the value as much, or to admit the value,” said Fields, 71. “I think nursing . . . has for so many years had a subservient position.”
Fields, who was not named for her distant cousin and only learned of Richards after beginning her own nursing career, said reading her memoir made Fields wonder why Richards isn’t more widely known, like Florence Nightingale, considered the founder of modern nursing, or Clara Barton, the Civil War nurse who founded the American Red Cross.
“I was pretty astounded when I read her book,” she said. “She was a very progressive woman for her time, and a very adventuresome woman to travel as extensively as she did.”
Early in her career, Richards spent several months in Britain observing a system developed by Nightingale, who became Richards’s friend and supporter.
Nightingale wrote of Richards, “I have seen her, and have seldom seen anyone who struck me as so admirable. I think we have as much to learn from her as she from us.”
Natasha McEnroe, director of London’s Florence Nightingale Museum, said such praise was rare.
“Nightingale was not somebody who gushed warmly about people,” she said, “so when she speaks warmly and with admiration of Linda Richards, we sit up and take notice.”
One of Richards’s most significant contributions, McEnroe said, was her idea to record each patient’s progress on a chart at the foot of the bed, which she called “hugely influential.”
Recalling the life-saving efforts of paramedics, doctors, and nurses at last year’s Boston Marathon bombings, McEnroe said the portrait honoring Richards has a symbolic weight that goes beyond a single nursing pioneer.
“It’s acknowledging not just the legacy of Boston nurses in the past but it’s also acknowledging the fantastic work that Boston nurses do today,” she said.
The portrait and exhibit honoring Richards will be revealed at 11 a.m. May 6 at Mass. General’s Paul S. Russell, MD, Museum of Medical History and Innovation.
on Twitter @jeremycfox.