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THE SISTER NURSES

credit the vision of a nurse with the fact that us, too, to recognize that figures whom we now SSM Health Clare, St. Louis, recently became Women regard as historic were, in their own times, seen the first health care organization to win the as countercultural. In fact, they were simply Malcolm Baldrige National Quality Award. Religious doing what they felt called to do. Her clear and unwavering vision of how Sister nurses distinguished themselves in histo- gooI d our organization could become, coupled ry by caring not only for the public in general but with her enormous strength of" will, mobilized Have Long also by caring—joyfully—for people shunned by 23,000 employees, 5,000 physicians, and 5,000 society: people who had no money, were poor in volunteers at more than a score of"facilities in four spirit, were diseased, disfigured, disabled, alone, states. SSM Health Care's focus is its mission. Provided aged, or downtrodden. sisters who pro- "Through our exceptional health care," its mis­ vided care viewed health care as an sion statement says, "we reveal the healing pres­ expression of 's love for all people. If they ence of God." The culture of constant improve­ Care for could not save lives, they could at least try to save ment that now characterizes the system will con­ . tinue long after the Baldrige Award ceremony has America's Emily Friedman, the noted health care author faded to a distant memory, and lecturer, points out that the sister nurses Interestingly, the nurse who leads SSM Health made no distinction between what was clinical Care is also a : Sr. Mary Jean Ryan, a Poor, and what was social. Writes Friedman: "They Franciscan Sister of Mary. Sr. Ryan is ,m extraor­ provided nursing care, to be sure, but they read dinary woman. Like the nurse who built to the illiterate while they were dying, sang to Catholic health care in this nation, she can be Outcast, and those who were lonely while they bandaged their demanding. But like those pioneer healers, she wounds, and taught children their letters while has the courage to stand up for what she Disen­ they cleansed sores caused by Hansen's disease. and the inner strength to persevere in the face of They understood the concept of social medicine, seemingly insurmountable obstacles. of population-based health care, of healthy com­ It's good for those of us who work in Catholic franchised munities, long before these ideas became com­ 1 health care to remember that that history is not a monplace." thing wholly of the past. People continue to make history every day. and it is essential for us to BY SUZY FARREN CHARITY FOR ALL recognize events that are historical. It's good for One of the first women religious to articulate a Catholic approach to nursing care was Mother Mary Xavicr Clark, a Daughter of Charity of St. Vincent dePaul, who wrote "Instructions for the Care of the Sick" around 1841. "Our charity must be extended to all," Mother Clark wrote.2 That simple message speaks eloquently to the ministry of healing. Mother Clark called for the Ms. Fnrirn is manager, corpo­ fair and equitable distribution of medicine and rate communications, SSM food to all patients, explaining that, "a patient Health Care, St. Louis. should be able to sav, when a Sister leaves his

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bedside, 'That Sister is more like an angel than a In military hospitals, the sisters willingly gave human being. The very sight of her makes me their beds to wounded soldiers and slept on the think, of God and love him.'": floor. They did not differentiate between Union In the mid-1800s, Sr. Mathilde Coskcry, also a and Confederate, Caucasian and African- Daughter of Charity, wrote the first comprehen­ American, or Catholic and non-Catholic soldiers. sive document on nursing, which she called Anti-Catholic sentiment had been significant in Advices on Care of the Sick. In addition to a the United States before the war, but the sisters' wealth ot practical recommendations, the docu­ service during it did much to improve the image ment offered this advice about alcoholics: "For of Catholics. God's sake do not laugh at them or suffer others Abraham Lincoln wrote of the sisters' wartime to treat them with contempt, though this should •-CIA ice: "Of all the forms of charity and bene\o be the hundredth time he has been brought to lence seen in the crowded wards of the hospitals, 4 your care." those of some Catholic sisters were among the It was the Daughters of Charity who trained most efficient. . . . More lovely than anything I Florence Nightingale at the Institute of St. had ever seen in art, so long devoted to illustra­ Vincent de Paul in Alexandria, Egypt. tions of love, mercy, and charity, are the pictures Nightingale was impressed with the sisters' orga­ that remain of these modest sisters going on their nization, training, and discipline. She wrote: errands of mercy among the suffering and the "What training is there compared with that of a dying."" Catholic nun? Those ladies who are not Sisters have not the chastened temper, the Christian PERSONAL grace, the accomplished loveliness .\nd energy of Florence In peacetime as well as during war, the sisters the regular nun. I have seen something of differ­ sought to meet the needs of their communities, ent kinds of nuns and am no longer young, and Nightingale sometimes at great personal sacrifice. do not speak from enthusiasm but from experi­ An event in the early history of Mercy Hospital ence.'"' In 1854 Nightingale took 18 nuns, some of Pittsburgh illustrates this sacrifice. In January Catholic, some Anglican, to Russia with her to was impressed 1848, the admitted a sick boat­ serve as nurses in the Crimean War. man to their hospital. When they realized he had by the sisters' typhus, the sisters, most of whom were Irish THE CIVIL WAR immigrants, thought of the deadly epidemics they The same discipline that so impressed Florence organization, had witnessed in Ireland. Despite their fear, they Nightingale helped women religious adapt to the cared for the patient, ,\nd subsequently opened a demanding lives they would lead as nurses in our training, and special ward to care for 18 additional tvphus vic­ Civil War. "The Sisters brought to their aid in tims who arrived at the hospital. The sisters caring for the sick and wounded soldiers the diseipline. nursed these patients night and day, exhausting experience, training and discipline of the religious themselves. By the time the epidemic ended less bodies with which they were identified," notes than a month later, all but four of the patients one writer." "Self-denial was a feature of their had recovered. But the entire nursing stall—four daily life, and the fact that they had taken vows of Sisters of Mercy, all of them under 30 years old- , and obedience peculiarly tilled had died."' them for a duty that demanded personal Similarly, in 1878, when yellow fever broke out almost every hour of the day and night." in Memphis and Canton, MS, the St. Louis- Through the long, bloody war, 617 sisters based Franciscan Sisters of Mary (as they arc now from 12 congregations served as nurses on the known) sent a third of the congregation—13 sis­ battlefields, in military hospitals, on transport ters—to nurse the sick. Following the death of ships, in prisons, and on the first naval hospitals. five of the sisters. Sister Rose, aged 23, wrote this Mother Augusta Anderson, a Sister of the Holy letter to Mother Odiiia Berger, the congrega­ Cross from Notre Dame, IN, described the hor­ tion's leader: rific scenes the sisters witnessed: "Manx wounded men whose limbs had been amputated were there­ I am homesick, Reverend Mother, and every with little or no care. We pinned up our habits, day I wish 1 could see you, even if only for a got brooms and buckets of water, and washed the moment; then everything would be alright. blood-stained walls. We were not prepared as Since that is not possible, I must be pre nurses, but our hearts made our hands willing, pared to live my as well as possible. and with God's help, we did much toward allevi­ The yellow fever is really horrible and the ating the suffering."" other sisters are still quite weak and can't be

HEALTH PROGRESS MARCH - APRIL 2003 • 39 SPECIAL SECTION

left alone. I feci so lonely during the days to tenement in the poorest section of New York .md nights, being 500 miles away from you City, Lathrop nursed the poor and the dying in md unable to listen to your words. It seems their own homes. In 1899 she opened St. Rose's .m eternity to me and I hope that God will Free Home for Incurable Cancer, .md in 1900 let me come home soon. . . . Only four she founded the congregation now known as the nights have I been able to take off my Hawthorne Dominican Sisters. She refused to clothes when I went to bed, all the other accept any form of payment for her services from nights I was always caring for the sick. patients M\d supported her ministry through beg­ However, I am happy to be of service.1" ging. To this day, the sisters operate St. Rose's Home in New York City. And they still refuse to Among many congregations that cared for the accept payment from patients for their services. sick during the influenza epidemic of 1918 was Many Americans have heard of Fr. Damien de the Sisters of Mercy from Cincinnati. Sr. Veuster and his work with the lepers of Molokai, O'Conncr and IS other sisters traveled in mule HI, but few know about Mother Marianne Cope, carts through the hills of Kentucky to attend to a Sister of St. Francis of Syracuse, NY. In June members of coal-mining families who had con­ 1883, Mother (lope received a letter from a bish­ tracted influenza. Sr. O'Connor died while nurs­ op requesting help with a ministry to lepers in ing the sick, just days before her 58th birthday. Hawaii. More than 50 religious congregations An of the American Red Cross wrote to Another had turned down the 's appeal, but the congregation: "I am so distressed to hear that Mother Cope was intrigued by it. That October, one of your number paid the 'supreme sacrifice' historical figure she Mid six other sisters left Syracuse, expecting after her heroic work in helping others. She no to be gone for only a few weeks. She never less gave her life for her country than did our who left a returned. brave boys; for this flu epidemic threatened our The sisters worked at the Branch Hospital in country most seriously, and nowhere was the suf­ lasting legacy Kakaako, HI. Among their tasks was dressing the fering more than in our mountain section. I lepers' sores. In her Sonjj of I'tljirimajjc know that you did everything to save her, but and Exile, Sr. Mary Laurence Flanley, OSF, that her lift went as she wanted it to be in doing was Rose describes the task: "bach sister-nurse learned to for others."" wash away the scabs, the pus, the maggots, the Hawthrone rot from those fetid ulcers, to cut away the dead SERVICE TO PEOPLE IN NEED putrescent flesh at the margins of the sores, to Being of sen ice was what mattered to Henriette Lathrop, apply soothing ointments to the raw wounds, and 1 DeLille, a light skinned woman of color, who, to bind them about with clean cloths." * Mother decades before the Civil War, responded to the daughter of Cope enforced strict hygiene among her sisters. needs of elderly slaves who had been abandoned She promised them that no Franciscan Sister by their masters. Born in New Orleans in 1813, Nathaniel would ever contract leprosy. None ever has. DeLille could have declared herself white accord­ Until her death in 1918, Mother (lope cared ing to the law of the time, but she refused to Hawthorne. for people with leprosy (now called Hansen's dis­ deny her heritage. But, as a woman of color, ease). After Fr. Damien died of the disease in DeLille was not permitted to join a white congre­ 1889, she took over his Leper Settlement on gation. So, in 1842, she founded the Sisters of Molokai. She transformed these group homes, the , a religious community for once dens where the reviled outcasts lived in women of color. The sisters' ministry was to care squalor, into places where there was always music for the elderly, particularly former slaves. To the and the patients were Stylishly dressed. She grew elderly the sisters opened their own quarters, in plants, fruit, and vegetables, and restored dignity which they nursed them and provided a home. to people who had lost all hope. To this day, her Although DeLille died before Lincoln signed the religious community maintains a presence on Emancipation Proclamation in 1863, the institu­ Molokai.15 tion she founded—Lafon Nursing Home—exists A similar commitment to lepers was made by to this day in a New Orleans suburb.'-' the Daughters of Charity in Carviile, LA. In 1896 Another historical figure who left a lasting four sisters went to Carviile to care for people legacy was Rose Hawthorne Lathrop, the daugh­ with the disease. Because the public so feared lep- ter of the great New England novelist Nathaniel rosv, the sisters could never, once they had Hawthorne. Her ministry, in the late 1800s. was arrived at the Louisiana Leper Home (as it was care for poor people with cancer, a disease then then called), leave it to return to the larger soci­ thought to be contagious. Going from tenement ety, fhe Leper Home was a small community in

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the swamp, which was itself rife with malaria and ty it contains. Those devoted Sisters of water moccasins. There the sisters provided care Mercy willingly presented themselves and for people who otherwise would have received entered on a mission of charity from which none. The sisters" commitment has spanned the all others shrink in dismay MK\ affright. . . . centuries. Even after the federal government took Their fearless, self-sacrificing love is .m over the home, the Daughters of Charity main honor to their Church and to their Order." tained a presence there. And although the home was closed to new patients in 1999 (because there Mother Russell and Sr. Benson nursed in the is now a cure for Hansen's disease), the pesthouse for nine months, until the epidemic Daughters have chosen to remain there with subsided. Their congregation was one of many elderh residents who intend to live there until that responded to smallpox and other fiercely they die. contagious diseases. Today talk of a possible smallpox epidemic provokes great fear in this country. However, RESPONDING TO NEED ACROSS THE COUNTRY numerous congregations have in the past provid­ As immigration to the United States increased in ed care to people with smallpox. In the summer the 19th century, so did demand for health care. of 1868, for example, Mother Baptist Russell and who had come from to settle in Si. M. Frances Benson, both Sisters of Mercy, U.S. communities sent requests back to their asked the municipal government ot San Francisco native lands for nuns to open hospitals and nurse to allow them to take charge of the local "pest- the siek here. On their arrival, the sisters opened house" during a smallpox epidemic. They and established health ministries, in explained their request in a letter: whatever form the community needed. Once the The sisters congregation was established, it would often send It is one of the privileges of the Sisters of two or more sisters to oilier parts of the country Mercy that we attend on our fellow in often worked in response to calls from or priests. whatever form of disease it is the Divine Despite their poverty, their lack of fluency in Will to afflict them. Therefore, if the City English, and the fact that America in the 1800s Authorities are willing to accept our 14 or more was definitely a man's world, the sisters opened Services, two of our Sisters will DA'. [Deo hospitals all across the nation. Not only did they polente, or "God willing"] go to the Pest hours a day, open these hospitals, they staffed them as well, house .md take up residence until such time often working 14 or more hours a day, seven d.\\ s as the Almiglm wills to deliver the City seven days a a week. They nursed patients, fed them, did the from this terrible malady. . . . One room is washing, cleaned the hospital, ^nd grew vegeta­ all we require. You know the accommoda­ week. bles and raised animals to provide food and milk. tion of a Sister of Mercy is very simple.1" The vast majority of these sister nurses lived and died in obscurity, known only to their birth fami­ After she and her colleagues had begun their lies, their religious sisters, and their patients. work, Sr. Benson wrote to the sisters in Ireland For much of their history as nurses, Catholic about smallpox: "It is truly a horrible disease, so women religious worked without the aid of loathsome, so disgusting, so pitiable. . . . Not antibiotics and modern technology, so their care one spot from the crown of the head to the sole was necessarily largely custodial. They could, of the foot was sound, the eyes of the greater however, do everything possible to make their number closed and pus running from them down patients comfortable and to show them compas­ the cheeks; their throats so sore that to take a sion. And somehow, even before Joseph Lister, drink almost chokes them . . . and the mnl-odour the sisters seemed to understand the link between so terrible that they themselves cry out: 'O Sister, cleanliness and health. I cannot stand the smell.'"'" At the time, a local newspaper pointed out TRAINING PROGRAMS FOR THE that: By 1872 there were about 75 Catholic hospitals in the United States. By 1910 the number had none of our religious denominations have, grown to 400. As the number of hospitals like the , . . . any organiza­ increased, the need for formal training programs tion that could furnish help—competent, for nurses—including lay nurses—grew as well. intelligent, kind female nurses to enter the The Hospital Sisters of the Third Order of St. home of misery .\nd take charge of its min­ Francis opened the first Catholic nursing school istrations to the crowd of suffering humani in the United States at St. John's Hospital in

HEALTH PROGRESS MARCH - APRIL 2003 • 41 SPECIAL SECTION

Springfield. IL, in 1886. Other congregations care for pregnant women and to educate young followed suit. In 1893, Cardinal James Gibbons mothers. She was appalled that these women often of Baltimore wrote of the training received by had to choose between taking a sick child to the such students: "Under the guidance of the sis doctor, on one hand, and feeding the family, on tens, from whom they learn the principles which the other. Sr. Simpson wrote letters to her congre­ underlie the intelligent treatment of the afflicted, gation in Evansville, IN, describing her work. they become skillful in the hospital wards, and On February 23^ 1968, she wrote: acquire that gentleness and ease of manner, that devotion to duty so much appreciated by the I went to visit an expectant mother today. . . . 1 physician and patient." '' She is the mother of 12, all at home. 1 hey As the 20th century began, nursing care was live in three small rooms. . . . The house changing from the custodial to the scientific, and v\us cold. One gas heater in the middle the nc^d for formal education for nurses was room made very little heat. I was cold as I increasing. In addition, hospitals were increasing talked to the mother, and I had on boots I heir bed capacity, prompting a need for nurses, and my all-weather coat with a heavy lin­ both sisters and lay. By 1915, some 30 congrega­ ing. . . . The baby was whining, trying to tions sponsored 220 Catholic nursing schools." cry. I picked her up, ,\m\ it was like holding a frozen fish. The poor little darling had on CIVIL RIGHTS a dress—period. . . . How can a country as In 1933 the congregation known today as the rich as ours have so much poverty? I keep :: Franciscan Sisters of Mary opened the first The Franciscan asking myself that question day after day. ( atholic hospital for African Americans in the United States: St. Mary's Infirmary in St. Louis. Sisters of Mary Sr. Simpson did make a difference in Mound The opening of this hospital served two purpos­ Bayou. When she went back to visit at the age of es. It both provided care for the sick and offered opened the 83 in 1994, she visited the women for whom she much-needed opportunities for African-American had provided care nearly three decades earlier. physicians and nurses to practice their profes­ On the walls of their modest houses were ph<> sions. That same year, the sisters opened St. nation's first tographs of their children and grandchildren, the Mary's School of Nursing, the nation's first vast majority of whom have graduated from col­ school of nursing for African Americans. It school of lege. offered a three-year nursing diploma program. In 1951, Sr. Helen Clare Bauerback, a Sister of nursing for THE LAY CHALLENGE Joseph of Wheeling and the administrator Certainly the declining number of women reli­ of Si. Francis Hospital in Wheeling, VVV, took African gious will forever change Catholic health care. what was then the bold step of hiring three SSxM Health Care's Sr. Ryan, is one of only a few African-American nurses. When 25 staff nurses Americans. sisters left who head health systems today. threatened to leave the institution unless the Friedman, discussing the declining number of three were fired, Sr. Bauerback remained firm. sisters in health care, predicts that the great chal­ Twenty white nurses quit. To keep the hospital lenge for the laity will not be competition with from closing, the congregation airlifted Sisters of for-profit hospitals or reproductive issues. "It is from other West Virginia hospitals. that there will be fewer sisters in the future, and Some physicians left as well MU\ the patient cen­ therefore that spirit—that crystal-pure charitable sus declined, but the hospital weathered the con­ spirit, that pride in eschewing material things, troversy. The strike lasted about three months.21 but, most important, that majestic insistence on serving—must somehow be kept in other vessels, CARE OUTSIDE THE WALLS in other ways."" The struggle is different than it As Catholic hospitals grew into complex health was for the nineteenth -century sisters, but the care organizations staffed largely by the laity, foes, Friedman writes, are the same: "pain, suffer­ some sister nurses saw the need to go outside the ing, abandonment, greed, heartlessness, and w alls of the institution to provide care to people hatred." with unmet needs. Mother Clark set the standard for Catholic Sr. Man- Stella Simpson, a nurse midwife, was health care when she wrote in 1841, "Our charity one of them. In 1967, at the request of the must be extended to all." Throughout our histo­ American Nurses Association, Sr. Simpson, a ry as a nation, sister nurses have taken special joy Daughter of Charity, went to Mound Bayou, in caring for the poor, the disenfranchised, the MS—an impoverished African American town—to Continued on page 65

42 • MARCH - APRIL 2003 HEALTH PROGRESS INVISIBLE RADICALS THE SISTER NURSES THE NURSE SHORTAGE Continued from page 37 Continued from page 42 AND OUR MINISTRY Continued from page 26

9. Spratley. 10. "Erie RN Wins $10,000 in CHA Competition to Address Nursing Workforce Shortage." Catholic Health people shunned by society, even World, May 1, 2002, pp. 1-2. 11. See, besides the AHA Commission on Providence, Spokane. WA, no date. p. 7. when doing so was seen by society .is Workforce for Hospitals and Health 37. Chronicles of Providence Hospital. countercultural. After all, , the Systems. Tri-Council for Nursing. 38. Chronicles of St. Joseph's Hospital. healer, was countercultural. Strategies to Reverse the New Sisters of Providence, Spokane. WA, no As we move forward, Catholic Nursing Shortage, available at date. p. 20. health care must celebrate its historic www.aacn.nche.edu/-publications/ 39. Chronicles of Providence Hospital, p. positions/tricshortage.htm; Joint 16. figures, and, at the same time, recog Commission on Accreditation of 40. Lucia, p. 83. nize the people today who are shaping Healthcare Organizations, Health 41. See Chronicles of Providence Hospital, the future, for they will one day be Care at the Crossroads: Strategies for p. 40. One hospital patient was so hos­ seen as historic figures themselves. • Addressing the Evolving Nursing tile to the sisters that her physician Crisis. Chicago, 2002; Service Em­ brought in a private, secular nurse for ployees International Union, The her. However, by the end of her stay the National Nurse Survey: 10,000 patient had dismissed both the private NOTES Dedicated Healthcare Professionals nurse and the physician and had Report on Staffing, Stress and Patient become a firm friend of the sisters. 1. Emily Friedman, "Fulfilling the Sisters' Care in U.S. Hospitals, Washington, 42. Lucia, p. 95. Promise." Health Progress. January- DC. 1993; and U.S. General Account­ 43. Clara S. Weeks' A Text-Book of Nursing February 1997. pp. 50-55. ing Office, Nursing Workforce: (Appleton & Co., New York City. 1885), 2. Mother Clark is quoted in Christopher Emerging Nurse Shortages Due to which Cox used with the Little Medical J. Kauffman. Ministry & Meaning: A Multiple Factors, Washington, DC, Guide, was the first nursing text pub­ Religious History of Catholic Health 2001. lished in the United States. Care in the United States, Crossroad, 12. Spratley. 44. Margaret Tynan, St. Vincent's School of New York City, 1995. p. 37. 13. See U.S. General Accounting Office. Nursing of the Institute of Providence: 3. Kauffman. p. 39. 14. R. Donley, et at., "What Does the Its History and Alumnae, St. Vincent's 4. Suzy Farren. A Call to Care: The Women Nurse Reinvestment Act Mean to School of Nursing. Portland. OR. no Who Built Catholic Healthcare in You." Online Journal of Issues in date, p. 53. This is a collection of papers America, Catholic Health Association. Nursing, December 20, 2002, avail­ written by Tynan, a registered nurse at St. Louis, 1996, p. 138. able at www.nursingworld.org/ St. Vincent's. According to her. it was 5. J. B. Darcy, "Florence Nightingale and ojin/topicl4/tpcl4_5.htm. Cox's opinion that nuns did not need the Sisters of Mercy," available at www. 15. Spratley. diplomas. stjohnsarchodiocese.nf.ca/monitor/ 16. Spratley. 45. Charles E. Rosenberg. Tne Cholera darcy_nightingale.html 17. Spratley; American Association of Years: The United States in 1832,1849, 6. George Barton, "A History of the Labors Colleges of Nursing, "Though En­ and 1866, of Chicago Press, of the Catholic Sisterhoods in the Civil rollments Rise." Chicago, 1990. War," available at www.gospelcom.net. 18. American Association of Colleges of 46. Gerald M. Kelly, The Life of Mother 7. Farren, p. 9. Nursing, Nursing Faculty Fact Sheet, Hieronymo. Daughters of Charity 8. Farren, p. 15. 2002, available at www.aacn. Archives. Albany. NY, no date, p. 3. 9. Farren, p. 206. nche.edu/media/backgrounders-/ 47. See Henninger, p. 1. for the German- 10. M. Agnita Claire Day. A Woman for All facultyshortage.htm. born Sisters of St. Mary, and Kelly, for Times: Mother Mary Odilia, Franciscan 19. See, besides Aiken, J. Needleman, et the Daughters of Charity, who, in the Sisters of Mary. St. Louis, 1980, p. 373. al.. "Nurse Staffing and Quality in northeastern United States, were pre­ 11. Farren, p. 111. Hospitals in the United States," Policy, dominantly Irish. 12. Farren. p. 162. Practice, & Nursing Practice, vol. 3, no. 48. Letter of Mother St. Pierre to Mother 13. Farren. pp. 200-205. 4, pp. 306-308. Marie of Jesus, September 14. 1882, 14. Mary Laurence Hanley and 0. A. 20. R. A. DeMoro. "What California Has Archive of the of the Bushnell. Song of Pilgrimage and Exile: Started . . .," Modern Healthcare, vol. Incarnate Word, San Antonio. The Life and Spirit of Mother Marianne 32. no. 13, p. 26. 49. Keuenhof. Fr. Keuenhof was the chap­ of Molokai, Franciscan Herald Press, 21. R. A. Heifitz and D. L. Laurie. "The lain of the Sisters of St. Mary Infirmary Chicago, 1981. Work of Leadership," Harvard in Kansas City. 15. Farren, pp. 97-103. Business Review, January-February 50. Marvin O'Connell, "The 16. Kauffman, p. 124. The bracketed phrase 1997, pp. 124-134. Tradition since 1545." in Ronald L. is Kauffman's. 22. Heifitz and Laurie, p. 126. Numbers and Darrel W. Amundson. 17. Kauffman. 23. See D. J. O'Brien. A Century of eds.. Caring and Curing: Medicine in the 18. Kauffman, pp. 124-125. : Contexts Western Religious Tradition, Macmillan. 19. Kauffman, p. 161. and Comments. Orbis , Mary- New York City. 1986, pp. 108-145. 20. Kauffman, p. 167. knoll. NY, 1991. 51. Ann Doyle, "Nursing by Religious Orders 21. Farren, p. 37. 24. See AHA Commission on Workforce in the United States," American Journal 22. Farren, p. 218. for Hospitals and Health Systems, for of Nursing, nos. 10,19 and 29,1929. 23. Friedman, pp. 54-55. example.

HEALTH PROGRESS MARCH - APRIL 2003 • 65 JOURNAL OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES www.chausa.org

HEALTH PROGRESS®

Reprinted from Health Progress, March-April 2003 Copyright © 2003 by The Catholic Health Association of the United States