Phillips Beth Israel School of Nursing: A New Role For Nurses

1948 American Nurses Association required licensing for RNs and LPNs. The School's course of study covered three years, including psychiatry and communicable diseases, with clinical experiences at Bellevue , Central Islip , Willard Parker and Kingston Avenue . 1949 Beth Israel Hospital nursing supervisors doubled as nursing instructors
During the 1940's nursing continued to cope with low pay and long hours, including night service; it was Florence Nightingale's belief that a nurse's care never ceased. The Beth Israel student magazine, Signs and Symptoms, referred to young nurses who worked nights as "creatures of darkness." Many of their duties, such as preparing cotton balls, applicator sticks and dressing packs, would be performed by aides today. Even routine tasks such as intramuscular injections or taking blood pressure required the presence of staff doctors. Patients received regular massages from nurses, a treatment considered a luxury today. By the late 1940's efforts were once again initiated to reduce work hours.
	World War II nurse
	World War II nurse assisting doctor.
Nursing has been transformed as a result of national and international conflicts. During World War II, the Beth Israel School of Nursing participated in the US Cadet Nurse Program, established in 1943 under the Nurse Training Act. The Bolton Act, named after Frances Payne Bolton - a congress woman from Ohio - provided education subsidies to nursing students who agreed to war duty. The US Cadet Corps enrolled 124,000 students during wartime. After the war, Cadet Nurses received scholarships and thousands of women could afford to attend further schooling. Nursing students entered 1,125 participating nursing schools and two thirds of the entering class graduated. In 1946, the Beth Israel School of Nursing class consisted of 104 students. 102 of them were cadet nurses.
7th Floor Nurse’s Station in 1945	In 1944, Clare M Casey, R.N., M.A., was introduced to the board as the new director of the nursing school. Casey proposed the program include courses in psychiatric and communicable diseases. An advocate of the 8 hour day, Casey promoted the shorter work shift on both the local and state levels. New York City municipal hospitals had approved the 8 hour day in 1937 and under the leadership of Clare Casey, all hospitals soon incorporated this staffing innovation. While nurses were in short supply during the war, aides and orderlies were utilized in unprecedented numbers. As in previous conflicts, the war broadened the dimensions of the nurse's role. By the end of 1945, 212,000 women had become certified aides. Along with their impact on the actual work of nursing, the aides' classification of hospital worker required that nurses make distinctions between skilled and non-skilled nursing care.
In 1947, the American Journal of Nursing cited 18 procedures that became newly assigned nursing responsibilities as a result of the war; intramuscular injections, irrigation and drainage of catheters, tubal feedings, pediatric gavage, intravenous and irrigations, and applying polio packs. The use of antibiotics increased, and ambulation in postoperative care, obstetrics and rehabilitation were introduced. As nurses began administering direct patient care within the hospital, aides and orderlies covered many of the more mundane tasks. Increased responsibilities created a need for practical nurses. A practical nurse, or LPN - licensed practical nurse - practices under the supervision of a registered nurse, whose education is more extensive. The educational program for a practical nurse comprises one year, including classroom study and practical training in a hospital, followed by a state licensing examination.		1940’s vintage illustrtaion of nurse’s training
In 1948, the American Nurse Association recommended "a restratification of nurses into three main categories: Nurse Educators, Clinical Nurses, and Trained Practical Nurses. The Nurse Practice Act of 1949 required that all nurses for hire must be registered professional nurses or licensed practical nurses. At that time in the US there were 75,154 professional nurses and 14,806 practical nurses. A nurse worked in 5 major clinical areas: medicine, surgery, obstetrics, pediatrics, and psychiatry. An integrated approach to total patient care was the goal, involving physical, psychological, social, spiritual, preventative and rehabilitative aspects.
Class of 1949 recieving instruction		Capping ceremony in 1946

Beth Israel School of Nursing director Clare Casey bought further change to the curriculum as students would visit other locations for certain aspects of their education; the Nursery and Child's Hospital for pediatrics, Sloan's Hospital and Lying-In Hospital for obstetrics, Post Graduate Hospital for dietetics, and later, the Kingston Avenue Hospital for contagious diseases. Beth Israel did not have a psychiatric unit and Casey remedied the situation by enacting affiliations with Bellevue and Central Islip Hospital where students studied the theory and practice of psychiatry in a clinical setting