Principal Women

Monday, October 1, 1906

A trio of significant women guided the nursing education program at the University of Kansas during the first three-plus decades of its existence. Their names were Pearl L. Laptad, S. Milo Hinch, and Henrietta Froehlke.



Their work enabled what was originally called the Training School for Nurses to gain a solid institutional foundation and instill increasingly rigorous professional and academic standards. At the same time, they provided the KU School of Medicine’s Bell Memorial Hospital with a competent and cost-effective nursing staff.



Each woman left the state of nursing at KU successively better than she’d found it, and from an enrollment standpoint, far healthier as well – from a mere handful of “pupil nurses” to a thriving department with some 100 students.



The cumulative accomplishments of Laptad, Hinch, and Froehlke are all the more remarkable since they were achieved in an era when male physicians rarely accorded nurses anything approaching professional respect and women rarely attained executive-level positions.



It all began on October 1, 1906, when Pearl L. Laptad welcomed the first class of six nursing students – all of whom she had personally selected – to the first day of school at KU’s nascent nursing education program.



This Training School for Nurses, then organized as a sub-department of the KU School of Medicine, had been established for a very practical and specific purpose. The Medical School had become a four-year MD-granting institution just the year before, thanks in part to a $100,000 gift that had enabled the construction of the 35-bed Eleanor Taylor Bell Memorial Hospital atop “Goat Hill” in Rosedale (part of present-day Kansas City, Kansas.)



Now the new hospital needed nurses. With public funding in short supply, KU opted for the do-it-yourself approach, founding its own nursing education program that would generate the necessary nursing staff. Among this arrangement’s main attractions was that so-called “pupil nurses” would enroll in a three-year apprenticeship program and serve as an unpaid workforce in return for their room, board, and education.



To manage this undertaking, the KU Board of Regents sought an accomplished nurse with multiple talents. Her job would include providing competent hands-on instruction to the nursing students, handling the myriad administrative responsibilities of running the Training School on a day-to-day basis, and supervising the young women under her charge with a strict disciplinary regimen.



The Regents’ choice was 33-year-old Pearl L. Laptad, an unmarried “graduate nurse” from Lawrence. With the title of principal, she would report to Lawrence physician Dr. George H. Hoxie, who was serving as both dean of the Medical School’s two-year Clinical Department and superintendent of the Bell Memorial Hospital.



Among Laptad’s impressive qualifications was a nursing diploma from Christ’s Hospital Training School in Topeka, which she had earned in 1901. (The licensing of registered nurses, or RNs, did not begin in Kansas until 1913.) Laptad had also spent several years as a Lawrence schoolteacher and had taken postgraduate nursing work at Chicago’s Presbyterian Hospital. At the time of her hiring by KU, she was head nurse at Simmons Hospital in Lawrence, a small private institution founded in 1903 by local surgeon and KU School of Medicine faculty member Dr. Charles J. Simmons.



Officially, the Board of Regents gave Laptad “limited authority” to influence overall Training School policies. Nonetheless, she seems to have played a prominent role in shaping its curriculum anyway. As Dean Hoxie remembered it, “The course of study” – which, in addition to technical, on-the-job nursing instruction, also included academic work in subjects like anatomy, pathology and dietetics – “was developed from what Miss Laptad … had gone through” during her own student days. It was then further augmented by the examples of “eastern schools such as Harvard.” In short, said Hoxie, recalling his early collaborations with Laptad, “We worked out what we thought we could carry through and changed our plans as soon as we found something wrong.”



In addition to her duties as principal, Laptad also served as a lecturer on nursing and, in this capacity, was the Training School’s only female and only non-physician faculty member. She even authored a chapter called “The Care of the Patient and the Sick-Room” in the Training School’s first textbook, a tome titled The Practice of Medicine for Nurses that was edited and largely written by Dean Hoxie himself. As it turned out, though, Laptad herself apparently was rarely in the classroom, for she had either instituted (or, if not, had certainly helped enforce) a tremendously arduous work regimen that kept both her and her students busily occupied in daily hospital and nursing tasks for well over 60 hours each week.



As Shirley Veith has observed in her 1988 KU doctoral dissertation, “The Development of the Nursing Profession at the University of Kansas: 1906-1941,” Laptad “viewed the bedside caring role as the essence of nursing.” Classroom instruction, therefore, became a second-tier priority when any work was still be done in the wards, or when any patient had need of either physical or emotional comfort.



What’s more, nursing coursework often took a backseat to general housekeeping duties, too. Laptad saw such tasks as bed making, floor scrubbing and food serving as indispensable nursing responsibilities that were essential to a well-run hospital. Indeed, according to Veith, she appears to have accepted “the paternal model and the leadership role of physicians in the treatment of disease. Also, like physicians,” Veith added, Laptad “conceptualized the feminization of the nurse’s role to be nurturer, efficient manager and empathetic caretaker.” Laptad taught her students to embrace this concept as well.



As principal, Laptad appears to have been something of a workaholic. She regularly put in the 60 hours a week required of her charges, was present anytime an operation was performed, and was perpetually on call for emergencies. She also maintained constant maternal vigil over her nursing trainees during their off hours. Consequently, it is perhaps little wonder that she chose to resign her position in late 1908. According to Hoxie, she “literally wore herself out and it was months before she recovered from the exhaustion incurred at Rosedale.”



Once she did recover, however, Pearl Laptad embarked upon a rich post-KU nursing career and time and again was commended for her “professional skill and devotion to her work.” She entered the relatively new field of public health – a movement championed by Kansas State Board of Health secretary (and future KU School of Medicine dean) Dr. Samuel J. Crumbine. At first, she taught courses on the nursing aspects of public health at Columbia University’s School of Nursing. Later, Laptad returned to Kansas and assisted Crumbine’s Board of Health directly by teaching the basics of infant care to high school-age girls throughout the Sunflower State (a practice deemed controversial by more than a few contemporary observers). By 1920, Laptad was working full-time as a public health nurse for the American Red Cross and remained with this organization until her retirement in 1934.



Reflecting on her legacy decades later, her former boss and fellow administrator, Dean George Hoxie, praised Laptad as a “monument to integrity and thoroughness,” one who “did a marvelous job of initiating standards in spite of a paucity of materials and equipment. The nurses under her inspiration regarded service as their aim in life, not money, not places of authority.” (From Hoxie, a devout adherent of the “paternal model” of medicine, this should be read as a most high compliment.) Finally, referring to the birth and early development of KU’s Training School for Nurses, he concluded: “We were fortunate in having Miss Laptad to guide the destinies of the new project.”



Laptad’s relatively brief tenure may be an indication of just how demanding and physically taxing the job of Training School principal was. Further proof might be derived from the fact that following Laptad, KU’s nursing program went through four directors in five years. In 1914, however, there came a much-needed “stabilizing influence” in the person of S. Milo Hinch, RN.



A Canadian by birth, Hinch also was single. She was educated at the New York Hospital Training School for Nurses and then worked “in the best hospitals on the North American continent,” as KU School of Medicine professor and institutional historian Dr. Ralph H. Major once put it. While it is unclear exactly how Hinch came to settle in Kansas, once she began her duties as supervisor of nurses at KU’s Training School, Major speculated that “she must have felt she was on the Western frontier of nursing education.” (Even if this was her attitude, Major hastened to add, Hinch – who had a “fund of dry humor and was a very interesting conversationalist” – never once “made odious comparisons between the New York Hospital and the Bell Memorial Hospital.”)

A “forceful, vigorous and methodical” leader, as Veith characterized her, Hinch had “extensive supervisory experience … and knew the conditions that should exist in a well-organized hospital.” Unfortunately, in Hinch’s judgment, Bell Memorial did not exactly fit the “well-organized” definition – not by a long shot. She fully supported the 60-hour work requirements for nursing trainees – firmly believing, like Laptad, that abundant practical experience and hands-on, bedside instruction were absolutely essential to training top-notch nurses. However, Hinch also thought that impossible burdens were being placed on her and her roughly one dozen students. And in stark contrast to Laptad, Hinch chose not to suffer in silence.



Repeatedly and vociferously she informed University and Medical School administrators that there were entirely too few nurses to do all the work expected of them. What’s more, they were short on necessary supplies and equipment. And if that wasn’t bad enough, the nurses’ on-campus housing quarters were almost devoid of privacy. They were, in Hinch’s words, “little short of a disgrace.” (Since the 1911 completion of a second and larger Eleanor Taylor Bell Memorial Hospital, also on “Goat Hill,” the original hospital facility had been home to both the Training School and its complement of student nurses. So cramped were the conditions there that Hinch herself did not even have a private office and some women reportedly had to sleep on makeshift cots.)



In the end, the tactic that ultimately proved most effective in spurring some corrective action was not sincere pleading but rather Hinch’s recurring threats to quit. So valuable, it seems, was she in the eyes of University officials that they variously satisfied her demands to hire more graduate nurses, raise the wages of dispensary workers, bring on more kitchen and housekeeping help, and hire her a part-time office assistant. More than once, in fact, memos were circulated encouraging Hospital and Medical School staff members to always show her “the greatest possible courtesy.”



This was perhaps the least they could have done considering all the services Hinch provided. Indeed, in 1915, following the dismissal of the superintendent of Bell Memorial Hospital on the charge of “mismanagement of funds,” she was asked to take on his administrative duties in addition to her own as head of the Training School for Nurses. Despite claiming to know “nothing whatsoever about keeping books and accounts,” Hinch eventually relented and very reluctantly agreed. As it turned out, she proved more than up to the job, keeping “the hospital going and the finances in good shape” for the next five years, all the while amassing no small amount of power and influence for herself in a heavily male-dominated environment.



According to Veith, however, the manner in which Hinch often wielded her power had a rather disquieting effect on many of her pupil nurses. “Miss Hinch would show up at unexpected times of the day or night and check on the students’ work,” a practice that “kept them in a constant state of fear that she might arrive and reprimand them if she found something wrong.”



Moreover, Veith added, “Miss Hinch ran the school under a rigid disciplinary model that taught obedience to her and to other authority figures. Power ran only downward from her to the lowliest, newly-arrived [trainee].” And not even in off-hours could they escape her ever-watchful eye since she “ruled” the students’ social lives as well, sternly enforcing Training School rules and regulations that governed just about every conceivable aspect of the women’s daily routines.



Nonetheless, “Nurses were never known to speak disparagingly” of Hinch, at least according to one account (though perhaps they were simply too frightened to do so). “Rather, they spoke of her with deep respect and gratitude for the excellent training she had instituted” during her six-years at the Training School helm – a tenure that would have surely been longer were it not for Hinch’s untimely death in 1920.



What Hinch left behind was a Training School that continued to insist upon the highest standards of clinical nursing instruction, albeit occasionally to the detriment of academic coursework, though this was generally in keeping with most other early twentieth-century nurse training programs nationwide.



In terms of the living conditions she and her students had had to endure, these were still pretty much as they had been when Hinch arrived in spite of her relentless efforts to effect improvements in nursing student housing. In 1928, however, the University posthumously recognized Hinch and her championing of the pupil nurses’ lot when the new $300,000 nurses’ home – located on the Medical School’s present-day campus at 39th and Rainbow Boulevard in KCK – was named Hinch Hall in her honor.



On hand to celebrate the building’s opening was Henrietta Froehlke, RN, who, one year earlier, had been named KU’s “director of nursing education.” This was yet another title change, but the job itself was virtually indistinct from “principal” or “supervisor of nurses.” Like Laptad and Hinch, Froehlke was responsible for directing the Training School’s educational program as well as supervising the nursing services at Eleanor Taylor Bell Memorial Hospital. Unlike her predecessors, though, Froehlke set about immediately to cause a marked change in educational emphasis by stressing the academic, and not just the clinical, component of nursing instruction at KU.



Froehlke’s own scholastic background doubtless influenced this effort. In addition to a 1922 degree from St. Luke’s Hospital School of Nursing, located in her hometown of Chicago, she had also earned a BA from Columbia University’s Teachers College. Her major, appropriately enough, was in school of nursing administration. (In 1932, incidentally, she would also complete her MA at Columbia Teachers College, becoming the first KU nursing director to hold an advanced degree.)



Upon beginning her duties at 39th and Rainbow, on September 15, 1927, Froehlke decided that her primary aim should be to convince University administrators to allow nursing students – who numbered around 40 by this time – to pursue a bona fide baccalaureate degree. This was not exactly a new idea, having been originally proposed by Dean George Hoxie some twenty years earlier. Yet since that time, it had lacked any advocates determined to re-champion the cause. Fortunately, Froehlke gained an influential ally in Dr. Harry R. Wahl, dean of the KU School of Medicine (1924-48). And soon after, the entire Medical School community registered its “complete approval of the plan.”



In the end, despite opposition from some KU administrators on the main campus in Lawrence – who insisted that the vocational profession of nursing had no academic place in the College of Liberal Arts and Sciences – Froehlke and her supporters eventually prevailed. In 1929, the University authorized creation of a new Department of Nursing Education and began offering the Bachelor of Science in Nursing degree (BSN), which could be earned following a special five-year course of study. (For the BSN, students took two years of background science instruction on KU’s Lawrence campus and then enrolled in the regular three-year nurse training course given on the Med School campus in KCK. However, the original three-year diploma program also remained in effect and was not phased out completely until the 1950s.)

Another important nursing milestone was reached in 1932, when the University – again with Froehlke’s energetic backing – bestowed academic rank on 15 nursing department faculty members. For her part, Froehlke was named associate professor of nursing education and, later, would be promoted to full professor status.



Beyond prioritizing coursework for both degree- and diploma-seeking students, Froehlke was instrumental in discontinuing the small monthly allowances that nursing trainees had been receiving since 1908-09. Seeing this as a vestige of the old payment-for-service apprentice system that treated pupil nurses not as students but, rather, as a discount labor force, she helped institute a standard tuition-based system.



Froehlke had hoped to use the additional revenue the tuition would bring in to hire extra graduate nurses, thus freeing up nursing trainees for even more class time. Unfortunately, her hopes on this score were dashed when Medical School administrators proceeded to “redirect” the badly needed funds into other areas. “It takes such a long time,” Froehlke once lamented, “to educate men … to the needs of student nurses and patient care.”



Froehlke enjoyed greater success in her quest to further professionalize nursing education at KU when she gained a dramatic reduction in the amount of housekeeping work that pupil nurses performed. She also presided over the establishment of a six-week training program in public health, affiliated with the Kansas City, Kansas, Health Department, and additionally organized a four-week nursing course specifically devoted to working with tuberculosis patients. What’s more, Froehlke assisted her students in their successful efforts to obtain a chapter of the Sigma Theta Tau nursing honor society and lent her support as well to the formation of a nursing student council. She even helped end the original 1906, Victorian-era prohibition on married women becoming KU nursing students, though she herself remained single.



During her 14-year tenure, Froehlke also served as editor of The Kansas Nurse and as president of both the Kansas State Nurses’ Association and the Kansas League for Nursing Education. But despite her stellar statewide and regional reputation, there was one goal she could not attain for the Training School – accreditation from the National League of Nursing. Among the reasons given for denying KU this status were the Medical School’s effective administrative domination of nursing education, plus “heavy weekly hours for student nurses and an inadequate number of graduate nurses” on staff.

These, of course, were the very aspects of the program over which Froehlke exercised the least control. As Veith has pointed out, the 1928 establishment of the University’s Nursing School Committee profoundly curtailed the nursing director’s independence and authority. Although Froehlke was a member of this new administrative body, every other member was a physician appointed by the Medical School dean. Not surprisingly, they proved most unwilling to allow their presumed workforce of pupil nurses too long a leash. “Control of the nursing school,” noted Veith, “was now firmly centered in the School of Medicine” and would remain so for decades to come. Full accreditation would not come until 1959.



In 1941, Henrietta Froehlke brought her time at 39th and Rainbow to an end when she announced her plans to return home to Chicago and accept the directorship of Presbyterian Hospital’s School of Nursing (one of Pearl Laptad’s alma maters, incidentally.) Contemporary and modern-day accounts alike have agreed that, with her departure, “an important era in the education of nurses at the University of Kansas” had come to an end as well.



What endured, however, was the affection her former students still felt for her even after she’d gone. “To her student nurses,” declared the short-lived nursing yearbook Kuh-Kuh in its 1942 edition, “Miss Froehlke was more than a director of nurses. She was friend and counselor. She won the admiration and regard of each student nurse. Her dignity and understanding,” it concluded, “place her in our highest esteem.”



Editors

KUhistory.com

 

[Source Notes: The documents and materials consulted for this article can be found in the University of Kansas Medical Center Archives. They include the following: Shirley Veith, “The Development of the Nursing Profession at the University of Kansas, 1906-1941,” (PhD dissertation, University of Kansas, 1988); Hester I. Thurston, RN, “The Kansas University School of Nursing: An Historical Perspective” (paper presented at the Nursing Perspectives Workshop, May 15, 1982); Sara A. Patterson, “Out of Our Past” (paper presented at the Inter-Century (KU 1866-1966) Day in Nursing); Dr. George H. Hoxie, “The Training School for Nurses of the University of Kansas (undated reminiscences); Ralph H. Major, MD, An Account of the University of Kansas School of Medicine (University of Kansas Medical Alumni Association, 1968), pp. 1-58; Lawrence H. Larsen and Nancy J. Hulston, The University of Kansas Medical Center: A Pictorial History, (University Press of Kansas, 1992), pp. 3-76.]