There have been several women in history who have been instrumental in initiating significant changes to the profession of nursing—from the most famous Florence Nightingale, the quintessential ‘Mother of Nursing’, to current leaders, researchers and educators who continue to provide information for the betterment of the profession. However, there are only a handful of individuals who, through their lifelong work, commitment and vision for what was to be the future of nursing have been recognized as true contributors to the practice of professional nursing and nursing education.
The purpose of this paper is discuss the contributions of Isabel Hampton Robb to professional nursing, to the formation and growth of nursing organizations and to establishing guiding principles for nursing education. Nursing Leader Isabel Hampton accepted her first administrative position as Superintendent of Nurses at Cook County’s Illinois Training School for Nurses in Chicago in July 1886. Having no real leadership or administrative background, she soon settled into the position with the help of the board of lay women managers.
The school contracted with the politically controlled Cook County Hospital to provide them with nursing students to care for the patients. With every election year came the removal of the current hospital staff and replacement of an entirely new staff, and even though the nursing department was spared from this process, replacement was threatened. Isabel was instrumental in not only keeping the nursing students in the existing wards, but having students provide care to patients in additional wards, thus solidifying the school’s position in the hospital and thwarting political jurisdiction over the nursing staff.
Isabel had quickly become known as a nursing education reformer. Landmark changes that Isabel instilled while Superintendent were “strict admission criteria, specific entry times for applicants, and impartial grading system to evaluate academic and clinical progress and hospital affiliation experience for the students to gain experiences not available to them at their own school. Her leadership strengthened the ethical and educational structure of the school” (Welch and Hutchinson, Spring 2008) Historical Background
When Isabel was 21, she overheard a conversation of two fellow teachers discussing a change into the profession of nursing, and being that her teaching certificate was soon to expire, decided to apply and subsequently be accepted to the Bellevue Training School for Nurses in New York in 1881. She was always passionate about conscientious and organized work, attributes that made her a successful student. Isabel, despite her youth, proved to be mature, careful and thorough both within the classroom and while tending to patients at the bedside.
She was enthusiastic, methodical and precise, wanting to know the ‘how and why’ of her undertakings, and even though it slowed her work, continued to exhibit these traits far beyond her student tenure. Graduating in 1884, Isabel was offered to attend the prestigious St. Paul’s House for Trained Nurses in Rome, Italy. During her eighteen months in Europe, her duties took her to all the major cities of Italy, France and Germany caring for English speaking patients both within the hospital and in patient’s homes or hotels.
This was Isabel’s first exposure to International nursing, and she quickly saw the need to promote and strengthen international relationships between nurses in the US and abroad. After a successful tenure in Chicago, Isabel was one of a hundred applicants to apply for the opportunity to develop the up-and-coming Johns Hopkins Training School for Nurses in Baltimore Md. In 1889, at the age of 29, she was awarded the position and quickly went to work, knowing that the Hopkins would be the first in the US to have a primary interest in education, research and health care.
While performing her duties as Principal, she organized and initiated many associations with neighboring facilities and schools, one of which was the Thomas Wilson Sanitarium, which provided students the opportunity to practice pediatric care. She also founded a Journal Club, which became the Alumnae Magazine, and established (through the senior students’ leadership) an Alumnae Association in 1896, what was then called the Nurses Association Alumnae of the US and Canada.
The Alumnae Magazine and the Alumnae Association would eventually merge and evolve into what is now known as the American Nurses Association (ANA), with in 1911 Isabel being elected as their first President. Ownership of the Magazine, later called the American Journal of Nursing, was transferred to and became the sole owner of the ANA. In 1892, Isabel was asked to chair the subsection on nursing, part of the planning unit for the World Congress of Charities, Correction and Philanthropy. The conference was scheduled to convene at the 1893 World’s Fair in Chicago.
Working alongside several distinguished nursing colleagues, their papers were written and presented at the Congress meeting which would set in motion the direction of nursing’s future. “Miss Hampton’s opening paper on nursing education standards…outlined issues and responsibilities to be undertaken in establishing professional organizations” (Welch and Hutchinson, Spring 2008). This speech clearly articulated the challenges facing the nursing profession.
Afterwards, the Superintendents of American (nursing) Training Schools met and set in motion the establishment of the American Society of Superintendents of Training Schools for Nurses. The Chicago World’s Fair became the stage for international introduction of the beloved and endeared writing: Architect of American Nursing” (Welsh and Hutchinson, Spring 2008), or what was to be known as Isabel’s thesis of the thoughts of standards and principals in building a professional association. “On June 16, 1893, they (World Congress of Charities, Correction and Philanthropy) adopted a platform of resolutions establishing the American Society of Superintendents of Training Schools for Nurses.
The Society’s three goals were: “to promote fellowship among nurses; to establish and maintain universal standards of training; and to further the best interest of the profession…. Isabel Hampton Robb served as President in 1909. In 1912 the Society evolved into the National League for Nursing Education (NLNE)” (Welsh and Hutchinson, Fall 2008). Isabel surprisingly resigned her position as the Principal from Johns Hopkins in1894 to marry Hunter Robb, an up and coming young surgeon. This shocked not only the newly organized nursing world, but fellow colleagues, students and educators.
To think of how the program and the school would survive without her at the helm, but moreover how a woman with such an immense ability of leadership and organizational skills could step down? “It seemed inconceivable that what she had so boldly initiated could be carried on in her absence”, (Welch and Hutchinson, Spring 2008). But she did carry on her passion after her relocation to Cleveland Ohio where her husband established his obstetrical practice. Isabel continued to be active in committees and organizations throughout her marriage and the birth of her two sons.
Mrs. Robb continued to advocate for a program of higher education to prepare nurses for supervisory positions and urged nurses’ self-governance and organization to establish nursing as a profession. When Cleveland’s Lakeside Hospital Training School for Nurses needed assistance, Mrs. Robb became a member of the Lady Board of Governors utilizing her educational skills and obtaining the best lecturers and affiliation opportunities for the student nurses of Lakeside. Effect on the Nursing Profession
Following their work together at the World’s Fair, Isabel Hampton Robb and British colleague Ethel Bedford Fenwick, continued their professional association through various activities including membership in the Matrons Council a small international group of nurses interested in professional development. At the 1899 Matrons Council conference, a committee was established to plan for the new nursing organization, the International Council of Nurses. Mrs. Robb and Lavinia Dock were American representatives to the committee, with Miss Dock being elected as Honorary Secretary.
The first international meeting of the new organization was held in Buffalo, NY in 1901. “Thus, eight years after the 1893 World’s Fair, countless American alumnae, local and state nursing organizations, two national American nursing associations (NLA and ANA), proliferation of nursing associations in other countries and an umbrella international nurses organization confirmed Mrs. Robb’s organizational genius and gentle, but oh so firm, tenacity” (Welsh and Hutchinson, Fall 2008). The International Council of Nurses (ICN) was born, with the incorporation of American, British, and European nurses and schools of nursing.
Today the ICN represents nurses from more than 130 national nurses associations and represents more than 13 million nurses worldwide, and is the widest reaching international organization for health professions (Retrieved from: http://www. icn. ch). Isabel accomplished much since her beginnings as a young twenty-one year old nursing student. One day in April 1910, she and a friend were talking and, as they were crossing a Cleveland street, Isabel stepped backwards to avoid a speeding car and ultimately stumbled onto the tracks of two passing streetcars, crushing her and killing her instantly.
Her family and the nursing world were horrified and devastated by the accident. In her almost 30 years of dedication she was successful in establishing multiple organizations and programs responsible to train and teach nurses and educators and to develop the profession of nursing, as well as solidify the existence and successes of such organizations as the ANA, the NLA, and the NLNE. Hampton Robb set the bar high for nursing education in an era of hospital growth and proliferation of nursing schools.
With nursing education highly disorganized, she advocated for admission standards and formalized curriculum. A scholar of nursing, she took on the task to disseminate teaching materials nationally and wrote reports, articles, and textbooks to provide a sound basis for practice. She addressed the clinical practices of her day, the ethics of nursing, and the standards for nursing education. In an era when travel was slow, Hampton Robb travelled nationally and internationally and maintained an active correspondence in support of her vision for nursing education (Wolf, 2011).
Prediction of the future needs of nursing Isabel Hampton Robb dedicated her entire working tenure to develop nursing from a physician-controlled subservient servant attitude into a trained professional caregiver, utilizing acquired scholarly critical thinking and clinical skills in the practice of nursing. She expanded on the foundation laid by Florence Nightingale, her mentor and friend. Nursing as a professional career has grown significantly since the early 1900’s with the inception of community colleges offering associate training programs to
Bachelor’s, Master’s and Doctorial degree programs, and a plethora of opportunities available to suit the desires of every working nurse. The profession is continuing to evolve with discoveries uncovered through evidence based practice research and best practice reviews. As more and more facilities are requiring their nurses to acquire higher educational degrees, the level of care to patients improves through innovative critical thinking and advanced clinical skills. Isabel was committed to organizing educational programs The future of nursing looks brighter than ever, thanks to the commitment, dedication and innovators of nurses past.