Times Past: Put to the test at the Massachusetts Mental Health Center

  • Student nurses at Franklin County Public Hospital, what is today Baystate Franklin Medical Center, make their rounds on the 1 South open ward in the 1940s. Courtesy Photo/Images of America: Baystate Franklin Medical Center

  • KEYES

Published: 2/22/2019 1:55:36 PM

The Massachusetts Mental Health Center was a weird place, with plenty of bizarre experiences for young student nurses.

The location was in the Back Bay section of Boston, and I was very glad the newly constructed nurses’ residence was actually completed before I got there in late 1959. Previous Franklin County Public Hospital students had been there while construction was still in progress, when the doors could not be securely locked.

When my nursing classmate and I got to “Boston Psycho,” we found that we shared a room and also worked on the same floor, Five B. It was the most securely locked women’s unit.

In the center of that area was a large day-room, where women could socialize, along with the men of the locked unit at the other end of that floor, Five A. We wore regular street clothes, not uniforms, and we carried a large key ring so we could get in and out of the locked unit, the med room, the treatment room and the padded isolation room.

As I recall, we had classes one day a week, and worked on our unit the rest of the time. We students had to cover the unit for day and evening shifts seven days a week, with every other weekend off for each of us. Our bosses honored our maturity and sense of responsibility, and gave us the privilege of creating our own time sheets, working together cooperatively. This involved students from New England Baptist Hospital, Franklin County Public Hospital and Peter Bent Brigham Hospital.

Another set of students, from New England Deaconess Hospital, had a very different, nicer arrangement. They had classes with us, and were on the units the other four days a week from 8 a.m. to 4:30 p.m. with every weekend off. Their only responsibility was to talk with their patients.

The rest of us had to give medications, do bed baths for a bedridden patient who had smashed a leg in a jumper-suicide attempt, and do a complicated ileostomy irrigation daily. The bed bath included a bed shampoo once a week, and of course linen changes. I believe we also had to change bed linens for ambulatory patients regularly.

In addition to our regular classes, educational opportunities were plentiful, theoretically. At 7 a.m., we took report from the night nurse. At 8 a.m., a few staffers, and of course the Deaconess students, went down to a meeting room on Unit Three to get the morning house report with updates on all the most interesting patients — primarily for the nursing supervisors and the psychiatrists.

(Note: Privacy was virtually nonexistent. The Health Insurance Portability and Accountability Act (HIPAA) did not yet exist, but of course doctors adhered to the Hippocratic Oath and nurses, including student nurses, obeyed the Nightingale Oath.)

Then at 10 a.m., they had Morning Rounds, a conference/presentation of a case study on one patient. The presentation was by a psychiatrist, a nurse and the patient. On Tuesdays, they had Grand Rounds at noon in a large auditorium somewhere downstairs. An older, white-haired, very distinguished-looking psychiatrist presided over an hour-long presentation of an interesting case study, done by about three doctors.

New England Deaconess students went to all of these educational offerings, along with interns, a few staff nurses and a few of the nurses’ aides called “attendants.” Occasionally, we other student nurses were allowed to go, if our grunt work was completed.

In 12 weeks, I got to the morning house report three or four times, Morning Rounds a couple times and Grand Rounds twice. On Christmas Day, I had to work a special shift — 7 a.m. to 6 p.m. — covering both the men’s and women’s units on the fifth floor, covering at the last minute for someone who had called in sick. This included giving and charting the 6 p.m. medications, and pouring and labeling all the bedtime medications for the convenience of the evening supervisor, who was covering both those units 6 to 11 p.m. in addition to her responsibilities for the whole hospital.

Allan, my fiance, came to get me at around 4 p.m., and then had to wait in the day room chatting with me and some patients until he got to take me home at about 7:30 p.m. I don’t remember much about the rest of that Christmas Day.

Deaconess students also got to admit all new patients, who arrived only on Wednesdays. These were their patients. The rest of us students had to do our case studies on patients who had been admitted prior to our 12-week rotation, who were generally less interesting because they had greatly improved since admission, or were fairly interesting and frustrating because they were unlikely to improve.

It must be puzzling to people of younger generations that we passively accepted these blatant forms of abusive unfairness and the injustice of it all. Protests, demands and activism were just not on the radar yet, nor was empowerment. We just grumbled and quietly accepted that student nurses were at the bottom of the pecking order and that the New England Deaconess Hospital had negotiated a fantastic deal for its students.

One other feature of “Boston Psycho” was the practice of assigning each student nurse to a staff nurse who would be her adviser. Some students would be assigned to power-mad advisers who would second guess their every thought and deed, and would convince the student that she “needed help,” and would set up appointments with psychiatrists for them. Questioning their own mental health, some students would become agitated and depressed. I do not think that any of them dropped out of nursing, but they went through hell. I thank God that my advisor was normal, not abusive.

The only Pepsi machine was on the ground floor of the main hospital building. One evening I was craving a Pepsi, so I took my dime (yes!) over to the hospital, where in that basement corridor I encountered a day patient who was not supposed to be on the hospital grounds after dark. He greeted me politely, then tried to make a move on me.

I knew that sexual inappropriateness was his primary symptom, so I panicked. I swung my right arm around and cuffed him just under the left ear, sending him reeling. I think I said something like, “You get out of here!” Then I grabbed my Pepsi and raced back to the nurses’ residence.

The next day I had an appointment with my advisor, and I told her of the incident. Miraculously, she smiled, and said, “You did exactly the right thing! It is called ‘reality testing’ and he needed an appropriate dose of reality!” I never heard another word about the incident. And I never tried to get work in any psychiatric facility, ever.




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