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Doris Schwartz: A living legend
LEADERS
IN
D o r i"s S ch wartz: A L l"v 'l ng
Legend* BY
PRISCILLA
EBERSOLE
Doris Schwartz has been outstanding in many ways: the only nurse and only woman to receive an invitation to participate in the World Health Organization Committee on Aging and Geriatric Care held in Geneva in 1965; the codirector of the first Primex program to prepare geriatric nurse practitioners in 1976; the first nurse to receive a Fogerty Fellowship; and the first to be invited to work with Sir Ferguson Anderson and to participate in planning the care of the aged in Scotland. From this experience a fine textbook in gerontology and geriatric nursing emerged, possibly the first to combine the medical and nursing viewpoints in the care of the agedJ In the early 1980s Ms. Schwartz expressed her indignation in a letter to Geriatric Nursing regarding the lack of clinical research investigating the implications and inhumane effects of tying up our elderly. Two young faculty researchers, Neville Strumpf and Lois Evans, took up the challenge and began a decade of extensive research into the use of restraints. Ms. Schwartz always seems to have been at the hub of clinical practice issues that affect quality of life. The following excerpts from an interview with Doris Schwartz will introduce our readers ro her personal perspective. earliest experiences with the aged were with my M ymother's siblings. She was the youngest of 10 children whose ages stretched over 25 years. I had the privilege of caring for, or helping their children to care for, six of them who lived to extreme old age. They were all extremely independent, and most of them wanted very
*The focus on Doris Schwartz in this issue of Geriatric Nursing concurs with her recognition as a Living Legend by the American Academy of Nursing, November 13, 1997. Doris Schwartz was awarded the Lillian D. Wald Spirit of Nursing Award in 1994 at the one hundredth anniversary celebration of the Visiting Nurse Services of New York. Geriatr Nurs 1997;18:277-9. Copyright © 1997 by Mosby-Year Book, Inc. 0197-4572/97/$5.00 + 0 34/1/85622
GERIATRIC NURSING Volume 18, Number 6
much to remain at home. In addition, I had an unusually good experience as a nursing student. I was at the central hospital of the Methodist church, and we cared for Methodist missionaries from all over the world. They were an outstanding group of elderly people, wonderful story tellers and characters from the word go. They were deeply religious and looked at us student nurses as another culture. They really worked on us hard. These experiences with elderly family members and the Methodist missionaries made me aware of the potential for independence of older people. I had one of the early grants from the Public Health Service to study elderly chronically ill patients attending the outpatient clinics at Cornell-New York Hospital. That study was published as a book at a time when nursing research was seldom done, and if done was not published in a book. 2 As a result, I was asked to serve on two World Health Organization committees that met in Geneva. The one on Aging and Geriatric Care was a great experience: I was the only nurse, the only woman, and the only American on that committee. That was where I met Sir Ferguson Anderson, and at the end of the conference he said to me, "If you have a sabbatical at any time, Doris, come and spend it with us." I was due for a sabbatical, and so I applied for a Fogerty Senior Fellowship. That had never been awarded to a nurse before, but to m y surprise I got it and went to Scotland to work with Sir Ferguson. He was interested in what a nurse had to offer in presenting an opinion and a plan that was different from that of a doctor. That was fun! British medical people were well ahead of our doctors in developing geriatric medicine, but our nurses were well ahead of theirs in developing geriatric nursing. This fascinated me. Immediately upon my return from Glasgow I was appointed chair of the geriatric nurse practitioner program at Cornell. I developed the course with Robin Kennedy; who had been my preceptor at Glasgow. He was an exchange physician in the United States the year I came back. Our course was held at Burk Rehabilitation Center, an arm of the Cornell Medical Center. There were no geriatric nurse practitioners at that time, so we worked as a team: a doctor and a nurse as role model. I worked with Ebersole 277
Doris Schwartz, during mid-1960s when she was teaching public health nursing at CornelI-New York Hospital.
Doris Schwartz, at Foulkeways about 1990.
Dr. Arthur Seligman. He taught doctors how to work with There was a wonderful, wonderful article in the nurse practitioners, and I taught nurse practitioners, as did American Journal of Nursing way back in 1942 by a great Marge Miller, who was on our faculty, how to work with researcher who was interested in nursing, Genevieve doctors. This is the secret of good teaching in nurse practi- Bixler. It is about the people who are delivering care on tioner programs. As long as doctors and nurses are educated the firing lifie and recognize needs, both those that are separately, it is only the exceptional nurse and the excep- met and those unmet. By reporting observations and tional doctor who learn to work together effectively. seeking to have them validated, they begin the process of Much later, after retirement, when I was working on a clinical research. part-time basis at Penn, helping Mathy Mezey develop I ' m very interested in another problem confronting geronthe geriatric nurse practitioner program, I was asked to tic nursing. I happen to be a Quaker, and I'm on the Social visit nursing homes in the area to see which ones would • Action Committee of the Quaker Meeting at Gwynedd. We are conbe useable for students for cerned about the parents of clinical practice. I was horrithe developmentally disabled These experiences with elderly fied at the amount of rechildren born with mental or straints that ! saw being physical problems who used family members and the used. In 1984 or 1985 I to die before the age of 6, 7, wrote to the editor of Methodist missionaries made me or 8 years old. They are now Geriatric Nursing, Cynthia living to become middle-aged Kelly, spelling out how trouadults. They are for the most aware of the potential for bled I was at the tremendous part taken care of by their paroveruse of restraints. I reents. And now, their elderly parindependence of older people. ceived a great many letters ents, who should be in the few months after that. thoughtfully planning for Some said their employers wanted restraints to prevent their own later years, are instead consumed with the needs lawsuits. Had anybody looked at this from a research of their adult offspring. We have no place to replace the care basis? What were the alternatives? Someone had discov- given by the parents and, sad as it sounds, their prayer is reered that if you untie everyone who is restrained for 10 ally, "If only he would die before I do." minutes of every hour and walk with them, or massage In June of 1990 students and faculty from Penn and them if they are incapable of locomotion, within 3 or 4 some I had first worked with at Cornell turned up here for days the restraints were no longer needed. That was a an absolutely wonderful birthday party. At that time, with neat little discovery that was going no further than her all my friends from Foulkeways present, the announceown nursing home. Neville Strumpf and Lois Evans, fac- ment was made of a new Chair in Gerontological Nursing ulty at University of Pennsylvania, took this restraint at the University of Pennsylvania, which would be named issue very seriously and began investigating, as did many the Doris Schwartz Term Chair of Gerontological other nurses. In the years since then an enormous litera- Nursing. I sat there with tears coming down my face and ture on the subject has come into being. I think I planted a silly grin underneath the tears and I just couldn't bethe seed for real research into this problem. lieve it. The proceeds of my book, Give Us To Go
278
Ebersole
November/December 1997 GERIATRICNURSING
Blithely, 3 will be contributed to the support of the Chair. The title of the book is a quotation from Robert Louis Stevenson. It is the story of m y 50 years in nursing. On the cover is a plant that shows roots. Those roots are symbolic of nursing but the leaves of the plant are of many, many different kinds. The leaves from many kinds of trees symbolize the many different opportunities in nursing.
Doris suffered a stroke at a younger than usual age, which only challenged her the more and led her to begin leading stroke recovery groups. Through shared personal experience she enhanced the quality of life for those individuals suffering the aftereffects of stroke. A paper prepared for the Monthly Meeting of the North Pennsylvania Hospital Stroke Support Club expresses her thoughts. Each of us, in this room, today is here because we have been through a c o m m o n experience. We are here because we are recovering from a stroke or are the caring family members of someone who has been the victim of a stroke. I have partially and with considerable success recovered from a stroke. Each of us here surely has become discouraged and needed hope when we realized our predicament, for hope is basic to all rehabilitation. We who battle our way back from a stroke are constantly tugged between two forces: that which we were once able to do and can do no more and that which remains within our control and for which we can learn to manage by intense effort and development of new skills. We all are ethnologists, eyewitness informants of the events of a stroke; primary sources. We are unique, each of us a
GERIATRIC NURSING Volume 18, Number 6
mini-authority, able to inform the less well informed. In preparation for this meeting, I have searched the literature and found enormous amounts of information, but there is no record of a group such as this discussing their experiences and pooling their knowledge to share with family and professional caretakers. We have the rare privilege of being informants about stroke. We have become amateur ethnologists, sharing our observations of how it was and of what we experienced.
Our admiration for Doris is unbounded as she daily accepts the challenges that are presented to her. She continues to send gems of thought and practice, which we have shared with the readers of Geriatric Nursing. 4,s Professionals and students interested in a more thorough study of Ms. Schwartz's life will find excellent, well-catalogued archives of her works at the University of Pennsylvania School of Nursing. Our congratulations to Doris. She truly is a living legend. REFERENCES 1. Anderson WF, Calrd FI, Kennedy RD, Schwartz D. Gerontology and geriatric nursing (US edition). New York: Arco Publishing; 1982. 2. Schwartz D, Henley B, Zeita L. The elderly ambulatory patient: nursing and psycho-social needs. New York: Macmillan; 1964. 3. Schwartz D. Give us to go blithely. Philadelphia: University of Pennsylvania School of Nursing; 1990. 4. Schwartz D. Doris Scbwmntz: a creative role for faculty in community health. Geriatr Nurs I997;18:83-4. 5. Schwartz D. Learning is a two-way street: reciprocity and rewards. Geriatr Nuts 1996; 17:22-3.
Ebersole 279
IN
D o r i"s S ch wartz: A L l"v 'l ng
Legend* BY
PRISCILLA
EBERSOLE
Doris Schwartz has been outstanding in many ways: the only nurse and only woman to receive an invitation to participate in the World Health Organization Committee on Aging and Geriatric Care held in Geneva in 1965; the codirector of the first Primex program to prepare geriatric nurse practitioners in 1976; the first nurse to receive a Fogerty Fellowship; and the first to be invited to work with Sir Ferguson Anderson and to participate in planning the care of the aged in Scotland. From this experience a fine textbook in gerontology and geriatric nursing emerged, possibly the first to combine the medical and nursing viewpoints in the care of the agedJ In the early 1980s Ms. Schwartz expressed her indignation in a letter to Geriatric Nursing regarding the lack of clinical research investigating the implications and inhumane effects of tying up our elderly. Two young faculty researchers, Neville Strumpf and Lois Evans, took up the challenge and began a decade of extensive research into the use of restraints. Ms. Schwartz always seems to have been at the hub of clinical practice issues that affect quality of life. The following excerpts from an interview with Doris Schwartz will introduce our readers ro her personal perspective. earliest experiences with the aged were with my M ymother's siblings. She was the youngest of 10 children whose ages stretched over 25 years. I had the privilege of caring for, or helping their children to care for, six of them who lived to extreme old age. They were all extremely independent, and most of them wanted very
*The focus on Doris Schwartz in this issue of Geriatric Nursing concurs with her recognition as a Living Legend by the American Academy of Nursing, November 13, 1997. Doris Schwartz was awarded the Lillian D. Wald Spirit of Nursing Award in 1994 at the one hundredth anniversary celebration of the Visiting Nurse Services of New York. Geriatr Nurs 1997;18:277-9. Copyright © 1997 by Mosby-Year Book, Inc. 0197-4572/97/$5.00 + 0 34/1/85622
GERIATRIC NURSING Volume 18, Number 6
much to remain at home. In addition, I had an unusually good experience as a nursing student. I was at the central hospital of the Methodist church, and we cared for Methodist missionaries from all over the world. They were an outstanding group of elderly people, wonderful story tellers and characters from the word go. They were deeply religious and looked at us student nurses as another culture. They really worked on us hard. These experiences with elderly family members and the Methodist missionaries made me aware of the potential for independence of older people. I had one of the early grants from the Public Health Service to study elderly chronically ill patients attending the outpatient clinics at Cornell-New York Hospital. That study was published as a book at a time when nursing research was seldom done, and if done was not published in a book. 2 As a result, I was asked to serve on two World Health Organization committees that met in Geneva. The one on Aging and Geriatric Care was a great experience: I was the only nurse, the only woman, and the only American on that committee. That was where I met Sir Ferguson Anderson, and at the end of the conference he said to me, "If you have a sabbatical at any time, Doris, come and spend it with us." I was due for a sabbatical, and so I applied for a Fogerty Senior Fellowship. That had never been awarded to a nurse before, but to m y surprise I got it and went to Scotland to work with Sir Ferguson. He was interested in what a nurse had to offer in presenting an opinion and a plan that was different from that of a doctor. That was fun! British medical people were well ahead of our doctors in developing geriatric medicine, but our nurses were well ahead of theirs in developing geriatric nursing. This fascinated me. Immediately upon my return from Glasgow I was appointed chair of the geriatric nurse practitioner program at Cornell. I developed the course with Robin Kennedy; who had been my preceptor at Glasgow. He was an exchange physician in the United States the year I came back. Our course was held at Burk Rehabilitation Center, an arm of the Cornell Medical Center. There were no geriatric nurse practitioners at that time, so we worked as a team: a doctor and a nurse as role model. I worked with Ebersole 277
Doris Schwartz, during mid-1960s when she was teaching public health nursing at CornelI-New York Hospital.
Doris Schwartz, at Foulkeways about 1990.
Dr. Arthur Seligman. He taught doctors how to work with There was a wonderful, wonderful article in the nurse practitioners, and I taught nurse practitioners, as did American Journal of Nursing way back in 1942 by a great Marge Miller, who was on our faculty, how to work with researcher who was interested in nursing, Genevieve doctors. This is the secret of good teaching in nurse practi- Bixler. It is about the people who are delivering care on tioner programs. As long as doctors and nurses are educated the firing lifie and recognize needs, both those that are separately, it is only the exceptional nurse and the excep- met and those unmet. By reporting observations and tional doctor who learn to work together effectively. seeking to have them validated, they begin the process of Much later, after retirement, when I was working on a clinical research. part-time basis at Penn, helping Mathy Mezey develop I ' m very interested in another problem confronting geronthe geriatric nurse practitioner program, I was asked to tic nursing. I happen to be a Quaker, and I'm on the Social visit nursing homes in the area to see which ones would • Action Committee of the Quaker Meeting at Gwynedd. We are conbe useable for students for cerned about the parents of clinical practice. I was horrithe developmentally disabled These experiences with elderly fied at the amount of rechildren born with mental or straints that ! saw being physical problems who used family members and the used. In 1984 or 1985 I to die before the age of 6, 7, wrote to the editor of Methodist missionaries made me or 8 years old. They are now Geriatric Nursing, Cynthia living to become middle-aged Kelly, spelling out how trouadults. They are for the most aware of the potential for bled I was at the tremendous part taken care of by their paroveruse of restraints. I reents. And now, their elderly parindependence of older people. ceived a great many letters ents, who should be in the few months after that. thoughtfully planning for Some said their employers wanted restraints to prevent their own later years, are instead consumed with the needs lawsuits. Had anybody looked at this from a research of their adult offspring. We have no place to replace the care basis? What were the alternatives? Someone had discov- given by the parents and, sad as it sounds, their prayer is reered that if you untie everyone who is restrained for 10 ally, "If only he would die before I do." minutes of every hour and walk with them, or massage In June of 1990 students and faculty from Penn and them if they are incapable of locomotion, within 3 or 4 some I had first worked with at Cornell turned up here for days the restraints were no longer needed. That was a an absolutely wonderful birthday party. At that time, with neat little discovery that was going no further than her all my friends from Foulkeways present, the announceown nursing home. Neville Strumpf and Lois Evans, fac- ment was made of a new Chair in Gerontological Nursing ulty at University of Pennsylvania, took this restraint at the University of Pennsylvania, which would be named issue very seriously and began investigating, as did many the Doris Schwartz Term Chair of Gerontological other nurses. In the years since then an enormous litera- Nursing. I sat there with tears coming down my face and ture on the subject has come into being. I think I planted a silly grin underneath the tears and I just couldn't bethe seed for real research into this problem. lieve it. The proceeds of my book, Give Us To Go
278
Ebersole
November/December 1997 GERIATRICNURSING
Blithely, 3 will be contributed to the support of the Chair. The title of the book is a quotation from Robert Louis Stevenson. It is the story of m y 50 years in nursing. On the cover is a plant that shows roots. Those roots are symbolic of nursing but the leaves of the plant are of many, many different kinds. The leaves from many kinds of trees symbolize the many different opportunities in nursing.
Doris suffered a stroke at a younger than usual age, which only challenged her the more and led her to begin leading stroke recovery groups. Through shared personal experience she enhanced the quality of life for those individuals suffering the aftereffects of stroke. A paper prepared for the Monthly Meeting of the North Pennsylvania Hospital Stroke Support Club expresses her thoughts. Each of us, in this room, today is here because we have been through a c o m m o n experience. We are here because we are recovering from a stroke or are the caring family members of someone who has been the victim of a stroke. I have partially and with considerable success recovered from a stroke. Each of us here surely has become discouraged and needed hope when we realized our predicament, for hope is basic to all rehabilitation. We who battle our way back from a stroke are constantly tugged between two forces: that which we were once able to do and can do no more and that which remains within our control and for which we can learn to manage by intense effort and development of new skills. We all are ethnologists, eyewitness informants of the events of a stroke; primary sources. We are unique, each of us a
GERIATRIC NURSING Volume 18, Number 6
mini-authority, able to inform the less well informed. In preparation for this meeting, I have searched the literature and found enormous amounts of information, but there is no record of a group such as this discussing their experiences and pooling their knowledge to share with family and professional caretakers. We have the rare privilege of being informants about stroke. We have become amateur ethnologists, sharing our observations of how it was and of what we experienced.
Our admiration for Doris is unbounded as she daily accepts the challenges that are presented to her. She continues to send gems of thought and practice, which we have shared with the readers of Geriatric Nursing. 4,s Professionals and students interested in a more thorough study of Ms. Schwartz's life will find excellent, well-catalogued archives of her works at the University of Pennsylvania School of Nursing. Our congratulations to Doris. She truly is a living legend. REFERENCES 1. Anderson WF, Calrd FI, Kennedy RD, Schwartz D. Gerontology and geriatric nursing (US edition). New York: Arco Publishing; 1982. 2. Schwartz D, Henley B, Zeita L. The elderly ambulatory patient: nursing and psycho-social needs. New York: Macmillan; 1964. 3. Schwartz D. Give us to go blithely. Philadelphia: University of Pennsylvania School of Nursing; 1990. 4. Schwartz D. Doris Scbwmntz: a creative role for faculty in community health. Geriatr Nurs I997;18:83-4. 5. Schwartz D. Learning is a two-way street: reciprocity and rewards. Geriatr Nuts 1996; 17:22-3.
Ebersole 279