SON at 20: A Division Steps Into
Martha Hill, the School of
Nursing's third and current dean, with portraits of the
first two superintendents of nursing at Johns
PHOTO BY HPS/WILL KIRK
By Greg Rienzi
They sure grow up fast. The
School of Nursing
is still the youngest offspring of the university, but it's
about to leave childhood behind.
This year marks the 20th anniversary of the School of
Nursing as a full division of the university. It also marks
115 years ago that the Hopkins nursing education program
began. To honor these and other Hopkins landmark events,
the school has embarked on its 2004 Milestone Celebration:
A Yearlong Commemoration of Our History.
The kickoff event is "Who Will Care for Us?" a
symposium this week on the role of nurses in an aging
population. The keynote speakers are Claire Fagin, director
of the John A. Hartford Foundation's Building Academic
Geriatric Nursing Capacity Program, and Bill Novelli, CEO
and executive director of AARP. Fagin, who last year
received an honorary doctorate from Johns Hopkins and spoke
at the School of Nursing Diploma Award Ceremony, is the
dean emeritus of the University of Pennsylvania School of
Nursing and former interim president of Penn.
Sam Donaldson, ABC News correspondent, will moderate
the panel discussion, which will take place from 4 to 6
p.m. on Thursday, Feb. 26, in the School of Nursing Alumni
Auditorium. A full list of anniversary proceedings can be
On the eve of the first celebration, The Gazette sat
down with School of Nursing Dean Martha Hill, who was named
interim dean in June 2001 and dean in summer 2002.
JHU to her core, Hill earned her R.N. diploma,
bachelor's degree and doctorate at Johns Hopkins and has
been a member of the faculty since 1980. She was one of the
first four faculty members hired when the School of Nursing
was established as an independent division of the
university in 1984. Previously, nursing education at
Hopkins had occurred within another university school or in
a hospital-based school.
Talking in her office in the Anne M. Pinkard Building,
opened in 1998 as the School of Nursing's first permanent
home, Hill reflected on the past, present and future of the
school, which she said has literally outgrown its footprint
and is poised for yet another growth spurt.
Q: Walking down the hall with you just now, people
all seemed to know not only you but one another. Is it that
tight-knit a community here?
A: We have a very strong community here. There is a
sense of pride in being the School of Nursing in this
university. It did take a while to get there. We are
extremely proud of this building, and we are very proud of
the quality of our students and academic programs —
and, of course, our faculty and staff. That is why I
instituted all-school retreats once a year, and all-school
meetings twice a quarter, as a way of bringing our
students, staff and faculty together to talk about issues
that are common to all of us.
Q: What, in essence, are you celebrating this
A: We are celebrating everything [laughs].
It started out by the fact the school is
going to be 20 years old. So, to me, this means becoming an
adult. We have had Carol Gray as the founding dean; she got
us through gestation, labor and delivery and childhood. Sue
Donaldson was the dean in the next phase of life; she sort
of got us through that tremendous growth spurt, literally
building this building we are sitting in today. The other
mandate Sue had been given was to build the research
infrastructure, which she did very, very ably. We then
leapt into the top 20 for research nationally, and then we
went from 15 to nine, all with just 10 faculty writing
grants on the research track. That is rather remarkable
when you consider many of our peer research institutions
are nearly twice our size.
Q: Why are you honoring all the milestones?
A: I see [the school] as someone who is ready to go
off to college and learn to be independent. You need to
look back and appreciate all those different milestones
that were the foundation from which you can now go
Q: Why was the "Who Will Care For Us?" topic chosen
to kick off the yearlong celebration?
A: Caring for our aging population is a key secular
thread that runs through everything we do at Hopkins
Nursing, from training to development, and is universal to
all Americans. We are aging, we are caring for aging
parents, and a large segment of our health care provider
population is moving toward retirement. It's a critical
issue we must look at today and find solutions for
Q: This year you started 'Johns Hopkins Nursing'
magazine. Why did you launch this publication?
A: The launching of the magazine was a very
deliberate strategy to achieve several goals. One of my
charges as dean is to enhance the partnership with Johns
Hopkins Hospital's Department of Nursing — to bring
these two together, the way the School of Medicine is tied
to the hospital. So, Karen Haller [director of medical
nursing at JHH] and I began meeting, and one thing we
quickly realized is that there is no brand name for Johns
Hopkins nursing. There is the School of Nursing, and the
Department of Nursing. We said, Let's just invent ourselves
as Johns Hopkins Nursing and use that as a term that
defines the excellence of nursing, education, practice and
research here at Hopkins. That being said, we thought, How
do we create this sense of self and new identity? It's an
ongoing project, but the magazine was one of the first ways
to begin to do that.
Secondly, we had a series of different
publications here. Some were targeted to alumni, some to
donors, some were targeted to peer institutions. I was
interested in gaining efficiency and greater impact by
uniting all those publications.
Q: What has the response been to the magazine?
A: The first issue had an enormous positive impact,
and the second one was as good or better. The question
quickly became, Could you really set the bar very high and
maintain it? I think we've done it. Some people have told
me, "Well, I picked [the magazine] up and just flipped
through it, and I thought I would put it down and read it
later, but an hour-and-a-half later I was still reading."
We are very excited about continuing this.
Q: Pre-1984, what was the state of nursing education
here at Johns Hopkins?
A: There was no school of
nursing. What had been the hospital's nursing training
school, which was in Johns Hopkins' will, phased itself out
in 1973. During these [intervening] years, there was
tremendous political pressure from a wide variety of
sources, not the least of which were the physicians, who
were very distressed by the adverse impact on patients of
not having nursing education in the environment. It
impacted everything, the whole tone of the place as a
teaching institution, and the quality of patient care. It
impacted recruitment and retention of nurses. Eventually
people stepped up to the plate and said, If Hopkins claims
to be an international leader in hospital-based care and
medicine, we need to have all the various medical
professionals educated together as a team, and that
Q: How Hopkins-ized has the School of Nursing become
since its inception?
A: The intent was that there be a Johns Hopkins
University School of Nursing, and that indeed the nursing
dean would have all the rights and responsibilities of all
the other deans here. It would have formal degree-granting
programs, and the faculty would be standing faculty at the
university, meaning they would have to meet all the other
expectations and requirements. The vision and intent was
that it meets the mark of all the other divisions. There
was no interest in being second tier — we had done
that for a long time.
Q: Has research always been a primary focus?
A: Yes, but we still have to balance the demands of
a clinically expert teaching faculty and our faculty who
are, if you will, the scholars. We can't lose sight of our
Q: Has there been a significant evolution in the
makeup of the student body in the past 20 years?
A: Basically, it's the same. We are still
predominately female. Our percentage of males varies from
each semester and by program — everywhere from 5
percent to I think we have been as high as 12 percent. We
don't quite understand why that is, and we would love to
increase our male population.
Our percentage of minorities has
increased, but it has been very steady for the last five to
10 years. We run around 22 percent. We work hard at that
and are proud of that. Internationally, we attract folks
more at the master's and doctoral level. The numbers could
be higher, but it is complicated because of the visa issues
and the limit of opportunities they have to stay here.
Q: Are there any former SON deans or nursing
superintendents you model yourself after, or admire in
A: Each one of those early women was an intelligent,
competent leader. They were all revered for different
personal characteristics. In terms of our recent history,
Carol Gray I admire for her focus and ability not to be
distracted by all the "could be's." She was very successful
at leading us in our early years.
Sue Donaldson is a woman of extraordinary
intelligence and vision. She is really an out-of-the-box
thinker and risk-taker; she was prepared to catapult us.
She was the dean during our early and mid-adolescence, so
she in effect said, Let's stretch and flex and get out
there. I think of myself as the dean of a school that is
getting ready to assume adult responsibilities. What do we
want to be, and what do we want to look like? That is what
we now have to ask ourselves.
Q: What was the top priority you had when you
A: One was to have nursing be fully integrated,
along with medicine and public health, in the leadership on
this campus and in the university. This is the only place
in the country, to my knowledge, where you have a School of
Nursing, School of Public Health and School of
Medicine all ranked in the top 10. We can, and we
should, be working more deliberately together as
Q: What is the next milestone on the horizon for the
School 0f Nursing?
A: I think it's first maintaining and reinforcing
all we've got. But one thing we are focused on is building
capacity for leaders in nursing. One thing I think that is
missing is that there are no nurses in [Johns Hopkins']
Society of Scholars. Why is that? It's because nursing
education at Hopkins has not had the years of experience,
the history, of training at the graduate and post-graduate
level. That is where we want to go, so that in 15 years you
will see nurses being inducted into the Society of Scholars
because they have received graduate or post-graduate
training here at Johns Hopkins.
Q: How successful have we been so far to this
A: I think we have successfully begun, and you can
find examples that are world-class. Just one example is the
work we have done in the comprehensive high blood pressure
care for young black men. We had all three medical schools
and other units involved in this work. If any place should
be able to show how you do social and behavioral research
that is integrated with clinical research and basic
sciences, this place has the capacity to do it.
Q: The 'Wall Street Journal Online' recently
published results of its 2003 Health Care Poll.
Participants were asked, "How much do you trust each of the
following to do the right thing for the health care of
those whom they have responsibility for?" In the "a lot"
column, nurses topped the list at 65 percent, more so than
doctors (61 percent), dentists (56), pharmacies (49),
hospitals (44) and others listed. What was your reaction to
A: I was pleased to see it. I would ask what it
would take to get our number up to 85 percent.
I think as a general statement, nurses
spend a lot of time thinking and working on issues of
inclusiveness, making people comfortable, wanting to help
people and wanting to make a difference. Those are filters
that everything runs through. We are more relational and
people-focused than focused on molecules or organs. In
part, that explains these results. We are the 24-7 group
who spends more time with patients.
Q: Who is a Johns Hopkins nurse?
A: Think of Johns Hopkins Nursing like the Olympic
flag with the intersecting circles. Some Johns Hopkins
nurses are alumni; they came here, and they were educated
here, and they are now all over the world. Others are, of
course, people who are working here, our students and
faculty. Then you have the nurses at the hospital. And we
would like to think that people who come to this school for
training, who may be less clearly and strongly imprinted,
are Johns Hopkins nurses, too.
Q: Do you have a proudest moment in terms of your
long history with nursing here at Johns Hopkins?
A: I guess for me it was the groundbreaking for this
building. We would not have had a groundbreaking in the
first place if there hadn't been a total, total, total
commitment for the full development of the School of
We have grown so much and so successfully
that we now have to extend the  building in back.
There is wonderful support from university leadership in
doing this. We have to expand the building if we are going
to continue to fulfill our potential. We are never going to
be a big school, but right now we don't have an empty
office for faculty, and we have students sitting on tables
up and down the hall. We are also growing the research
program — labor-intensive work — so you have to
hire people to do the data collection and interventions.
Where are you going to put all those research
We just need a little more room, so we
can grow a bit more.
A Brief Look at 115 years of Johns Hopkins
Fulfilling the wishes of the university's and
hospital's benefactor, the Johns Hopkins Hospital Training
School for Nurses opened in May 1889, five months after the
hospital opened its doors.
In a letter to his trustees, Johns Hopkins made plain
his desire to establish a nursing school that would "secure
the services of women competent to care for the sick in the
hospital wards, and will enable you to benefit the whole
community by supplying it with a class of trained and
In essence, today's School of Nursing began.
The early years: The 1893
graduating class of The Johns Hopkins Hospital Training
School for Nurses poses with superintendent Isabel Hampton,
in dark dress.
PHOTO BY THE ALAN MASON CHESNEY
MEDICAL ARCHIVES OF THE JOHNS HOPKINS MEDICAL
The training school's founding superintendent was
Isabel Hampton, who in left the school in 1893 and later
founded what is now the American Nurses Association.
Hampton's replacement was M. Adelaide Nutting, a
member of the nursing training school's first graduating
class. Nutting led the school from 1894 to 1907. In 1904,
the year that legislation was passed to allow for the
registration of nursing school graduates, Nutting became
the first Registered Nurse in Maryland.
In 1910, Elsie M. Lawler became nursing superintendent
and the school struck out on a lively portion of its
history. During Lawler's 30-year tenure, the school became
involved with the American Red Cross through the United
States Army Nursing Corp during World War I; assisted with
the establishment of a nursing school at the Peking Union
Medical College in China; opened Hampton House, a residence
for nursing students; and, with dedicated space in the
hospital for classrooms, upgraded the curriculum and
created the public health nursing program.
In 1940, the training school became the School of
Nursing and Nursing Services, whose first director was Anna
D. Wolf. The Johns Hopkins McCoy College, later named the
Evening College, began granting BSN degrees in the late
Throughout Wolf's 15-year tenure, and into the 1960s,
several efforts were made, and dashed, to establish a
university-based school of nursing at Johns Hopkins, which
then had an all-male student body.
The School of Nursing and Nursing Services began to be
phased out in 1970, and its last class graduated in
In 1975, nursing education returned to Johns Hopkins
under the auspices of the School of Health Services. This
nursing program would last only four years.
In 1986, two years after the
School of Nursing became a division of The Johns Hopkins
University, Sue Appling teaches a class in one of the many
buildings the school formerly used. Its first home, the
Anne M. Pickard Building, opened in 1998.
PHOTO BY THE ALAN MASON CHESNEY
MEDICAL ARCHIVES OF THE JOHNS HOPKINS MEDICAL
In 1983, the School of Nursing was re-established as a
degree-granting division of The Johns Hopkins University,
and Carol Gray became the new school's first dean.
Initially an undergraduate school, SON began master's
and postdoctoral fellowship programs in 1987.
The early 1990s was another active time at the school.
It established the Wald Community Nursing Center in East
Baltimore, developed the Peace Corps Nursing Fellows
Program for returning Peace Corps volunteers, began
offering a doctoral program and in 1995 established the
Institute for Johns Hopkins Nursing, linking nursing
education and nursing practice.
A nomadic entity, Johns Hopkins nursing — in its
various incarnations — has had offices and classrooms
in various buildings on the East Baltimore campus. In 1998,
however, the school opened its first permanent home, the
Anne M. Pinkard Building, located at 525 N. Wolfe St.,
directly across from the hospital's main entrance.
Today, the school enrolls nearly 600 students a year
and has 55 full-time and 62 part-time faculty. Its graduate
program has been ranked among the nation's top five by
U.S. News & World Report. A research institution in
the Hopkins tradition, the school conducts major research
initiatives in hypertension, cardiovascular health,
domestic violence, community health, pain management,
maternal health, geriatric health care and a host of other
Maryann Fralic, a professor and director of corporate
relations at the School of Nursing, joined Johns Hopkins in
1993 as vice president of nursing at the hospital. Fralic,
who serves as executive adviser for the Nursing Executive
Center of the Advisory Board Company in Washington, D.C.,
said that in the annals of nursing education, Johns Hopkins
stands very tall.
"When you look at the School of Nursing's history, it
is as distinct as the history of medicine as a discipline
at Johns Hopkins," Fralic said. "The school has been
blessed with outstanding leaders throughout its history. We
have never aspired to produce large volumes of students
here. Our mission has always been to produce leaders for
this profession. We are living that mission. The caliber of
students, who come from all over the country, is
exceptional, and only becomes more so with each passing
year." — Greg Rienzi
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