Asheville Archives: City confronts nursing issues, 1923

“Talked of in many homes in Asheville and in all parts of the country is a problem which finds little place in public print — as yet. It is the problem of nurses,” declared a Jan. 9, 1923, editorial in The Asheville Citizen. “[T]here are not enough graduate nurses who serve and the policy of the medical profession and the rules of the graduates’ guild has tended so greatly to lessen the number of partly trained and practical nurses that few of these are available.”

The paper argued that medical institutions needed to reconsider their requirements to encourage a wider range of nursing options for the general public. Too high a standard within the nursing industry, the editorial noted, did more harm to the community than good.

“[I]s it a wise saying that no bread is better than half a loaf?” The Asheville Citizen pondered.

Not everyone agreed with the paper’s assessment. In a letter to the editor, published Jan. 11, 1923, Bessie A. Haasis, a mother and former registered nurse, argued that the issue of the partially trained nurse was not as simple as the paper made it out to be.

“When the Central Registry for Nurses was organized about a year ago by the graduate nurses of the city, every effort was made to enroll every practical or partially trained nurse so as to make them available to the public as well as the graduates,” Haasis wrote.

This strategy, she continued, resulted in 140 graduates and 80 nongraduates. A subsequent questionnaire sent out to the program’s nongraduates ascertained the extent of their training. This information, Haasis pointed out, was now available to any doctor or patient interested in knowing more about the background of partially trained nurses in the area.

“No attempt whatever has been made to regulate fees, but it has been found that the majority [of partially trained nurses] are charging $20, $25 and $30 a week [roughly $350 to $515 in today’s currency] and more than one has represented herself to her patients as a graduate and charged accordingly [$35 a week].”

There was no single solution, Haasis continued. Instead, she proposed a number of changes to both the health care industry as well as individual approaches to wellness. First and foremost, she emphasized the need for better informed residents capable of addressing minor medical emergencies at home.

Hassis wrote:

“During the war, thousands of women and girls took the Red Cross courses in Home Care of the Sick, but now there is little demand for them. But why not include such instruction in the work required of each girl in High School and college, with extension courses for those these courses would not reach? This would go a good way to reduce the ‘untold suffering’ you [the paper] mention, which is often due in large measure to ignorance of just such elementary instruction. ”

In addition, Haasis called for either a public or private association to provide graduate nursing services by the hour at cost. She also noted the need for stronger recruitment and better incentives within the medical industry.

“Good salaries and reasonable working conditions are now offered to women in so many lines, is it any wonder that nursing, which everyone knows requires unusual endurance and often entails considerable sacrifice and discomfort, fails to attract large numbers,” the letter writer wrote.

“Some people may clamor for ‘poor nursing for poor folks,’ but we cannot be satisfied with less than good nursing for everybody,” Haasis stressed.

In the same day’s paper, the editorial team expressed its disagreement with Haasis’ letter. “Our position was, and is, that half a loaf is better than no bread — that a partly trained or practical nurse is better than none at all, especially where all members of a household are bedridden, as no few have been, with influenza.”

On Jan. 14, 1923, Charles C. Orr, secretary of the board of directors for the Asheville District Nurses Association, reminded the paper and its readers that the organization had established the Nurses’ Club and Central Registry in October 1921 to address the area’s health needs.

“Anyone in need of nursing service will find prompt response to calls for either graduate or practical nurses through Nurses’ Registry,” Orr asserted. “An all-time Registrar, with regular, salary, is employed to answer calls for nursing service day and night. The financial responsibility for the maintenance of the registry is assumed by the Nurses Association.”

Editor’s note: Peculiarities of spelling and punctuation are preserved from the original documents.