Johanna Winchester interview, History 150 Spring 2017, Conducted by Molly Jacobs, Progression and Advancement of Nursing in the mid 1900’s and gender roles, March 17, 2017.

A. Overview of Interview Process:

This interview was conducted over Google Hangout on my laptop and I recorded it using QuickTime Player. I had no problems using this software and I did not edit the recording. I did a test round of recording her voice on QuickTime player to ensure that there would be no problems with recording. The interview took place in my bedroom and I made sure that nobody was home to make any noises in the background.

B. Brief Biography:

Johanna Winchester was born in Lebanon, Kentucky. Her family moved numerous times before living in McKeesport, Pennsylvania when she was five years old. She lived there until she left for her original school of Nursing which was Prespetarian University Hospital of Pittsburg. This school included a three-year diploma program which was the primary way nurses were educated at that time. She attended this school from 1958-1961 and was closely affiliated with the hospital. She explained that the students were placed in as they worked forty hour weeks and that, as a junior, they would work evening shifts and as a senior they would work nights. Because of their staffing this hospital, schooling was only $500 for three years and almost everything was included such as having their work clothing cleaned for them.  Shortly after getting married and having children, she moved to North Carolina and attended NC State to receive her BSN. If she had continued to work in a Pittsburg hospital, she would not have had to study for her BSN; however, she attended school for almost twelve extra years to achieve this great accomplishment. These twelve years learning at NC State included a few breaks for her to care for her children while working days and nights. Mrs. Winchester had numerous jobs throughout her career as a nurse. Of the many she listed she included Critical care Certification, Nursing Administration, Night Supervisor, Assistant, Advisor and VP for nursing. She worked part time, full time, days and nights. She also had responsibility for every nursing program in the hospital. She was a nurse for thirty-one years.

C. History of Nursing:

I chose to interview my Mrs. Winchester because of the many interesting stories that she has told our family about nursing throughout the years. The mid 1900’s were a time of advancement in woman’s roles in society. At this time, it was common to have mostly female nurses. Mrs. Winchester had experience as nurse, as well as many other leadership roles in the hospital. Typically, in the time that she was a nurse, males held higher level jobs such as the ones that she pursued such as VP for nursing. Along with the commonality of women being nurses, they were also expected to raise and care for their families. I very much enjoy hearing about the changes that have occurred in this field of work.

D. Interview Transcription:

Molly Jacobs(MJ): My name is Molly Jacobs and today I will be interviewing Mrs. Johanna Winchester who was a nurse for about 31 years. And so first of all I just want to make sure with you that it is ok with you that I share this interview with my classmates and my teacher.

Johanna Winchester(JW): It is.

MJ: Perfect. Ok so first question.

What do you believe made you want to pursue nursing?

JW: Well, I, I was born in 1940 so by the time I was playing out in the neighborhood and things, uh it was the end of World War Two. And we played war, uh we lived in a very hilly area so it wasn’t very good for ball sports or anything like that. And uh mostly in my neighborhood I was the only girl, everyone else was boys so they were the soldiers and I was the nurse. And one of the families there let us have their backyard and we dug fox holes, I took bread and water and bandaged them up and all this kind of stuff. And I tell ya it just set my life for the life course I wanted to do.

MJ: That sounds awesome! That’s funny. Ok second question.

Were there any men in your class at nursing school?

JW: In my original class, none. Uh, in, when I went back to pursue a BSN, cause I got, I graduated first from a diploma program that was connected to a hospital in Pittsburg. When I went back, uh, there were, I think there were two in my BSN class. And since, then, uh, every class has about ten in it at UNCG. I’m very familiar with that school. I graduated from that school, I’m on their, uh, alumni board, I support scholarships for nursing so I’m included in a whole lot of planning things. And so I know the school and their classes well. And men are very much a part of the nursing schools now. Interestingly though, if you what kind of jobs that men pursue, it’s emergency room, they like to be the, on helicopter crews when they go out to pick up, uh, victims of accidents..etc. They like administration, they like critical care. All of those things seem to speak more to, uh, male nurses. And regular school, school nursing, or unit nursing on the floors and things like this, we have some but mostly they like the scarier types.

MJ: Ya. They like the excitement.

JW: Pardon me?

MJ: I said they like a little more excitement.

JW: That’s it. They want the challenge. Uh and so, now you used to say, “what a man in nursing, must be a sissy.” No, uh uh, not anymore.

MJ: No way, that’s interesting that there weren’t that many back then compared to now.

JW: Oh back then there were none.

MJ: I just met one the other day that’s going through nursing at JMU and he loves it.

JW: Yes and a lot of them also choose to go on to anesthesia. Uh, so they, they really and truly try to make it a career and do something that will challenge them from then on.

MJ: Well that’s awesome. It’s a great career to pursue. Ok question three.

What would you say was the most challenging part of being a female nurse?

JW: Well, I think the, um, actually the best part about being a nurse is that generally, people like nurses. They see them as helpers. And so they are more, um, prone to be positive about nurses. And patients, maybe older patients like female nurses. Um, but the problem is, is, if you try to make change within a hospital or any other system, you run into the problem that any female runs into and that is, only males have brains. Only they can make suggestions. Only they can do things. So it’s harder, uh, you have to really establish yourself, and then you can make change. But, uh, it’s harder to do that as a woman than it is as a man. You’re a man and you say “this needs to happen”, uh, the people in charge who are also men think, “well, he knows what he is talking about.” Uh, if a woman makes that same suggestion, they think “eh, we’ll study it a while.” Uh, if they say that, that’s really kind of a positive response. Uh, they’re also very likely to say, “eh, no. Not gonna do it. She doesn’t know anything.”

MJ: Interesting. But you said you had a lot of different roles in the hospital like including leadership roles.

Do you think you had a better say because you were higher up in that?

JW: I had, I had a hard time with it. I really did. Uh, one of my friends said it’s sort of like “you hit the ball and drag Charlie to get to first base.” You just, uh, you just have to have a very very cogent argument to make your case. And um, men are very much so more accorded acceptance than than women. Plus, I was in charge of the largest work force so I needed the most resources. So everyone else didn’t like that very much. And um, you’re continuously fighting. You’ve really got to have a good reputation for working with others to get anywhere in hospital administration as a woman. And if you don’t, you soon find yourself pounding the pavement. Uh, so, uh, there’s, you know it may be changing now because the whole world is changing. And there are more women in administration, uh, then there were. Before, it was just the nurse administrator that was there. But you can have a CFO that’s female, you can have the head of the HR Department that’s female and they all sit in on the board meetings. So, you may not be completely alone.

MJ: That’s good. I would hope that would be changing.

JW: Yes, it is.

MJ: Not very fair.

Ok next question was, can you explain what it was like to balance caring for your family and working?

JW: Well, uh, when my family was small, uh, I didn’t work. I just didn’t see how I could. And then, uh, when our youngest child went to school, kindergarten, is when I started to work. But I worked nights so that there was always somebody at home with the children. Um, either my husband was there all night while I worked, or I was there all day while he did. And uh, sometimes, uh, I may have been half comatose, but I was there. And uh, so I could uh, oversee what they were doing, I could go to the park with them. I could do things like this. And then when I needed a nap, I found that they must have a nap too.

MJ: Wouldn’t doubt it.

JW: We made it work out. But I had a lot of friends that had a very difficult time because when, you know, a nurse goes to school early so that meant that their child would have to get up when they got up, at like 5:30. And if the child said, “I don’t feel good”, they were in a quandary. Should I stay home today and really mess up the patient care in my unit, my, my fellow nurse’s assignments, etc., uh, so that I can make sure this child is ok. Or do I take their temperature, oh its normal, or not very high. I’ll send them on, if it’s bad they’ll call me. And then they would, they would worry. And the kid would go to school half sick. I never had to worry about that because if a child said they didn’t feel good I’d say stay in bed. You know, I was home.

MJ: Perfect, you still got to experience them growing up and growing with them.

JW: See, one of the things about nursing is, um, literally is, especially if you choose hospital nursing. Patients are always there, twenty-four hours, so they need nursing care twenty-four hours. So you can tell your employer, I would like to work the evening shift, I would like to work the night shift, now its twelve hours, I would like to work twelve hour nights, 3 nights a week. Whatever it is that works within your family, you can pretty well get that. And uh, if you really need, uh, a daytime job, eight hours, there are doctors’ offices, there are, uh, research facilities, there are, uh, lab facilities, there are any number of places, school nursing, that you can work an eight-hour day schedule. You can work nothing but weekends if that’s what your family needs. So, that’s really an advantage for people going into nursing who also want to have a family and want to have some family time.

MJ: Ya. Sounds great, I’m learning that from my sister too. Learning about her different schedules. When she’s on and off duty.

JW: If she wants to go on for a graduate degree… etc., she can work her class schedule into her work schedule. Uh, you know, uh, if you, if you have a very stated schedule that cannot vary, you’re stuck in a lot of ways. So, uh I think, I think nursing, you know people say, “oh gosh, you have to work on Christmas.” Well, you might, um, but uh, you also have some lee-way for a lot of other things. So you know, take the good and the bad.

MJ: So along with that question, I guess you kinda answered that.

Um, it says did you ever feel pressured to quit your job once you had children? So you did end up staying home.

JW: I, I, the reason I stayed home um, you know, one of the biggest changes that has happened with nursing has to do with nothing medical, it is financial. And that is, when I graduated from nursing school in 1961, I went to work right away, and uh, I also got married right away. And uh, about a year later, I had a baby. And uh, that was Greg by the way. And uh, at that time I was making $95 a week and I looked into what it would cost for someone to take care of Greg while I worked. It was going to be like $125 a week. So I said, “I’m not paying somebody to work,” that’s all there is to it. And besides that, I wanted to stay at home. So it was not financially reasonable for me to go to work and pay somebody to watch my baby. But then, in 1965, uh, Medicare came in. The whole thing changed because reimbursement to both hospitals and physicians changed. And when I graduated, you hardly had any graduate nurses in the hospitals, the hospitals were staffed with students. Uh, and they had to be or else there would be nobody. The hospitals didn’t have enough money to pay nurses to have the incentive to work. And so they didn’t. Uh, they went through three years of nursing education connected with the hospitals, they took their state boards, then they worked for a little while but then they quit. And they either did something else or, or stayed home with family or did whatever but they did not work. Well after Medicare, hospitals started getting some money. State boards of nursing changed their requirements for nursing students and now they said, “you can’t treat student nurses like that. They are there for an education. They’re not there to staff your hospital, so they’re not going to. So, you better hire somebody to do that.” Well, they did hire people and and nursing salaries went up. Uh, well what the hospitals also discovered was, “gosh we are literally going to get paid for every day we have a patient in here.” So patients came into the hospital pre-operatively, for all their tests they stayed, they might be in the hospital for three days before they actually have surgery. And then they would have surgery and then they would recover completely for the next two weeks in in the hospital. So hospitals length of stay was long. Alright well, after a while the government said, “gosh we’re paying ridiculously for these people.” Also, physicians ordered every test that was on their minds that might be helpful in making a diagnosis. So they were paying for boo coos of tests. And uh, in 1982, there was new legislation called T-E-F-R-A, TEFRA, and that uh, involved in reducing the length of stay. In other words, people were not going to be able to come into the hospitals and have all these tests in advance. They were going to have to have this on an out-patient basis. So there was going to be a big out-patient department to handle that business. Get them in, get their testing done and send them home within a matter of hours. Same thing was true with surgeries. Can we bring them in, have their surgery and send them home within twenty-four hours? We’re going to call that an out-patient, the reimbursement is better. And so we had big out-patient departments of caring. And out-patient nurses instead of being all in-patient nurses. Also, you had to move the patient along, they couldn’t just stay in the hospital for two weeks after surgery. Uh, you had to have a discharge plan to get them out of the hospital as quickly as you could. So now you had to have case managers and social workers work in a team like that. Have discharge planners. Uh, so different, new categories for practice came into being with nurses. Also computers, they said, “you’re charging for this stuff and we don’t have any proof that patient actually got it.” So they wanted computer systems at the bedside to, um, take a measurement of the patients’ identification, the measurement of the medication. “Don’t charge me for something that I am not sure that that patient got.” So, now we had to have computer based nurses. And uh, so, uh now we got nurses at the IT department at hospitals always evaluating how to make that better. And then, uh, with the affordable healthcare plan in 2010, more changes came into being and more people were now covered. So the, uh, emergency departments could become more emergency instead of everything for everyone who doesn’t have insurance. So every time we have a big financial change that impacts doctors or hospitals, it also impacts nursing. And it either gives rise to new and different jobs that nurses do, and really have to know how to do well, uh, and uh, and it changes literally everything that happens in a hospital. So hospitals and nursing are nothing like they were in 1961 when I graduated. Believe me, nothing.

MJ: Ya. That’s a huge leap.

Do you think that the technology and different jobs are the biggest difference that you’ve seen since you were nursing?

JW: That and the way um, and the place where patients are treated. Are they treated as an in-patient or out-patient? You know um, and another big change really tends to be with how nurses see themselves. And um, for a long time I don’t think we saw ourselves as professional. We saw ourselves more as well trained uh, people in a particular practice of some sort. But the more that we were taught in our schools of nursing, the more the schools of nursing became university based, and the more nurses became either BSN prepared or MSN prepared, um, the more they saw themselves as people practicing a profession. And they wanted to practice that way, they wanted to dress that way, they wanted to uh, talk to physicians and administrators. Anyone that they could make contact that way. So the more subservient role in 1960 has changed to an autonomous practice in 2017. It’s also a major improvement let me tell you.

MJ: I can tell just from those stories. Very different. In a good way.

JW: Yes.

MJ: What do you think, have, like the events or situations that you have experienced, what do you think have had the biggest impact on you?

JW: Well, uh, I think the change in the way that things are done has had a major impact on me and on everyone else that practices. And one of the things that I think nurses tend to do, is that they practice in areas until they find one that just speaks to them. And intensive care was that for me. Uh, when I left, uh, work we didn’t have intensive care. When I came back we did and uh, working in an intensive care unit was just my cup of tea. I, I really liked it. I think that had the biggest impact on me as a practitioner as well as um, I don’t know, the education, the additional education, the additional opportunities. Uh, I can’t point to any one single event. Um, the whole milieu was of interest to me the whole time I practiced. Everything was interesting. So.

MJ: So it was all new. Like every day, everything was different so that’s interesting.

JW: Everything, every day was different. Even if they have the same, um, medical problem that you have experienced and taken care of. That patient brings their own story to your day.

MJ: That really helps you grow as a person because you’re learning how to do things differently every day and learning about new people.

JW: If you’re any good you do. If you, if you, see nursing is a relational discipline. If you don’t have a relationship with the patient that you’re taking care of, um, it won’t work. Um, the patient is not going to respond to what you’re trying to help them do to try to take care of themselves if they can’t stand you. So uh, what you’re trying to do is figure out what is it that this patient needs, what can I help them with, what can they do themselves and how can we work together to accomplish getting this patient better for today and better for the rest of their life. Well, to do that you have to have a relationship with that patient. So that means every day has to be new, every patient has to be different. And that’s just the way of it.

MJ: That’s great.

So, in closing, my last question was what advice would you give a freshman in college hoping to study nursing?

JW: Do it. Haha. If you are a person that likes a challenge every day and uh, has both scientific and a social uh, convention to what it is you like to do, you probably will like nursing. And if you also want to uh, marry and have children it’s a job that you can do full time, part time, day, evening, or night, weekends, every other weekend. You know, you name it. You can work it into your schedule. If you want to go to graduate school, and I hope everybody will, you can add other dimensions to your practice. And uh, and nursing is very dynamic. A lot of fields right now are pretty stayed, they, you know, they’ve been where they are for a long time and that’s where they’re going to stay. But nursing is pretty dog-on dynamic. So, um, you know, I would say, if you’re thinking about it, do a little more investigating and if that’s your bet. Go for it. But I’ll tell you what. Don’t do it if you’re not a good student because they won’t keep ya.

MJ: Be hard-working. Ya, that’s what I’ve heard.

JW: It’s the truth too.

MJ: Thank you so much for answering those questions.

JW: You are so welcome Molly. I hope that it gave you the information you needed.

MJ: Ya, it was great!

 

E. Conclusion:

I am very happy that I chose to interview Mrs. Winchester. She is so passionate about what she has experienced and learned from being a nurse. I think that this interview went really well! I was not expecting it to be as long as it was but I enjoyed every minute of listening to her answers and having a great conversation with her. I did not run into any troubles with the interview because she was very friendly and willing to answer each question in detail. This was a great first experience with interviewing for me!