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Teaching nurses for over 100 years

Brockton Hospital school is the last of its kind in Mass.

Student nurse Tasia Lopes checks a patient’s record at Brockton Hospital during clinical training at the hospital. Student nurse Tasia Lopes checks a patient’s record at Brockton Hospital during clinical training at the hospital. (Jonathan Wiggs/Globe Staff)
By Emily Sweeney
Globe Staff / September 30, 2010

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BROCKTON — If you walk around the Signature Healthcare Brockton Hospital campus, you can get a glimpse into the past through the large, framed black-and-white photographs that hang on the walls.

They are like windows into a world of old-fashioned health care. Nurses in crisp white uniforms and caps tending to patients. Nurses holding babies in the maternity ward. A group photo of four young women dressed in Victorian-era nurse uniforms — pinafores, stiff collars, puffy sleeves, and removable cuffs — the first class to graduate from the hospital’s nursing school, in 1898. The images are a quiet reminder that, for more than a century now, Brockton Hospital has operated its own nursing school, through which more than 2,500 students have gone on to become registered nurses.

When it opened in 1897, Brockton Hospital School of Nursing was typical of its time. Back then virtually all nursing schools were based at hospitals. Today it is the only hospital-based nursing school left in Massachusetts.

The hospital school, which was scheduled to hold an open house yesterday, is a local institution, and its administrators are striving to preserve its storied past while continuing to move forward into the 21st century.

Dean Susan L. Taylor said the connection between the school and the 253-bed teaching hospital is as strong as ever.

“The hospital is committed to keeping the school open,’’ she said. “We have such a long history. There’s always been an affinity between the hospital and the school.’’

There is no single path or national standard for becoming a registered nurse. To earn the coveted initials RN, students must graduate from a state-approved nursing education program and pass a licensing exam. They can choose to complete a four-year baccalaureate degree program, a two-year associate degree program, or a hospital-based diploma program. But at the end, each student takes the same exam.

After Florence Nightingale opened her groundbreaking nursing school at a London hospital in 1860, most nursing education took place in hospital settings, and it remained that way for the next century. Hundreds of hospital-based diploma schools operated in the United States. In the 1960s, there were more than 800 diploma schools across the country; today there are only 68, according to the National Council of State Boards of Nursing, representing only 4 percent of RN programs.

“There’s so few of them left,’’ said Dawn M. Kappel, spokeswoman for the National Council of State Boards of Nursing. “It used to be very common, but the rise of the community college programs pretty much changed the way nurses are educated.’’

Of the nursing students who took the RN licensing exam in the United States this year, 73,670 came from baccalaureate and associate degree programs; only 1,777 were products of diploma programs, said Kappel, clear evidence that nursing education has shifted away from the disinfected trenches of hospital wards and toward tree-lined college campuses.

Tougher regulations made nursing schools less profitable for hospitals, which quickly realized they could no longer rely on nursing students for a steady supply of free labor. (A century ago, nurses not only cared for patients, they also cleaned chimneys, washed windows, mopped floors, and shoveled coal into pot-bellied stoves.)

In 1965, the American Nurses Association began pushing for higher education standards for entry-level nurses, and one by one the old-style hospital nursing schools disappeared. Their decline continued in Massachusetts through the 1990s; in 1998 Massachusetts was home to six hospital-based diploma programs.

Brockton Hospital School of Nursing currently has 334 students in two divisions. Full-time students attend school during the day and can finish the program in two years; part-time students take classes on weekends and during the evening over four years. After they graduate with a diploma in nursing, they can apply to take the RN licensing exam.

Taylor said being based at a hospital has many advantages. The students do clinical work right there on the campus, and they really get to know Brockton Hospital and how it is run. They see familiar faces in the halls, and they get to know their way around the hospital buildings.

“They already know the systems in place here,’’ she said.

Another upside is the school’s ability to evolve and adapt quickly. Taylor said curriculum changes and improvements can be implemented more swiftly than if they had to go through the various bureaucratic layers of a college or university.

“Because we’re not part of a college, there’s very little red tape,’’ she said.

Over the years, the school has had relationships with several area colleges, including Bridgewater State and Stonehill. For the past 20 years it has partnered with Fisher College, whose faculty teach the nursing students courses that include anatomy, physiology, microbiology, pharmacology, and psychology. And Brockton Hospital nursing students have the option of earning an associate’s degree from Fisher while they pursue their nursing diploma.

Brockton Hospital’s graduates stack up well against their counterparts in many area college- and university-based programs. Last year, 93 percent of Brockton Hospital students passed their licensing exam; by comparison, Curry College’s pass rate was 91 percent, Quincy College’s was 91 percent, and Massasoit Community College’s was 83 percent.

Of the 68 students who graduated in May, 66 passed their exams on the first attempt, according to Taylor.

Graduates can go on to continue their education, or work in rehab or assisted-living facilities or hospitals (some even land jobs at Brockton Hospital).

There are challenges at the hospital school. As with many nursing schools across the country, “getting nursing faculty is the biggest challenge,’’ said Taylor.

Keeping up the school’s physical plant, which dates back to 1905, is also an effort. At one time, the nursing school building doubled as a dormitory for the young women enrolled in the nursing school.

The structure is filled with artifacts from the earlier days of nursing. In addition to the black-and-white photos on the walls, there’s a closet full of archived records and vintage nursing uniforms, including a cadet nursing corps cape.

“We’re trying to keep the stuff that is historically significant while making sure we’re moving forward into the 2000s,’’ said Taylor. “Why are we still here? We’ve been very fortunate.’’

The dorm rooms are long gone; today, the school building houses classrooms, offices, and labs.

Inside the old meets the new. The old library was recently renovated into a state-of-the-art laboratory. School officials recently dedicated a room in honor of Mary Cruise Kennedy, an alumna who graduated in 1931 and worked at Brockton Hospital as a supervisor for many years. The mother of state Senator Thomas P. Kennedy, a Brockton Democrat, she recently celebrated her 100th birthday and was honored for being the hospital school’s oldest living graduate.

The school admits about 150 students per year from all over Southeastern Massachusetts.

Tasia Lopes, 29, of New Bedford said she enrolled because of the school’s reputation; she said she knows other nurses who went through the program, and “they said it was a really good program.

“I knew it was one of the best schools in the area,’’ said Lopes. “They got a lot of hands-on experience, and they felt ready when they got out.’’

Ryan Leonard, 21, of Abington said he chose the school because “it’s right down the street’’ and “a really good school.’’ He applied in 2007, was placed on the waiting list, and started in the fall of 2009. He expects to graduate next May.

Kevin Runey, 26, of Pembroke said he chose the school for its track record of students passing the board exams, and he likes that the school is based at the hospital.

“We have Brockton Hospital right here, so we don’t have to travel far,’’ he said. “We get to see and get to know the staff more — that’s definitely a plus.’’

Emily Sweeney can be reached at esweeney@globe.com. Follow her on Twitter @emilysweeney.

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