Woman With A Mission
February 1, 1949
When E. Jean Hill became superintendent of nursing and took command of the Department of Nursing Education at the University of Kansas School of Medicine on February 1, 1949, she inherited a program that retained vestiges of an apprentice-style training regimen and slighted academics in favor of hands-on hospital service work.
Student nurses still worked essentially full-time on the floor of KU’s Bell Memorial Hospital in the Rosedale section of Kansas City, Kansas. Nursing students could still graduate with non-academic diplomas. The program itself was unaccredited by any national body. And the responsibility for administering nursing education and nurse staffing at the hospital was co-mingled under one job title.
By the time Hill formally resigned from KU in 1964, all of this had changed. The nursing program’s diploma track that graduated Registered Nurses without an academic degree was abolished. Full control of the baccalaureate degree in nursing was transferred from KU’s College of Arts and Sciences in Lawrence to the Medical Center campus on Rainbow Boulevard in Kansas City. And the position that Hill initially inherited was split in two, further strengthening the academic component of KU’s nursing education program.
Perhaps most significantly of all under Hill’s watch, the department gained accreditation from the National League for Nursing – temporarily in 1952, provisionally in 1957, and fully in 1959. With accreditation came an academic stature that KU’s nursing program had heretofore lacked, and consequently further bolstered the KU Medical Center’s growing reputation for high quality that had begun under the administration of Med School dean Franklin Murphy and was continuing under his successor, W. Clarke Wescoe.
The woman who orchestrated these advances at what is the present-day University of Kansas School of Nursing was born in 1911 in Missoula, Montana. The daughter of a peripatetic college professor father, Hill had lived in several states and Canadian provinces by the time she entered the University of Kansas in 1930. Hill was already something of a Jayhawk at this point since her father was a member of the Chemistry faculty at the Lawrence campus, and an older brother of hers had graduated from KU in 1931.
In 1933, she completed her BA in English at KU, and then went on to earn a Bachelor of Nursing degree from Yale in 1935. Then for three years she taught Nursing Arts at Maine General Hospital in Portland. She followed this with a five-year stint as surgical supervisor for Newton-Wellesley Hospital in Massachusetts. During World War II, she shifted to become orthopedic supervisor at Children’s Hospital in Boston. Immediately after the war she completed coursework for an MS in Administration of Schools of Nursing at Case Western Reserve University in Cleveland, Ohio.
Upon completion of her degree at Case Western, Hill became an instructor in advanced orthopedic nursing for Teacher’s College at Columbia University in New York City. While there in late 1948 Hill accepted an offer from KU School of Medicine dean Franklin Murphy to become associate professor of nursing education as well as superintendent of nursing at the Medical School’s Bell Memorial Hospital. Her education and professional experience made Hill the best-prepared head of KU’s nursing program to that time.
By 1949, Dean Murphy was already well on his way toward reconfiguring the Medical School so that it could provide greater service to the residents of Kansas. Hiring E. Jean Hill fit perfectly with his plans to upgrade the academic quality of the institution as a whole. Her first main task was to overhaul the curriculum and revise the nursing portion of the Medical School course catalog.
To this end, Hill relied on her experience in the educational environment of Teachers College at Columbia University – where much of the twentieth century innovation in nursing education took place – to provide KU students with new courses that did not relate directly to hospital ward nursing. Among her additions to the catalogue were required courses in Methods of Teaching and Educational Psychology.
But the major focus of Hill’s early years was the attainment of academic accreditation for KU’s nursing education program. Only with this credential could the department gain full respect academically within the Medical School as well as across the country. Additionally, with accreditation, KU nursing graduates would possess degrees that enjoyed full acceptance by any hospital or college graduate program in the United States.
The first attempt to gain accreditation for KU’s nursing education program had taken place more than a decade before Hill arrived at Rainbow Blvd. In 1938, the National League for Nursing Education selected KU’s nursing program, then led by Henrietta Froehlke, for participation in a pilot study as a first step toward eventual accreditation. However, the pre-accreditation visit pointed up many challenges facing the department such as the heavy workload for the student nurses and the program’s light educational content. It became clear that KU nursing was not yet ready for accreditation at that time.
To begin to address these issues, the program started requiring degree-seeking student nurses to complete two and one-half years of clinical work, including summers, on top of their three semesters of scientific education that were a prerequisite for formal entry into the program. (Previously, the requirement in the degree program was for two years and one summer.) The purpose of this change was to increase the hours devoted to classroom instruction. It also extended the time for completion of the baccalaureate program in nursing to five and one-half years.
The disruptions associated with the Second World War – including the voluntary enlistment by several dozen Bell Memorial Hospital nurses in the US Army’s 77th Evacuation Hospital Unit – prevented any further progress toward accreditation for much of the 1940s. However, after Hill’s arrival at Rainbow Boulevard, the College of Arts & Sciences on KU’s Lawrence campus transferred authority for the baccalaureate program in nursing to the School of Medicine.
This move assured that full academic control of the clinical nursing curriculum would be with the Nursing Education department. While Hill did not initiate this change, which had been a goal since before World War II, she pursued it doggedly because it fit perfectly with the plan to emphasize the importance of academics.
Also during the late 1940s, Bell Memorial Hospital finally moved to eight-hour shifts for nurses after decades of requests from both students and professional nurses. While necessary to comply with federal wage-and-hour laws, the change also enabled additional class and study time for student nurses.
The “1948-50 Biennial Report of the Medical School” gave Hill high marks and called her an “extremely competent director of the Department of Nursing.” This report, designed to place the Medical School and its departments in the best light, called attention to one of Hill’s curricular reforms that fit into Dean Murphy’s “Rural Health Program for Kansas” for making the Medical School essential to the entire state.
According to the report, Hill had initiated “…a basic modification in curriculum…whereby young women may stay in their college of choice for two years before entering the University degree program.” This meant that nursing students could begin their path toward a BSN degree in almost any part of the state with an accredited liberal arts or junior college. The report concluded that this change “…has put more meat into our emphasis that we are the medical educational institution for the entire state of Kansas.”
Following what Hill conceived as a natural progression towards accreditation, in 1951 the Nursing Department discontinued accepting new students into the diploma track leading to a Registered Nurse certificate. Initially, this non-degree program had been the only academic program available to student nurses at the Medical School.
In 1929, the Kansas Board of Regents had authorized the University to begin offering the baccalaureate degree. The appeal of the BSN, which required more work to obtain, had grown slowly during the years of the Great Depression. It took until1940 for the number of students in the Registered Nurse diploma track and those in the baccalaureate degree track to become roughly equal. At the 1953 commencement ceremonies, Hill capped the last non-degreed RN from the Nursing Education Department.
All of these efforts were components of Hill’s main charge to obtain accreditation for the program. The gaining of academic accreditation is a laborious process whenever undertaken by any University unit. The Medical School itself had only attained accreditation as a whole in 1939, and only gradually did specialized departmental programs gain approval of their respective professional bodies.
In the case of nursing, several constituencies had to be satisfied. First, Hill had to gain the support of the Medical School Advisory Committee for Nursing, made up primarily of doctors and administrators in the KU School of Medicine. Then, she had to be sure of approval from the Kansas State Board of Nursing.
The final step was to satisfy the demands of the National League for Nursing (NLN) and its stringent academic requirements. In 1952, after Hill and her staff completed dozens of forms and self-study documents, the NLN granted the Department of Nursing at the University of Kansas School of Medicine its first national accreditation approval. This certification was temporary and required continuing supervision and review by the NLN staff professionals.
With this new status E. Jean Hill became the first formal chair of the department. The title – which replaced Hill’s former designation of “Superintendent of Nursing” that implied more of an employment responsibility at the hospital than an educational position at the Medical School – marked yet another small step on the department’s road to full academic credibility.
To be sure, Hill still retained her duties as nursing superintendent, but this was to be short-lived. In 1956, a separate director of nursing service was appointed for the first time, allowing Hill to devote all of her efforts to academic administration. Also, by this time, nursing students were required only to work “service time” as part of their training, but actual class work and study comprised the greater portion of their total time commitment.
The value of these and related reforms became clear when the nursing education program advanced from temporary to provisional accreditation status in 1957, and finally proceeded to full accreditation in 1959. In just 10 years, Hill had achieved her prime mission.
Ironically, Hill’s success in this endeavor did not make the remainder of her tenure at KU any easier. She was thwarted in her efforts to upgrade the pay and rank of the nursing faculty, almost all of whom were instructors that earned barely half the national average and even came in at $600 to $1,500 per year lower than comparable positions at institutions in Iowa and Minnesota. The low KU salary ranges for nursing instructors caused several well-qualified applicants to take better paying jobs elsewhere, an outcome that left Hill further frustrated. At the same time, Dean Arden Miller of the Medical School seemed oblivious to these difficulties and instead criticized Hill for not being able to implement more graduate programs in nursing.
In spite of these setbacks, the Department of Nursing received its first continuing accreditation in 1962. The endorsement included the department’s curriculum in public health nursing, making it the first such accredited program in Kansas. Also around this time, federal government financial support became available to certain students in their final year in the department. It was a crowning touch.
In 1963, Hill took a leave of absence to pursue a doctorate in nursing education from her former employer, Teachers College of Columbia University. Although intended to prepare her to continue upgrading the nursing department at KU, Hill did not return to the University after completing her PhD. Instead, in 1967 she accepted the job of dean of nursing at Queens University in Kingston, Ontario, Canada. She retired from that position in 1981. In 1982 the KU School of Nursing conferred upon her Honorary Alumni status in honor of her years of service. Hill retired in Kingston and lived there until her death at the age of 95 in February 2006.
William S. Worley
Adjunct Professor of History
University of Missouri-Kansas City