Lystra Eggert Gretter
Public Health Advocate and Professional Reformer
By David Yates
Gretter made many contributions to nursing. She shifted the model of nursing education from a one-year apprenticeship to a three-year academic pursuit. She created nurse-run hospital wards instead of allowing nursing students to run them. Gretter cut the work day to 8-hour shifts, to afford nurses and students more time to study and recreate. She wrote what is believed to be the first standardized textbook for nursing education and created one of the first professional nursing libraries. And Gretter was a founding member, at the end of the 19th Century, of groups that later became the American Nurses Association and the National League for Nursing. She established an early visiting nurses association.
Noting that the public perception of nursing was that of "women's work," Gretter lobbied for more political power, including aligning nursing with suffragettes who sought the vote. And Gretter was "the moving spirit behind the creation of "The Florence Nightingale Pledge," an oath of ethics that many graduating nursing students still make today.
Gretter also worked to advance public health generally. She established tuberculosis hospitals, lobbied for in-home nursing care and became a vocal public health advocate for Detroit's burgeoning poor and immigrant population. She also successfully introduced the first state-wide health inspections of school children and a free maternity/infant care clinic in Detroit.
Lystra Elizabeth Eggert was born in Bayfield, Ontario in September 1858. Specific details regarding her family's early years in Canada are sketchy. Her Swiss-born father was one of the village physicians. Her mother was born in Canada of Dutch descent. A maternal grandfather was a Mennonite Bishop who migrated to the United States and then to Canada in the early nineteenth century.
Eggert inherited from her father a passion for health care and from her mother a benevolent Christian spirituality that characterized her adult life.
Upon the outbreak of the American Civil War, Lystra's father enlisted as a surgeon in the Union Army. The family remained in Bayfield where Lystra began her primary education. In 1866, the rest of the family moved to Greensboro, North Carolina. Lystra continued her education in southern private schools.
At age 19, Lystra married John Birney Gretter in 1877. A veteran of General Robert E. Lee's Confederate army, her 45-year-old husband was a Virginian who listed his occupation as Deputy U.S. Marshall in the 1880 census. The same census rather quaintly noted Lystra as "keeping house." It seemed Lystra Gretter could look forward to a secure life of middle class southern gentility.Unfortunately, in 1884, tragedy struck as her husband died suddenly when she was 26, leaving her with a three-year-old daughter. Her father seems to have also passed away by this time. Together with her mother and sister, Gretter moved to Buffalo, New York, and enrolled in the Buffalo General Hospital Training School for Nurses in 1886.
As a single mother returning to school, she was well ahead of her time. She graduated with honours in 1888 and was immediately appointed Principal of the Farrand Training School for Nurses at Harper Hospital, Detroit, in 1889. Gretter held the position of Nursing School Superintendent until 1907.
Despite her administrative inexperience, Gretter initiated sweeping reforms that would revolutionize nursing training, which was done in the hospital setting and involved a great deal of clinical work. Rather than overwork exhausted women in 12-15 hour shifts and 73+ hour work-weeks, the Farrand School was the first school to institute the eight-hour shift.
To make up for the reduction in floor hours by students, Gretter extended the nursing training system first from one to two years, and in 1896, to three years. She argued that "a part of the extra time thus afforded Nurses will be spent in study and outdoor recreation."
The Farrand School under Gretter's supervision became a model for nursing education. A Gretter biographer, Helen Manson, R.N., noted that nurse training became less an apprenticeship and more of a professional education under her direction.
Incredibly, there were few training manuals for nurses. Gretter is believed to have written the first standardized textbook for nursing training. She also formed a professional library and encouraged students to remain current in the latest nursing procedures. The novelty of her nurses' library attracted donations from across the continent.
Due largely to Gretter's efforts, in 1909 Michigan became one of the first states, after New York, that required the certification of practicing nurses.
During the Spanish American War, Gretter recruited qualified nurses to staff the Daughters of the American Revolution Hospital Corps. Dr. Anita McGee, the hospital's chief medical officer, thanked Gretter for her "valuable assistance in the careful selection of graduate nurses" and further paid tribute to Gretter's nursing education system by expressing her belief that the training the nurses received was "so excellent" that it "has distinctly advanced the credit of the schools."
Gretter established the Detroit Visiting Nurses Association that encouraged nurses to visit major hospitals to study the latest in health care innovation. A Canadian whiskey distiller, Hiram Walker, recognized Gretter's reforms in nursing education by leaving a sizable bequest of $20,000 to the Farrand School.In 1908, Gretter was appointed the Director of the Detroit Visiting Nurses Association where she turned her attention to broader social as well as health care issues. She established tuberculosis hospitals, lobbied for in-home nursing care and became a vocal public health advocate for Detroit's burgeoning poor and immigrant population. She also successfully introduced the first state-wide health inspections of school children and a free maternity/infant care clinic in Detroit.
One of the barriers to improving the status of nursing as a profession was that it was considered "women's work" and, therefore, of little value. Gretter formed a strong alliance between the Michigan Nursing Association and the suffragettes in fighting for women's right to vote. Without political power, Gretter argued, nursing would never become a "respectable" profession.In 1904, Gretter was the first President of the Michigan Nurses Association. She was also a founding member of the American Society of Superintendents of Nursing Training Schools (1893) which later became the National League for Nursing. Gretter founded in September 1896 the Nurses Associated Alumnae of the United States which later became the American Nurses Association. [see Munson (1949), p. 346]
One of Gretter's most enduring legacies was "The Florence Nightingale Pledge." Although Gretter modestly credited the work of a committee which she presided over for its creation, Gretter biographers claim that she was "the moving spirit behind the idea" for the pledge.
The Nightingale Pledge was a statement of the ethics and principles of the nursing profession. It included a pledge to "abstain from whatever is deleterious and mischievous" and to "zealously seek to nurse those who are ill wherever they may be and whenever they are in need." In a 1935 revision to the pledge, Gretter widened the role of the nurse by including an oath to become a "missioner of health" dedicated to the advancement of "human welfare"--an expansion of nurses' bedside focus to an approach that encompassed public health.Until the 1970's, the pledge was solemnly recited at graduation or "Pinning" ceremonies across North America. In recent decades, the pledge has either been dropped or substantially altered because of its reference to loyalty to physicians. Nursing is an autonomous profession and any loyalty should be to protect the patient, even in the face of physician opposition.
In addition to helping recruit nurses for the American Red Cross Nursing Service in two world wars, Gretter remained the Matron of the Detroit Visiting Nurses Association until her death in Grosse Pointe in 1951.
Lystra Eggert Gretter literally defined modern nursing as a profession of noble principles and high standards of education. Gretter herself said that she believed "improved education, sublimated by spiritual gifts and graces, will develop nursing into a wider, more helpful ministration patterned after the example of Him who went about doing good."
Miller, Elizabeth J., "Those who marched. Lystra E. Gretter, RN (1858-1951)", (2004), pp. 8-9.
Munson, Helen W., "Lystra E. Gretter" The American Journal of Nursing, (1949), v. 49, issue 6, pp. 344-48.
"Lystra Gretter," (2004), Michigan Women's Hall of Fame.
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