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Linda Richards was the first nursing graduate in America and a major pioneer in nursing education. During a 38-year career, between 1873 and 1911, she founded or reorganized 10 schools of nursing, including one at Kyoto in Japan, and served as superintendent of three others (National League for Nursing Education, 1923).
She became interested in the nursing care of psychiatric patients during her later years and systematized education in general nursing at the Taunton and Worcester State Hospitals in Massachusetts. Richards then worked as director of nursing and nurse training at the Kalamazoo Asylum from 1906 to 1909 as requested by her friend from Worcester, Dr. Alfred I. Noble, when he became superintendent (Doona, 1984)· This article reviews the history of her work and influence at that institution.
History of the Hospital
The Kalamazoo Asylum opened in 1859 after Dorothea Dix's campaign for more humane care of the mentally ill (Kestenbaum, 1990). This first state hospital in Michigan was planned by Drs. John F. Gray and Edwin VanDeusen of the progressive Utica Asylum in New York. The latter psychiatrist directed the hospital for 20 years (Michigan Writer's Project, 1941). The facility initially had 288 beds but was accommodating 1,757 inpatients when Richards arrived (Gregory, 1859; Noble, 1906).
Problems facing Linda Richards
The new director of nursing joined Noble when she was 65 and found many challenges that would seem formidable today. These included frequent outbreaks of disease in the hospital, increasing pressure to admit geriatric patients, overcrowding, and an overworked staff. In addition, she had to upgrade a new nursing education program, which was just a step above a school for psychiatric attendants. The successes of Noble and Richards were linked, but particular contributions by the latter included the removal of tubercular patients from the regular wards, the upgrading of a nursing school, which survived for another 39 years, and improved conditions for patients, nurses, and attendants.
Clinical Management of Patients
Moral therapy was the major treatment at the Kalamazoo Asylum and its use persisted into the early 20th century under the supervision of Richards, one of its adherents. This regimen began in England in the mid- 18th century with William Bade at St. Luke's, John Monroe at Bethlem, and Henry Tuke at the York...