UCC SONM 25 Year Book

Professor Geraldine McCarthy

Professor Josephine Hegarty

UCC / School of Nursing and Midwifery

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Deans and Heads of School 1994-2019 - Mission Statements

Professor Geraldine McCarthy

Mission: To establish a School of Nursing and Midwifery within University College Cork, offering undergraduate and post graduate programmes, build research capacity and a culture of enquiry and collaboration with the health services.

The Book hopefully will find a place in many homes as an accessible but also comprehensive and reasonably detailed record of the historical development of nursing and midwifery in the Cork region. Those early in their careers can read and understand the origins of our disciplines and how nurse and midwifery education in this region progressed to becoming the School of Nursing and Midwifery we see today in University College Cork (UCC). The School continues to support an agenda of excellence in education, research, clinical practice and community engagement which we hope future generations of educators and students will propel forward.

Professor Eileen Savage

Mission: To lead the School of Nursing and Midwifery to be world class, that is, dynamically engaged at local, national and international levels with shaping the provision and quality of healthcare for the benefit of all through education, research and practice.

Professor Josephine Hegarty

Mission: To ensure the School as a whole is sustained and developed through: prioritising the student experience of programmes, maintaining academic excellence in teaching and examining, ensuring responsiveness of programmes to changing societal and healthcare needs, promoting research with global impact, supporting active academic-clinical- community partnerships and supporting staff and students in the fulfilment of their ambitions.

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Acknowledgement

This book tracks the historical development of nursing and midwifery from the early times to the present it profiles the challenges faced, acknowledges visionary leaders who responded to both societal and health service demands and latterly how nurse and midwifery education transferred into University College Cork (UCC). We would like to acknowledge the nurses and midwives who chose to complete their studies in association with UCC; clinical partners who contributed to their education and the staff of the School of Nursing and Midwifery, UCC. We would like to particularly acknowledge those who drew on their extensive experience to contribute to specific sections in this book including: Dr. Nicola Cornally (Research), Dr. Harry Gijbels (Psychiatric Nursing), Dr. Helen Mulcahy (Community/Public Health Nursing), Dr. John Sweeney (Intellectuality Disability Nursing), Dr. Rhona O’Connell (Midwifery), Nuala Walshe (Clinical Skills and Simulation), Carmel Buckley (NMPDU), Dr. Seán Kelleher and Carol Condon (International Developments). Specific thanks is also due to Dr. Mary Rose Day for her editorial and proof reading skills and to Ms. Kay O’Sullivan for contributing to early versions of the text and providing some of the photos which she sourced from individuals who had worked for the health services over the years. Thank you to Therese Ahern and Dr. Teresa Wills for their assistance with this project.

To Tony Archer who searched for appropriate photos to include and who contributed to the overall design of the Book. We would also like to acknowledge the vital role played by Regina Murphy, School Manager whose knowledge of the history of the School was invaluable and who provided administrative support and relevant documentation. On the production level we wish to thank all those who helped with the design and lay out of the text including Gavin O’Shea, Two and Six Creative and Michael Courtney, City Print, Cork. There were many people who contributed to this book, too many to name everyone, thus we would like to thank everyone who contributed to the work of the School over the last 25 years and to those who contributed to this account of the history of the School. The Book hopefully will find a place in many homes as an accessible but also comprehensive and reasonably detailed record of the historical development of nursing and midwifery in Cork. Those early in their careers can read and understand the origins of our disciplines and how nurse and midwifery education in this region progressed to become the School of Nursing and Midwifery we see today in University College Cork (UCC). The School continues to support an agenda of excellence in education, research, clinical practice and community engagement which we hope future generations of educators and students will propel forward.

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contents

Chapter 1 INTRODUCTION – THE CONTEXT WITHIN WHICH NURSING AND NURSE EDUCATION DEVELOPED

Chapter 3 THE SCHOOL WITHIN UCC AND DEVELOPMENT OF UNDERGRADUATE AND POST GRADUATE EDUCATION

The early years for Nurses in Acute, Psychiatric and Intellectual Disability Services

Location of School within University College Cork Academic Programme Management Structures

66 68 70 72 74 74 74 74 74 76

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St. Finbarr’s Hospital Cork University Hospital Mercy University Hospital North Infirmary Hospital

13 16 19

Academic Administration Academic Programmes

Undergraduate Nursing Degrees (BSc) with Professional Registration

24 26 28

South Infirmary/ Victoria Hospital

Acute Care General Nursing

Bon Secours Hospital Psychiatric Nursing

Acute Care General and Children’s Nursing

31 31

Psychiatric Nursing

Our Lady’s Psychiatric Hospital

Intellectual Disability Nursing

Mental Handicap/Intellectual Disability Nursing

35 38 40

BSc Midwifery Degree

COPE Foundation and Associated Schools

The Health Service Executive and Department of Health-Evolving structures and Partnerships

Summary

78

Post Graduate Education and Professional Development

Chapter 2 THE CALL FOR CHANGE: COMMISSION IN NURSING, ESTABLISHMENT OF THE CATHERINE MCAULEY SCHOOL OF NURSING AND MIDWIFERY

80

The Nursing and Midwifery Planning and Development Unit Cork and Kerry Postgraduate Education in Nursing and Midwifery with Professional Registration

81

84 84 84 84 84 85 94

Higher Diploma in Midwifery

Introduction

42 44

Higher Diploma in Public Health Nursing Postgraduate Certificate in Nurse Prescribing MSc Advanced Nurse/Midwife Practitioner Midwifery Education and Practice origins to 2019 Community / Public Health Nursing origins to 2019

The Commission on Nursing

Establishment of the Department of Nursing Studies, University College Cork

46 49 53 59 60 63 64

Physical Facilities

Clinical Skills Simulation Resource Centre (CSSRC)

Other postgraduate Certificate / Diplomas and Specialist areas of Clinical Practice Postgraduate Certificate in Nurse Prescribing Advanced Practice in Nursing Case Studies

Library Support of the School Clinical Placements, Allocation and Processes in Service Areas

96 99

100 106

Recruitment of students

MSc End of Life Health Care Ethics

Summary

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contents

The Future THE STUDENT EXPERIENCE

Online Learning and Pedagogy

106 107 108 109

MSc Nursing in Healthcare Quality Improvement

Students and Staff Numbers increase

Remembrances Academic Staff

Conclusion

170

110 114 118

Reflections by Heads of School

171

Professional Support Staff

Summary

References Appendices A: Mercy Hospital -

Chapter 4 THE STUDENT EXPERIENCE

Acceptance to training letters

182

B: St. Vincent’s Nursing School North Infirmary - Regulations for student nurses

184 188 196 197 198 199

UCCs’ Nursing and Midwifery Society

120 121 124

C: Staff Listing

Student Awards

D: Adjunct Appointments

I am a Nurse: Student Perspective

E: Brookfield Health Sciences Complex - Information at the Opening

Students coming to and travelling out from the School of Nursing and Midwifery

126 128

F: The Best and the Brightest G: Graduating Class of 2002

Formative Experiences

Summary

132

H: Continuing Professional Development

200

I: Annual Research Conferences

201

Chapter 5 RESEARCH AND SCHOLARSHIP – THE LAST 25 YEARS

Research Building Capacity and Current Status

134 140

Fulbright Scholars in the School

Research Priorities

141

Research Themes at the School of Nursing and Midwifery Research Outputs and Direction

142 153 155 156 159 163 166

Internationalisation Visiting Scholars Research Conferences International Awards

Summary

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1 THE CONTEXT WITHIN WHICH NURSING AND NURSE EDUCATION DEVELOPED

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Introduction: The early years in acute, psychiatric and intellectual disability services

The story of nursing andmidwifery is linked to social, political, medical and economic history and to the evolution of the Irish health services. In particular, changes over time in patterns of disease, medical advancements have led to developments in nursing and midwifery education, professional regulation and clinical practice. In Chapter 1 of this Book the emerging health services and clinical practices with the simultaneous development of training and education in each of the services locally from their initial establishment up to 1994 are described. The contribution of the religious sisters of Mercy, Bon Secours and Daughters of Charity are detailed. The influence of a religious vocational philosophy which permeated the profession for many years is evidenced in relation to general nursing. The development of nursing and midwifery education is described in the hospitals from the inception of services within these institutions up to 1994: St Finbarr’s Hospital, Cork University Hospital, Mercy University Hospital, South Infirmary/Victoria University Hospital, Bon Secours Hospital. The North Infirmary Hospital (now closed and refurbished as a hotel) will also be mentioned as will the contributions of the Daughters of Charity Religious Order who operated this hospital. The development of Mental Handicap Nursing in COPE Foundation, Cork and Psychiatric Nursing at Our Lady’s Hospital Cork are profiled as they developed during this period. The evolution of Midwifery is dealt with separately even though many of the hospitals already profiled also operated these services and associated training. Public Health Nursing as the first programme to be offered in UCC is detailed as well as its evolution over time. In Chapter 2 the reform of nurse education and practice is explained. The influence of the Report of the Commission on Nursing (1998) and subsequent support for the wide-ranging recommendations of the Report by the Irish Government (supported by Department of Health, Department of Education and Department of Finance) is detailed. Changing patterns of diseases and the need for competent well- educated practitioners to work in increasingly more complex services in hospital and the community is discussed. Reforms of the Health Services are explained and the implications therein outlined. Chapter 3 details the challenges of establishing a new academic discipline within University College Cork (UCC). The building and opening of the School of Nursing and Midwifery at Brookfield Health Sciences Complex is described. Each of the undergraduate and postgraduate programmes presently being offered in collaboration with diverse health care providers are briefly addressed. The changing role of the nurse and midwife and the supporting programmes developed in UCC are explained. Staffing of the School is detailed. Student experiences are profiled. Building Research capacity is explained as well as progress in this area of academic endeavour. The text ends with an exploration of possible future endeavours. Reflections from the successive Deans/Heads of the Catherine McAuley School of Nursing and Midwifery are included.

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The Developing Health Services

The development of the health services is of critical importance to nursing. The training of nurses and midwives began in hospitals and hospitals continue to provide clinical placements for students. By the early 19 th century hospitals began their development when the epidemics of infectious diseases forced the government and voluntary agencies to provide for the sick poor. There was no central authority established for the health services until 1838 when the Poor Law Act established Workhouses which quickly became infirmaries for the sick poor. These grew in importance as seen in relation to St. Finbarr’s Hospital in Cork. Medicine, health services and nursing and midwifery developed within them. “Nursing” in the Workhouse was conducted by the sick paupers or by religious sisters who were trained elsewhere. As the years progressed to 1919 “trained nurses” were recruited and a hierarchical structure began to emerge with Matrons appointed who were either trained by the religious orders in Ireland or in the UK in a system influenced by the philosophy of Florence Nightingale (Nightingale, 1950). The Health Services developed and saw major growth in the period from 1950-1994. Medicine advanced and the demand for hospital care grew. In 1947 the Department of Health was established. The net effects of the Health Acts of 1947 and 1953 were that the County Councils were given powers as Health Authorities to administer the health services which existed side by side with the Voluntary Hospitals. In each County a general hospital existed, and one or more district hospitals and a county home provided for the chronically ill. The 1960’s saw a need for reform. Infectious diseases became less of a problem, and new care problems emerged such as heart diseases, cancers and morbidities associated with ageing and accidents. In this period general and specialist services began to develop with consultant medical staff appointed and relationships with universities deepened. The Health Act (1970) led to the establishment of Health Boards with officers accountable to the Department of Health (DoH) for general hospital services, community and specialised services. The Boards, comprised of membership from political parties and professionals, managed the services until 2005.

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A number of Policy Documents were commissioned and published during this period including The Years Ahead (Government of Ireland, 1988) a policy document for elderly care and Shaping A Healthier Future (Government of Ireland, 1994) which set down general principles for the development of services. This was followed by a series of specialist strategies.

Governed by Legislation

Nurses supported State control and registration of qualifications and thus the Nurses State Registration Act of 1919 provided for the establishment of the General Nursing Council (GNC) of Ireland to make rules, register nurses and control training institutions. Subsequently Schools were officially established in hospitals and were inspected to ensure adequacy of opportunity for learning, curricula were based on requirements of the Council and Council examinations were introduced. The General Nursing Council (Ireland), (1919) existed until 1950. Nursing and Midwifery are regulated by legislation. The Nurses’ Act 1950 made provision for a single agency. In 1951 the Irish Nursing Board (An Bord Altranais (ABA) was founded and the General Nursing Council and Central Midwives Boards were disbanded. An Bord Altranais quickly established rules and regulations regarding schools, developed curricula requirements, identified teaching numbers and set state board examinations. Schools of Nursing were situated within the hospitals, the Matron of the hospital was in administrative

The An Bord Altranais logo is a representation of Saint Brigid’s cross or Brigit’s cross which is a small cross usually woven from rushes. The cross and garlands motif was selected by Dr. Patrick MacCarvill (an obstetrician), the last Chairman of the General Nursing Council for Ireland and the first President of An Bord Altranais. It is believed that the motif was chosen to represent both nursing and midwifery. The badge was worn by generations of nurses and midwives after registration.

charge of nurse training, the post of Principal Tutor was created and schools were staffed with tutors and sometimes clinical teachers. The annual intake in Schools varied, facilities changed over time and methods of teaching and teaching supports evolved. This led to the introduction of a block release system for nurse education and training where nurses were given an initial period of classroom induction. This was followed by four week periods of classroom based education at regular intervals with curricula content guided by An Bord Altranais (ABA) regulation and EU Directives. The Nurses Act 1985 further regulated nursing practice, gave statutory powers and authority to the profession, established a live register, and extended powers with respect to fitness to practice. In 1972, Ireland joined the European Union (formerly European Economic Community

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(EEC) becoming a member State in 1973. This initiated an important and continuing strong influence on nursing education (Chavasse, 2000). An EEC Directive for general nursing in 1979 sought mutual recognition of qualifications in member European states and in 1989 a further Directive mandated 4,600 hours of theoretical and practical instruction for nurses across all European countries. EU Directives (Luxembourg, 1977) ushered in considerable change to the undergraduate nursing programme. Community and mental health clinical placements were introduced. It also led to the situation where a nurse proficient in the language of another EU country has the right to practice in that country. From the early days the professional training of nurses in Ireland was based on the apprenticeship model (Fealy, 2005, Fealy 2006) which was endorsed by An Bord Altranais and the Department of Health. This continued until the last decade of the 20 th century. Students were trained on the job by more experienced nurses, student nurses were salaried employees and they provided a core part of health service provision. The Matron and/or their assistants and sometimes medical practitioners taught the trainees at the patient’s bedside. As hospitals grew in number the demand for nurses increased with each hospital wishing to recruit (using their individual criteria) and train their own nurses; a practice which existed until 1994. At the end of the 19 th Century the practice of training nurses had permeated nearly every hospital irrespective of bed numbers or available clinical experiences. This form of nurse training was a compromise which neither challenged the medical profession or hospital administration (McCarthy in Robins, 2000) Reflection on the gendered division of labour is important. In the 19 th century women were excluded from the workforce by factory acts and legal prohibition which existed until 1974. This ideology construed women and men as inherently different, whose abilities were suited to differentspheresofemployment.Theeducationalneedsofnurseswerealowpriority(Elms,Tierney, &Boylan,1974)andtherewasaperceptionthatthereexistednoindependentbodyofknowledgeto be transmitted. Specialisation within nursing began to gain momentum from the early 1970s. Among the earliest appointments were Stoma Therapists and Infection Control Nurses. Many nurses from the Cork Hospitals enrolled in specialized courses in the major Dublin teaching Hospitals and in the United Kingdom. Accident and Emergency, Coronary care, Theatre, Renal Nursing and Neurosurgery were among the earlier specialties. These courses were generally of 6 or 12 months duration and the participants were full time based at the providing hospital for the duration of the course. All successful candidates were given a hospital certificate and the courses were approved by An Bord Altranais.

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The transition years Nurse education based on the existing hospital systems of “apprenticeship type” training continued to exist in Ireland until 1994. Such training produced nurses who were highly skilled at clinical hospital work but were generally unquestioning and submissive. The apprenticeship system neither challenged the other healthcare professions nor made demands. Such an approach to education and an associated hierarchical system could have only existed in a world where women were prepared to be submissive, self-denying, amendable to discipline and hardworking within a routinised work system (McCarthy in Robins, 1997) Mark Loughery in a historical text, In Century of Service: A History of the IrishNurses andMidwives Organisation: 1919–2019, noted that in February 1919, twenty nurses and midwives disgruntled with their working conditions took the decision to establish a trade union. The Irish Nurses and Midwives Organisation (INMO) grew from those twenty nurses to a membership of over 40,000 nurses and midwives. The INMO have negotiated and been the public voice of nursing. Other representative organisations include the Psychiatric Nurses’ Association (PNA) and the Services, Industrial, Professional and Technical Union (SIPTU). Over the years these unions represented nurses and midwives and played a significant role in the reforms portrayed in this book. The reform of nurse training in Ireland was influenced by the Working Party Report on General Nursing (Department of Health, 1980), The Future of Nurse Education and Training in Ireland (An Bord Altranais, 1994). Rationalisation of schools was recommended and some rationalisation occurred. As nurses and midwives approached the mid 1990’s many were critical of provisions for nurse education and practice but felt especially powerless to make the necessary changes. They may have been caught in their socialisation process which had encouraged the subservient role for which education was not considered necessary. Education required resources. Politicians and the Departments of Health and Finance had to believe in the worth of allocating resources and nurse leaders needed to emerge to lead. A profile of the major hospitals in Cork city and their influence on the development of nursing and nurse education is given in the following text. Each Hospital has played a unique role and today in 2019 continue to provide the clinical placement areas for students of the School.

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St Finbarr’s Hospital The history of nursing and midwifery education at St. Finbarr’s Hospital Cork goes back to the establishment of the Cork Workhouse in 1854 and is detailed in many reports and texts including A Tale of Two Hospitals (Browne, 1988).

St. Finbarr’s Hospital

The origins of nurse training at the Cork Workhouse stemmed from the initiatives of certain members of the Mercy Order. In 1871, Sr. Cecelia Leahy and seven of her colleagues were appointed by the Board of Guardians of the Workhouse to take charge of the then called Fever Hospital. Recognising the need for specialized care required by these patients, Sr. Leahy commenced the training of Religious Sisters in Fever Nursing. In 1919 The GNC approved the first School of Nursing in the District Hospital (previously called the Workhouse) and the School in St. Finbarr’s was established in 1925 (the Mercy Hospital at that time only trained Mercy Sisters). In 1928, the first students of the Fever Hospital graduated as Registered nurses. Education progressed under Sr. Cecelia’s guidance and Sisters of Mercy were trained in close association with lay persons. The title of the hospital changed to St. Finbarr’s in 1950 and services expanded. A nurse’s home was built to allow students to live near the hospital for the duration of their training. The training was based on the apprenticeship model. The School enrolled probationers entirely free of entrance fees which was widely welcomed at a time when young Irish girls had previously been forced for financial reasons to go abroad for training. The School continued and evolved as curricula were informed by requirements from An Bord Altranais and as services developed within the hospital. St. Finbarr’s hospital developed to incorporate medical and surgical specialist services and included children, maternity services and an emergency department. Students had considerable experience under the supervision of the trained nursing staff and clinical teachers from 1974 onwards. As time passed medical treatments evolved and new

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St.Finbarr’s No1 Presentation of certs Feb.’58 (L-R): Mary Browne, Nancy Kelleher, Lil Kelly, Phil Burke, Agnes Brazil, Sister. M. Ignatius (Tutor)

St.Finbarr’s No 2 Preparing for the annual Christmas party 1957 (L-R): Mary Browne, Rita O’ Mahony (Midwifery Tutor) Sister Roche, Lil Kelly, Rita Fitzgerald & Back Row Gentleman Evan Flynn

nursing roles emerged. For example, in 1966 the first Central Sterile Supply Department in Cork was opened at St. Finbarr’s Hospital under the direction of a Nurse Manager (Mr. E. Higgins). This marked the end of ward and theatre-based sterilization with the stated aim of lessening the workload of nurses and making patient stay in hospital safer. This time also marked a significant turning point in the role of nursing in many other areas. Ward Auxiliaries were recruited and trained to alleviate nurses from many non-nursing duties which heretofore were carried out by nurses especially student nurses. By the early 1970s many regional medical specialties were introduced at St. Finbarr’s Hospital and included cardio-thoracic surgery, vascular surgery, genito-urinary surgery, neuro-surgery and plastic surgery as well as gastro-enterology, neurology, endocrinology, cardiology, renal and metabolic diseases, gerontology and dermatology. In fact, St. Finbarr’s developed the nucleus of most of the major specialties that exist at Cork University Hospital. Nurses worked to support these developments.

St Finbarr’s 50 Anniversary celebration 1978 – seated back row (L-R): Nora O Donoghue, Mary (Kelly), Margaret Staunton, Breda O Leary, Hannah Fitzgerald Front row Mary Murphy, Kay Lordan, Sr. Killian, Nora Mary Morley, Kay O Sullivan

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In 1975 the Golden Jubilee of the founding of St. Finbarr’s School of Nursing was celebrated with a reunion, attended by Sr. Cecilia its founder and first Tutor. Guests reminisced about times past and text from Memories (Southern Health Board 1971-2004) tells of earlier years “when the School opened in 1925 probationers were not paid for their first 6 months, they got 1-pound salary a month after that and 3 pounds a month in their 3rd year of training. Many of the wards had no heat, no light, and most of the work was done by those living in the hospital.” In 1978, three and a half years after the 50 th Anniversary of the opening of a School of Nursing at St. Finbarr’s Hospital the School was transferred to the newly built Cork Regional Hospital (now Cork University Hospital). The Sisters of Mercy continued to have responsibility for the School of Nursing until 1991 when Sr. Killian Searson retired from her post as Principal Nurse Tutor. The School at CUH took its last intake of student nurses to what subsequently was referred to as the traditional Programme in 1997 thus bringing to a conclusion in 2000 the 75-year history of nurse training at CUH and St. Finbarr’s Hospitals. The latter continues as a facility for older adults and rehabilitation services where students still gain considerable clinical nursing experience.

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Cork University Hospital

Cork University Hospital

In 1972 a 600 bed inpatient hospital with capacity for further expansion was planned. It ultimately opened as Cork Regional Hospital in 1978. The 40-year history of the hospital is told in a recently published book (St Ledger, 2019) in The Tale of Two Hospitals (Browne, 1988) and in Memories (Southern Health Board, 1971-2004). On opening all acute services transferred from St. Finbarr’s Hospital, cardio-thoracic and mental health services from St. Stephens Hospital, Glanmire. In 2000 Mallow General and Bantry General hospitals joined Cork University Hospital under a single management unit as acute service partners. The Hospital was managed up to 1985 by the Southern Health Board and from 1985 to date by the Health Service Executive. It has become the largest hospital in the South of Ireland and designated as a level 4 Acute Hospital responsible for complex care. In 1994 emphasizing the importance of its role as a teaching hospital and its links with UCC the name of the hospital changed to Cork University Hospital. From 1961 a system of medical joint appointments existed.

Graduation at CUH, 1994 (L-R) front row: Pat Lydon, Margaret Landers, Catherine Flanagan, Finola O’ Sullivan, Tony McNamara, John Dennehy, Fr. Hartnett, Rosaria Murphy, Dr. William Fennell

Sr. Thecla Kelleher, Matron presenting flowers to Emily Curren from Tipperary who was the first patient to be transferred from St. Finbarr’s Hospital to the new Regional Hospital. Michael Cogan Head Porter, is on the right with Tony Fitzgerald Porter. The nurse maybe Mary Owens (Photo: Irish Examiner/Evening Echo)

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Tutors at CUH 1980 Back row Catherine Flanagan, Eileen O Donnell, Sr. Killian, Geraldine McCarthy Rosaria Murphy Front row Fr. John Kingston, Pat Lydon, Ft Pat O Shea

In the 40 years since its opening there have been advances in medicine, improvements in technology and changes in many aspects of care, all of which has had an impact on the hospital. New buildings were constructed to accommodate new services and the hospital has grown to 800 beds with a very busy Emergency Department and over 40 specialties many of which are Regional services. Amongst the major developments were: the building of the Cork University Maternity Hospital (2000); The regional Cancer South Service (2009) as one of the 8 major cancer services in Ireland; the new Cardiac Renal Services (2010); Acute Medical Unit (2011); Cystic Fibrosis Unit (2015); Adult Mental Health Unit (2015); Surgical Assessment Unit (2017); new paediatric Outpatient Unit (2017) and Radiology/Oncology Centre (2019). CUH is designated as one of the two Major National Trauma Centres to be built in the coming years. As a result, medical care has become more specialized and complex which has resulted in evolution in the role of the nurse. This is seen especially in clinical nurse specialist and advanced practitioner roles. The School of Nursing at St. Finbarr’s Hospital transferred to the new hospital. Until 1997 there was a twice-yearly intake of 70 student nurses and 14 nurse tutors worked in the School. Up to the early 1990s students lived for one year in a Nurse’s home on campus. The 3-year apprenticeship model of training prevailed, curricula and state examinations were as set by An Bord Altranais who also periodically inspected the School and validated the programme. The School took its last intake of what was subsequently referred to as the traditional Programme in 1997 thus bringing to a conclusion in 2000 the 75-year history of nurse training at St. Finbarr’s and Cork University Hospital. The Undergraduate Diploma in General Nursing operated at CUH with its first intake in 1998 and it’s final one in 2001. In 2002 students registered with UCC for their BSc programme and CUH became the nominated hospital for clinical placements for the largest group of general nursing students.

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The role of the Matron changed considerably over time. Traditionally the Matron was responsible for overseeing staff not only in nursing but also in catering and portering. By the late 1900s the role had evolved into that of Director of Nursing responsible for nurses and nursing including nurse education and with a greater emphasis on strategic planning and quality assurance. To support the Director of Nursing, Divisional NurseMangers were appointed from 1978 onwards. These held responsibility for clinical practice in collaboration with medical directors. As a result of a recommendation of the Commission on Nursing (Government of Ireland, 1998) at ward level a new grade of Clinical Nurse Manager 3 was introduced with additional responsibilities for clinical practice. This together with the appointment of Clinical Nurse Specialist and Advanced Nurse Practitioner roles led to enhanced quality of care for patients and more autonomy in patient care for nurses. The physical appearance of the nurse changed in the early 21 st century with the white starched uniform and hat being replaced by more comfortable and practical clothing. Nursing staff from many other countries have always worked in CUH. The workforce became particularly diverse from 2000 onwards. The first oversees recruited nurses arrived in CUH from the Philippines in 2001. They were joined in subsequent years by staff from India and other countries. Nursing has changed enormously over time but continues as the only professional group giving 24-hour bedside care 365 days a year. What had not altered is the commitment of nursing staff to the care and wellbeing of patients.

51 years of nursing and midwifery leadership (1955-2006) Sr. Thecla, Matron St. Finbarr’s Hospital (SFH) (1955-1978), DON, CUH (1978- 1988), Elizabeth Kelly, Matron SFH (1978-1988), DON CUH ( 1988-1997), Kay O’ Sullivan Matron SFH (1990-1997) DON CUH (1997 -2006)

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Mercy University Hospital Catherine McAuley born in Dublin in 1778 founded the Sisters of Mercy in 1831. She opened a home and School for poor children in Baggot Street, Dublin, along with providing home care services. The Mercy sisters arrived in Cork on 6th July 1837 and focused on home nursing. Their contribution to the health services in Cork is set out in a number of publications including those by Sr. Emmanual Browne (1998); Sr. Angela Bolster (1977, 1978, 1987, 1999) and the Irish Examiner Mercy University Hospital.

During the Crimean War, seven of the fifteen Irish Sisters of Mercy who nursed in military hospitals of Scutari, Koulali and Balaclava were from convents in Cork city and county. The participation of the Irish Sisters of Mercy in the military hospitals of the Crimea under the leadership of Sister M Frances Bridgeman of Kinsale, marks an important era in the history of military nursing.

Mercy University Hospital

The Mercy Hospital Cork was opened on March 17 th 1857. Four Sisters of Mercy were appointed to take charge of the hospital. Mother McAuley’s dream of having a hospital administered entirely by her own sisters in Cork was fulfilled. Extensions and improvements to this hospital and the quality of its service led to its recognition in 1911 as the first Irish Training School for Nursing religious sisters. On the 23 rd January 1912 the training of the Sisters commenced, a development sanctioned by the Senate of Universities of Cork and Dublin. Thirteen years later, in 1923, the Mercy Hospital, in conjunction with the North and South Charitable Infirmaries, were among the first institutions nationwide to receive approval from the General Nursing Council for the training of lay nursing probationers. The Sisters and “young ladies” continued to train together until 1928 after which the demands of the Sisters in Cork from Convents both at home and in the missions became so great that lay student training was discontinued. It was not until December of 1955 that the first group of five lay students recommenced nurse training in the Mercy and the School was formally established in 1979. Since that time a great number of nurses have trained at the Mercy and were proud to call themselves “Mercy Nurses”. It was difficult to obtain a place as a student nurse in the hospital and there were a number of requirements as set out in Appendix A.

In 1987, with the closure of the North Infirmary Hospital, nursing students on a four-year combined General/Paediatric Nurse Training Programme with Crumlin Hospital, Dublin and

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School of Nursing transferred to the Mercy Hospital to complete their training. Two years later in 1989, the Department of Health and An Bord Altranais amalgamated the Schools of Nursing at the South Infirmary and Victoria Hospital to the School of Nursing at the Mercy Hospital, which was known as the Cork Voluntary Hospitals School of Nursing, Mercy Hospital until 1997. In 1996 in line with the National reforms in nurse education the Registration/ Diploma in Nursing Programme began in partnership with UCC. The Mercy, for most of its 158-year existence has been a Voluntary Hospital. It is beyond question that the life and work of the Sisters of Mercy has been central to the local community in Cork. The Sisters have been, in a very real sense, co-workers responsible in many ways for the development of the health service in Cork City and County.

Teaching session with students in the Mercy University Hospital

Students and Staff at Mercy University Hospital

Nurse Graduates with Director of Nursing, MUH Margaret McKiernan and Sr. Laurentia Roche 2018

The Sisters of Mercy have been acknowledged for their outstanding contribution over the years especially, Sr. Concepta Twomey Principal Tutor (MUH), Sr. Laurentia Roche Director of Nursing (MUH) Sr. Killian Searson Principal Tutor (St Finbarr’s Hospital and CUH), Sr. Immaculata Hegarty, HomeSister (St Finbarr’sHospital andCUH), Sr. Kevin Ryan Principal tutor (South Infirmary) and all of the Sisters who support the education of nurses over the decades. In April 2008 having received approval from the College of Medicine and Health and University College Cork the School was formally called the Catherine McAuley School of Nursing and Midwifery.

Sr. Laurentia, Sr. Liz Murphy, Professor Geraldine McCarthy, and Sr. Concepta on the occasion of the naming of the School as the Catherine McAuley School of Nursing and Midwifery, University College Cork, 2008.

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Honorary Awards to Sister of Mercy As detailed throughout the book the Sisters of Mercy have contributed significantly to the Health Services and specifically to nursing in the Southern Region of Ireland. University College Cork has recognized this service by awarding two Mercy Sisters Honorary degrees.

Sr. Margaret Healy

Graduation of Sr. Margaret Healy: Honorary Doctorate in Civil Law 2001 Prof. Eamonn Quigley, Prof Wrixon, President UCC, Sr. Margaret Healy, Professor Geraldine Mc Carthy, Professor Denis O’ Sullivan

The significant contribution of the Sisters of Mercy was celebrated on May 11 th 2001 when Sr. Margaret Healy was conferred with an Honorary Doctorate in Civil Law, for over 40 years’ service to the nursing and medical profession. Her medical colleagues who had witnessed her outstanding efforts to improve medical care at St. Finbarr’s Hospital and Cork University Hospital during her nursing years nominated Sr. Margaret, (also known as Sr. John Mary) a native of Rossacon, Kanturk, Co Cork for the prestigious honour. At the age of 21 and already a qualified nurse, Sr. Margaret joined the Sisters of Mercy order. Sr. Margaret began working as a Staff Nurse in St. Finbarr’s Hospital in 1960, thereby embarking on what proved to be a remarkable 32-year association with St. Finbarr’s and Cork University Hospital, and with the Department of Medicine at UCC. Within four years, her talents had been recognized by her appointment as Sister in Charge of the Medical Professorial Unit, at St. Finbarr’s Hospital. This was a time of dramatic change at St. Finbarr’s Hospital, which was in the process of emerging as a major teaching hospital and home to several of the clinical teaching departments.

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Sr. Margaret Healy played a major role in this evolution and was, with Professor Denis O’Sullivan, instrumental in the establishment of the regional specialty unit for diabetes and endocrinology at St. Finbarr’s Hospital, of which she became the first Sister in Charge. Academically, Sr. Margaret also pursued further study, despite dedicating herself full time to the wards. She achieved all that could be achieved academically in the nursing field during that time. She successfully sat the first Fellowship in Nursing examination in 1981 at the Faculty of Nursing, Royal College of Surgeons (RCSI), and later became the first Diabetes Clinical Nurse Specialist, outside of Dublin working with Professor Denis O’Sullivan at Cork University Hospital. On the occasion of her conferring, Professor Eamonn Quigley, then Head of the Medicine School praised Sr. Margaret saying: “Through her vast and caring experience, supplemented by periodic post-graduate studies in Irelandandabroad,shebecameatrueexpertin[diabetes]andwasfundamentaltothegrowing reputation of Cork as an international centre of excellence in diabetes and endocrinology. Every nursing and medical student came under the influence of “John Mary” , as we knew her then, and will always remember her incredible devotion to the unit, its patients and its staff”. (Introductory text delivered by Professor Eamonn Quigley at the Conferring). Sr. Margaret Healy maintained close contact with her former students and nurses; who in turn remember her, not only for the central role that she played in their education and professional development but also with much personal affection. Though highly proficient and qualified in nursing management, she resisted all pressures to join the echelons of administration, always believing that her real place was “at the cold face”, with her patients and clinical colleagues. What administration lost, clinical nursing and medicine gained. Sr. Margaret “retired” to use her own phrase, in 1992; others would scarcely see anything remotely resembling “early retirement” in her next commitment, as a manager of Cara House (a joint venture of the Mercy Order, the Daughters of Charity and the Southern Health Board, which provides a residential and respite home for older adults). The achievements and pioneering work of Sr. Margaret Healy reflect the commitment and contribution of the Mercy Order to the development of nursing in Cork and across the country. In Sr. Margaret’s own words:

“Yesterday is history; tomorrow is a mystery, and today is a gift. I give God thanks for the many ways he enriched my life through his people and life”.

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Sr. Laurentia Roche Sr. Laurentia Roche, retired from her position as Director of Nursing at the Mercy University Hospital in 2003. In acknowledgement of her contribution to the health services and to nursing in particular, she received an Honorary Masters’ Degree in Nursing from University College Cork on 7 th December 2010. Sr. Laurentia was born in Kinsale, Co. Cork in 1931, where she received

her primary and secondary education. In 1950, she entered the Mercy Congregation in Cork and in 1953 commenced her training as a student nurse. Sr. Laurentia worked in various positions in the Mercy Hospital over the years as a student nurse, Staff Nurse, Ward Sister, Assistant Matron, Matron and Director of Nursing. In all she worked as a Nurse from 1953 – 2003, fifty years, half a century of giving service in health care to the people of Cork and the greater surrounds. During her training and in subsequent times as a staff nurse, patient care was always paramount. Working as Staff Nurse and Ward Sister in St. Catherine’s female surgical Ward, Sr. Laurentia worked 12 hour days but was on call 24 hours a day as was the norm for all Mercy Sisters.

Sr. Laurentia Roche with Professor McCarthy and Sr. Concepta Twomey

In 1969, Sr. Laurentia became Assistant Matron with responsibility for both nursing and many other services within the hospital. In 1982, having taken a nursing administration course in the UK, she became Matron/Director of Nursing (DON) of the hospital and served in this post from 1982 to 2003. In 1975, the Hospital celebrated the Golden Jubilee of the Hospital School of Nursing and in 2002 the School, under the leadership of Sr. Laurentia, transferred students and some Nurse Tutors to University College Cork (UCC). Thus began University Diploma and Degree level education or Nursing in collaboration between the Mercy Hospital and UCC. During her 50 years as a Nurse, Sr. Laurentia has worked in an era of no disposable appliances or dressings to the introduction of piped oxygen and keyhole surgery. She has seen the focus change from an emphasis on cleanliness to an emphasis on complex diagnostic and treatments modalities, a changing environment and legalistic perspective. She has seen the demand that these changes placed on healthcare professionals in general and on Nursing in particular. The conferring of Sr. Laurentia with an Honorary Master’s degree again reflects the commitment of the Mercy Order. It is beyond question that the life and work the Sisters of Mercy has been central to the Mercy Hospital, St. Finbarr’s Hospital, South Infirmary Hospital and Cork University Hospital. The last remaining Sisters of Mercy transferred from the Mercy Hospital Convent to St. Maries of the Isle in 2019.

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North Infirmary Hospital

North Infirmary Hospital In 1895, the Catholics of the City of Cork, presided over by the Most Rev. Dr. O’ Callaghan, the Bishop of Cork, met at the Presbytery of St. Peter & Paul Church, Cork. The object of the meeting was to devise a plan for supplying Catholic trained nurses for the sick. The Daughters of Charity Religious Order were entrusted to take charge of the North Infirmary. They agreed to accept the responsibility of supplying properly trained nurses for the North Infirmary, who would aid the Sisters in attending the sick confided to them, and also a considerable number of Certificated Nurses for the houses of the sick in the city and elsewhere based on certain conditions. Students were called probationers and a document dated 1904 (Appendix B) describes regulations for acceptance for training, during training and if obliged to leave. The St. Vincent’s Catholic Nursing School operated from 1895-1989 and was established by Sr. Teresa O’Callaghan, Matron of the Hospital. By the time St. Teresa O’Callaghan died in 1909, hundreds of nurses had obtained hospital certificates. In 1919, the General Nursing Council (GNC) approved the School as a Training School for Nurses. In 1938, the GNC of Ireland requested the re-application of all training Schools after the issue of new regulations. In August 1938, an application was made and granted, to have the Nursing School recognized as a Training School for Nurses for the General Register. In 1955, An Bord Altranais (formerly the General Nursing Council of Ireland) issued a new set of regulations regarding the minimum requirements essential for the recognition of Nurse Training Schools. In 1957, the “Greencoat School Building” was acquired by the Trustees of the North Infirmary Hospital and knocked down to provide a

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site for a new nurse’s home and a new outpatient department. This never materialized but was a subject of much contention for many years. In 1961, the first full time training School commenced at the North Infirmary to comply with regulations and The Nurses Act (1950). The North Infirmary Hospital closed in 1987, and the General/Paediatrics nurse training was transferred to the School of Nursing, Mercy Hospital Cork. This Programme ceased to exist soon thereafter. Students trained in Sick Children’s Nursing in the North Infirmary in collaboration with the National Sick Children’s Hospital Harcourt Street, Dublin from the 1950s onwards. This was a three-year course. Many of those registered in the Sick Children’s Division of the Nurse’s Register could only find employment in Children’s Hospitals and so many sought places to train as general nurses also. Subsequently a four-year integrated course was introduced to resolve this situation in 1970 and led to a qualification as RSCN/ RGN (Registered Sick Children’s Nurse/ Registered General Nurse), thus allowing nurses to work in either discipline. A reciprocal arrangement to deliver this integrated course commenced between Our Lady’s Hospital, Crumlin and the North Infirmary in 1982. Some students commenced their training in Crumlin while others commenced in the North Infirmary and changed hospitals during the four-year period. This arrangement continued until the closure of the North Infirmary in 1987. Both of these hospitals ware managed by the Daughters of Charity. Special recognition needs to be given to Sr. Angela McGee, Eileen Healy, Ber Taylor who taught in the School in its final years.

Graduating Class North Infirmary Nov 1977 4 th row back Mary Gethings, Tess Browne, Ciaran Dillon, 3 rd row- Mary Grainger, Ann Hurley, Liz Farrrarley. 2 nd row- Eileen O’ Sullivan, Eileen O’ Leary, Patricia lynch, Elaine Burke, Barbara O’ Connell front row Anne Nealon, Gobnait Twomey, Sr. Angela Mc Gee (Nurse Tutor), Trudi Hourihane, Noreen Dennehy

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