University of Michigan. Medical-Surgical Nursing Area.

Department within the School of Nursing of the University of Michigan.

From the description of Medical-Surgical Nursing Area (University of Michigan) records, 1960-1990. (University of Michigan). WorldCat record id: 79360105

Medical-Surgical Nursing is one of six areas of instruction (similar to departments) within the School of Nursing at the University of Michigan. Medical-Surgical Nursing may be understood as encompassing nursing related to general adult health care; i.e. most nursing duties except those denoted by the more specialized fields of community health nursing, psychiatric nursing, and parent-child nursing. The Medical-Surgical Nursing Area was created in 1963 when the previously separate areas of Medical-Surgical Specialties and General Medical-Surgical Nursing were merged. Miriam Keller was chairperson of Medical-Surgical Specialties until 1961, when she became the Assistant Dean of the School of Nursing; she was succeeded for two years by Wanda Crouse. R. Faye McCain was appointed chairperson of the General Medical-Surgical Area in 1953, and was given the chair of the new Medical-Surgical Nursing Area after the 1963 reorganization.

In 1960 McCain initiated the development of a master's degree program in medical-surgical nursing, which would be one of the few available in the United States. The first medical-surgical graduate students matriculated in 1962. For its first five years, the program was funded by a grant from the W. K. Kellogg Foundation. The foundation, through its director of the Division of Nursing, Mildred Tuttle, provided consultative as well as financial support. The graduate program grew steadily, though slowly enough so that two people--McCain and Professor Josephine M. Sana--taught and administered the master's degree curriculum through the early 1970s.

Graduate programs in nursing were in their infancy in this country during the 1960s, and McCain did much to shape subsequent national development through her guidance of the medical-surgical curriculum at the University of Michigan. This program was, for instance, the first to emphasize clinical practice as well as the more traditional functional emphasis on teacher, supervisor, and administrator training. That is, students were encouraged to pursue development of clinical expertise, and heavy emphasis was place on clinical (as opposed to historical or functional role) research; graduates might therefore acquire expertise in specific nursing related medical problems while contributing knowledge to the development of better patient-care techniques.

A related aspect of the medical-surgical master's program, and one which also had far-reaching effects nationwide, was its basic methodological underpinning--the Systematic Nursing Assessment. McCain developed the idea that nurses required a systematic method of acquiring knowledge about their patients in order to identify short-term and long-term nursing care goals--in other words, a method of identifying and meeting the needs of their patients. Sana and other Medical-Surgical Area faculty members helped McCain test and refine the Systematic Nursing Assessment theory and procedures. Nursing "diagnosis" has since become standard procedure in most hospitals across the country, and has become so standard a part of nursing practice that it is now part of the undergraduate curriculum in all baccalaureate and diploma programs.

The Kellogg grant ended in 1967, and the University took full responsibility for funding what was by then one of the nation's leading medical-surgical nursing graduate programs. McCain and Sana marked the program's coming of age by organizing a major conference to discuss and promote the Assessment methodology. A major curriculum revision was also begun that year, prompted largely by recommendations made by alumni. It is a hallmark of the Medical Surgical Area graduate program that student, alumni, and faculty curriculum ideas were continually sought and acted upon. While small program changes were often made, other major revisions occurred in 1972 and from 1977 to 1980.

The Medical-Surgical Area undergraduate program was not ignored during McCain's tenure as chairperson. The area may have been the first in the nation to employ the module system of course structure. Yet the area chairperson has consistently been more involved with the graduate than with the undergraduate program since 1962. In part this was the result of the time and energy required of McCain to establish, promote, and teach the graduate program during its early years. Since the number of Medical-Surgical Area faculty competent to teach graduate-level courses was significantly increased in the early 1970s there has been, in essence, two separate faculty within the area--one teaching undergraduate courses and one teaching graduate courses. The area chairperson has usually been a member of the graduate faculty and has always been charged with directing the graduate program. Also an important reason for the chairperson's preoccupation with the master's degree curriculum was the relative lack of autonomy of the area's undergraduate program, which was intimately tied to the general baccalaureate program design of the School of Nursing. Since 1972 the area has had an undergraduate coordinator to supervise the undergraduate curriculum, both reflecting and reenforcing the chairperson's graduate program orientation. Chairpersons subsequent to McCain have found the administrative task of performing as area chair and as director of the area's graduate program rather a burden, but no substantial change has been made to date.

The year 1975 brought major changes to the Medical-Surgical Area and to the School of Nursing. Responding to a national trend which it had helped inaugurate, the School added three more master's programs and a general doctoral program. The School also moved to increase the number of doctorally prepared faculty. McCain, whose generation had had little possibility of acquiring a Ph.D. in nursing, stepped down from the area chair. She retained her position on the Medical-Surgical Nursing Area graduate faculty and became the Coordinator of Graduate Studies for the School. The deanship of the School also changed hands in 1975. This reorganization, expansion, and changing of the guard did not go smoothly for either the School of Nursing or the Medical-Surgical Area; the latter saw five chairpersons between 1975 and 1982 (see appended list). (There were, in addition, many rapid changes in support staff, increasing the problems of maintaining adequate records.) In 1977 Barbara Hansen was appointed to the new post of Associate Dean for Graduate Studies and Research in the School of Nursing; McCain remained in her teaching position until her retirement in January 1980 (she died suddenly in 1982).

Each area in the School of Nursing underwent three major evaluations from 1975 to 1982: the Program Evaluation Advisory Committee (PEAC) Report of the School of Nursing in 1976; self-evaluation for accreditation by the National League for Nursing (NLN) in 1977; a graduate program review by the Horace H. Rackham School of Graduate Studies in 1981.The Medical-Surgical Area, as one of the School's most visible, and suffering from the lack of a permanent chairperson, received especially intense scrutiny. While the period was thus rife with tension and pressure, innovation within the area continued nonetheless. In 1979 a special PhD. program concentration in medical-surgical and gerontological nursing received funding from the U.S. Department of Health, Education, and Welfare. In 1980 the four-year revision of the School's undergraduate curriculum begun in 1977 reached the senior year courses, and the area's core course was revamped and restructured.

In 1982 Ruth M. Barnard became the first permanent chairperson of the Medical-Surgical Area since 1978. Barnard moved to the chair from her tenure on the faculty of the School of Nursing's Research Area. She moved to unify the area by breaking down the distinctions between graduate and undergraduate faculty. Not only were separate graduate and undergraduate faculty meetings eliminated, but the position of undergraduate coordinator was reduced to that of coordinator of the undergraduate core course (N456). Still, Barnard retains the dual titles and responsibilities of Area Chair and Director of the Medical Surgical Graduate Program. Despite the turmoil of the last decade, both the undergraduate and graduate programs in medical-surgical nursing at the University of Michigan are currently ranked among the five best in the United States.

• 1963 - 1975 : R. Faye McCain
• 1975 - 1978 : Connie L. Greene
• 1978/79 (interim): Joyce Crane
• Fall 1979 (interim): Mara Baun
• 1980 - 1981 (interim) : Jo Anne Horsley
• 1981/82 (interim): Eleanor L. Strang
• 1982 - : Ruth M. Barnard

• 1972 - 1973 : Rebecca F. Collins
• 1973 - 1974 : Jo E. Denton
• 1974 - 1975 : Candace M. Burns
• 1975 - 1977 : Frances L. Mlynarcheck
• 1977 - 1978 : Nina H. Williams
• 1978 - 1980 : Kathleen Hoffer
• 1980 - 1981 : Zenaida S. Spangler
• 1981 - 1982] : Shirley Jones

From the guide to the Medical-Surgical Nursing Area (University of Michigan) records, 1960-1990, (Bentley Historical Library, University of Michigan)