Clara Barton Lives Here
Florence Nightingale. Edith Cavell. Clara Barton. They are legends in the history of nursing, women who demonstrated what it means to do something extraordinary in response to great need. For graduates of the Stanford nursing program, the skills and resilience they took away have lasted a lifetime — and generated accomplishments that show Stanford nurses making legends of their own
“I have an almost complete disregard of precedent, and a faith in the possibility of something better. It irritates me to be told how things have always been done. I defy the tyranny of a precedent. I go for anything new that might improve the past.”
That’s how Clara Barton, Civil War nurse and founder of the American Red Cross, replied when asked how she overcame obstacles, from battlefield nursing to bureaucratic governmental agencies. Compassionate, self-confident, innovative, fearless — Barton’s spirit characterized the unique group of women who graduated from the Stanford School of Nursing between 1912 (when Lane Hospital Training School for Nurses was renamed) and 1974 (when the school closed). And, it’s some kind of symmetry that today’s Stanford Nurse Alumnae president, Patti Fry, is also a leader in the American Red Cross, the institution Clara Barton established in 1881 and led for more than 20 years.
Recently, Bench & Bedside talked with Fry and three of her fellow alumnae — Kathy Keogh Berra, Rita Chow, and Donna Ver Steeg — to discover how the careers that Stanford nurses pursued have exemplified the spirit of Clara Barton and Stanford itself. For all these women, the path began with the simplest of goals — taking care of others.
The path to nursing
“As a little girl I was fascinated by nursing,” says Berra, BSN ’68. “My mom was a nurse and she would get ready to go to work, tuck us in bed, kiss us goodnight, and head out to heal people. And there was that white uniform with the cape.”
As a Stanford freshman, Berra focused on English and history until a physiology class inspired her to pursue the career that was so compelling to her as a child. “I was fascinated with the science and the mystery of it, how complicated and intricate the human body is,” Berra recalls. “That’s when I figured out I wanted to be a nurse.”
“At Stanford, every student is a leader or has the potential to be a leader,” says Patti Fry. “It was very empowering to feel that way. Nursing is at the heart of interdisciplinary teams anyway, and within health-care settings, leadership is absolutely required.”
For others, nursing was simply an attractive career choice in an era when women’s options seemed limited. “After starting as a music major, I felt I needed a professional goal at the end of my college education,” says Fry, BSN ’72. “Nursing offered a great combination of science and humanitarian service that really appealed to me.”
Best of the best
It’s hard to imagine someone drawn to nursing who isn’t also interested in taking care of people. But for those drawn to Stanford, there was often something more: intellectual curiosity, an interest in pushing boundaries, or to quote Barton, “defying the tyranny of the precedent.”
“At Stanford, every student is a leader or has the potential to be a leader,” says Fry. “It was very empowering to feel that way. Nursing is at the heart of interdisciplinary teams anyway, and within health-care settings, leadership is absolutely required.”
“Stanford nurses were an elite group,” says Ver Steeg. “In those days, most nurses didn’t go to college. And it was understood that Stanford nurses had the ability to be nurses anywhere. We were good...and we knew we were good.”
“Stanford nurses were an elite group,” says Donna Ver Steeg. “In those days, most nurses didn’t go to college. And it was understood that Stanford nurses had the ability to be nurses anywhere. We were good...and we knew we were good.”
That confidence would prove key to overcoming what, for many years, was one of the biggest challenges in nursing — providing the best care even when it meant standing up to strong-willed doctors.
Fighting for patients
The Stanford nursing program was guided by the belief that nurses were not merely supporting players; they were front and center when it came to patient care, and they were expected to step up to that challenge. “The faculty was not traditional,” says Ver Steeg. “Stanford had a military unit that served in World War II and many faculty members thought of themselves differently. They expected you to defend the patient above all else and behave in a professional manner.”
That attitude was a Stanford hallmark in nursing — acknowledgement that, on an effective interdisciplinary team, a physician may have oversight, but the day-to-day leadership functions belong to nurses.
“At some schools, nurses were taught to be subservient,” says Ver Steeg. “Stanford nurses were different. We were taught that our responsibility was to the patient. We were taught to be courteous to the physicians, to manage their demands and respect their expertise, but not to be subservient. Some did not take kindly to the Stanford approach.” Or, as Ver Steeg calls it, “Stanford chutzpah.”
The whole patient
The Stanford philosophy of nursing revolved around understanding all factors involved with a patient. “The center of the circle was the patient,” says Berra. “We were taught to learn the patient’s story: family, culture, environment, as well as many different factors. It wasn’t just a ‘kidney in Room 103.’The patient was identified and appreciated as a person.”
“In pediatric nursing, we were encouraged to be innovative,” says Rita Chow (below left). As she points out, creativity wasn’t a “nice-to-have;” at Stanford, bringing energy and imagination to taking care of patients was expected.
Fry echoes that perception. “Our education focused on the whole person, and on critical thinking related to a patient’s circumstances,” she says. “Sure, mostly we were looking at physical aspects, but we were also taught to understand the social issues, including a patient’s support system.”
Creative and compassionate
Even though Silicon Valley was still in its formative years when Stanford nurses were being educated — and Biotech Bay wasn’t even on the radar — the spirit of innovation and creativity flourished among nursing students.
“In pediatric nursing, we were encouraged to be innovative,” says Chow, BSN ’50. “During three years of pre-nursing studies before transferring to Stanford, besides the required sciences, I was taking a lot of liberal arts classes, including arts and crafts. One of my classmates, Shirley Juarez Boydstun, and I decided to put on a puppet show for the children in the hospital. We made the puppets ourselves, and everyone was delighted to see us take such a creative approach to care.” As Chow points out, creativity wasn’t a “nice-to-have;” at Stanford, bringing energy and imagination to taking care of patients was expected.
“Stanford prepared us by encouraging creativity and teaching us to be organized, knowledgeable, and caring clinical decisionmakers,” she says. “We learned that compassion must come from the heart. I think there were very few schools genuinely encouraging that mindset in nursing students.”
Springboards to leadership
After (and even before) graduation, Fry earned valuable nursing experience in a number of settings: public health in Appalachia, critical care, and as an assistant head nurse at a medical center. “After working in different health-care environments, I decided I wanted to learn how to run these places better, but I didn’t have the skills,” says Fry. So she attended the Graduate School of Business (GSB) at Stanford, and armed with an MBA, went to work in management consulting in healthcare and hospital systems, then on to sales and consulting management in a variety of industries at IBM. Later, after connecting with the American Red Cross through a volunteer project with the GSB, she was asked to chair the merger of two chapters that became the Silicon Valley Red Cross. Like all mergers, it was a process that required patience and the ability to look at a whole system, lessons Fry still carried with her from her days as a nurse with a holistic approach to care.
The “Stanford chutzpah” Ver Steeg identifies led her to question many givens about her profession, including the definition of caregivers. “The need for a mid-level practitioner became very obvious,” she says. Rising to the challenge, she helped pioneer the evolution of physician’s assistants and nurse practitioners, and authored one of the key scholarly articles on these two new career tracks.
Stewarding the evolution of the nursing profession brought political and professional stresses. In a Nurseweek article on that era of change, Ver Steeg said, “Doctors were beside themselves. It was clear that nurses were practicing medicine. Nurse practitioners started existing by the late ’70s as a separate legal entity in some states.”
The Stanford philosophy of nursing revolved around understanding all factors involved with a patient. “The center of the circle was the patient,” says Kathy Berra. “We were taught to learn the patient’s story: family, culture, environment, as well as many different factors. It wasn’t just a ‘kidney in Room 103.’”
Berra credits her nursing and physician colleagues with helping her navigate to the right place at the right time in leadership. “They taught me to find something I was really passionate about,” she says. When she left Stanford, she knew her gifts were in communication and teaching. She explored those skills in the Army Nurse Corps, then came back to campus. An opportunity to get deeply involved in cardiac prevention, care, and rehabilitation clicked with her interests. Over the course of her 25 years in the Cardiac Therapy Program of the Mid-Peninsula, she helped shape changes, participated in leading research, and put one of her other gifts — writing — to work on behalf of medicine. Her career at the Stanford Prevention Research Center gave her an insider’s opportunity to participate in research that has changed the practice of medicine. Berra has been widely honored as a clinician, researcher, and writer, but even more important to her, she’s done work that matters. “My Stanford education provided such unique opportunities for me,” she says, “and my experiences gave me the confidence to do all the things I care about most.”
Chow still remembers how the Class of ’50 scholarship award enabled her to pursue graduate work, and how Stanford taught her to be an independent decision-maker. Everywhere she’s put her talents to work
— from the Army Nurse Corps during the Korean War to the National Interfaith Coalition on Aging to the National Council on Aging — Chow has honored Stanford’s spirit of “the best.”
“The Stanford director of nursing, Grace Ringressy, knew I was studying part-time for my master’s,” Chow recalls. “She came to me and said,
‘I want you to think about going to the very best graduate school in the nation. Just pick it and go.’” And so she did. Today, that commitment to “the best” motivates Chow as she looks at the toughest issues in aging, including economic insecurity and how declining health affects quality of life.
The Stanford School of Nursing is gone and the landscape of the profession has changed dramatically, but the remarkable group of women that includes Berra, Chow, Fry, and Ver Steeg still influences the art and science of nursing. These legends-in-the-making are optimistic, energetic, and — much like Clara Barton — still tirelessly searching for that “something new” that will improve upon the past.
Stanford nurse leaders at a glance
Kathy Keogh Berra
BS ’68, MSN and Advanced Practice Nurse (Nurse Practitioner) ’96, University of San Francisco; Certification ’97, Adult Nurse Practitioner, American Nursing Association; FAHA; FAAN
Current Positions: Cardiovascular Nurse Practitioner, Cardiovascular Medicine and Coronary Interventions, Redwood City. Research Nurse Practitioner, the LIFE Study, Stanford University School of Medicine. Co-Director, The LifeCare Company. Assistant Clinical Professor of Nursing, University of California School of Nursing, San Francisco.
Career Highlights: Founder and past president of the Preventive Cardiovascular Nurses Association. Clinical trial director for the HERS Study (Heart and Estrogen — Progestin Replacement Study). Stanford Prevention Research Center. Editor-in-Chief, Journal of Cardiopulmonary Rehabilitation. Awarded a fellowship in the American Academy of Nursing. Co-author of Heart Attack: Advice for Patients by Patients and writer of many articles on cardiovascular disease risk reduction and the role of nurse case management when treating coronary artery disease.
Selected Honors & Awards: American Heart Association Clinician of the Year in 2009. Past president of American Association of Cardiovascular and Pulmonary Rehabilitation, and recipient of their highest honor, Award of Excellence, and a distinguished service award. Received the Wenger Award for clinical contributions to women’s health by WomenHeart.
Rita Chow
BS ’50; MS ’55, Case-Western Reserve University; Ed.D ’68, Columbia University; BIS ’84, George Mason University
Current Position: Senior Volunteer Fellow, National Council on Aging, Washington, D.C.
Career Highlights: Former director, National Interfaith Coalition on Aging of the National Council on Aging in Washington, D.C. Held several positions in U.S. Public Health Service, including Director of Nursing for the Federal Bureau of Prison Medical Center in Fort Worth, Texas, and the Director of Patient Education at the National Hansen’s Disease Center in Carville, La.
Selected Honors & Awards: Public Health Service Distinguished Service Medal, “Artist for Life,” first prize from the International Women’s Writing Guild in 1987, and the American Medical Writers’ Association, Atlantic Chapter “Award of Merit” for her textbook Cardiovascular Nursing Care: Understandings, Concepts and Principles for Practice. Named Holistic Nurse of the Year by the American Holistic Nurses Association in 2001.
Patti Fry
BS ’72, MBA ’77
Current Position: President, Stanford Nurse Alumnae. Chair, Board of Directors, American Red Cross Silicon Valley Chapter.
Career Highlights: Chair regional advisory council for the four Red Cross chapters serving the 10 counties of the greater Bay Area. Nearly 30 years of business experience, ranging from consulting and sales management with IBM and Booz & Company (formerly Booz Allen Hamilton) to health care with Kaiser Permanente and others. Volunteer project leader for GSB Alumni Consulting Team (ACT) projects. Serves on Board of League of Women Voters, South San Mateo County. Co-chair, Green Building SubCommittee of Menlo Park Green Ribbon Citizens’ Committee. Former Planning Commissioner, Menlo Park.
Selected Honors & Awards: Phi Beta Kappa. Received numerous national and regional corporate sales leadership awards. Recognized with Partnership Award from American Red Cross and honors from numerous nonprofit organizations. Recently elected to membership in the Stanford Associates for exceptional volunteer service to Stanford.
Donna F. Ver Steeg
BS ’51; MSN ’65, University of California, San Francisco; MA sociology ’65, University of California, Los Angeles; PhD sociology ’73, UCLA; FAAN
Current Position: Professor emerita, UCLA School of Nursing.
Career Highlights: Central figure in researching health-care labor roles. Key advisor during the development of the physician’s assistant and nurse practitioner job designations in California. Past president of the California Nurses Association.