An early bulletin from Saint Joseph Hospital’s School of Nursing, one of the first established in Georgia, indicated that the school was “to form young women possessed of the necessary qualifications to the noble, self-sacrificing and delicate duty of caring for the sick in an intelligent manner.” A list of rules forbade nurses to loiter in the hallways or the landings, to talk or laugh loudly when passing through the infirmary, and to “keep themselves scrupulously clean and neat, paying particular attention to hair and nails.”

After four Sisters of Mercy nurses from Savannah opened what was then called Atlanta Hospital in 1880, they opened the Training School for Nurses in 1890. The school held its first graduation ceremony in 1903 when it granted diplomas to five young nurses. Calling the professional training of nurses a “great boon to humanity,” William Perrin Nicolson, M.D., in addressing the first graduating class, said he remembered well when “nursing was conducted in all cases by the family, assisted by friends and by the presence of an old lady acquaintance who enjoyed the reputation of being a good nurse.”

Nicolson told the graduates: “It lies with you by your lives and your work to assist in impressing upon the world the ever-increasing value of the trained nurse, and to show that, hand in hand with the physician and the surgeon, you are giving your heart and soul to lessening the sufferings and ills of burdened humanity and bringing light into dark places and comfort to aching bodies and hearts.”

In the 1930s, nurses and other public health officials were focused on disease prevention, including sewage disposal, water treatment, food safety, organized solid waste disposal, and public education about hygienic practices, such as food handling and hand washing. Tuberculosis was on the decline.

Nurses in the 1940s saw the development of medications that dramatically improved patient outcomes. Sister Melanie Courtney, who entered the hospital’s school of nursing in 1939 at the age of 18 and the convent at 19, remembers well the advent of a new type of drug—sulfa—that miraculously treated pneumonia. Then came antibiotics, treating previously incurable bacterial illnesses with a wider range of targets and fewer side effects than sulfa drugs. And thanks to regional mosquito-control measures, nurses also saw a sharp decrease in malaria patients, once endemic throughout the Southeast.

Nursing school bulletins from this period reflect the times, with notices of 41 nursing school graduates joining the Army during World War II. The March 1941 issue of Saint Joseph Nurse reported that 10 School of Nursing graduates were serving their country, proclaiming, “They’re in the Army Now.” The same issue was dedicated to “our fellow alumna members who form our first volunteers in the National Defense Program!”

In 1949, the program became the first accredited school of nursing in Georgia. Daisy Brazzeal, R.N., who graduated from the school in 1949—and who still works at Saint Joseph’s as an operating room coordinator—loved her work but not the oppressive heat under the hot lights of the OR. “There was no air conditioning, and we had to wear gowns and gloves. Summers were miserable for the nurses and the patients.”

She also marvels how nursing has changed since that time. “We simply didn’t have the modern technology we have today. We didn’t perform total joint replacements or open-heart surgery or treat cancer successfully. Patients just had to cope with those ailments the best they could.”

But major medical advances were just ahead. Sister Maureen Cartwright, R.N., recalls the day in 1957 that Dr. William Hopkins performed the first open-heart surgery in the Southeast using a heart-lung machine he designed in the hospital’s basement. “The patient and I had to stay in the hospital’s recovery room for days because there was no intensive care unit. He was in an oxygen tent, but there were no heart monitors. And back then we didn’t get patients up and moving right after surgery the way we do today.”

In 1960 Saint Joseph’s opened Atlanta’s first coronary care unit. Sandy Shupe was a new teenage student in the nursing school that year and has fond memories of living in the dorms with three students to a room with two sisters in the next room. “The freshman curfew was 8:30 p.m., with lights out at 9:30 p.m. Saturday was date night. We could visit with our date on a sofa in a room with partitions that didn’t go all the way down to the floor. The house mother kept a close eye to make sure all four of our feet were on the floor at all times,” she reminisced. “We called it a semi-convent. We were very closely monitored.”

Party nights with the sisters were also fun.

“The sisters threw parties for us and invited the single resident physicians, but we weren’t allowed to invite our boyfriends,” Shupe recalled with a laugh. “I distinctly remember doing ‘The Twist’ with the sisters on party nights.”

She also remembers that nurses on duty in the hospital automatically stood up when a physician entered the room, offering their chairs as a sign of respect.

The year of 1963 brought a major change from the era of segregation to health care—and to all professions—as Saint Joseph’s desegregated in May and began serving African-Americans, a historic action called for by Archbishop Paul J. Hallinan of Atlanta. Later, in November that year the 4th U.S. Circuit Court of Appeals made a landmark ruling in the Simkins v. Moses H. Cone Hospital case to deny federal funds to hospitals that racially segregated or denied admittance or employment based on race, which was affirmed by the Supreme Court and led to nationwide health care desegregation.

To prepare for integration, then-administrator Sister Melanie Courtney and the hospital board of trustees met privately with the physicians, swearing the doctors to secrecy, then meeting with each nursing shift. During the first week of desegregation, Saint Joseph’s treated two black patients on the same floor as white patients. Sister Melanie remembers receiving threatening phone calls but had the full support from the hospital. And the staff had a surprise when Dr. Martin Luther King Jr. checked in the next year for exhaustion and a respiratory infection, and got word there the morning of Oct. 14, 1964, that he had received the Nobel Peace Prize. He held a press conference in the hospital auditorium.

Another important year was 1966, as the hospital staffed and trained the city’s first general intensive care unit.

“This hospital has always been on the leading edge of medical innovations, which has given its nurses the opportunity to continuously sharpen their skills and advance their knowledge,” said Shupe, manager of pre- and post-operative care, who served as the ICU’s first charge nurse. “In that first ICU unit—a single room—we treated all types of critically ill patients, from burn victims to heart attack patients and even high-risk maternity cases. We certainly had to have a clinical background that was broad as well as deep.”

In the 1970s and ‘80s advances in the hospital’s cardiac, vascular, cancer, orthopedic, neurology, gastroenterology, and pulmonary programs offered numerous opportunities for nurses to specialize in their area of interest. Shupe recalled that as the nursing school closed in 1973 and the standard became to get a four-year bachelor’s degree, it was phased out and informally merged into the Georgia State University program, as some sisters from Saint Joseph’s moved over to the school and helped to establish it.

In 1978 the hospital relocated from downtown Atlanta to Peachtree Dunwoody Road, with three intensive care patients being the last to be transferred. Shupe recalled how they had a picnic at the new site as the building went up, and how “it was like we were moving to the country … It was well coordinated. We have been building ever since.” With Northside Hospital across the street and Children’s Healthcare of Atlanta around the corner, Shupe added that “we complement each other” as Northside delivers the highest numbers of babies in the country, and Saint Joseph’s is an adult, tertiary center.

While downtown the hospital had provided care for the poor in churches, Shupe and other nurses after the relocation organized efforts and returned there to provide care to the homeless, starting with foot care—giving their feet antiseptic baths, checking for blisters, clipping toenails and providing new socks and slippers. Those simple efforts eventually led to the establishment of Saint Joseph’s Mercy Care Services.

“We had lost that base of serving the indigent and that’s what started Mercy Mobile. We thought we needed that because of our philosophy,” she said, with a soft Southern accent.

At nursing school, Shupe said, the nuns “were a big influence on our life and helping us to develop into nursing leaders with their religious influence. One of our instructors who really impressed me when I was a very young student said ‘if you will care for every patient as if they were the body of Christ you will do no harm’; and that’s been the philosophy, so that with every person you maintain their dignity and privacy … with everyone connected to the hospital,” she said, sitting in her aqua blue scrubs in her office with a wooden crucifix outside the post-operative care area. While employees represent many faiths, they embrace “the Judeo-Christian ethic in the way we treat our patients as individuals, honoring their differences.”