superintendent caroline milne

Superintendent Caroline I. Milne (1895-1920) (All images from Barbara Bates Center for the Study of The History of Nursing, School of Nursing, University of Pennsylvania)

Happy Women’s History Month! While this annual celebration highlights the accomplishments of women across all backgrounds and fields, the National Women’s History Project has chosen “Nevertheless She Persisted” as this year’s theme to specifically honor women who have combated gender discrimination.

In the late nineteenth century, women across the country began to break down the systemic gender barriers barring them from studying and practicing medicine. Though the prevailing attitude remained that professional medicine was not a field for women, these pioneering women paved their way into medical schools and hospitals — and in 1871, into the leadership roles of the hospital that would later become Penn Presbyterian Medical Center.

Long before PPMC was a leader in the region, it was the quiet, 45-bed “Presbyterian Hospital of Philadelphia” located on a 2.5 acre plot of land donated by reverend Ephraim D. Saunders. 55-year old Anna M. Knisell was designated the hospital’s first matron, and she worked with the superintendent, board of trustees, and attending medical officer to ensure that patients were receiving the best care possible in accordance with the hospital’s mission to “provide for the needs of the sick and disabled, regardless of race, color, or creed.”

As matron, Knisell also likely played a role in managing purchases, supervising the nursing staff, and monitoring the cleanliness and efficiency of the wards. Though the powerful role of the matron was phased out over time, Knisell’s early leadership role ensured that women remained a key part of the hospital’s evolution and expansion. With the help of the local Ladies’ Aid Society, a Women’s Surgical Ward was opened in 1878, and a training school for nurses was established in 1889.

presbyterian nursing first grad class

First graduating class: Josephine Ambler, Annie Wilson, Agnes Holly, Mary McClelland, Margaret Strathie, Mabel G. Gilling, Margaret Mubray, Marion Bennett (1891)

Over the years, the training school was under the leadership of multiple capable and decisive “directresses” who developed new programs and protocols:

Caroline L. Farnum was the the first Directress of Nurses; Lucy Walker introduced British practices and extended the training program to 3 years; Mary Close Eden established a relationship with Pennsylvania Hospital and pioneered courses in psychiatric nursing; and Helen Leader responded to World War II needs and supported involvement with federal Cadet Nurse Corps Program.

Another of Presby’s earliest stars was Caroline Isabella Milne, a British immigrant who was initially appointed as her classmate Lucy Walker’s assistant, then rose to the position of superintendent herself in 1895.

presbyterian 1900s nursing

Group of nurses posing for a photo (c. 1900)

Over her 15 years of leadership, Milne participated in the Spanish-American War effort; established a gynecology course and a probationary course for student nurses who wanted to work in the new maternity wards; accelerated the training program to two years in 1918 to graduate more nurses during World War I and the influenza outbreak; and helped to supervise the Army School of Nursing at Camp Dix.

She returned home to Scotland after retiring in 1920, but throughout her tenure, Milne’s commitment to redefining nursing, transforming nursing education, and growing the hospital was unshakeable. Without her dedication, organization, and ambition (and yes, some occasional British “stiff upper lip” sternness), PPMC would likely look and feel very different today.

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