Lillian M. Simms, Ph.D., R.N. F.A.A.N Associate Professor of Nursing Emerita
University of Michigan School of Nursing
Dr. Simms completed her baccalaureate, masters and doctoral degrees at the University of Michigan. Her undergraduate studies were in nursing and her doctoral work was in gerontology. She has combined extensive clinical and management experience in a unique combination of appointments including staff nursing, clinical and management teaching, administration of the first nursing administration program in the School of Nursing and research. She was the first Assistant Dean for Clinical Affairs and Associate Director for Nursing at the UM Hospitals and School of Nursing, serving an interim appointment from 1981 to 1982. She has published numerous articles and books. Her research on nursing work redesign and work excitement is widely used in this country and has extended to other countries. Dr. Simms loves to travel and has been able to combine her professional nursing work with scholarly endeavors in other lands. She has conducted workshops in Guangzhou, PRC, Taiwan and New Zealand and has presented papers in Beijing, Hong Kong, Australia, New Zealand and Canada. She has had a long time interest in rehabilitation and learning new behaviors in the later years, including the use of assistive technologies in activities of daily living. Her expertise in Gerontology and Nursing Administration has led to international collaborations with schools of nursing in China and New Zealand. She retired in 1995 but continues to maintain contacts in Australia and New Zealand.
MEMOIR FROM THE UNIVERSITY OF MICHIGAN
By Dr. Lillian M. Simms, Ph.D., R.N., F.A.A.N.
I first came to the University of Michigan in the Fall of 1947, where I had been admitted to the College of Literature, Science and Arts. Carrying one suitcase I arrived at the Ann Arbor bus station on Huron St. and struggled to find a way to the co-up where I was to live at 1219 Washtenaw, Mary Markley House. The cab driver struggled to find the place, as he had never heard of it. I managed to find the address on the corner of Washtenaw and N. University and was finally delivered to the right place. In those days, entering students did not come to school ahead of time for orientation. You were expected to get to campus on time and on the right date. Little did I know that day that I would eventually wear many hats at the University of Michigan, including student, staff nurse, research assistant, instructor, assistant professor, associate professor, interim associate director for nursing at UMH and assistant dean for clinical affairs. What a life was in store for me.
The original Mary Markley House was a three-story house on the central campus and was a wonderful place to live. Eighteen young women were housed there all with different levels of cooking skills who were expected to earn part of their room and board by sharing cooking responsibilities. Everyone but one black student was assigned to shared study rooms with sleeping arrangements in the army style dormitory on the third floor. The single black student had her own room. Every evening, a formal dinner was cooked and served by the assigned student cooks. Candlelight and opening prayer were always the rule. Every evening we sang college songs over dessert and the warm companionship was most welcome. I had grown up on a small farm in central Michigan and I will never forget the warm family atmosphere at Mary Markley.
It is impossible to describe all the events that occurred in rapid order. Physical examinations at the Barbour and Waterman gyms were conducted in army style. Wrapped in a single sheet only, students moved from station to station to have every part of their anatomy examined. Sex education in those days included a series of lectures that we were all required to attend. The ultimate experience in those early days was to find the Library commonly known as the “Lib” where one could spend hours searching the stacks and studying. I was sure I was in heaven as I loved books and never imagined the extensive collection of books that could be checked out by any student.
It is difficult to think about planning my memoirs for so much comes to my mind. Just being here among other bright energetic students from many lands was such an unforgettable experience. For the first time in my life, I did not feel like an oddball. There were no class distinctions. Everyone went to the same dances and parties except for the sorority and fraternity specials. Even so, as an independent, I was invited to fraternity parties. Dances at the League and Union were open to all, even though women had to enter the Union at the side door. In those days, women were not permitted to enter the main doors. Many events on campus like square dancing at Lane Hall were open to all students, free of charge. It was a great place to meet new people. Students were not permitted to have cars on campus so almost everyone rode bicycles. In those days, one could reach most parts of the central and medical campuses easily by bicycles.
I spent two years in LS&A and then transferred to the Nursing School, which at that time was a hospital based training program. Most young women in those days were expected to either become a teacher or a nurse. Eventually I became a nurse, teacher and writer. Although I was able to work my way through school, it would not have been possible if I hadn’t transferred to nursing. I had a Regents Alumni scholarship for tuition but room and board was a big item. Fortunately, nursing students were provided both in the form of a furnished room at Couzens Hall and a monthly stipend of $37.50 from the hospital. We students actually earned the money as we provided morning and evening care several days of the week as soon as we had successfully completed our courses in Fundamentals of Nursing. Married students who moved out of the dorm received $50/month. Many of my nursing colleagues and I managed to cook our supper meals in a tiny basement kitchen in Couzens Hall, thus making our stipend go farther. Two friends and I cooked together in this way. It was cold in Ann Arbor in those days and we often kept milk, bread and peanut butter on our window ledges between pane and screen. We took turns cooking and managed some very creative meals on one burner. Use of the tiny oven required a reservation a few days in advance. Also the ability to light the gas burner with a paper towel if no matches were available.
I have many fond memories of Couzens Hall. We students pioneered a way of life that is now encouraged in the new dorms. We had our nursing classes in Couzens, met with our faculty there and had many shared events that brought a spirit of comradery that was hard to find in single room housing on campus. We all ate breakfast at the hospital cafeteria and the food was very good. Those years went by rapidly and I was to become thoroughly “trained” in the ways of good medical care. Nursing was not yet a professional discipline. Many of our faculty were physicians and we were early on expected to obey doctors’ orders without question. It was like another world, separate from regular campus life. The only shared course with medical students was anatomy. The old lab on N. University was filled with cadavers and we were expected to locate and identify most parts of the body. Physiolology was not easy to teach in this environment and it would be several years before I returned for graduate study, there to obtain a really good course in Pathophysiology.
After marriage in February, 1952, I successfully completed my baccalaureate of science degree in nursing in June, 1952. After graduation, my husband (who had graduated in Physics) and I moved to VA for seven years. I learned a great deal from him and always wondered why nurses and physicians weren’t studying Physics as well as Chemistry. Returning to Ann Arbor in 1959 brought us to more exciting times as my husband was employed by Bendix Aerospace and was involved in working on the moon landing. There was a lot of sharing with the College of Engineering as the scientists at Bendix were part of the new age of tinkerers and were ahead of the current courses at the University. My husband and other scientists at Bendix often had graduate students working with them for their graduate projects.
In 1960, I returned to work at University Hospital as a staff nurse on a new unit called Rehabilitation, a first in the Old Main hospital. In those days, rehab wasn’t widely accepted and physical therapy wasn’t even mentioned for older people. The idea that people of all ages could learn new behavior was revolutionary. After two years as a staff nurse, I decided I had to become educated not trained and I hungered for the many opportunities that had become available. I entered and successfully completed a master’s degree in Medical-Surgical nursing, thoroughly enjoying campus courses in psychology, learning theory and anthropology. Something new was happening on the campus. Older women were going back to school seeking new opportunities and I was one of them. My additional credentials lead me to a joint appointment as a staff nurse on the rehab unit and a teaching appointment as an instructor in the School of Nursing. Never satisfied for long, I again sought to learn more and enrolled in the educational gerontology doctoral program in the School of Education. This was to be a defining experience in my life as for the first time, I learned that older people were Persons in their Later Years, not worn out sick oldies. Professor Howard McClusky had a great influence on my thinking and he was a major contributor to the developing concept of lifelong learning and the prediction that societies would change and the future would see older adults participating in learning opportunities for many years. This was a new idea at the time and I was surprised to learn that research now supported the idea that learning does not stop at age 20. Of course, by this time, I already knew this, as I was busy progressing through graduate courses in gerontology in the Schools of Public Health and Aging. The Medical School was not at all interested in courses on care for older adults. This was to come much later as the Institute of Gerontology developed and encouraged multidisciplinary and interdisciplinary participation.
Completing my Ph.D. in 1978 led me to further opportunities in teaching and activities across the University. I became Director of the Nusing Health Services Administration Graduate Program, a joint program between the School of Public Health and Nursing. This was very exciting, as it was a W. K. Kellogg funded program that supported the education of nurses from around the world, a new concept at the time. Students came from many lands and went back to their countries in leadership roles that brought about changes in health care. The core curriculum included courses in organizational theory, financial management, economics, health care systems, statistics and graduate nursing. The Kellogg Foundation was instrumental in providing financial support for other international, interdisciplinary programs across campus. By providing stimulus funding, the Kellogg Foundation early on supported the development of interdisciplinary relationships as well as education in leadership and management. The School of Nursing so long isolated from the rest of campus began to open its doors to new ideas. I began to think in different ways about health care and no longer remained focused on a nursing point of view. For ten years I had a joint appointment in the School of Public Health in Gerontology and was able to frequently interact with faculty with an international perspective.
As my responsibilities increased and opportunities arose for collegial activities across campus, I became involved in administrative research that was more patient focused than nursing focused. Involvement for the first time in nurse staffing pattern research with colleagues in the School of Public Health helped me develop a broader perspective on the health care system. A focus on gerontology in my doctoral studies was very beneficial to understanding new thinking across campus. Also my staff nursing experience was beneficial to understanding the new developments occurring in Rehabilitation and Biomedical Engineering. Although nursing had been closely involved in creating new approaches to patient care, little work had been done in developing assistive technology devices that could improve the quality of life for older people and people with various kinds of disabilities.
I began to explore more opportunities for interdisciplinary interaction and discovered that considerable work had been taking place in sports medicine. In my mind, there could be a direct link with patient care. Student athletes at the University were being treated and cured for injuries that were also occurring in the general population. Amazing things were going on at Domino’s Farms in Sports Medicine that were unknown in the School of Nursing. Cardiac Rehabilitation was also emerging as an essential part of patient care. It was exciting to see the new products and procedures that were developing because of interdisciplinary efforts.
In 1981, I was asked to assume the role of Interim Associate Director for Nursing and Assistant Dean for Clinical Affairs a joint position between the School of Nursing and University of Michigan Hospitals. It was a time of significant change and renewal and I was able to provide leadership for nursing in a time of unrest. That year of appointment again afforded new opportunities as I was the first nurse to sit on the Hospital Executive Board, a group of top hospital administrators and physicians who met monthly with the President of the University. It was a wonderful learning opportunity for me as all manner of clinical and administration issues were discussed at these meetings. Preparation for these meetings required reading extensive reports and financial documents. What was most amazing was how little a nursing point of view was considered. This was to change when a new Dean of Nursing arrived. As a former staff nurse, it was hard to believe that nurse staffing issues were being discussed across campus from an entirely different point of view, usually financial and the impact of staffing problems on hospital income.
After completing my administrative roles in 1982, I was free at last to pursue my scholarly work and international activities. From 1982 until my retirement in 1995, I developed my own research on nursing assignment patterns, focusing on the essential characteristics of nurses necessary to developing creative approaches to patient care problems. Nurses are in a crucial position in developing innovative, assistive technologies and I was able to assemble a research team of interdisciplinary graduate students who were instrumental in developing the work excitement and unit cultural tools that are now in use in nursing practice around the world. As our work was published in books and research articles, more and more graduate students and practicing nurses sought to use our instruments. Interest in entrepreneurships has become popular on the University of Michigan campus. Creative nurses with high-level work excitement were already developing businesses, as recorded in my nursing administration text published in 2000 by Delmar. The nurses starting businesses were not just enthusiastic they had high levels of work excitement. Because of my published work, I was frequently invited to present papers and workshops in other countries, in particular China and New Zealand.
Around this same time, a huge change was occurring on campus, President Duderestadt announced his concern about the lack of computer literacy among the faculty. In my small way, I had been encouraging my graduate students to use computers to write their papers. In fact I would announce at the beginning of each semester that I would no longer read hand written or typed papers. At first students rebelled but soon came to see the advantage of editing their work after suggestions were made for change. The computer revolution that occurred on campus was mainly instigated by the President who was able to arrange with Apple Computer and Steve Jobs for discounted Macintosh computers to be sold on campus. This was a very exciting time in the University. Imagine the thrill of being able to participate in the first sale of personal computers on campus. My husband and I participated in these sales from the first. We thoroughly enjoyed ordering our computer, software and printer and then picking up everything in a grocery cart at a central site. In those days we could even figure out how to assemble everything with the help of techs from the Learning Center, a new computer business in Ann Arbor. It was a very exciting time and faculty and staff were strongly encouraged to attend computer classes on campus if they wished to keep working at the University. There was much resistance in various parts of campus, including the hospital where physicians wanted to keep their unintelligible handwriting. It was a great time for interdisciplinary interactions as classes were open to all. Faculty and staff went back to school together and rediscovered the “joy of learning.”
I would say that the major changes in the University of Michigan during my tenure were: globalization, transition to an emphasis on lifelong learning versus degree preparation for employment, computerization, expanded opportunities for women, change of medical thinking to high tech therapies, rehabilitation and interdisciplinary projects producing innovations and entrepreneurships. The development of sports medicine has encouraged new interest in health and fitness programs. The maturing of the practice of nursing to a recognizable profession with both undergraduate and graduate programs became accepted among the healthy schools on campus. Research based clinical nursing practice has contributed immensely to the quality of patient care at the University of Michigan Medical Center, no longer know as University Hospital.
In my early retirement, I found it very rewarding to volunteer at the Patient Education Resource Center (PERC) in the Cancer Center. For the first time in my long career, I was directly able to assist patients and families with computer skills and knowledge based information about their individual diagnoses and care requirements. I still hear from students in other lands and know that the University of Michigan has contributed to the improvement of lives around the world. Because of my experiences at this university, I believe I have become a citizen of the world.