Extensions of Nursing Field 215 There was no training for nurses, or attendants, in asylums or hospitals for the insane, until Dr. Edward Cowles, at the head of the McLean Asylum in Massachusetts, established a definite course on educational lines, which, beginning in 1879, was well organized by 1882. Other hospitals followed his example. Trained nurses were, from the first, associated with this work, and Linda Richards (America's first trained nurse as she has been called) devoted herself for some years to training school organization of this form, going from one hospital to another to reconstruct. Sara E. Parsons, a younger woman, did similar work, laying the foundations in one place and then going to another. Little is known of the very first nurse workers in this field, whose insight penetrated beyond their day. Although the general standard of nursing care for the insane is yet, as a rule, below that required in most general hospitals it may also be said that there is usually a profound ignorance of mental nursing, among nurses trained in general hospitals. Efforts are being made to bring about affiliations between mental and general hospitals, with the object of improving the nursing care of both types of pa- tients, and of arousing among nurses a keener in- terest in the development of mental nursing.
