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Our Nurse of the Week only received honorary credentials at best, but in the end, even a very hostile medical community had to acknowledge that Sister Elizabeth Kenny’s polio treatments helped thousands of children in the 1940s recover from the disease without being immobilized and imprisoned in braces and casts.

Sister Kenny. Australian War Memorial.

Born in 1880 in a New South Wales village in Australia, Elizabeth Kenny found her career path the way many nurses do today – as a girl, she found herself a patient and became fascinated with the science and practice of healing. When she broke her forearm after falling off a horse, the teenager developed a hunger for learning about human bones and anatomy. She found a mentor in the physician who treated her and, as David Anthony Forrest, PhD, RN, ANEF, FAAN relates in Nursing’s Greatest Leaders, “He had a wonderful library that contained a skeleton. She played with the skeleton for hours and learned how to trace muscle from origin to insertion.”

As she reached adulthood Kenny shadowed various nurses and doctors, then began to work as a “bush nurse” in Queensland, delivering babies and treating injured laborers, sick adults, and children. Bush nursing was a bit like being a traveling FNP, but young Elizabeth never attended a school, she reached her patients via horseback rather than plane, and instead of money she only accepted barter as payment. Kenny went on to work as a nurse on troop ships in World War I, and when they promoted her to “Sister” she adopted the title for the remainder of her career.

A treatment nearly as dreadful as the disease

In 1911 Sister Kenny encountered her first poliomyelitis epidemic. Polio had been endemic for most of known history when epidemics of the devastating intestinal infection began to break out in the 20th century. There was no cure and the Salk vaccine was not developed until 1955, and the fearsomeness of polio was exacerbated by the unpredictability with which the disease could strike. Before the vaccine, parents around the world faced each summer with dread: a fun family outing could turn on a dime and become a tragedy. It happened in 1921 to a then-39-year-old Franklin Delano Roosevelt during a vacation, and in the US 35,000 children and adults were afflicted every year during the 1940s.

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In treating children afflicted by a deadly disease with no known cure, her lack of classical medical training prompted her to base her treatments on empirical evidence. When she had treated soldiers with meningitis during the war, Kenny had learned that patients responded well to a combination of exercise, moist heat, and massage or manipulation. Could this also help in treating polio victims? Doctors were often horrified by her refusal to immobilize young patients who they believed should be immobilized ion braces, corsets, and casts, but Sister Kenny insisted that her methods not only were less harmful, they were usually more effective as well and her patients seemed more likely to recover the use of their limbs. While standard practice at the time was to confine patients – child or adult – in plaster casts for as long as 10 months, at which point some of the more advanced doctors recommended some light physical therapy.

As medical historian Bruce Becker, MD states, “The then-orthodox treatment of prolonged encasement in plaster was almost as bad as the disease.” Sister Kenny, however, feeling a nurse’s empathy for her charges, recognized this at the time without needing the benefit of hindsight. Arlene Wynbeek Keeling, Ph.D., R.N., F.A.A.N recounts in her History of Professional Nursing in the United States:

“Kenny maintained that patients’ affected muscles and limbs should be wrapped in hot packs and exercised—not immobilized, as was the customary medical treatment. Kenny’s method was most successful on early cases before deformities and paralysis occurred.

 

The treatment was done in three stages. In the first stage, hot moist packs were applied to the patients’ muscles; this helped to relax both the muscle and the pain. Next, gentle manipulation of the affected limb and muscles was performed. As treatments continued, the patients were allowed to move their own limbs with assistance until they were able to independently do so.”

The “screwball” vs the “dodos”

The medical communities in her home country and in the US were naturally hostile to the very idea that the patients of an uneducated nurse might be more likely than their own to recover and have a better quality of life during treatment and afterward. After all, as the Minneapolis Star Tribune once put it, “Most experts at the time thought polio killed nerve cells and yanked muscles out of place, requiring immobilizing casts and splints. Kenny insisted the muscles were merely tight so “your splints and casts are illogical; throw them out.” When she arrived in the US in 1940 to treat kids during the relentless summer polio epidemics, doctors in New York City and Chicago simply referred to her as a “screwball.”

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The former bush nurse was never shy about returning fire, though, and it was not unusual for Kenny to tell experts that they were “dodos” for dismissing her methods without a hearing. Minneapolis truly embraced the persistent Sister, though, and she and her daughter treated patients at the Mayo Clinic and the Minneapolis General Hospital. By 1941, doctors started to abandon their “dodo” views. The National Foundation for Infantile Paralysis (NFIP) issued a report and Harvard orthopedist Frank Ober, an erstwhile skeptic, wrote in JAMA, “when her ideas are applied, splinting is not necessary. Sister Kenny’s treatment is superb nursing and common sense.” In 1942, she opened a 65-bed facility in Minneapolis, the Elizabeth Kenny Institute, and her work helped place the city on the map for implementing much-needed advances in polio treatment.

Sister Kenny’s determination and sheer force of character, her refusal to be intimidated  – and the fact that their children not only seemed more likely to survive but even thrived after her treatments – certainly won over the American public. Today’s nurses – who are rightly proud of being America’s most trusted profession – might be pleased to know that in Gallup’s “most trusted women” polls the self-taught bush nurse ranked second only to Eleanor Roosevelt throughout the 1940s. Sister Kenny owned that #2 spot for nearly a decade and made #1 in 1952 just before she died.

Resources on Sister Kenny

If you are interested in the history of nursing, Sister Kenny is one of the most colorful nurses ever to make a mark. Her significance and popularity in the US were such that Hollywood made a film about her in 1946 starring Rosalind Russell and new accounts of her life, battles, and work continue to appear in both the US and Australia.

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Koren Thomas
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