Chapter 04: Observations about Renilda Hilkemeyer and Nursing at MD Anderson

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Chapter 04: Observations about Renilda Hilkemeyer and Nursing at MD Anderson

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In this chapter, Ms. Alt first notes that her own three years as supervisor corresponded to a difficult time for Renilda Hilkemeyer. Ms. Alt discusses Dr. Hilkemeyer’s contributions and the thoughts about her length of service in the role head of nursing. She then talks about how difficult it was to find trained oncology nursing, as the specialty was not treated in depth in nursing schools. She comments on the process by which Dr. Hilkemeyer was removed from her position.

Identifier

Alt,J_01_20180529_S04

Publication Date

5-29-2018

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subjects Story - Overview; Portraits; Overview; MD Anderson Culture; Working Environment; The History of Health Care, Patient Care; Institutional Politics; Controversy; Professional Values, Ethics, Purpose; Institutional Mission and Values; Building/Transforming the Institution

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Chapter 04: Observations about Renilda Hilkemeyer and Nursing at MD Anderson A: Overview;CodesC: Portraits;A: Overview;B: MD Anderson Culture;B: Working Environment;D: The History of Health Care, Patient Care;B: Institutional Politics;B: Controversy;

Tacey A. Rosolowski, Ph.D:

Okay, okay, interesting. Now, so then you became Assistant Director of Nursing for Surgical Services, and you were reporting, it says here on your CV, reporting directly to the Interim Director of Nursing. So two questions, just factual questions. How long were you a supervisor, about? Do you remember a date when you became assistant Director of Nursing? So about how long were you supervisor?J

Joyce Alt, RN, MS:

I’m going to say maybe three years, I don’t know, because nursing was really shaken at that time. Ms. Hilkemeyer was attacked, because she did a lot of good for oncology nursing at MD Anderson, wrote articles, very much valued by our staff and people in the community, but it was getting harder and harder for her to change [or to make changes].

Tacey A. Rosolowski, Ph.D:

Why do you think that was?J

Joyce Alt, RN, MS:

I’m not real sure. I think she was very content in her perceptions of what—this is the way it should be, because it’s always been done that way.

Tacey A. Rosolowski, Ph.D:

Okay, so you meant it was hard for her to change her perspective. Okay, gotcha. And so was she kind of—did you feel that MD Anderson was sort of evolving and she was becoming out of sync with where it was going, or the culture? What was the situation there?J

Joyce Alt, RN, MS:

[It was hard for her to be viewed as a change agent anymore. It was more that she was operating as if she was “right because she has always done it that way.”]

Tacey A. Rosolowski, Ph.D:

Well there’s always a lot of discussion, you know how long should a leader be in a leadership position? When is the time to step away? A lot of people have a lot of opinions on that but it sounds like this is one of those situations when there was a discussion about that; how long does this one person stay in charge?J

Joyce Alt, RN, MS:

I think that was it. I wasn’t real close to Ms. Hilkemeyer, I mean I wasn’t in a position to be that close, but I respected her and I appreciated what she had done for nursing.

Tacey A. Rosolowski, Ph.D:

What do you think were some of her big places of impact on the field?J

Joyce Alt, RN, MS:

[ ] [She introduced “oncology nursing” to the nursing world and wanted nursing to focus on the delivery of nursing care as opposed to being the extra hands running errands. She identified and paved the way for a nurse to have an oncology specialty. Prior to that, specialization was limited to e.g. operating room, obstetrics, medical nursing, surgical nursing, etc. Miss Hilkemeyer developed the concept of oncology nursing to be expanded to specialties within oncology such as leukemia, head and neck, gynecology, protected environment, urology, etc. This specialization was emulated in major cancer centers and is still true today.]I think she tried to move nursing forward, not just bathing a body but treating the person as a whole. [ ] [She liked to be in charge and perhaps this concept at times collided with the physicians who wanted to be in charge.]

Tacey A. Rosolowski, Ph.D:

Now, one thing I was very aware of when I started conducting interviews with people in nursing… I was looking at my own assumptions and realized, wow, I think I went through most of my life thinking of nurses as doctors’ helpers, I mean shame on me.J

Joyce Alt, RN, MS:

No, but that’s what [some] doctors [and administrators] would like you to perceive [nursing] as [during Miss Hilkemeyer’s reign. It wasn’t just doctors, though: extra hands for services not staffed on certain days by adminstrators.]

Tacey A. Rosolowski, Ph.D:

And I think that’s a lot of people’s perceptions. When I started reading about Renilda Hilkemeyer, I thought wow, you know, here’s a person who was really trying to change that. Did you agree? I mean was she trying to turn nursing into something that was different than that perception of doctor’s helper?J

Joyce Alt, RN, MS:

[I think so and perhaps at times she could be perceived as “closed” when in fact that was what she was trying to accomplish.]

Tacey A. Rosolowski, Ph.D:

No, I’m just asking for impression. Because I mean, I kind of look back and see it in the context of history and it’s easy to overread sometimes. Somebody like Barbara Summers [oral history interview], who came later, she’s very clear: “Oh yeah, we are doing away with that doctor’s helper thing, that’s not what nursing is any more, no, and we need to fight against that.” So she’s very clear about that. Renilda Hilkemeyer, that wasn’t part of her consciousness.J

Joyce Alt, RN, MS:

[Perhaps but not as controversial as it was in years later. But again, not just doctors, but administrators too.]

Tacey A. Rosolowski, Ph.D:

Okay, yeah. So patient care and treating the whole person. What are some other places where she had a big impact, do you think?J

Joyce Alt, RN, MS:

On oncology nursing [as a whole. Forcing nurses to keep up with the ever changing field in oncology care.]

Tacey A. Rosolowski, Ph.D:

On oncology. How so?J

Joyce Alt, RN, MS:

Well, one of the things that—and I’ll talk about that later, when we get into my role. I found out even then, oncology nursing was being taught four hours only, in preparing a bachelor’s nurse.

Tacey A. Rosolowski, Ph.D:

Wow.J

Joyce Alt, RN, MS:

People came to us then and with me then, they were not prepared to work at MD Anderson, they just weren’t. Number one, they were scared and number two, a whole new world [before them].

Tacey A. Rosolowski, Ph.D:

So what are the special dimensions of oncology nursing in your mind?J

Joyce Alt, RN, MS:

Patient care, family care, treatment, bereavement, [emotional support –a holistic approach]. It’s just a package and you just can’t focus on the illness. There’s a lot of people in a hospital that just focus on illness, you know, and particularly in a cancer hospital, where the impression was for a long time, people just come there to die.

Tacey A. Rosolowski, Ph.D:

Right. Yeah.J

Joyce Alt, RN, MS:

Anyway, she had to really try to teach people what nursing in a cancer hospital and our hospital is about.

Tacey A. Rosolowski, Ph.D:

And you shared those values? I mean did you know early on in your own career, that those were values you shared?J

Joyce Alt, RN, MS:

No, I really [didn’t believe patients came to MD Anderson just to die. I was taught early in my nursing education that we should view the patient as a whole person and part of a family.]

Tacey A. Rosolowski, Ph.D:

What was your own learning curve about that or developing those values?J

Joyce Alt, RN, MS:

I think working at Anderson, particularly working with people very committed to that. Medical staff, there’s no question, they’re trying to focus on a cure and I felt we complemented that by, “Yes, we can do these things to help that too, but when cure fails, we must be there.” It just, it was more than an illness.

Tacey A. Rosolowski, Ph.D:

How does that connect up, if it does, with your experience growing up in a small town?J

Joyce Alt, RN, MS:

Probably a lot.

Tacey A. Rosolowski, Ph.D:

Why do you say that?J

Joyce Alt, RN, MS:

I was brought up that way. I don’t know why I get so emotional about it but I do.

Tacey A. Rosolowski, Ph.D:

I guess it just struck me because you were talking about how close-knit the community was, people helping each other, all that.J

Joyce Alt, RN, MS:

Yeah.

Tacey A. Rosolowski, Ph.D:

People being there for each other.J

Joyce Alt, RN, MS:

Crops failed, you get your tractor… (becomes choked up) Yeah. [An ever presence of being grateful for many blessings and the need to keep that in mind when dealing with others.]

Tacey A. Rosolowski, Ph.D:

So you worked in a place that gave you a lot of meaning.J

Joyce Alt, RN, MS:

Yes.

Tacey A. Rosolowski, Ph.D:

Not everybody can say that. That’s nice.J

Joyce Alt, RN, MS:

Lucky.

Tacey A. Rosolowski, Ph.D:

Yeah. I was going to say, lucky you. (laughs) Yeah.

Chapter 04: Observations about Renilda Hilkemeyer and Nursing at MD Anderson

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