Note: During the 2001 Annual Congress in San Francisco, Calif., Evan Koch, MSN, CRNA, sat down with Goldie Brangman, MEd, MBA, CRNA, and discussed a myriad of topics that spanned from advocacy and leadership to becoming a nurse anesthetist and founding a nurse anesthesia program in the1940s. The following accounts are taken from this first-hand interview.
How Harlem Hospital School of Nurse Anesthesia was Born...
The year 2019 marks 75 years since African-American nurse anesthetists were extended membership into the American Association of Nurse Anesthetists (AANA). Many Certified Registered Nurse Anesthetists (CRNAs) and students have heard of Goldie Brangman, (AANA president, 1973-74), but may not know the story about how Harlem Hospital became the first hospital in New York’s 32-hospital system to have an African American program director of its nurse anesthesia program.
During World War II, most male doctors were away in the war and in the City Hospital of New York, nurses were being asked to give anesthesia. “You didn’t really have nurse anesthetists per se, just nurses assigned to anesthesia,” said Brangman. “When you weren’t doing a case, you went on the wards to work. But at any rate, I started in anesthesia and was there for a year.” For a year Brangman, Arcelia Williams, and Ina Maude-Sims worked in obstetrics helping with inductions, using Avertin and gas (nitrous oxide) oxygen-ether (GOE) for maintenance on patients.
According to “Goldie Brangman Remembers the Operation to Save Dr King,” written by Evan Koch, MSN, CRNA, and Goldie Brangman, MEd, MBA, CRNA, (pp 386-387): GOE stood for gas (nitrous oxide)-oxygen-ether, a blended anesthetic technique that had been developed a few decades earlier. With GOE anesthesia, small amounts of ether were added to as much as 70% nitrous oxide in oxygen to provide muscle relaxation and permit close control over anesthetic depth. GOE anesthesia was described in a 1939 text as “the best all-round method thus far devised.” Ms. Brangman called GOE “our standby, the first thing we looked to until spinals came along.”
“The surgical residents taught us anesthesia, so we learned everything. At the end of the year I decided I liked anesthesia. Anesthesia was a real challenge. I decided to go to a formal school of anesthesia,” she recalled.
“Getting into school in 1946 was more than just a notion. In New York City, there was the New York Hospital School of Anesthesia for nurses – forget it. They were not taking any black people at that point. Kings County and Bellevue, which were city hospitals, would take black people but had a waiting list, like forever,” said Brangman.
Brangman and classmate Arcelia Williams decided to apply to the anesthesia programs at two historically black colleges: Meharry Medical College, which had a nursing school at the time, and Tuskegee University.
Just before Brangman and Williams left for Meharry Medical College to attend anesthesia school, Dr. Helen Mayer, who had recently begun working at Harlem Hospital as the head of the anesthesia department, told Brangman that if she stayed at Harlem Hospital, she would teach them anesthesia and help -her start an anesthesia school. Brangman said, “Under those circumstances, I’ll stay.”
Shortly thereafter, Brangman and Williams went to Dr. Roth, a doctor who trained foreign medical graduates to take the American boards. They worked nights at Harlem Hospital and would go to class during the daytime. They attended classes on anatomy, physiology, pharmacology, and many other subjects. Then the two of them would go back to work in the evening and teach other nurses what they had learned during the day. “Dr. Mayer would work with us on the clinical part to get our skills up to date,” said Brangman.
When the time was right, they reached out to the AANA. “We got in touch with Florence McQuillen, AANA executive director at the time, told her what we wanted to do and how we were planning to do it. She gave us her blessing and said if we managed to really get it off the ground and we felt confident enough, we could challenge the certification exam. It was difficult, but it was fun.”
“The certification examination back then was all day long and was a bit more involved than exams are at the present time. At any rate, finally in 1949 Arcelia, Ina Maude-Sims, and myself, challenged the board certification examination and passed,” said Brangman.
A new anesthesia school in town
Now to the business of opening the Harlem Hospital School of Nurse Anesthesia. “Dr. Mayer and I had gone to the mayor of New York earlier and asked for permission to open a school of anesthesia for nurses. He gave us that permission, conditionally, as long as it didn’t cost the city any money. That meant we were not going to get any salaries for anything more than bedside nurses. So, we opened the school in 1949,” Brangman explained.
She remembers her very first students. “My first class consisted of an Irish Catholic girl, a Jewish boy – these were people who found it difficult to get into schools of anesthesia either because of their race or ethnicity. The Jewish student had a PhD. I had two boys from the gold coast of Africa, one Filipino and one Korean student. The rest of the class of 16 were a mix of Caucasian, Hispanic, and Black students from New York and New Jersey.
“When we started our anesthesia program, the average time was 9-12 months. We formulated a 26-month course because we felt we couldn’t do an adequate training in less than that. It was 26 months because the students were given one month of vacation during each school year. We started it out with prerequisite courses in mathematics and reading comprehension – even the American nurses had to take reading comprehension because there’s so much reading to do,” explained Brangman. “They needed math to prepare them for physics and chemistry. We later added patient care for the first three months because many of our students with an associate and bachelor’s degrees did not spend a lot of time in the clinic. Therefore, they didn’t have as much patient experience as the diploma school nurses. I was fortunate that in my first class, I didn’t have anything but diploma nurses so they were all patient savvy. So that was good. But after that it was ground zero we had to pull from.
“The school became famous, it really did, because as Dr. Mayer and I both said, if you’re going to train nurse anesthetists to do something that physicians do – not that it is medical practice or practice of medicine for nurses to do anesthesia, but the nurses will need to do it just as well or better than the physicians.”
Over the 38 years that Goldie Brangman was director of the Harlem Hospital School of Nurse Anesthesia, she estimated that she educated at least 700-750 students. “Sometimes we would start out with 20 students and end up with 16, we did not keep a student if we had any doubts about his or her abilities.” Brangman also attributed the popularity of her program to the fact that Harlem was one of the few programs in the nation that taught regional anesthesia in the early days of the program.