Recognizing Distinguished Nursing

Chadwick: seeing about seniors.

A longtime advocate for the rights of nursing-home patients, Laurel Rosenbaum Chadwick B.S.N.Ed. ’53, received the Duke School of Nursing’s 2003 Distinguished Alumni Award, presented at the school’s alumni association luncheon during Reunion Weekend in April. Chadwick, after earning her degree, taught an array of subjects in the nursing school and designed and implemented a math program for incoming students.

While at Duke, she met and married Harry R. Chadwick ’51, LL.B. ’53. They moved to St. Petersburg, Florida, where she worked at a local veterans’ hospital until her husband was drafted. They moved to Germany, where he was stationed and where their first child was born. After her husband’s military service ended, the family returned to Florida, where she taught both clinical and theoretical courses at St. Petersburg Junior College’s nursing school.

Laurel Chadwick discovered a passion for caring for older citizens. Then, as now, St. Petersburg had a large population of elderly residents, and Chadwick persuaded college officials to let her teach a geriatrics course.

At the time, nursing homes in the St.Petersburg area served primarily as warehouses for indigent residents. Living conditions were often deplorable: Dirt floors for incontinent patients and an outside area for hosing down residents were not uncommon.

In 1961, Harry Chadwick, a successful attorney who chaired the county commission, established a partnership with a local group to build a new nursing home. There were only ten in the county at the time. The Chadwicks started with forty-four beds; within a year, that number had nearly quadrupled, and a program of expansion followed.

At the time, the state’s only regulatory body for nursing homes was the Pinellas County Board of Health, and the only gauge for determining a home’s quality of care was the presence of bedsores. Laurel Chadwick became dedicated to improving the standards for Florida nursing homes and the care of their residents. In 1963, she implemented what may have been the state’s first nursing-home rehabilitation unit, launched a nurse-assistant education program, and created a job description for a new position: rehabilitation aide. She also started a restorative therapy program—a concept not officially endorsed until the 1987 passage of the Omnibus Budget Reconciliation Act—designed to create and maintain the highest possible level of nursing-home operation.

Chadwick also oversaw the construction and operation of a number of Pinellas County nursing homes, including the purchase and restoration of a psychiatric facility, which had housed a room known as “The Pavilion.” The dirt-floored room, with iron rings and restraints to chain uncooperative and combative patients to the wall, outraged her—so much, she says, that she marked it as the first in line for demolition.

In 1965, the State of Florida recognized the need to address the standard of care in nursing homes and convened a statewide task force, with Chadwick as the representative from the Florida Health Care Association (FHCA), an organization of nursing-home operators. Over the years, she had served as the FHCA’s district secretary and later president; she was state vice president the year the task force was formed.

Within the FHCA, the task force, and elsewhere, Chadwick had advocated the right of nursing-home patients to quality of life—recognizing that individual diagnoses required distinct definitions of quality of life. This was an idea she preached again and again during her tenure as chair of the FHCA’s Education Committee.

In 1971, Florida asked Chadwick to design and teach a mandatory course for all of its nursing-home operators. Owners and administrators from around the state attended the two-day seminar in preparation for the first-ever Board of Nursing Home Administrator’s licensing examination. The American College of Nursing Home Administrators was founded soon after, and Chadwick was among the first members and later became a fellow.

The Chadwicks, who have established a scholarship at the Duke School of Nursing, have two daughters and a son, James M. Chadwick ’77. Their granddaughter, Laurel M. Chadwick, is in the Duke class of 2006.

“ This year’s fiftieth anniversary of my Duke graduation is a good time to reflect upon my life, career, and accomplishments,” says Chadwick. “Duke has played an important role in my life and continues to do so.”