Free School of Obstetrics and Nursing of Mexico: Goals, Bylaws, Rules, Study Plans, and Programs (c. 1931)

Dr.Jethro Hernandez Berrones, Southwestern University

INTRODUCTION

Arturo Palmero founded the Free School of Obstetrics and Nursing of Mexico in 1920. Free schools were institutions of professional education that emerged during the Mexican Revolution (1910-1917) as an alternative to the professional schools sponsored by the regime of Porfirio Díaz. Critical of the elitism and encyclopedic curriculum of official schools, free schools proposed programs that adapted to the needs of students—recent immigrants to Mexico City or from working-class families—and offered a more practical and less theoretical curriculum. Most free schools offered programs in medicine, nursing, dentistry, and obstetrics, and many of them aligned with homeopathy, a medical system in tension with the type of medicine taught at the National School of Medicine. Throughout the 1920s and 30s, post-revolutionary governments used the programs of medicine, nursing, and obstetrics at the National School of Medicine as models to regulate the training and certification of these health professionals, first through the National University and subsequently through the Secretary of Public Education. The Free School of Obstetrics and Nursing of Mexico offers a window into an alternative model of midwifery training and practice.

Arturo Palmero Alcocer (1872?-1938?) graduated from the school for teachers in the state of Yucatan and later taught at Merida’s Instituto Literario. He obtained the degree of doctor in surgery and obstetrics from the National School of Medicine in Mexico City with a dissertation titled “El sistema curativo que debería adoptar la homeopatía” [The therapeutic system that homeopathy should adopt] (1895). His interest in the popularization of obstetrics came two years later with the publication of the manual “Elementos de obstetricia para la enseñanza de las señoras” [Foundations of obstetrics for women] (1897). In the first decade of the twentieth century, his consulting office offered electrical treatments, massages, and light therapy, and only as a last resort surgery, for his patients. He supported the cause of the wealthy hacendado Francisco Madero, who in 1910 organized an armed uprising calling for fair elections. Politically and academically active, Palmero participated in several national and international meetings as a member of academic societies including the Mexican Society of Geography and Statistics, the Universal Scientific Alliance, and the Mexican Indianist Society. The free school became the focus of his career for the rest of his life.

The Handbook of the Free School of Obstetrics and Nursing of Mexico details the goals, regulations, material resources, and academic programs of the school. This document was archived with additional materials that inspectors from the Secretary of Public Education (SEP)’s Legal and Revalidation Office compiled about the school. The publication date is unclear, though it could possibly date back to the early years of the school. The document was a work in progress. Stricken out with pen and with typewritten additions, the handbook suggests that the way Palmero adapted the school’s program was in response to multiple reforms to secondary education and the government institutions that regulated it during the first years of the 1930s. The section transcribed here shows the school’s pedagogical orientation, its emphasis on linking its programs with social needs and professional careers, and its meticulous record keeping. Palmero emphasizes the practical approach of his program.

Questions for Further Exploration:

How does he describe this approach in the handbook? What is the kind of Mexican citizen this approach seeks to form? How does the school’s program implement the practical pedagogical approach in obstetrics? How is labor related to a woman's body and an individual’s economy and morality?

TRANSCRIPTION

“Escuela Libre de Obstetricia y Enfermería de México”, Archivo General de la Nación, Secretaría de Educación Pública, Dirección Jurídica y de Revalidación, 31737, 17-1-10-41, p. 12-30.

ESCUELA LIBRE DE OBSTETRICIA Y ENFERMERIA DE MEXICO

(FUNDADA EN MAYO DE 1920)

FUNDADOR Y DIRECTOR: DR. ARTURO PALMERO.

PROSPECTO, ESTATUTOS, REGLAMENTO, PLANES Y PROGRAMAS DE ESTUDIOS.

Esta Escuela está reconocida por el gobierno y los títulos que expide tienen la misma validez que los de la Universidad (Decreto de 10 de marzo de 1931, publicado en el Diario Oficial el 24 del mismo mes).

3ª. CALLE DEL PANUCO, 65

MEXICO, D. F.

[Pags.13-14.5 no fueron transcritas]

CRITERIO QUE PRIVA EN LA ENSEÑANZA DE LA E.L.O.E. O ESCUELA PALMERIANA.

Distinto del universitario, pero de más eficientes resultados. No busca honores, porque huye de la pompa insubstancial y egoísta; pero da siempre satisfacción en la conciencia por los éxitos constantes que se observan en la práctica de mis alumnos y en la mía propia. Ese criterio es el que he seguido silenciosamente en mi larga práctica médicoquirúrgica, y que debo ya anunciar a los médicos y al público en general.

Helo aquí en breves preceptos:

1º.- Simplificación de los aparatos de Fisioterapia, suprimiendo los inútiles, costosos y estorbosos aditamentos y tuberías, que el mercantilismo norteamericano ha traído a la Ciencia médica para engañar a los bobos.

2º.- Simplificación del gran instrumental y personal quirúrgicos, que sólo sirven para hacer creer en la importancia de una operación pequeña.

3º.- Simplificación de los procedimientos quirúrgicos, esto es, hacer sencilla una operación de importancia.

4º.- Tendencia a ahorrar las operaciones quirúrgicas en los pacientes.

5º.- Simplificación de las fórmulas terapéuticas en Medicina.

6º.- Investigación de la mayor eficiencia en todo acto profesional, poco importa su rendimiento económico y su comprensión y agradecimiento por el cliente. La vida estudiantil y profesional debe ser, antes que nada, la ascensión constante hacia el ideal de la Patria, de la Humanidad y de la Ciencia.

7º.- Tener constantemente como base fundamental, imprescindible, de toda la Terapéutica e Higiene, la desoxidación, la desintoxicación y la asepsia y antisepsia, local y general, del organismo.

8º.- Tener vida filosófica; enseñar lo que se ha de practicar, y practicar lo que se aprende y se enseña.

México, 12 de enero de 1929. Dr. Art. Palmero.

CONSTITUCIÓN O ESTATUTOS DE LA ESCUELA LIBRE DE OBSTETRICIA Y ENFERMERIA DE MEXICO.

I.- Objeto de la Institución, Planes de Estudio, Métodos y Procedimientos de Enseñanza

[Arts 1º-3º no son accesibles en el documento; el 4º y el 5º no fueron transcritos.]

Art 6º.- En cuanto al sistema pedagógico, la enseñanza será esencialmente intuitiva, técnica, educativa, de acción, de socialización y de evolución. El profesor deberá facilitar la labor del estudiante, enseñándole el camino que ha de seguir con su propia actividad, mediante un ligero impulso, a fin de evitarle la fatiga intelectual y el agotamiento cerebral que lo harían irritable, neurasténico, amnésico, etc. La Pedagogía moderna quiere, y así lo practica esta Escuela, que el alumno realice una labor individual, que lo coloque en actitud de pensar, juzgar y obrar personalmente, de observar e investigar por sí mismo en el ejercicio de su profesión; no pretende imponerle la estructura moral y científica del profesor o del autor que estudia, sino le permite juiciosamente el desarrollo libre y armónico de su personalidad, que manifieste toda su peculiar psicología y originalidad, para contribuir al desarrollo de la Ciencia en nuestra Patria, facilitar la evolución de su espíritu para que aparezca el nuevo hombre, que se presiente ya en la actual etapa de la evolución humana; pero el profesor debe ayudar al alumno a vencer las dificultades para dejarle sus energías a nuevas orientaciones progresistas y estar listo siempre para dirigir las que signifiquen involución o retrogradación de la Ciencia y la personalidad humana. La Escuela que deja la libre manifestación de la personalidad sin ninguna orientación en los casos regresivos, ha perjudicado inmensamente a la especia humana, invirtiendo los valores científicos y morales.

En la realización del programa de cada materia, se seguirá un método dialogado o expositivo, inductivo o deductivo, según los casos, y la enseñanza será siempre eminentemente intuitiva, práctica, investigadora, útil, interesante y amena para que el alumno no experimente el marasmo escolar ni sienta repugnancia por el aprendizaje de su profesión, y sí vea, cada clase, como una función de teatro o de cine, en la que él entre con ansia e interés, persiguiendo siempre una amena expansión de su espíritu y un nuevo conocimiento útil que añadir a su acervo intelectual.

En cuanto al método, el profesor, tanto en la teoría como en la Clínica deberá materializar, objetivar todos los conocimientos para que éstos puedan ser comprendidos y puestos inmediatamente en práctica por el alumno, cualquiera que sea su capacidad. Cada clase de teoría será a la vez una verdadera clínica abreviada o sintética: toda palabra técnica, que no puede eliminarse en la enseñanza médica, tendrá su correspondiente idea clara y precisa en el cerebro del alumno y, en consecuencia, éste podrá, sin dificultad alguna llevarla a la práctica en cualquier momento de su vida y servirle de guía para el avance del Arte; en una palabra, teoría bien comprendida y fácilmente llevable a la práctica, y práctica nosocomial y civil en consonancia con la vida social contemporánea. No se trata, pues, de intelectualismo verbalista, de frívolas e inconscientes enseñanzas librescas, sino de un método activo, de la verdadera Escuela de la acción científica, esto es, saber y saber hacer, convertir la idea en hecho en cualquier momento de la vida y de aquí las Técnicas de Laboratorios, que he ideado e implantado en esta Escuela, antes que nadie para servir de puente entre la Teoría y la Clínica.

El profesor no será el simple transmisor de conocimientos, ni el alumno el receptor pasivo. El primero tratará de desarrollar las facultades del alumno, para que éste pueda fácilmente aprender y asimilar lo conocido, investigar nuevas verdades y ejercitar su profesión a plena conciencia, relacionándolo con el medio en que vive para que conozca y comprenda su verdadera situación en la sociedad; además, le creará el criterio profesional y el sentimiento de su deber; su fin nos será lucirse en la clase, sino instruir, educar y enseñar a pensar, a obrar, a investigar y a luchar por su arte, por la vida y por el progreso de la Nación y del mundo entero. Tal es la orientación filosoficopedagógica de mi Escuela, que deja atrás, a millares de leguas las Facultades Universitarias dirigidas por personas sin ciencia y sin pedagogía.

En consecuencia, esta Escuela de acción y de socialización, que rompe con los añejos métodos de enseñanza, creando otros, fundados en las nuevas orientaciones psicopedagógicas y socialistas, tratará de poner al alumno en contacto directo con la realidad, con el objeto de estudio, haciendo observar, leer y practicar los conocimientos en la naturaleza misma, en el medio social en el que vive, y dejará el libre desarrollo de la voluntad individual, sin disposiciones dogmáticas, pero inspirado todo acto profesional en la observación directa de la naturaleza, en la moral y en la ciencia. Observar mucho, ayudar y ejecutar después, tal es el camino pedagógico de mi Escuela, tanto en la enseñanza teórica como en la Clínica y en la práctica. Por consiguiente, para ser enfermero o partero, a cada alumno se le hace pasar por 3 grados sucesivos. Observador, ayudante técnico y practicante. En fin, mi método especial de enseñanza es intuitivo, de acción y de evolución constante para crear en el alumno un espíritu de socialización y de investigación científica que le haga convivir con el pueblo.

Con este método y sistema especial de enseñanza, la Escuela Libre de Obstetricia y Enfermería de México proporcionará a la mujer y al joven un modo de obtener con rapidez una profesión independiente y útil a ellos y a la sociedad, pues desde el segundo curso de Enfermería los alumnos quedarán aptos para asistir enfermos, y desde el segundo de Obstetricia, para asistir partos. La vigilancia e inspección constante del Director en las cátedras, orientarán los métodos y sistemas de enseñanza para lograr la unidad en la variedad.

  1. 7º.- Desde el segundo curso, la Escuela comenzará a formar clientela a cada alumno, de modo que éste, al recibirse, además de tener ya clientela propia, habrá recuperado el costo de sus estudios, ventajas importantísimas que ninguna otra Escuela proporciona (sistema cooperativo); y además tiene por supremo fin la socialización del alumno, acercándolo al pueblo y adentrándolo en la práctica civil de su profesión y creándole al mismo tiempo sentimientos de solidaridad humana y de vida común para todos los (…) con la prolongación en el hogar, de los servicios gratuitos de la Escuela.

[II.- Requisitos de admisión. Los arts. 9º-11º describen los cursos, la documentación, el proceso y las cuotas requeridas para la inscripción. También detalla algunas excepciones.]

[III.- Libros, Exámenes, Títulos y Vacaciones. Los arts. 12º-20º indican los procedimientos administrativos que garantizan el funcionamiento adecuado de la escuela y la certificación por parte de la Secretaría de Educación Pública.]

REGLAMENTO INTERIOR DE LA ESCUELA LIBRE DE OBSTETRICIA Y ENFERMERIA DE MEXICO.

[I.- Moralidad y Disciplina del Establecimiento. Los arts. 1-23 son un código de conducta para el aprendizaje efectivo de los alumnos, para la buena relación entre alumnos y entre estos y los profesores y para el respeto de los alumnos hacia la escuela.

II.- Prácticas y Clínicas de Enfermería y Obstetricia

Art. 24º.- Las prácticas clínicas se harán en la Escuela, en el Dispensario, en el Laboratorio y clientela civil (maternidades y hospitales públicos y particulares). Cada alumno pasará por 3 grados sucesivos: observador, ayudante técnico y practicante.

Se formarán grupos de alumnos para las prácticas y guardias, en las cuales se harán clínicas, y que serán para cada grupo, una vez por semana de 9 a 12 o de 14 a 17. Las guardias en el Sanatorio y en el Dispensario, serán designadas especialmente por la Dirección en cada caso.

Señalado el grupo al que corresponde el alumno, la Dirección no tendrá que recordarle cada vez su turno respectivo. Estas enseñanzas prácticas y explicadas a pequeños grupos, constituyen el sistema moderno que mi Escuela ha introducido en la enseñanza de las Clínicas, pues con el antiguo procedimiento de todos los alumnos a la vez, la Clínica resulta inútil para la mayoría, ya que sólo aprovechan los 4 ó 5 alumnos que están cerca del enfermo o del operado; y por eso, en las Clínicas europeas se trata de suplir esta deficiencia con el empleo de películas cinematográficas.

[Art. 25. Sobre las ausencias.]

Art. 26.- Los alumnos de Enfermería deberán hacer las hojas de observación de los enfermos que el profesor les encomiende; y los de Obstetricia, la historia de las embarazadas de la Clínica, del Sanatorio y de la clientela civil y a las cuales ayuden o asistan en sus alumbramientos. Dichas hojas de observación e historias deberán traerse siempre a la Clínica y a las guardias. Las historias estarán numeradas, fechadas y bien escritas con tinta o en máquina y deberán hacerse y presentarse a la Dirección para ser revisadas y corregidas dentro de los ocho días de terminada la asistencia. La falta de cumplimiento de esta prevención y el abandono de enfermos confiados al cuidado especial de cada alumno, serán motivos para privarle temporalmente, a juicio de la Dirección, de la asistencia particular de enfermos, lo mismo en el caso en que no llame oportunamente al alumno que, en calidad de enfermero, se le hubiese asignado para ayudarlo en la asistencia de un parto.

Art. 27.- Los alumnos de Enfermería deberán traer para la guardia una bata, una cofia, un termómetro y una jeringa para inyecciones hipodérmicas; y los de Obstetricia deberán traer, además, para la guardia y la Clínica, un estetoscopio. No deberán dejar sus batas en el Establecimiento.

Art. 28.- Anotarán por orden numérico, en una hoja, las prácticas de Enfermería o de Obstetricia que sucesivamente vayan aprendiendo a hacer personalmente, tanto en las Clínicas como en las guardias y clientela civil. Estas hojas, revisadas por la Secretaría o el profesor respectivo, servirán en los exámenes para comprobar en parte el caudal de conocimientos prácticos de cada alumno.

Art. 29.- Las hojas de prácticas tendrán el siguiente encabezamiento: “ESCUELA LIBRE DE OBSTETRICIA Y ENFERMERIA DE MEXICO.- Hoja de prácticas de Primer Curso (o Segundo Curso) de enfermería (o de Obstetricia) del alumno N. N.”, y en seguida la fecha de la inscripción. Los alumnos deberán traer y presentar estas hojas todos los días para su revisión, anotadas ya las prácticas del día. Cuando no traigan sus hojas de prácticas o no anoten lo practicado en la Clínica, se pondrá falta de asistencia. Fin pedagógico: enseñar a los alumnos el hábito de anotar los datos de su práctica.

Art. 30.- Los alumnos instruirán a los enfermos del Sanatorio y Dispensario y clientela civil en las reglas higiénicas que necesitan observar, para evitarles complicaciones o alguna enfermedad extraña y a las embarazadas y puérperas en los principios de la Maternología y Puericultura, lo que constituye una prolongación a los hogares de los servicios que presta la Escuela (extensión del servicio escolar).

[III.- Internado. Art. 31 no transcrito. IV.- Horario de clases. Art. 32 no transcrito. V.- Penas Disciplinarias. Art. 33 no transcrito.

PROGRAMA PARA LA ENSEÑANZA DE ENFERMERÍA

[No transcrito. Detalla los cursos para los estudiantes de enfermería.]

PROGRAMA PARA LA ENSEÑANZA DE OBSTETRICIA (CONTIENE EL PROGRAMA DE LA UNIVERSIDAD NACIONAL)

[No transcrito. Detalla los cursos para los estudiantes de obstetricia.]

El Director,

Dr. Art. Palmero.

TRANSLATION

FREE SCHOOL OF OBSTETRICS AND NURSING OF MEXICO

(FOUNDED IN MAY 1920)

FOUNDER AND DIRECTOR: DR. ARTURO PALMERO

GOALS, BYLAWS, RULES, STUDY PLANS AND PROGRAMS

This school is recognized by the government and the diplomas it issues have the same legal value as the ones issued by the University (Decree dated on March 10, 1931 and published in the Diario Oficial on the 24 of the same month).

65 Panuco Street

Mexico, D. F.

[Page 12.5 describes the school’s staff. The goals section starts describing some of the healthcare problems in Mexico. These include the lack of nursing and obstetrics staff for homes, clinics, and hospitals; the high proportion of unqualified healers; the high rate of pregnant women or newborns who die at birth; and the lack of vocational training provided by the state. The school aims to contribute to the solution of these problems by training women as nurses and midwives.Doing so would provide women with an income while it would also promote hygienic values, the use of vaccines, and the avoidance of heroic drugs. It explains that there must be coordination between the National University and the Secretary of Public Education, as well as between public and private schools in order to fulfill the social role of education in Mexico. The school used a textbook that facilitates student learning thanks to its accessible language, its path to personal discovery, and its practical applications to national problems.]

TEACHING CRITERION AT ELOE OR THE PALMERIAN SCHOOL

[The teaching in this school] differs from that of the National University, but it provides more efficient results. It does not seek praise or honors, because it avoids insubstantial and selfish pomp. However, it always brings me personal satisfaction because I am able to witness the continuous success of my students’ practice, and of my own. Having successfully, and quietly, followed this criterion during my long medical and surgical practice, I now want to disseminate it to all physicians and the lay public.

What follow are a few brief principles of my practice:

1st.-Simplification of physiotherapy devices, [to be achieved] by avoiding the useless, expensive, and bulky pipes and attachments that North American mercantilism has introduced into medical science—mercantilism that deceives fools.

2nd.-Simplification of the great surgical staff and instruments, which only contribute to make a simple operation fashionable.

3rd.-Simplification of surgical procedures, this is, to make important operations [as] simple [as possible].

4th.-Encourage the avoidance of surgical procedures in patients.

5th.-Simplification of therapeutic formulas in medicine.

6th.-Research how to make every professional action more efficient, without caring so much about its profitability or how well the patient understands it, or how grateful they may be for it. Student and professional life must be eminently a constant ascension towards the ideal of the Nation, of Humanity, and of Science.

7th.-Constantly remember that the unavoidable and fundamental basis of all hygiene and therapy is the deoxidation, detoxification, asepsis, and antisepsis, local and general, of the organism.

8th.-Having philosophical life. Teach what it is practiced and practice what it is learned and what is taught.

Mexico, January 12, 1929. Dr. Art. Palmero

CONSTITUTION OR BYLAWS OF THE FREE SCHOOL OF OBSTETRICS AND NURSING OF MEXICO

I.-Aim of the institution, study plans, teaching methods and processes

[Arts. 1-3 are not accessible in the document. Arts. 4 and 5 are not transcribed.]

Art 6.-Regarding the pedagogical system, teaching will be intuitive, technical, educational, and inclined to action regarding socialization and evolution. The professor should facilitate students’ work, by teaching through example, and by not pushing students too hard, in order to avoid provoking the kind of intellectual fatigue and cerebral exhaustion that would make the student irritable, neurasthenic, amnesic, etc. The modern pedagogy’s goal, as practiced by this school, is that students engage in individual work that lead them to think, judge, and act on their own accord, to observe and research by their own the practice of the profession. It does not intend to impose the moral and scientific structure of the professor or author that students read. Instead, it allows for the free, judicious, and balanced development of students’ personality; it promotes the full manifestation of students’ peculiar and original psychology.This contributes to the development of science in our homeland, facilitates the evolution of spirit of students, and the emergence of the new man that is perceived in the current state of human evolution. The professor, however, must help students overcome challenges, so that they will use their energies on progressivist orientations that help redirect oppositional forces which would lead to the involution and regression of science and human character. A school that allows the free manifestation of personality without correcting backwardness will cause profound harm to the human species by inverting moral and scientific values.

In order to teach each course, a deductive or inductive method, lecture- or seminar-based approach, must be followed, [with reasonable differences allowed,]according to each particular case. Teaching will always be eminently intuitive, practical, research-oriented, useful, interesting, and appealing. This will combat the boredom that prevents students from learning the profession. The student will attend classes with the same interest and eagerness as when going to the theater or the movies, activities which provoke entertaining expansions of the spirit and the acquisition of new and useful knowledge for the mind.

Regarding the method, the professor must materialize, or make objective, all concepts so students of any skill level are able to understand them and put them into practice. Each theory class will be at once a truly abbreviated clinic. Each technical term, unavoidable in medicine, must have a very clear and precise representation in the brain of students, so that students will be able to put [that representation] into practice at any time and use it as a guide in the progress of the Art [profession]. In a single word, it will be theory well understood and easily transferable into practice as well as hospital and domestic practice—it will be applicable to real life. This method is not about wordy intellectualism, trivial and unscrupulous learning by the book, but rather, it is about an active method of a truly scientific school of action; that is to know and to know how, to turn ideas into facts at any moment in life. The laboratory techniques that I have created and implemented in this school, before anyone else did, come from this method; they bridge theory with practice.

It is neither true that a professor is a simple conveyor of knowledge nor that students are the passive receptor of [this knowledge]. The former will promote the development of students’ skills so the latter can easily learn and assimilate what is to be known, research new truths, and exercise the profession self-consciously. The professor will put students in contact with the environment so that the latter learn and understand their real position in society. Furthermore, the professor will [in]form the students’ professional judgment and sense of duty; the professor’s goal must not be to show off, but to instruct, educate, teach how to think, act, investigate, and fight for the art, life, the progress of the nation, and of the entire world. This is the philosophical and pedagogical orientation of my school, which is thousands of leagues ahead of many university schools led by people without science and pedagogy.

Consequently, this school of action and socialization, which breaks away from old-fashioned teaching methods and creates new ones based on the new psycho-pedagogic and socialist orientations, will try to place students in direct contact with reality, with the object of study, making the student observe, read, and practice knowledge in, from, and on nature itself and the social environment where students live. It will also allow the free development of individual will, without dogmatic dispositions, but inspiring all professional acts on the direct observation of nature, moral, and science. Plenty of observation first, execution and help later. This is the pedagogical road of my school, in theoretical classes as well as in the clinic and in practical classes. In accordance, each student goes through three consecutive levels in order to become a nurse or midwife. Observer, technical assistant, and practitioner. My special teaching method is intuitive and of constant action and evolution in order to create in students the spirit of socialization and scientific investigation that leads them to live in community with the people.

With this specialized teaching method and system, the Free School of Obstetrics and Nursing of Mexico will swiftly provide young women and men with an independent profession [beneficial to] them and society because students are qualified to attend patients in the second course of nursing, and births in the second course of obstetrics. The Director’s continuous inspection and supervision in the classroom will guide the teaching methods and system in order to attain unity from variety.

Art. 7.-In the second course, the school will start providing clientele to each student. By the time of graduation, students will have recovered the cost of tuition and will have their own clientele. No other school offers these extremely important benefits (cooperative system), based on the supreme goal of socializing students. With the extension at home of the school’s free services, students get simultaneously closer to the people, introduced into the civil practice of their profession, and imbued with the sentiments of human solidarity and community life among all men.

[Section II on “Admission requirements” details the coursework, paperwork, timing, and fees required for enrollment, as well as special provisions. Section III on “Books, Exams, Degrees, and Vacations” provides administrative details that warrant a proper school functioning and most importantly certification by government authorities, particularly the Secretary of Public Education.]

Internal regulations of the Free School of Obstetrics and Nursing of Mexico

[Section I, arts. 1-23, on “Morality and Discipline of the Establishment,” offers a detailed list of behavioral expectations from students and faculty in order to promote learning in an environment of mutual respect and respect towards the school.]

II.-Nursing and Obstetrics Practices and Clinics

Art.24.-Clinical practices will take place at the school, at the dispensary, in the laboratory, and among the civil clientele (public and private maternity clinics and hospitals [handwritten in the original]). Each student must go through three stages: observer, technical assistant, and practitioner.

Students should organize in groups for the practices of and rotations in clinics. Each group should do them once a week from 9 to 12 or from 14 to 17hrs. The Director’s Office will designate rotations in the sanatorium and the dispensary. [Stroke out in the original]

Once students are assigned to one group, the Director’s Office will not have to remind them about their turn. These practical teachings explained to small groups constitute the modern system that my school has introduced to teaching the clinics. With the old approach of all students at once, the clinics are useless for most of them because only the 4 or 5 students closer to the sick or surgical patient are benefited. European clinics supplement this deficiency by using motion pictures.

[Art. 25 on absences.]

Art. 26.-Nursing students should write observation reports of the patients the professor assigns; Obstetrics students, as well as those students who aided or helped during birth, histories of the pregnant women in the Clinic, the Sanatorium, and the civil clientele. Those observation reports and histories must always be brought to the clinics and rotations. Histories must be numbered, dated, well written in ink or with a typing machine, and completed and turned in for revision and correction at the Director’s Office within eight days following the birth assistance. Lack of compliance of this prevention as well as the abandonment of patients assigned for special care to each student will result in the provisional suspension at the discretion of the Director’s Office of the personal assistance to patients. The same applies if the student does not call in due time to the student who was specifically assigned as nurse to assist during a particular birth.

Art. 27.-Nursing students must bring a white coat, a coif, a thermometer, and a syringe for hypodermic injections to the rotations; obstetrics ones must bring, in addition, a stethoscope to both rotations and clinics. They should never leave their white coats in the establishment.

Art. 28.-They must proceed in numerical order writing on a sheet of paper the nursing and obstetric practices that they successively learn to do, both at the clinics as well as the rotations and the civil clientele. These reports, revised by the Secretary or the corresponding professor, will aid during exams to corroborate partially the wealth of practical knowledge of each student.

Art. 29.-The practical reports will have the following heading “FREE SCHOOL OF OBSTETRICS AND NURSING OF MEXICO.-Practice report of the First Course (or Second Course) of Nursing (or Obstetrics) of student N. N.,” followed by the date of completion. Students must bring and present these reports, with the practices already included, every day for revision. When they do not bring their practice reports or they do not include what they practice in the Clinic, they will be marked as absent. Pedagogical goal: To teach students the habit of keeping a record or their practice.

Art. 30.-Students will instruct patients of the Sanitarium, the Dispensary, and the civil clientele on the hygienic rules they should follow in order to avoid complications or any strange disease; in the case of pregnant and puerperal women, on the principles of Maternology and Puericulture. This constitutes an extension of the services provided by the school to the home (school service extension).

[III. (Art 31). On internship; IV. (Art. 32) On class schedule; V. (Art. 33) On disciplinary penalties.]

[The PROGRAM FOR THE TEACHING OF NURSING details the coursework for nursing students.]

[The PROGRAM FOR THE TEACHING OF OBSTETRICS details the coursework for students of obstetrics.]

The Director,

Dr. Art. Palmero.

Digital copy of the source (with pictures of the school, faculty, and students)