Alice Magaw proved that nurses could give anesthesia. Agatha Hodgins turned it into a profession with a school, a curriculum, an organization and an examination.
Lakeside
Hodgins was born in Toronto in 1877, moved to Boston, and graduated from the Boston City Hospital Training School for Nurses in 1900. She went to Lakeside Hospital in Cleveland in 1900 and became chief anesthetist to the surgeon George Crile.
Crile was working on shock, and his interest in what anesthesia did to a patient's physiology — rather than merely whether they stayed asleep — shaped how Hodgins practised. She became the leading American practitioner of nitrous oxide and oxygen anesthesia, a technique that was harder to administer than ether and much gentler on a patient in poor condition.
France
In 1914, at the start of the war and before American entry, Hodgins went to France with the Lakeside Unit, an American hospital team sent to support the French and British.
There she taught nitrous oxide and oxygen anesthesia to British and French doctors and nurses, in a setting where the patients were shocked, bleeding and hypothermic — exactly the population the technique suited. British anesthesia had been physician-delivered; the American nurse anesthetist model reached Europe through this unit and this war.
The school
Hodgins came back to Cleveland and began teaching in 1911; in 1915 she opened the Lakeside Hospital School of Anesthesia, the first formal postgraduate programme in anesthesia in the United States. It admitted graduate nurses who had passed their state boards, and also physicians and dentists — who at that point had nowhere else to learn it either.
She then built the institutions around it. She organized the school's alumnae association in 1923, and used it as the nucleus of something national: on June 17, 1931, forty-eight nurse anesthetists met in a classroom at Lakeside and founded the National Association of Nurse Anesthetists, with Hodgins as its first president.
It became the American Association of Nurse Anesthetists and is now the American Association of Nurse Anesthesiology. Certification followed in 1945 and mandatory continuing education in 1978 — decades ahead of nursing generally, which is why the role has always sat slightly apart from the other advanced practice tiers. See certified registered nurse anesthetists.
Hodgins also spent years defending the field in court and in legislatures against claims that a nurse administering anesthesia was practising medicine without a licence — the same argument, in its original form, that is still being had over nurse practitioner practice authority and the Medicare supervision opt-out.
She died in 1945.
Related
- Alice Magaw
- Certified registered nurse anesthetists
- Nurse practitioner practice authority
- Scope of practice
- History of nursing
Sources
- Hodgins, Agatha C.. Encyclopedia of Cleveland History, Case Western Reserve University. Accessed September 9, 2026.
- History of AANA. American Association of Nurse Anesthesiology, on the 1915 school and the 1931 founding. Accessed September 9, 2026.
- Surgeon-nurse anesthetist collaboration advanced surgery between 1889 and 1950. Accessed September 9, 2026.