Ada Plumer, RN
Editor's Note: The following article was researched and written by Andrew Glyman, BA, MGH Research Institute Intern, Susan Fisher, BA, RN, MGH School of Nursing (SON) ’66, and Mary E. Larkin, MS, RN, MGH SON ’76.
Ada Plumer (1916 to 2007) left an indelible mark on the nursing profession through her pioneering work in intravenous (IV) therapy.
Plumer graduated from the Massachusetts General Hospital School of Nursing (MGH SON) in 1938, and began her career at Mass General in November of that same year.
She quickly became known for her remarkable ability to find veins in pediatric patients that needed blood transfusions.
She was so adept at this skill, a colleague recalled, that hospital leaders once asked the police to interrupt her during a night out at the movies so that she could come to MGH and assist in placing an IV in a critical pediatric patient.
In 1940, Plumer began work as the first dedicated “intravenous nurse,” in the Department of Surgery to relieve the residents and interns of the responsibility of placing IVs.
The use of IVs had grown significantly due to a surge of new research and medical techniques, and the increased need for these services could no longer be met by the medical staff alone.
Plumer was the first nurse anywhere to be designated as an IV Nurse. In her first year she answered 300 calls for IV therapy.
The groundbreaking work she did at MGH in the 1940s would define IV nursing as a specialty practice.
Evolution of the IV Nurse Role at MGH
Ada Plumer's early years at MGH were marked by her exceptional dedication to patient care and her innovative approach to nursing.
She navigated uncharted territory to establish new protocols and practices that would become the foundation of modern IV therapy.
She also developed the first “IV team,” a new concept in hospitals. The group, small at first, performed phlebotomy (blood draws), administered transfusions, maintained equipment, administered infusates (intravenous fluids) via rubber tubing and 16 or 18g steel reusable needles to patients secured by an arm board.
Plumer's leadership in the formation and expansion of the IV team at MGH demonstrated her dedication to this nursing specialty.
In 1942, Lamar, Soutter, MD, established the MGH Blood Bank with “a budget of $5,000 and a refrigerator in the basement of the Moseley Building." A staff of one nurse, one technician and a maid were added to the Blood Bank team.
The new director of the Blood Bank in the 1950s, Morten Grove-Rasmussen, MD, recognized the importance of having a team of nurses skilled at placing intravenous lines operating under the supervision of the Medical Director of the Blood Bank and Transfusion Service.
Under his leadership, the functions of the IV team were expanded to include administration of blood transfusions, donor phlebotomy, and patient blood specimen collection.
By 1961, the service had grown to a staff of nine nurses who carried out some 42,000 procedures for patients in the Baker Building and Phillips House.
What started with a single nurse, Ada Plumer, eventually grew into a comprehensive team providing round-the-clock coverage and had anywhere from 24 to 40 nurses by the latter part of the 20th century.
The team remained under the direction of Blood Transfusion Service for several decades, demonstrating improved patient outcomes and the cost-effectiveness of specialized IV nursing. The team became part of the Department of Nursing in 1997.
IV Nursing Recognized as a Nursing Specialty
Ada's pioneering efforts launched the transition of IV administration and transfusion therapy from something that was primarily performed by physicians into a specialized nursing practice.
This shift required developing new skills, training programs, and mentorship opportunities for nurses.
Technological advancements over time also played a crucial role in the expansion of IV therapy. The transition from metal needles to plastic catheters and the development of safer needle systems significantly improved patient safety and comfort.
These innovations, coupled with improved infection control protocols, transformed IV therapy into a more efficient and effective practice.
Today, infusion nursing is a specialized nursing practice and requires advanced training in the insertion, maintenance, and monitoring of intravenous lines.
Their expertise includes understanding the complexities of vascular access, the pharmacokinetics of IV medications, and the principles of fluid and electrolyte management, and transfusion therapy.
Their specialized education, skill and experience is crucial because it reduces the risk of procedure-related complications, increases the success rate of IV insertions, and minimizes the patient discomfort and anxiety associated with IV therapy.
IV nurses were a new concept in hospitals and provided a much-needed service for patients to ensure safety and define best practice.
"As research and evidence has evolved so have best practices," says Mary (Walsh) Alexander (MGH SON 1976), former MGH IV nurse and Executive Director of Intravenous Nurses Society (INS).
“The data, evidence, and research are the basis for our practice, validates what we do, and impacts patient care," Alexander says. "Adding to the science of infusion therapy can only lead to best practices in infusion care—our patients deserve nothing less!”
In 1970, Ada authored Principles and Practices of IV Therapy, a seminal textbook, now in its ninth edition, that provided essential guidelines for safe and effective IV therapy.
This work solidified her reputation as an expert and educator, influencing countless nurses and healthcare professionals.
In 1973, Plumer and Marge Knight from Johns Hopkins co-founded the National Intravenous Therapy Association (NITA), later renamed as the Infusion Nurses Society (INS) further cementing her legacy as a leader in the field.
The formation of NITA was a milestone in the professionalization of IV nursing. The organization was dedicated to standardizing IV therapy practice and education.
The INS established an academic journal and affiliates with a specialty certification body while continuing to uphold the standards initially set by Ada.
Her contributions were formally recognized in 1975 when she received the IV Nurse of the Year award.
Legacy and Impact
Despite her groundbreaking contributions, Ada was known for her humility. She was a quiet, reserved individual who did not seek the spotlight.
However, she had a pioneering spirit—as evidenced by her desire to embark on a job at MGH that had never been held by a nurse.
Her shy demeanor masked a wealth of knowledge and expertise that she was always willing to share with her colleagues and students.
Ada's approachability made her an excellent mentor, as she was always willing to take the time to teach and support others without any pretense or ego.
She continued to commute to Mass General from Hyannis to teach transfusion courses even after her retirement in 1977.
Her personal anecdotes and techniques, such as her precise use of tourniquets and needles, are remembered fondly by her colleagues and students.
Ada Plumer's legacy extends beyond her immediate contributions to IV therapy.
She inspired several members of the MGH IV Team to become new leaders in the field. Susan Pauley (MGH IV Team Supervisor), and Mary Alexander, Debbie Belisle, Nancy Delisio, Mary C. Larkin, and Donna Murphy (all former MGH IV nurses) played major roles leading NITA and INS, thus following in Ada’s footsteps.
She also played a pivotal role in linking IV practice with infection control, working alongside pioneers such as Carol DeMille, RN (MGH SON 1953) a leader in the growing field of hospital infection control.
Plumer's influence reached international levels, as the practices she helped establish spread globally, empowering nurses across different cultures.
As we look to the future, it is essential to preserve the history of IV nursing and continue the education and knowledge-sharing that Ada Plumer championed.
Her visionary approach to nursing set a high standard for excellence, one that continues to inspire and guide the nursing profession today.
Ada's story is a testament to the impact one dedicated individual can have on an entire field, and her contributions will be remembered and celebrated for generations to come.
IV Therapy at Mass General Today
The Vascular Access Team at MGH is a specialized group of nurses who are highly proficient in vascular access, medication and blood product infusions and reducing potential risks related to these procedures.
The MGH Vascular Access & PICC Program consists of 40 nurses and nine technicians who provide round the clock coverage seven days per week for all patient units.
In 2023, they inserted over 33,000 peripheral IVs, over 3,000 peripherally inserted central lines and obtained over 108,000 lab samples.
Although getting an IV or having blood drawn has come to seem routine in today’s health care delivery, the training, skill and standards required are complex.
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