The Littleton Hospital Association formed in 1906 with Dr. William J. Beattie as the founding doctor and a member of the Littleton Hospital Association Board of Directors. The hospital building opened in 1907. The Littleton Hospital Board of Directors appointed Miss Nellie Farr, "an experienced nurse", as the first Superintendent of the Hospital On Wednesday, March 20, 1907. The Board described Miss Farr as "popular", as she was "in touch with a large class, not only of our own people, but also summer residents. Her amiable disposition and tactfulness make her well fitted for the position. Miss Farr is in Boston taking a post graduate course in special work under Miss Lucy S. Drown, Superintendent of the Boston City Hospital [and Training School for Nurses]."
The operating room in 1907. Staff are identified as (l to r): Miss Nellie Farr, Dr. Page, Dr. Beattie, Miss Ferrin and Miss K. MacDonald
While at Boston City Hospital, Miss Farr was learning the responsibilities of a Superintendent from Miss Drown. Frances Heald, a historian from Littleton, New Hampshire reported that Dr. Beattie also had a hand in the training of Miss Farr for her responsibilities as the Hospital Superintendent. The White Mountain Republic Journal reported that on Friday, June 14, 1907 "Miss Nellie Farr, the Matron," was present at the hospital to supervise the placement of furniture and accoutrements as they arrived. Her dedication to patients was unsurpassed. An anecdote revealed that Miss Farr once gave up her own room at the hospital to a patient! The community dedicated the hospital building on June 27, 1907. In the early days of the hospital, it was accepted practice for the Superintendent to be the Executive Officer of the hospital. The Superintendent provided direction and administrative supervision in the daily operation of the hospital while reporting to the Board of Directors. In this capacity the Superintendent was in charge of every department of the hospital. Until 1921 the Superintendent also served as the chief anesthetist. By 1915, the Board of Directors voted to make the job of treasurer a separate paid position.
In 1910, Dr. Beattie and Miss Nellie Farr created a three year nursing program that met the requirements of the NH State Board of Registration for Nurses. In this year, Dr. Beattie began in earnest to conduct the actual training of Littleton Hospital nurses. He recruited four young "ladies" from East Weymouth, Massachusetts to come to Littleton Hospital Nursing School. These first students did not need uniforms but were expected to wear "nice clean dresses each day." Their training was mostly practical in nature. Student nurses were expected to serve night duty soon after their training began. The Board of the Littleton Hospital Association leased the nearby Lathrop House to serve as a residence for the students in nurses training.
The curriculum for the nursing program included deportment, health order and cleanliness, theory of nursing, hygiene, anatomy and physiology, dietetics, solutions, bandaging, ethics, diseases of the nervous system, materia medica (study of remedies of the eye, ear, nose and throat), contagious diseases, children's diseases, obstetrics, bacteriology, diseases of the skin, urinalysis and massage.
In her role as Superintendent of the Hospital, Miss Nellie Farr also directed the Littleton Hospital School of Nursing from its beginning in 1910. She managed the administration and disciplining of students as well as proctoring student examinations. Miss Farr returned to private nursing duty in 1913 and Mrs. Isabel R. Jarvis, who had been Principal of the School of Housekeeping in Hartford CT, was hired as the Littleton Hospital Superintendent. Part of her job included supervising the newly expanded School of Nursing at the Littleton Hospital.
By 1918, the Board of Directors considered expanding the School of Nursing. The demand for trained nurses during World War I increased as many nurses were recruited for military service. The need to educate and train new nurses became urgent. During this period, the Trustees authorized payment of travel expenses to New York for "local ladies to study nursing". In 1918 the Board decided to buy a neighboring residence (the Richardson House - down Cottage Street) to serve as a temporary home for the Hospital School of Nursing.
Superintendent Jarvis made several important changes in 1919. Mrs. Jarvis requested a clerical assistant. At that time a "pupil nurse" was authorized to be paid $5 per month "to keep books and records as the Superintendent required." The hospital also hired a nurse this year to operate the x-ray machine.