Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Patricia A. Roth, EdD, RN, Chair; Mary Jo Clark, PhD, RN; Mary Sarnecky, DNSc, RN


American history, biography, Christianity, missionary, nursing, women


Dramatically absent from nursing's historical knowledge and professional recognition are the lives, roles, contributions, and legacies of Christian faith-based nurses. The purpose of this study was to investigate the ministry and service of Sister Tutor Dorothy Davis Cook, Church of the Nazarene missionary nurse in the African country of Swaziland 1940 to 1972. The multi-dimensional, multi-task expanded roles manifested in her integration of Christian missionary and nurse were explored and her legacy identified. The most significant primary source for this study was Mrs. Cook herself. She was interviewed on three occasions and has provided personal documents, journals, and photographs. Data were also collected from four organizational archives. Other missionary nurses and Swazi nurses were interviewed. Mrs. Cook obtained her basic nursing education and training in the United States. Following her arrival in Swaziland, she earned her midwifery certification and Sister Tutor diploma. Building on the foundation of a nurse aide program, she upgraded nursing education and established the first state registered nurse program in Swaziland. To assist in this endeavor, she wrote four nursing texts which became the gold standard for similar nursing programs in the surrounding countries. She had leadership roles in the High Commission Territories' Nursing Council, the Swaziland Nursing Council, and the Swaziland Nursing Association, and co-authored the 1965 Swaziland Nurse and Midwifery Act. For the majority of her service years, Mrs. Cook lived with the Swazi nurses. Mrs. Cook educated several hundred Swazi Christian nurses who continue to influence the health, socio-economic status, and spiritual well-being of Swaziland today. In honor of her dedication to this cause, she was named the “Mother of Swazi Nurses.” The findings of this study yield unique teaching examples of missionary nursing, advanced practice nursing, nursing education, and nursing administration, each with a spiritual care emphasis in a transcultural environment. The importance of cultural sensitivity and competence in all areas of nursing is demonstrated. Christian spiritual care as a dynamic component of nursing education and nursing care is prominent.

Document Type

Dissertation: Open Access



Included in

Nursing Commons