THOMAS EFFERSON University Hospital staff members were puzzled when a Chinese woman who had given birth there wouldn't touch the hospital food.

Hospitals, of course, are not famous for gourmet food offerings, but the woman's refusal to eat wasn't because the food was unappetizing. She even turned down Jell-O, juices and salads.

Her heritage had taught her that these foods contain "yin," or cold energy, and impede the healing process.

When her husband brought her a meal of noodles and rabbit, she dug right in.

Joan Ulmer Bretschneider, director of Jefferson's Chinese Community Partnership Program, understood very well what was going on.

Jefferson had always made allowances for cultural differences among its patients, but not well enough to suit Bretschneider.

"We needed to do a better job in addressing their needs," she told the Inquirer in 1998. "We always made accommodations, but we didn't do it as thoughtfully."

Deep concern for the needs of patients, accompanied by a determined drive to upgrade the nursing profession, were the hallmarks of Joan Bretschneider's more than 30 years in nursing.

Joan Bretschneider died Dec. 14 in her Germantown home. She was 69. Her family said she died in her sleep of unknown causes.

A measure of how good a job Joan did in her professional career was illustrated when the University of Pennsylvania established the Joan Bretschneider Award for Nursing Excellence on her retirement in 2008. It is given to a nurse who exemplifies great leadership in working with patients and physicians.

Joan, who started her career as a high school nurse in Absecon, N.J., retired as director of education and lifelong learning at the Hospital of the University of Pennsylvania.

For 18 years before that she was a nursing administrator at Jefferson in charge of all departments relating to women and children. She went to Penn in 1999.

Joan had a lifelong concern not only for the care of patients of all cultures and ages, but for the sometimes strained relationships between nurses and physicians.

She was instrumental in establishing "magnet" programs at both Jefferson and Penn to help doctors and nurses work together in the care of patients.

She was also concerned with the improvement of the nursing profession, especially in encouraging nurses to be more assertive in sharing medical decisions. Two years ago, she traveled to Botswana in southern Africa to encourage nurses to assume more leadership in patient care.

"She connected with people in all walks of life," said her daughter, Pilar Yeakel. "She was caring and thoughtful and a wonderful listener, endlessly generous of her time."

Joan was always a champion of women and breast-feeding, especially among low-income mothers. She was a longtime supporter and board member of the Maternity Care Coalition.

She oversaw a study at Jefferson's obstetrics clinic in the '90s that showed that peer counseling and breast-feeding education raised adolescent breast-feeding rates from 20 percent to 29 percent.

She was a believer in starting early to teach youngsters the facts of life. In 1984, when she was teaching nursing at Villanova University, she was an instructor in a program at Jefferson to show children as young as 3 how babies are conceived and born, using a doll.

"We need to love and hold the new baby," Joan told the class. "What else does the baby need?"

When no one could come up with an answer, she said, "How about changing the baby's diaper?"

"Oh, no," one boy said, "It might drop on my shoes."

Joan was born in Atlantic City to Thomas H. and Frances Ulmer. She attended Holy Spirit High School in Absecon where she later served as school nurse. She received her registered-nurse certifcation from Fitzgerald Mercy Hospital School of Nursing, a master's degree from Penn and a doctorate in health education from Temple University.

She moved to Germantown in 1968 and worked at community hospitals before becoming a nursing professor at Villanova.

Joan was deeply involved in St. Vincent DePaul Church in Germantown, which recently merged with Immaculate Conception and St. Francis Assisi parishes.

"She worked with great care in the formation of eucharistic ministries for the merged parishes," said her husband, Sylvester "Bud" Bretschneider.

Joan was also on the board of the regional DePaul Catholic Elementary school.

Besides her husband and daughter, she is survived by a son, Martin; a sister, Eileen Wertz, and five grandchildren.

Services: Mass of Resurrection 11:30 a.m. Monday at St. Vincent DePaul Church, Price and Lena streets. Contributions may be made to DePaul Catholic School, 44 W. Logan St., Philadelphia 19144.