St. Francis Medical Center can trace its beginning to three nuns who took a riverboat from Carondelet to Cape Girardeau in the fall of 1875, their goal to care for the sick and dying.

As the 12-patient hospital they started grew, more nuns came to provide medical care and administrative help. By 1947, 22 sisters and 104 employees worked at the facility.

Things are different these days. Only four nuns work at St. Francis, and they are nearing retirement age. When they leave the medical center, there probably won't be anyone to replace them.

Sister Clare Nyderek, general directoress of a congregation of Franciscan Sisters, said the same trend is prevalent across the United States. Fewer women are interested in joining the sisterhood, opting instead to pursue careers and families.

Sister Nyderek has been working in Rome for the past 10 years, but must visit all the sisters in all the provinces she oversees during her six-year term as general directoress. She was at St. Francis Medical Center Thursday, although the local Catholic diocese sponsors the center now instead of the nuns.

St. Francis Administrator John Fidler said the drop in the number of nuns at the hospital simply indicates that the sisters fulfilled their mission there. More laypeople are involved in operation of the Catholic hospital, and nuns are able to go to countries where they are needed more.

The number of nuns is rising the most in Indonesia, Brazil, Africa and various other Third World countries. In Western Europe and the United States, where economies are better, the number is dropping.

Sister Nyderek attributed the trend to a number of factors. Families are smaller, and children don't receive as much religious instruction. Those who do are encouraged to marry and have children of their own.

"People today think more about their own pleasure and how they can have the good life," the directoress said.

On the up side, many are finding ways to help others outside of any particular religious order.

Even those who join the Franciscan Sisters express their faith in a variety of ways. Instead of working in cloisters, they spread out to where the need is, often abandoning their traditional habits and veils for simple skirts and sensible shoes.

Many work in community health centers or at counseling centers for AIDS patients.

Sister Nyderek said she felt the call to become a nun during her first year at a Franciscan college in Illinois. After serving in various capacities, she was elected to her position in Rome and will leave office in 1997.