Rural Nursing
Miss Fannie F. Clement,
Superintendent of Rural Nurses.
Before the Red Cross entered the field of rural nursing several attempts were made to extend this work on a broad plan into the country districts. After the Peace Conference, held at Portsmouth, N. H., in 1905, the Russian and Japanese envoys made a gift of $20,000 to the State, to be used for charitable purposes. At this time several persons who realized that rural nursing was an important factor in the improvement of social conditions tried to have this sum used in establishing a state-wide system. It was not possible, however, to convince those in authority that this would be the best disposition of the gift. It was the aim of the Holman Association, incorporated in 1911, “for the promotion of rural nursing, hygiene and social service.” to expand as resources permitted to meet the needs of rural communities in the United States, but the society has recently been disbanded.
There are but few instances where rural nursing has been extended by a single organization to cover any considerable area. A pioneer work was started seventeen years ago in North Westchester county, New York, where the District Nursing Association now employ six nurses and covers about twenty villages. Gradually new districts in the surrounding territory are being opened up by the association.
There are, however, several individual nurses meeting the needs of rural communities, and often under trying conditions. In isolated regions they are cut off from helpful association with others doing similar work and the stimulus that comes from identification with an extensive organized effort. The Red Cross has planned a service of which these nurses may become a part, which will assist them to establish and maintain high standards.
Rural nursing as it now exists is generally carried on under the supervision of a committee which may include several sub-committees. These are responsible for various branches of the nurses’ work. Wherever such committees are able to arouse a general interest much has been accomplished not only in behalf of public health, but in many lines of public welfare work.
It is expected that in the development of Red Cross rural nursing, local committees will be created, meeting standards of salary and other regulations which are deemed necessary to insure the best interests of a community. The locality benefitted by the work of a nurse is expected to meet the expenses connected with it. Fees collected from patients are not sufficient for this, as all sick persons are not able to pay for the services of the nurse. As a rule, patients are expected to pay for professional visits, according to their means, but those unable to make any payments should not go uncared for. The responsibility for raising the necessary funds rests with the local committee, which also superintends the work of the nurse.
A general supervision by the Red Cross is maintained through occasional visits of the superintendent of rural nurses and through monthly reports of their work.
During the 1910 Red Cross Christmas Seal sale, the Anti-Tuberculosis Association of Wisconsin, offered the services of a visiting nurse for one month to twelve cities of a limited population, making the highest per capita sale. The Red Cross Seal Committee of Ohio, in 1912, sent a visiting nurse for one month to each of twelve small cities throughout the State as a prize in the seal-selling contest. Interest in visiting nursing was thus stimulated to a degree that several of these towns have since been insisting upon a permanent nurse, and have raised funds necessary for her support.
Hospitals, dispensaries and medical attendance are seldom as accessible in the country as in cities. To have the rural nurse a resident in the community, her services for all regardless of any lines of distinction, to have intelligent nursing care for patients in their own homes, and instruction and demonstration given in the principles of hygiene, not only of person but as applied to home surroundings, are advantages which have been appreciated wherever the visiting nurse is established.
The best physicians have welcomed her assistance. No stronger testimony to the value of her services is needed than the present demand for public health workers in connection with industrial establishments, department stores, religious and civic institutions and health departments of city, town and county.
Women of the finest type are needed for this work and those who have had specialized training in public health activities. Several visiting nursing associations to be utilized as training centers for Red Cross nurses offer good opportunities for students to become familiar with social work of various kinds through lectures, study courses and affiliations with philanthropic societies in the city. Nurses may thus come in contact with milk stations, dispensaries, tuberculosis and charity organization societies, settlements and other social agencies.
Nurses eligible for appointment to the Rural Nursing Service, who have not already had experience or training in visiting nursing, after a minimum period of three months with a city nursing association will be placed one month with an association in the country, thus giving them actual experience in rural nursing and its problems before assignment to their post of duty. It is important that the rural nurse be informed upon the various branches of public health nursing and social service, as carried on in cities, in order that she may initiate work along these lines in country places where it is often wholly unorganized. She should be able to recognize contagious diseases and minor ailments among school children. By giving simple health talks in the schools, she is able to utilize one of the most advantageous avenues for influencing the home life of her people.
Local societies and clubs, the aim of which is to improve unfavorable conditions that exist in their communities can establish a no more fruitful source of helpfulness than by the employment of a visiting nurse. Red Cross Chapters will find in such an undertaking not only a means of creating interest in local work of the Red Cross, but opportunity of enlarging their field of usefulness to the community. The experience of the Red Cross Chapter in Islip, Long Island, in the employment of a rural nurse has long ago proven the value of this plan of work.