The house on Henry Street

by Lillian D. Wald

Part of the duty assigned to nurses of the Bureau of Child Hygiene is to inspect the bags of the midwives licensed to practice, and to visit the new-born in the campaign to wipe out ophthalmia neonatorum, that tragically frequent and preventable cause of blindness among the new-born.

These are a few of the manifestations of the new era in the development of the nurse’s work. She is enlisted in the crusade against disease and for the promotion of right living, beginning even before life itself is brought forth, through infancy into school life, on through adolescence, with its appeal to repair the omissions of the past. Her duties take her into factory and workshop, and she has identified herself with the movement against the premature employment of children, and for the protection of men and women who work that they may not risk health and life itself while earning their living. The nurse is being socialized, made part of a community plan for the communal health. Her contribution to human welfare, unified and harmonized with those powers which aim at care and prevention, rather than at police power and punishment, forms part of the great policy of bringing human beings to a higher level.

With the incorporation of the nurse’s service in municipal and state departments for the preservation of health, other agencies, under private and semi-public auspices, have expanded their functions to the sick.

I had felt that the American Red Cross Society held a unique position among its sister societies of other nations, and that in time it might be an agency that could consciously provide valuable “moral equivalents for war.” The whole subject, in these troubled times, is revived in my memory, and I find that in 1908 I began to urge that in a country dedicated to peace it would be fitting for the American Red Cross to consecrate its efforts to the upbuilding of life and the prevention of disaster, rather than to emphasize its identification with the ravages of war.

The concrete recommendation made was that the Red Cross should develop a system of visiting nursing in the vast, neglected country areas. The suggestion has been adopted and an excellent beginning made with a Department of Town and Country Nursing directed by a special committee. A generous gift started an endowment for its administration. Many communities not in the registered area and remote from the centers of active social propaganda will be given stimulus to organize for nursing service, and from this other medical and social measures will inevitably grow. It requires no far reach of the imagination to visualize the time when our country will be districted from the northernmost to the southernmost point, with the trained graduate nurse entering the home wherever there is illness, caring for the patient, preaching the gospel of health, and teaching in simplest form the essentials of hygiene. Such an organization of national scope, its powers directed toward raising the standard in the homes without sacrifice of independence, is bound to promote the social progress of the nation.

In the year 1909 the Metropolitan Life Insurance Company undertook the nursing of its industrial policyholders—an important event in the annals of visiting nursing. I had suggested the practicality of this to one of the officials of the company, a man of broad experience, and he, immediately responsive, provided opportunity for me to present to his colleagues evidence of the reduction of mortality, the hastening of convalescence, and the ability to bring to sick people the resources that the community provides for treatment through the institution of visiting nursing.

The company employed our staff to care for its patients, and the experiment has been extended until a nursing service practically covers its industrial policyholders in Canada and the United States. The company thereby gave an enormous impetus to education and hygiene in the homes and treatment of the sick on the only basis that makes it possible for persons of small means to receive nursing without charity—namely, through insurance.

The demand for the public health nurse coming from all sides was so great that for a time it could not be adequately met. Women of initiative and personality with broad education were needed, for much of the work required pioneering zeal. Instructive inspection, on the nurse’s part, like other educational work, requires suitable and sound preparation, a superstructure of efficiency upon woman’s natural aptitudes.